Winter 2021
STRONGER ST. BERNARDS Brings Healing Home
2021Annual Meeting Week
Virtual Highlights
YOUR CHILD’S HEALTH IS A BIG DEAL. Our Promise: Unprecedented Child Health. Defined and Delivered. Arkansas Children’s is the state’s only health system built just for kids. By working within the communities we serve, it’s our mission to make children better today and healthier tomorrow. We are Champions for Children where they live, learn and play.
#championsforchildren | archildrens.org (501) 430-3142
Your clients expect great service. AFMC can help you deliver. Put our health care call-center expertise to work for your clients today.
Our services are secure, confidential, compassionate and culturally competent. Let AFMC assist you with: • Patient engagement • Scheduling • Customer service Visit afmc.org/Solutions to find out more. in © 2021, AFMC, INC. ALL RIGHTS RESERVED.
ARKANSAS HOSPITALS | WINTER 2021 1
QUALITY AIR At Powers, we understand the important role HVAC plays in providing a clean, safe, and comfortable environment in hospitals and health care facilities. As the state’s WHAT WE DO premier HVAC, Heating and Cooling controls, and service • Air Distribution • Controls company, we have • HVAC Equipment the people, • Hydronics & Steam • Parts the equipment, and • NEBB TAB the expertise to Service deliver complete • Boilers & Chillers • Controls systems for • Mechanical controlling infection and air movement, as well as maintaining ideal temperature, humidity, and indoor air quality for patients, visitors, and staff. To learn more, call us at 877.274.7127 or visit us online at www.powers-hvac.com.
Great people, great service, and great products from companies like Siemens. This is how we create customers for life. One customer at a time.
B U I L D I N G H VA C , C O N T R O L S , & S E R V I C E • 8 7 7 . 2 7 4 . 7 1 2 7 • 2 WINTER 2021 | ARKANSAS HOSPITALS
W W W. P O W E R S - H VA C . C O M
STRONGER ADVERSITY SPARKS INNOVATION
12 UAMS Team Leads the Quest to Understand Long COVID 16 St. Bernards Brings Healing Home 40 AFMC TV Maximizes Digital Outreach
AHA REPORTS BACK
21 2021 Annual Meeting Week: Virtual Highlights 46 The Capitol Report 38 Barriers to Access: Pediatric COVID-19 Vaccines
IN EVERY ISSUE
5 President’s Message 7 Editor’s Letter 8 Hospital Newsmakers 10 Event Calendar 35 Leader Profile: Jay Quebedeaux 43 Coach’s Playbook 48 Where We Stand: The Swiss Cheese Respiratory Virus Pandemic Defence
ARKANSAS
HOSPITALS Arkansas Hospitals is published by The Arkansas Hospital Association
419 Natural Resources Drive | Little Rock, AR 72205 To advertise, please contact Brooke Wallace magazine@arkhospitals.org Ashley Warren, Editor in Chief Nancy Robertson, Senior Editor & Contributing Writer Katie Hassell, Graphic Designer Roland R. Gladden, Advertising Traffic Manager
BOARD OF DIRECTORS
Ron Peterson, Mountain Home / Chairman Larry Shackelford, Fayetteville / Chairman-Elect Peggy Abbott, Camden / Treasurer Chris Barber, Jonesboro / Past-Chairman Ryan Gehrig, Fort Smith / Director, At-Large Greg Crain, Little Rock Barry Davis, Paragould Carol Evans, Harrison Phil Gilmore, Crossett Vince Leist, Harrison James Magee, Piggott Johnny McJunkins, Nashville Gary Paxson, Batesville Jay Quebedeaux, Mena Brian Thomas, Pine Bluff Steven Webb, Searcy Debra Wright, Nashville
EXECUTIVE TEAM
Robert “Bo” Ryall / President and CEO Jodiane Tritt / Executive Vice President Tina Creel / President of AHA Services, Inc. Pam Brown / Vice President of Quality and Patient Safety Lyndsey Dumas / Vice President of Education Debbie Love / CFO Melanie Thomasson / Vice President of Financial Policy and Data Analytics
Winter 2021
DISTRIBUTION: Arkansas Hospitals is distributed quarterly to hospital executives, managers and trustees throughout the United States; to physicians, state legislators, the congressional delegation, and other friends of the hospitals of Arkansas. Arkansas Hospitals is produced quarterly by Central Arkansas Media. Periodicals postage paid at Little Rock, AR and additional mailing offices. The contents of Arkansas Hospitals are copyrighted, and material contained herein may not be copied or reproduced in any manner without the written permission of the Arkansas Hospital Association. Articles in Arkansas Hospitals should not be considered specific advice, as individual circumstances vary. Products and services advertised in the magazine are not necessarily endorsed by the Arkansas Hospital Association. To advertise, email magazine@arkhospitals.org.
ARKANSAS HOSPITALS | WINTER 2021 3
4 WINTER 2021 | ARKANSAS HOSPITALS
PRESIDENT’S MESSAGE
Going Strong W
e are embarking on a new year: taking stock of what we’ve learned, looking forward with curiosity about what’s to come, making plans for the coming months with cautious optimism, and always expecting the unexpected. The past two years have presented profound challenges, to be sure. In facilities large and small, key aspects of hospital operations have been completely reconfigured to respond to the real and menacing presence of COVID-19 in our state. Amid the many changes, our greatest strength has been the fortitude and resilience demonstrated by hospital workers in all roles – their commitment to provide care despite extreme difficulty. Though we don’t yet know what the coming year holds, hospitals are actively working together to protect their ability to provide access to topquality care to all Arkansans. They have been identifying meaningful ways to bolster and encourage their staff members, reaching out to their communities to keep Arkansans informed and motivated to protect themselves and others, and securing tools and resources to help prepare for the next phase of the pandemic. Something I feel certain we can expect in 2022 is that hospitals will keep
getting stronger. They will continue to collaborate and to learn from each other. They will continue to navigate countless obstacles with creativity and courage. For this issue, we’ve included articles that illustrate how even the toughest times can be seasons of innovation and remarkable growth. We learn how an interdisciplinary team of researchers at UAMS, led by John Arthur, M.D., Ph.D.,
“In times of crisis, we summon up our strength…” –Muriel Rukeyeser
are well on the way to discovering what causes Long COVID-19. They are hopeful that their research is leading them to viable options for treating patients whose lives are being disrupted by the unpredictability of symptoms like fatigue, brain fog, depression, and more. We also hear from Vincent Turner Jr., FACHE, on the topic of how St. Bernards’ Acute Health at Home program is exploring new possibilities for optimizing care while maximizing resources. If a patient is a good fit with the model, care teams can not only provide treatment and observation just as effectively as they can inside the walls of the hospital, but they are also able to give patients more time in comfortable, familiar surroundings with loved ones. We get the backstory on how the Arkansas Foundation for Medical Care Team turned remote work into an internet-based health care show that is the first of its kind – AFMC TV. Advancements like these are happening throughout the state, creating opportunities to improve the health and well-being of Arkansans. The COVID-19 pandemic is an ongoing test of strength, and there’s plenty of evidence that we are growing stronger than ever.
Bo Ryall
President and CEO Arkansas Hospital Association
ARKANSAS HOSPITALS | WINTER 2021 5
Vaccinate the Natural State is an initiative to encourage all Arkansans to get their COVID-19 vaccination when it's their time. We’re working in collaboration with multiple business, healthcare and community organizations statewide — including the Arkansas Hospital Association — to educate and engage Arkansans in doing our part to help end the pandemic.
Let's work together to... Protect caregivers.
Protect families.
Protect communities.
Whether you are providing vaccinations, getting your workforce vaccinated, or encouraging your family and friends, everyone has a role in helping end the pandemic. Find out more at www.vaccinatethenaturalstate.com
In partnership with:
In collaboration with: ¡ Arkansas College of Osteopathic Medicine/ Fort Smith
¡ Arkansas Medical Dental Pharmacy Association
¡ Arkansas Faith Network
¡ Association of Federally Qualified Health Centers
¡ Arkansas Hospital Association
¡ Community Health Centers of Arkansas
¡ Arkansas Immunization Action Coalition (Immunize Arkansas)
¡ NYIT College of Osteopathic Medicine/Jonesboro
6 WINTER 2021 | ARKANSAS HOSPITALS
¡ Arkansas Pharmacists Association
10111 3/21
EDITOR’S LETTER
Mindfulness and Mindset N
o one who knows me well would likely use the word “Zen” to describe me. I’m a classic “Type A” sort, with a to-do list running through my mind on repeat. But lately the whole AHA staff has been setting aside one hour each week to attend mindfulness training sessions, designed to give us new tools for managing stress and anxiety – so essential as the pandemic trudges on. Though I am, at times, hilariously bad at quieting my mind, it has been truly beneficial to incorporate the techniques we’ve practiced into the noisier aspects of my life. One of the most interesting parts of the sessions has been learning about the science behind practicing awareness and mindfulness. Like a workout for your brain, it can actually change the way your thought patterns, mood, and attention span work. In other words, it can make you mentally stronger. And like all workouts, the benefits don’t come unless you do it … a lot of it … and do it consistently … even when it gets uncomfortable and you want to quit.
The articles in this issue of Arkansas Hospitals have me thinking about my own budding mindfulness practice and how the same principles of being fully present and cultivating awareness could be operating in the world in unexpected ways. From ED doctors and nurses to environmental service staff, every individual who works in a hospital gets more practice than your average Joe at fully attending to the situation at hand and responding swiftly and effectively. Their mental strength is an inspiration. And the urgency of the pandemic, however unwelcome, has demanded that even more attention be directed to
addressing the challenges of the present. And that refocusing has been the source of some majorly innovative problem-solving in our hospitals. And those solutions, wrought in adversity, have made us stronger. I hope you find yourself inspired by these stories of the work our hospitals are doing, as they continue to respond to the COVID-19 pandemic. We’re stronger when we can alleviate pressure on hospital capacity by delivering top-quality care to patients in their homes, like St. Bernards is doing with its Acute Health at Home program. We’re stronger when researchers, like the team at UAMS working on the causes of Long COVID-19, believe they’ve found answers to questions that could help suffering patients begin to put their lives back together. We’re stronger when our leaders find ways to renew and reenergize themselves, so that they can continue to lead from a place of positivity without experiencing burnout. And because our hospitals are stronger, so are our patients and our communities.
Ashley Warren Editor in Chief
ARKANSAS HOSPITALS | WINTER 2021 7
HOSPITAL NEWSMAKERS Arkansas Colleges of Health Education (ACHE) in Fort Smith has received an anonymous $32.3 million gift to fund health and wellness initiatives. The gift will support renovations of the ACHE Research Institute Health & Wellness Center in Fort Smith, which will house instructional and communal gathering areas for students and the community. Included in the renovation are art labs and an art gallery, an occupational and physical therapy device lab, nutrition education and cooking venues, and a theater. The initial phase of the project is expected to be completed in December 2022. Mercy Hospital Fort Smith has announced a $162 million expansion of its emergency room and intensive care unit that should allow about 25,000 more patient visits per year. Groundbreaking for the ER/ICU is set for early 2022, with construction expected to last just over two years. The project will expand the ER from 29 to 50 rooms and increase ICU capacity from 38 to 64. The expanded Emergency Department will include special considerations for infectious disease and behavioral health patients. An additional 140 parking spaces will be added to accommodate the expansion, with parking closer to the new ER entrance.
orthopedic surgery, and other conditions. Featuring all private rooms, the rehabilitation section of the hospital will provide intense, interdisciplinary rehabilitation therapies and medical care to improve patients’ functional independence and help them return home. The facility’s distinct behavioral unit will offer a continuum of inpatient and outpatient behavioral health services for adults and seniors, including crisis stabilization for acute mental health and substance use disorders; detoxification from alcohol and drugs; and treatment for anxiety, depression, post-traumatic stress disorder and many other behavioral health illnesses. St. Bernards Behavioral Health (SBBH) has launched a new 24/7 call center aimed at providing informational resources for behavioral and mental health-related services and questions, filling a need in the region for an alwaysaccessible information hub. The call center will be staffed by licensed health professionals in confidential settings and will guide callers to available behavioral health resources. St. Bernards intends the call center to operate as a supplemental service, alongside crisis services and hotlines. The SBBH 24/7 call center is available immediately to assist with behavioral health questions at (870) 207-0440. The University of Arkansas for Medical Sciences (UAMS) has received $18.9 million from the National Institutes of Health (NIH) to support new research and interventions that will focus on reducing cancer and cardiovascular disease disparities among people who live in rural areas and in African American populations across Arkansas. The five-year award from the NIH National Institute on Minority Health and Health Disparities (NIMHD) will support the establishment of the Center for Research, Health and Social Justice – one of only 11 Multiple Chronic Disease (MCD) Centers funded in the United States.
Mercy Hospital Fort Smith plans a $162 million expansion of its Emergency Department that includes expansion of its ER from 29 to 50 rooms and increases ICU capacity from 38 to 64 in a concept that is designed to provide better workflow and flexibility. (Courtesy Mercy Fort Smith)
Jefferson Regional has announced plans to build and operate a 40-bed freestanding inpatient rehabilitation hospital that will also include an additional 36 behavioral health beds. The new facility, which is anticipated to open in 2023, is a joint venture with Kindred Healthcare, LLC, a partner that has managed the rehab unit at Jefferson Regional for the past 28 years. The hospital will provide inpatient rehabilitation services for adults who have experienced a loss of function or disability due to stroke, brain injury, spinal cord injury, neurological disorders, 8 WINTER 2021 | ARKANSAS HOSPITALS
Members of the research team leading the UAMS grant to address health disparities. (Photo: UAMS/Evan Lewis)
Washington Regional Medical Center has earned renewal of its designation as an Antimicrobial Stewardship Center of Excellence (CoE) by the Infectious Diseases Society of America (IDSA). This designation is considered the industry’s gold standard in antimicrobial stewardship. Washington Regional is the only hospital in Arkansas and one of only 131 hospitals in the United States to hold the prestigious CoE designation. Washington Regional first achieved CoE status in 2018 and is one of only 32 hospitals in the country to receive CoE renewal since 2018. National Park Medical Center recently announced the opening of Hot Springs' first cardiac electrophysiology lab to offer catheter ablations. The addition makes Hot Springs the only place south of Little Rock in Arkansas to house an EP Program. The EP lab provides diagnostic testing and treatment for patients with irregular heartbeats, including cardiac mapping, catheter ablations, and the insertion of pacemakers and implantable cardioverter defibrillators.
AHA WELCOMES NEW LEADERS
Jason Adams President, CHRISTUS St. Michael Health System Randall (Randy) Barymon Administrator, St. Bernards Five Rivers Brian Cherry CEO, CHI St. Vincent Sherwood Rehabilitation Hospital, a Partner of Encompass Health Shaun Fenton, MSN, RN CEO, Conway Behavioral Health Art Hickman CEO, WoodRidge of West Memphis, LLC D/b/a Perimeter Behavioral Hospital of W. Memphis Megan Holt-Miller, LCSW CEO, The BridgeWay
Attract. Engage. Develop. Reward. Gallagher's expertise goes well beyond employee benefits. Our team of consultants in compensation, engagement, leadership development, executive search and surveys use industry-leading data and analytics to empower clients. We leverage experience and wisdom to tailor flexible consulting solutions for your unique organization. To learn more, visit www.ajg.com/us/services/human-resources-compensation-consulting or contact us at your nearest Gallagher office: 6325 Ranch Drive Little Rock, AR 72223 501.485.3075
© 2021 Arthur J. Gallagher & Co. GBS40693
Quality Care Rooted in Arkansas
hope Is The Foundation. recovery Is The Journey. The pandemic has caused people to consume alcohol at unprecedented levels. The BridgeWay offers hope and recovery for adults struggling with alcohol or other substances. Led by Dr. Schay, a board-certified psychiatrist and addiction specialist, our continuum of care includes: • Medical detoxification • Partial hospitalization • Intensive outpatient program To learn more about our continuum of care for substance use disorders, call us at 1-800-245-0011. Physicians are on the medical staff of The BridgeWay Hospital but, with limited exceptions, are independent practitioners who are not employees or agents of The BridgeWay Hospital. The facility shall not be liable for actions or treatments provided by physicians.
Dr. Schay
Medical Director of Substance Use Disorders
ARKANSAS HOSPITALS | WINTER 2021 9
2022 Winter Calendar
JANUARY
FEBRUARY
JANUARY 18
FEBRUARY 17
340B Quarterly Meeting Virtual Event
January 20-21
AAHE 2022 Winter Conference Embassy Suites Northwest Arkansas Spa and Hotel, Rogers
JANUARY 26
Governance Megatrends: What is the Impact on Your Board? Webinar
MARCH
March 3-4
AHHRA 2022 Spring Conference Embassy Suites Hot Springs Spa and Hotel
Achieving a Culture of Zero Violence Leadership Strategies to Improve Health Care Safety & Security Programs An AHA Annual Meeting Virtual Offering Violence is one of the largest Brian Uridge, MPA, CPP, CHPA, CTM occupational hazards facing health Director of Michigan Medicine Security care workers today. Violence reduction programs should focus on developing a system-wide approach that recognizes every health care system is a community, with every floor being a unique neighborhood, each with different dynamics. Trust, transparency, and training along with a system-wide strategy focused on reducing risk and anxiety through exceptional, experience-based, nontraditional contacts, staff training, professionalism and critical incident response, forms the basis from which a strong security program is built. CE hours available.
Learn more about these events and all AHA offerings at www.arkhospitals.org.
Register for AHA Events Online!
Employees of AHA member hospitals can now log in to www.arkhospitals.org and register for events online. 10 WINTER 2021 | ARKANSAS HOSPITALS
00
00 00 00
Integrated, strategic real estate solutions Integrated, strategic real estate solutions Integrated, strategic real estate solutions Integrated, Integrated, strategic strategic real real estate estate solutions solutions Integrated, strategic real estate solutions 0000
al estate solutions
2226 Cottondale Lane Lane 2226 Cottondale 2226 Cottondale Lane 2226 2226 Cottondale Cottondale Lane Lane 2226 Cottondale Lane Suite 210 Suite 210 Suite Suite Suite 210 210 210 Suite 210 Little Rock, AR 72202 Little Rock, AR 72202 Little Rock, AR 72202 Little Little Rock, Rock, AR AR 72202 72202 Little Rock, AR 72202 2226 Cottondale 501Lane 716 501 5511716 5511 501 716 5511 501 501716 716 5511 5511 501 716 5511 Suite 210 Little Rock, 5100 AR W.5100 JB72202 Hunt Drive W.Hunt JB Hunt Drive 5100 W. JB Drive 5100 5100 W. W.JB JB Hunt Hunt Drive Drive 5100 W. JB5511 Hunt Drive 501 716 Suite 800 Suite 800 Suite Suite 800 800800 Suite 800 Rogers,Suite AR 72758 Rogers, AR 72758 Rogers, AR 72758 Rogers, AR AR72758 72758 Rogers, AR 72758 5100 W. JB Rogers, Hunt Drive 479 845 3000 479 845 3000 479 845 3000 479 479 845 845 3000 3000 479 845 Suite 8003000 Rogers, AR 72758 479 845 3000
MOBILE INTEGRATED PLATFORM MOBILE INTEGRATED PLATFORM MOBILE INTEGRATED PLATFORM MOBILE MOBILE INTEGRATED INTEGRATED PLATFORM PLATFORM MOBILE INTEGRATED PLATFORM MOBILE INTEGRATED PLATFORM
sagepartners.com sagepartners.com sagepartners.com sagepartners.com sagepartners.com sagepartners.com
You provide first class healthcare. provide first class healthcare. You provide first class healthcare. You YouYou provide provide first first class class healthcare. healthcare. You provide first class healthcare.
We do the rest. We the rest. We do the rest. We We do dodo the the rest. rest. We do the rest.
You provide first class healthcare.
We do the rest.
RESULTS RESULTS RESULTS RESULTS RESULTS
WHAT WE -- SERVICES WHAT WE --DO WHAT WHAT WE WEDO DO DO -SERVICES SERVICES SERVICES WHAT WE DO - SERVICES WHAT WE DO SERVICES Preventive, predictive && corrective maintenance Preventive, predictive &&corrective corrective maintenance Preventive, Preventive, predictive predictive & corrective maintenance maintenance Preventive, predictive corrective maintenance Preventive, predictive & corrective maintenance Asset management – accounting and lease administration Asset management – accounting and lease administration Asset Asset management management – –accounting accounting and andlease lease administration administration Asset management – accounting and lease administration Asset management – accounting and lease administration
HAT WE DO - SERVICES Energy conservation && sustainability programs eventive, predictive & corrective maintenance Energy conservation &&sustainability sustainability programs Energy Energy conservation conservation & sustainability programs programs Energy conservation sustainability programs Energy conservation & sustainability programs
277K 277K 277K 277K 277K
Project management && construction oversight set management – accounting and lease administration Project management construction oversight Project Project management management &&construction construction oversight oversight Project management construction oversight Project management & construction oversight Leasing & brokerage services ergy conservation & sustainability programs Leasing & brokerage services Leasing Leasing & & brokerage services services Leasing & brokerage services Leasing & brokerage services
savings & cost avoidance
savings &&cost savings savings &cost cost avoidance avoidance savings &&avoidance cost avoidance savings cost avoidance oject management & construction oversight NWA 479 845 3000 | Central AR716 501 716 5511 HOW WE DO IT -- STRATEGIES 1, including reduction NWA 479 845 3000 AR 501 716 5511 NWA NWA 479 479 845 845 3000 3000 | |Central | Central Central AR501 501 5511 NWA 479 845 3000 | Central AR AR 501 716 716 55115511 WE IT STRATEGIES year 1,year including reduction to HOW HOW WE WEDO DO IT-DO -STRATEGIES STRATEGIES year year 1, 1, including including reduction reduction toto to HOW WE DO IT STRATEGIES year 1,1, including reduction to NWA 479 845 3000 |AR Central 501 HOW WE IT - STRATEGIES year including reduction to HOW asinghospital & brokerage services Establish baseline building performance guidelines and benchmark facilities payroll due Establish baseline building performance guidelines and benchmark Establish Establish baseline building building performance performance guidelines guidelines and and benchmark benchmark Establish baseline building performance guidelines and benchmark hospital facilities payroll due hospital hospital facilities facilities payroll payroll due duedue hospital facilities payroll Establish baseline building performance guidelines and benchmark hospital facilities payroll due to CW Sage assuming fullStrategic detailed budgeting CW CW Sage Sage assuming assuming fullfullStrategic Strategic detailed budgeting budgeting tototo CW Sage assuming fullStrategic detailed budgeting NWA 479 845 3000 | Central AR 501 716 5511 to CW Sage assuming fullStrategic detailed budgeting OW WE DO IT STRATEGIES to CW Sage assuming fullStrategic detailed budgeting time employees Hire top talent / highly educated // experienced team members time time employees employees tablish baseline building performance guidelines benchmark time employees time employees Hire Hire top top talent talent /highly highly educated //and /experienced experienced team team members members Hire top / highly educated experienced team members Hire top talent /talent educated experienced team members time employees Hire toptalent / educated highly educated / experienced team members Partnership approach with clients ategic detailed budgeting Partnership Partnership Partnership approach approach with with clients clients Partnership approach clients with with clients Partnership approach with clients Leverage relationships through network of && Cushman’s buying power e top talent / highly educated / experienced team members Leverage Leverage relationships through through network network of ofcontractors contractors &&&Cushman’s Cushman’s buying power power Leverage relationships through network of contractors contractors Cushman’s buying power Leverage relationships through network of contractors Cushman’s buying Leverage relationships through network of contractors & Cushman’s buying powe Integrate high quality operations & maintenance support services through our rtnership approach with clients Integrate Integrate highquality quality operations operations & &maintenance maintenance support support services services through through our Integrate high quality operations & maintenance support services through our reduction in janitorial costs Integrate high operations & maintenance support services through our Integrate highplatform quality operations & maintenance support services through our reduction reduction janitorial janitorial costs costs reduction in costs reduction ininin janitorial costs state-of-the-art reduction injanitorial janitorial costs state-of-the-art state-of-the-art state-of-the-art platform platform state-of-the-art platform verage relationships through network of contractors & Cushman’s buying power platform while increasing the service state-of-the-art platform
25% 25% 25% 25% 25%
while while increasing increasing the the service service while the while increasing the service while increasing increasing theservice service
frequency egrate high quality operations & maintenance support services through our frequency frequency frequency frequency frequency platform WHY WE DO IT -- RESULTS te-of-the-art WHY WHY WE WEDO DO DOIT IT IT- -RESULTS RESULTS WHY WE DO IT RESULTS WHY WE RESULTS WHY WE -DO IT - RESULTS Cost control Cost Cost control control Cost control Cost control Cost control Insure operation within lease guidelines Insure Insure operation operation within within lease lease guidelines guidelines Insure operation within lease guidelines HY WE DO IT - RESULTS Insure operation within lease Insure operation withinguidelines lease guidelines Maximize employee comfort & st control Maximize Maximize employee employee comfort comfort & & safety safety Maximize employee comfort & safety safety Maximize employee comfort & safety annual projected savings Maximize employee comfort & safety annual annual projected projected savings savings annual projected savings Provide a consistent, convenient, streamlined maintenance process ure operation within lease guidelines annual projected savings Provide Provide a a consistent, consistent, convenient, convenient, streamlined streamlined maintenance maintenance process process Provide a consistent, convenient, streamlined maintenance process annual projected savings in year 2 Provide a consistent, convenient, streamlined maintenance process in in year year 2 2 Provide a consistent, convenient, streamlined maintenance process in year 2 in yearin2year Enhance value & improve patient “first impressions” ximize employee comfort & safety 2 Enhance Enhance value value &&improve improve patient patient “first “first impressions” impressions” Enhance value & improve patient “first impressions” Enhance value & improve patient “first impressions” Enhance value & risk improve patient “firstrisk impressions” Reduce regulatory as well as ovide a consistent, convenient, streamlined maintenance process Reduce Reduce regulatory regulatory risk riskas as well well asliability liability risk risk risk Reduce regulatory risk asas well as liability liability Reduce regulatory risk as well as liability risk Reduce regulatory risk as well as liability risk first class patient care Allow clients to on business; providing hance value & improve patient “first Allow Allow clients clients toimpressions” tofocus focus on ontheir their business; business; providing providing first firstclass class patient patient care carecare Allow clients to focus focus on their their business; providing first class patient Allow clients to focus on their business; providing first class care care Allow clients to focus on their business; providing firstpatient class patient duce regulatory risk as well as liability risk savings on one clinic savings savingson onone oneclinic clinic
$390k $390k $390k $390k $390k $41k $41k $41k $41k $41k
savings on one clinic savings on one clinic consolidation consolidation
savingsto onfocus one clinic consolidation Independently Owned and Operated/Member of the Cushman & Wakefield Alliance owconsolidation clients on their business; providing first class patient care consolidation consolidation Independently Independently Owned Owned and and Operated/Member Operated/Member ofof the the Cushman Cushman & Wakefield & Wakefield Alliance Alliance Independently Owned and Operated/Member of the Cushman & Wakefield Alliance
Independently Owned and Operated/Member of the Cushman Wakefield Alliance Allian Independently Owned and Operated/Member of the & Cushman & Wakefield
ARKANSAS HOSPITALS | WINTER 2021 11 Independently Owned and Operated/Member of the Cushman & Wakefield Alliance
At the Forefront:
UAMS Search for Answers to Long COVID-19 Yields Possible Cause By David Robinson
W
ithin months of COVID-19’s arrival, its list of disturbing health effects grew to include longlasting fatigue, brain fog and other debilitating symptoms. Known today as long COVID-19 or long-haul COVID-19, it has disrupted education plans, careers, and the basic activities of life. The global search for answers recently yielded a possible cause at the University of Arkansas for Medical Sciences (UAMS), drawing national attention and hope for those with long COVID-19. Leading the research is John Arthur, M.D., Ph.D., a UAMS nephrologist who has treated kidney failures caused by the virus, SARS-CoV-2. Through his research, he learned that
12 WINTER 2021 | ARKANSAS HOSPITALS
a protein known as ACE2 plays a key role in the body’s immune response to coronavirus. Arthur has long studied ACE2 because of its role in kidney function. “I was really inspired to begin this COVID-19 research because I was already familiar ACE2, which just so happens to be the protein that the coronavirus hijacks to get into cells,” Arthur said. SARS CoV-2 attaches to the ACE2, and once inside a cell the virus commandeers the molecular machinery and multiplies. He moved quickly in 2020 to conduct research into ACE2’s role in coronavirus infections. That work led to the recent groundbreaking discovery of rogue antibodies that appear weeks after an initial COVID-19 infection. The discovery
could lead to new treatments, possibly with existing drugs, Arthur said. “This all came together very nicely thanks to great support from our institutional leaders and a team with remarkable immunology expertise,” said Arthur, a professor in the College of Medicine Department of Internal Medicine and associate director of the UAMS Translational Research Institute. Arthur’s work and other signature COVID-19 research at UAMS has been supported by Laura James, M.D., director of the Translational Research Institute, and Shuk-Mei Ho, Ph.D., Vice Chancellor for Research and Innovation. Ho provided pilot funding to jump-start Arthur’s COVID-19 research in 2020, and James helped him quickly assemble the team needed to conduct the longCOVID-19 study starting in early 2021.
CONNECTING THE DOTS
A talented interdisciplinary team has been crucial to Arthur’s ability to advance the research, he said. Arthur knew that the normal function of ACE2 (angiotensin-converting enzyme 2) is to metabolize a peptide that activates the immune system. He was also aware that an acute infection causes a decrease in ACE2, and that ACE2 begins to function normally again during the typical two-to-three-week recovery period. But for those with long COVID-19, it appeared to Arthur that the normal activity of ACE2 was continuing to be suppressed, interfering with the body’s immune response. What could be causing it? “I couldn’t come up with an answer, but I knew who to ask,” Arthur said. He contacted Terry Harville, M.D., Ph.D., a professor in the UAMS College of Medicine Department of Pathology and Department of Internal Medicine, and medical director of the Histocompatibility and Immunogenetics Laboratories.
UAMS researchers Terry Harville, M.D., Ph.D. and John Arthur, M.D., Ph.D. (pictured here) lend their combined expertise, along with other key members of a multidisciplinary team to discover if autoantibodies are the true culprits in long COVID-19.
[…] it’s an exciting development that merits further study. “Whenever I have a complicated immunology question, I call Terry,” Arthur said. “I told him what I knew and where I was stumped, and it took him about 10 seconds to come up with the answer.” The two settled on the hypothesis that, in people with long COVID, the antibodies created to attack the virus begin producing autoantibodies that attack the ACE2. The autoantibodies attach to the ACE2 and disrupt its work, a possible cause of long COVID-19. “Even though the COVID infection may resolve, the autoantibodies may result in a wide range of longCOVID-19 symptoms,” Harville said.
FINDING THE ROGUE ANTIBODIES
Arthur then turned to a UAMS immunology team that had developed a high-accuracy antibody test in 2020 for SARS-CoV-2. That test was a key part of a statewide antibody survey supported by Arkansas Governor Asa Hutchinson and other state leaders. For Arthur’s study, an antibody test was developed by researchers Craig Forrest, Ph.D., professor; Karl Boehme, Ph.D., associate professor; and Shana Owens, Ph.D., post-doctoral fellow, in the College of Medicine Department of Microbiology and Immunology.
ARKANSAS HOSPITALS | WINTER 2021 13
This is true team science. The team’s work led to the first known discovery of rogue antibodies against the ACE2. Forrest recalls that he, Boehme, and Owens had less than two weeks to develop the test to meet a funding application deadline. They were “swinging for the fences,” Forrest said, but he was skeptical there would be autoantibodies against the ACE2 because there is so little precedent for it. He got a surprise when he reviewed the first lab results. “I was totally shocked, and I texted Karl, ‘Holy cow, we may actually have something here,’” he said. “Although I thought it wouldn't work, I also thought it was 100% worth giving it a try because it's a really compelling hypothesis.” Josh Kennedy, M.D., who worked with Boehme and Forrest on the 2020 antibody test, is also a collaborator on Arthur’s project. Kennedy is a clinical researcher at Arkansas Children’s Research Institute and associate professor in the Department of Pediatrics, Division of Allergy and Immunology. The team tested de-identified blood samples for ACE2 antibodies in 67 patients with known SARS-CoV-2 infection and 13 with no history of infection. In 81% of patients with a history of COVID-19, the samples had the antibodies that attacked the ACE2. In participants with no history of COVID-19, no autoantibodies were created to attack the ACE2 enzyme. “ACE2 is critical in the body for helping to regulate the level of inflammation,” Harville said. “So if
14 WINTER 2021 | ARKANSAS HOSPITALS
there’s disruption of this function, it increases inflammation in the body. Our research indicates that this may be one of the reasons why people with COVID-19 continue to have debilitating symptoms.” “Everything that we’ve found is consistent with these autoantibodies as the instigators of long COVID, so it’s an exciting development that merits further study,” Arthur said. The team’s findings were published in September in the journal The Public Library of Science ONE (PLOS ONE). Since then, Arthur has been bombarded with emails and phone calls from across the U.S. Most are from people experiencing long COVID-19 who are desperate for answers. “I receive a lot of correspondence from people who are suffering, and the stories are heartbreaking,” Arthur said. “One was from a medical student who had to give up his dream because he was so severely fatigued and depressed that he just could not go on. I had another from a university professor who had to resign.”
WHAT’S NEXT
Arthur is moving his research into the next phase, inviting people to participate. His goal is to determine if there is an association between the long COVID-19 symptoms and the rogue autoantibodies. “We're focusing on fatigue because that’s a primary symptom, and we're hoping to be able to recruit people from all over the country,” Arthur said. “This will give us a fuller picture and answer some key questions that we
couldn’t in our first study, which was limited to de-identified clinical data.” Arthur and UAMS are steering potential study volunteers to a website created by the Translational Research Institute. The website, ARresearch.org, includes a registry with checkboxes for interested volunteers to include their research and health interests. The registry was recently updated to include checkboxes for COVID-19 and Long Haul COVID-19. “Our team will be contacting people in the registry to ask if they would like to participate in this study,” Arthur said. “If our next steps confirm that these antibodies are the cause of long COVID-19 symptoms, there are medications that should work to treat them. If we get to that phase of research, the next step would be to test these drugs and hopefully relieve people of the symptoms they're having.” The multidisciplinary team also includes College of Medicine researchers Christian Herzog, Ph.D., in the Department of Internal Medicine, and Juan Liu, M.D., Ph.D., from the Department of Pathology. “This is true team science,” Arthur said. “We put together a great group of investigators that had never worked together to produce these very exciting results.”
David Robinson is the Communications Manager for the Translational Research Institute of the University of Arkansas for Medical Sciences.
ARKANSAS HOSPITALS | WINTER 2021 15
Bringing Healing Home: Hospital without Walls Programs Rethink Care Delivery By Vincent Turner Jr., FACHE
T
he latter half of 2020 stretched Arkansas hospitals to their limits. Steady surges of COVID-19 patients made available beds, especially those providing intensive care, scarcer each minute. While providers acted quickly to accommodate the rapid influx of persons needing isolated care, these demands forced extra shifts upon clinical and support staff as well as logistical and care challenges upon administrators. Despite the presence of a global pandemic, hospitals still operated under federal care regulations unreflective of the challenges surrounding them. Seeing this rigidity, the Centers for Medicare and Medicaid Services (CMS) reevaluated what constitutes a “hospital.” In fact, Seema Verma, who was CMS Administrator at the time, astutely noted that COVID-19 had created a new level of crisis response. “Our job is to make sure that CMS regulations are not
16 WINTER 2021 | ARKANSAS HOSPITALS
standing in the way of patient care for COVID-19 and beyond,” Administrator Verma said. CMS initially announced the Hospital without Walls program just as the pandemic reached Arkansas. Through this program, CMS authorized additional bed capacity and broad flexibility for hospital services beyond existing care structures. Ambulatory surgery centers, inpatient rehab hospitals, hotels, and dormitories would all play a role meeting this demand. While the initial expansion helped overflowing hospitals, many of these structures did not provide ideal patient environments. Meanwhile, hospitals themselves needed even greater flexibility. Consequently, the agency’s challenge involved fostering a care model that benefitted patients, caregivers and providers alike. In November 2020, CMS announced the follow-up program, Acute Hospital at Home, giving approved hospitals
unprecedented regulatory flexibility to treat eligible CMS patients in their own homes. Based on our telemedicine capabilities as well as our access to home care services, we at St. Bernards immediately saw an opportunity to improve patient care throughout our 23-county service area in Northeast Arkansas and Southeast Missouri. We applied for a CMS waiver on behalf of our flagship hospital, St. Bernards Medical Center (SBMC), receiving it in early January 2021. We named our program St. Bernards Acute Health at Home (SBAH), forming the first hospital at home system in Arkansas. SBAH began with 10 beds that provided 24/7 care, logistics and patient monitoring. Further replicating acute hospital settings, we installed a system to field patient and family questions while caring for patients’ social needs. SBAH Admissions began with SBMC patients – those arriving at the Emergency Department or those holding inpatient status. A St. Bernards navigator would identify potential hospital at home candidates before sending a list to the SBAH team, including a hospitalist, for further vetting. Our team would then verify whether it could care for a CMS patient at home, looking at both inclusion and exclusion criteria. For example, inclusion criteria required patients at least 18 years of age, clinically stable, living in a safe home environment in Jonesboro, and surrounded by social support mechanisms. Exclusion criteria indicated that patients could not need cardiac monitoring or intensive care services, and they could not have domestic violence concerns. With eligibility secured, patients and their families voluntarily agreed to a referral, initiating the hospital at home transfer process. To ensure hospital-level care, each SBAH patient would receive daily physician rounds via telemedicine technology brought into the home. An APRN or RN would complement those rounds, making two in-person visits that provided guaranteed, tangible contact. The care team would also include pharmacists, case managers, social workers and continuum of care navigators, while using physical, occupational and speech therapists as needed. Ultimately, with patients healing from the prime environment of home, we anticipated better experiences, outcomes and reduced healthcare costs. Our initial admissions began shortly after receiving CMS approval. The length of stay averaged two to three days during this time – valuable hours for the patients to heal at home and opportunities for SBMC to free-up capacity.
We often hear how healing at home reclaims families’ time together without visitation concerns for other loved ones. Most importantly, patient care never suffers; if anything, it improves because of the environment.
SBAH IN ACTION
Two patient examples particularly stand out: the first patient arrived at SBMC’s Emergency Department on April 14, 2021. SBMC admitted the individual to in-patient status under a diagnosis of pneumonia, hypertension, generalized weakness and hemoptysis with a sinus source. Six days later, SBAH received the patient. We dispatched an RN for an in-person visit that same day, taking vitals and providing medical education during our time in the home. The following day, April 21, included an in-person RN visit and physician
A case holds the telemedicine gear that allows at-home patients to interact with providers remotely. An in-person RN attends to assist with each virtual visit.
ARKANSAS HOSPITALS | WINTER 2021 17
telemedicine visit. Our physician immediately recognized a mental status change with the patient and initiated a transfer back to SBMC for further evaluation. At the hospital, providers determined the individual needed inpatient rehabilitation. We discharged the patient to a partner provider, simultaneously arranging follow-up appointments with the individual’s primary care, ENT and pulmonology physicians during the process.
The second patient also arrived at SBMC’s Emergency Department, admitted as in-patient on May 17, 2021. Providers diagnosed pneumonia and hypertension and transferred the individual to hospital at home care one day later. That same day, an SBAH RN made an inperson visit, taking vitals, providing medical education, obtaining a urine analysis, administering intravenous antibiotics and drawing blood. The
Introducing the 2021 Cohort! Each of these emerging technologies have strong potential to improve cardiovascular clinical outcomes and improve efficiencies within our providers’ operations. FDA-cleared biomagnetic imaging solution to detect myocardial ischemia in patients with chest pain and other anginal equivalents. AI imaging software that improves clinical outcomes and pre-operational planning with personalized solutions for each patient’s anatomy. Remote AI patient monitoring to better manage medications for heart failure patients, coupled with devices that collect patient biomarkers.
patient received two in-person RN visits and one physician telemedicine visit per day May 19-20. Our SBAH physician ordered a chest X-ray for the patient at St. Bernards Imaging Center, discharging the patient from SBAH the same day. Meanwhile, we arranged follow-up appointments with the patient’s primary care physician and Population Health coordinators. Based on these seamless care transitions, SBAH has unlimited potential. We plan to fine-tune each process – from the initial patient screening to discharge. In addition, as more hospital at home programs come online, we will borrow and share insights that make each program better. Lastly, as technology rapidly advances, we must ensure physicians, nurses and patients can access up-to-date, reliable, and cost-effective tools. Doing so will sustain SBAH’s successes – patients will feel a closer tie to their providers, and providers can more accurately monitor and diagnose patients. SBAH is nearing its one-year anniversary, and we have received extraordinary participant feedback. We often hear how healing at home reclaims families’ time together without visitation concerns for other loved ones. Most importantly, patient care never suffers; if anything, it improves because of the environment. There truly is no place like home. Perhaps one day, we, as health care providers, will even wonder why capacity concerns existed. It is our hope, and it is our goal.
Virtual cardiac rehab platform that boosts hospital revenues, improves clinical outcomes, and reduces readmissions. Intravascular denervation system using unfocused ultrasound for deeper penetration to treat resistant hypertension. www.healthtecharkansas.com To learn how your organization can participate, please contact Jeff Stinson at jeff@healthtecharkansas.com 18 WINTER 2021 | ARKANSAS HOSPITALS
Vincent Turner Jr., FACHE, is the Assistant Vice President of Continuum of Care at St. Bernards Healthcare and a recent recipient of the ACHE Regent’s Award for Early Career Healthcare Executive.
More Than A Medical School New York Institute of Technology College of Osteopathic Medicine (NYITCOM) at Arkansas State University is committed to training talented physicians who aspire to become servant leaders that positively impact their communities. Located in Jonesboro, NYITCOM at Arkansas State is uniquely situated to improve access to health care and health education in the state and the greater Mississippi Delta region. NYITCOM students are eager and ready to address the region’s significant health care needs through research, outreach, wellness initiatives, and superior patient care.
Training Physicians In Arkansas, For Arkansas
nyit.edu/arkansas | 870.680.8816 | ComjbAdmissions@nyit.edu
ARKANSAS HOSPITALS | WINTER 2021 19
• • • • • •
Therapy 7 days a week On-site7 Nurse Practitioner Therapy days a week On-site Nurse Practitioner Short-term rehab to home therapy program Short-term rehab to home therapy program Individualized rehabilitation program Individualized rehabilitation Program Orthopedic and post-surgical aftercare Orthopedic and post-surgical aftercare The A specialized all-female TheRetreat: Retreat: A specialized all female Memory Memory Care Community Care Community
12111 Hinson Road | Little Rock, AR 12111 Hinson Little Rock, 501.2 25.8888Road | encor|eatlitt lerock .orgAR 501.225.8888 | encoreatlittlerock.org
20 WINTER 2021 | ARKANSAS HOSPITALS
2021Annual Meeting Week
AHA’s Annual Meeting was cancelled, once again, in the interest of protecting the health and safety of our members. But we made the most of Annual Meeting week, by finding new ways to keep everyone connected … virtually.
Virtual Highlights
VIRTUAL AWARDS CEREMONY & KEYNOTE ADDRESS On October 7th, AHA livestreamed an awards ceremony that included a motivational message from Keith Jackson, former NFL player, and recognized our 2021 award winners: Phillip Gilmore, PhD, FACHE A. Allen Weintraub Memorial Award
Marcy Doderer, FACHE ACHE Senior Level Career Award
Vincent Turner Jr., FACHE ACHE Early Career Award
Diamond Awards Visit arkhospitals.org for a complete list of 2021 Diamond Award winners. You can view the ceremony at this link: https://bit.ly/3sc03gX
Meet Our Sponsors
On the following pages, we’re giving our Sponsors and Supporters a chance to connect with you from a distance. Keep reading to learn more about the essential products, services, and solutions they offer. And thank you to our digital sponsors for 2021, BKD and Mitchell Williams for their support this year!
DIAMOND LEVEL, p. 22 PLATINUM LEVEL, p. 25
LEADERSHIP WORKSHOP
The Four Disciplines of Execution for Healthcare Presented by Chris McChesney This free, three-day virtual educational series was presented live, then recorded and provided to any AHA member who expressed interest. For more information, contact Lyndsey Dumas at ldumas@ arkhospitals.org.
GOLD LEVEL, p. 28 SILVER LEVEL, p. 31 SUPPORTERS, p. 33
ARKANSAS HOSPITALS | WINTER 2021 21
THANKS, DIAMOND LEVEL SPONSORS!
AHA Services, Inc. (AHASI) is owned by the AHA membership and was created to serve you. AHASI connects member hospitals throughout the state with products and services that reduce costs and rive performance improvement. All AHASI Endorsed Vendors undergo a strategic vetting process to ensure that their offerings will help AHA member hospitals respond to the ever-shifting health care landscape. Though the pandemic has made communication more challenging – and despite the fact that our staff members have been less able to make frequent visits to hospitals throughout the state – AHA Services has continued to expand and enhance our offerings to meet your most pressing needs. AHASI revenues are reinvested in AHA to provide critical financial support for educational programs and member initiatives in every department of the organization. We invite you to maintain an open line of communication with the team at AHASI and let us know if there's a product or service you're seeking. This not only benefits all AHA members – affording more attractive pricing and benefits from vendors for all when we have stronger participation – it also maintains an important revenue stream that supports all of the other work we do here at the AHA. For these reasons we ask that you look to AHA Services first when there's a solution you're seeking. Not familiar with what AHA Services offers? Below is a list of just some of the challenges you may be facing for which we provide solutions.
EDUCATION
• Online Continuing Education • Talent Management • Clinical Student Orientation • Patient and Workforce Violence Training • Resource for Pricing, Price Transparency, Coding, Reimbursement and Compliance
FINANCE & OPERATIONS
• 340B Split Billing • 340B Contract Pharmacy • 340B Consulting and Solutions • Provider Enrollment Services • Class Action Settlement Claims Management • Third-Party Liability and Workers' Compensation Claims Recovery Services • Trusted Digital Marketplace for PPE • Supply Chain and Operational Solutions • Resources for Pricing, Price Transparency, Coding, Reimbursement and Compliance
INFORMATION
• Translation services • HIPAA Compliance/Quality Risk Analysis • Satisfaction/Quality Measurement • Trusted Digital Marketplace for PPE
INSURANCE
• Workers’ Compensation Program • Employee Benefit Solutions and Consulting • Liability Insurance and Consulting • “On-the-Job” Accident Coverage for Volunteers
22 WINTER 2021 | ARKANSAS HOSPITALS
Tina Creel, President, AHA Services, Inc.
As Arkansas’ oldest and largest health insurer, Arkansas Blue Cross and Blue Shield has been helping improve the health, financial security and peace of mind of the people of Arkansas for more than 70 years. The company and its family of affiliates (which includes Health Advantage, Arkansas Blue Medicare and BlueAdvantage Administrators of Arkansas) are national- and state-level leaders in health plan innovation and offer coverage options to fit any need or budget.
DIAMOND LEVEL
A proud history of promoting health, financial security and peace of mind
Arkansas Blue Cross offers two basic categories of coverage:
Consumer health plans (for individuals) – including a spectrum of health, dental and vision insurance policies for individuals and families, plus Medicare Advantage and Medicare supplement and prescription drug policies. Employer-sponsored health plans – including fully insured or self-funded versions of group health, dental and vision plans. Atrkansas Blue Cross employs more than 3,200 people in about a dozen locations throughout the state. The company serves more than 2 million members – nearly 800,000 people who live, work, learn and play in and around Arkansas and another 1.2 million through national accounts. Commitment to policyholders/members As a private, not-for-profit, mutual health insurance company, Arkansas Blue Cross stands apart. Arkansas Blue Cross is not a publicly traded company and does not pay shareholder dividends. Its policyholders, or members, actually own the company. Commitment to healthcare providers Healthcare providers played a key role in the founding of Arkansas Blue Cross, and they continue to be a key ally supporting the company’s mission. The company works closely with healthcare providers, sharing claims data, exploring new technologies and collaborating on ways to make the healthcare system more efficient and effective. Their shared goal is to ensure that each member receives high-quality, high-value care at an appropriate cost. Commitment to communities Arkansas Blue Cross also stands out because of its significant history of giving back to Arkansas – in ways that make life healthier. Arkansas Blue Cross and its employees commit financial resources, time and energy to address key health-related issues. Since 2001, the company’s nonprofit Blue & You Foundation for a Healthier Arkansas has awarded more than $40 million to more than 2,600 healthpromoting programs in communities (in all 75 counties) throughout Arkansas. The company also annually supports Arkansas civic, cultural and educational organizations and consistently contributes to disaster-relief efforts. Arkansas Blue Cross began as a “grassroots” effort to make life better for the people of Arkansas, and today, that philosophy remains at the core of its daily work and vision for the future.
Arkansas Blue Cross and Blue Shield P.O. Box 2181, Little Rock, AR 72203-2181 www.arkansasbluecross.com Facebook: @ArkansasBlueCross Instagram: @arkansasbluecross LinkedIn: linkedin.com/company/arkansas-blue-cross-blue-shield
ARKANSAS HOSPITALS | WINTER 2021 23
DIAMOND LEVEL
ST BERNARDS MEDICAL CENTER SURGICAL AND INTENSIVE CARE TowerJonesboro
What was once a small, family-owned construction company has grown into a large, multi-discipline firm. But one thing remains the same — the Nabholz name is still synonymous with integrity and has been since Bob Nabholz founded the business in 1949. Our company is guided by a simple purpose —to grow our people, serve our clients, and build our communities. The longevity and success of our company are due to the integrity and knowledge of our team members and a diverse service line that addresses virtually all our clients’ construction and facility needs. Nabholz is 100% employee and family-owned and operated, and Nabholz company owners live in all the states we serve, ensuring that revenue from our company spreads across the communities in which we work. Moreover, we carry on Bob’s legacy of dedication to craftmanship by offering employees at every level the exact same benefit package. This allows us to employ and retain the best skilled labor, maintain our ability to self-perform many trades, and ensure we produce quality work. Nabholz understands the unique nature of working in active healthcare environments — whether it be managing renovations or security upgrades or constructing additions or brand-new structures. Our experience ranges from small, multi-purpose clinics to five-story surgical towers. Our diverse service line aligns with healthcare clients’ facility needs, including the ability to transport and set complicated machinery; complete facility maintenance services; manage tenant finishouts, clean room, and laboratory construction; and even design custom nursing stations. Nabholz’ industrial team is also well-versed in installing MRIs in all stages of a medical facility’s lifecycle. We are experienced setting Canon Medical Technology, Siemens, and GE machines, both new and refurbished. Our industrial team has an impeccable record transporting, rigging, and installing MRIs, as well as all the equipment, including a large range of cranes, needed to safely complete this intricate work. We currently have offices strategically located throughout Arkansas, Oklahoma, Kansas, Mississippi, Missouri, Tennessee, and Connecticut and are licensed to provide services to clients in 41 states. 24 WINTER 2021 | ARKANSAS HOSPITALS
ARKANSAS CHILDREN’S NORTHWEST, Springdale
Primary Operations: • Construction • Machinery moving, installation & service • Infrastructure • Maintenance & repairs • Environmental hazard services • Crane and equipment rental • Energy performance & solar • Custom fabrication & millwork • Railroad services
uncertain times.
The COVID-19 outbreak is an evolving crisis, and we want to support hospitals The COVID-19 outbreak is an evolving with and other frontline health providers crisis, and we want to support hospitals the latest tax and accounting updates. and other frontline health providers with Visit our COVID-19 Health Care Resource the latest tax and accounting updates. Center at bkd.com/covid-19healthcare Visit our COVID-19 Health Care Resource forCenter relevant news, changing guidelines, at bkd.com/covid-19healthcare and regulations. fornew relevant news, changing guidelines, and new regulations.
Everyone needs a trusted advisor. Everyone needs a trusted advisor. Who’s yours? Who’s yours?
THANKS, PLATINUM LEVEL SPONSORS!
Trusted advice in uncertain times. Trusted advice in
501.372.1040 •• @BKDHC @BKDHC 501.372.1040
BXS Insurance has a long history of serving our clients’ risk management needs. Today, BXS Insurance is one of the top agencies in the nation. We attract and retain distinguished clients worldwide through our capabilities, specialized programs and constant desire to improve. As the healthcare landscape becomes increasingly complex, our Employee Benefits team plays a fundamental role in ensuring employers maintain highquality benefits while containing costs, ensuring compliance and more. Using a data-driven model, the EB team informs employers’ strategic benefits decisions and achieves macro-level results – such as improving health outcomes and driving down medical and pharmacy costs – by making microlevel changes. Our Commercial Lines team provides property and casualty insurance, along with surety insurance products for businesses. Commercial lines insurance helps keep the economy running smoothly by protecting businesses from potential losses they couldn’t afford to cover on their own, which allows businesses to operate when it might otherwise be too risky to do so. In the toughest of times when insurance is needed the most, we never lose sight of our mission: to exceed our clients’ expectations. Our agency is exceptional because we are disciplined, we execute consistently and we have a passion to win.
Bill Birch
Sr. Vice President – Risk Consultant
BXS Insurance
8315 Cantrell Rd., Suite 300 Little Rock, AR 72227 (501) 614-1170 Bill.Birch@bxsi.com
www.bxsi.com
facebook.com/BancorpSouthBank twitter.com/MyBXS linkedin.com/company/bancorpsouth
ARKANSAS HOSPITALS | WINTER 2021 25
PLATINUM LEVEL
Whether you are a hospital, physician group, healthcare provider, or a company that serves provider organizations, you know that the demands on the health sector are complex. At Friday, Eldredge & Clark, we offer a wide array of legal services including business and financing, healthcare and regulatory issues and medical malpractice defense.
For more information about our practice areas or the firm, visit www.fridayfirm.com
Healthcare Our healthcare lawyers have the insight, capability and experience to effectively address the complex issues inherent in the highly regulated healthcare industry, including regulatory and compliance matters, contract negotiations and preparations, reimbursement issues, and audit reviews and appeals. Business Our firm also represents clients in mergers and acquisitions; financing and restructuring; corporate, regulatory and strategic counseling issues; litigation defense; physician compensation; and labor and employment matters. Litigation The attorneys in our Medical Malpractice Group are devoted to defending medical care providers in malpractice cases, which provides unique insight into the complexities of this type of litigation. At Friday, Eldredge & Clark, we are focused on providing our healthcare clients with consistently talented, ethical and efficient representation.
Attract. Engage. Develop. Reward. Our team of consulting experts in compensation, engagement, leadership development, executive search and surveys, use industry-leading data and analytics to empower clients. We leverage experience and wisdom to tailor flexible consulting solutions for your unique organization. To learn more, visit https://www.ajg.com/us/services/human-resources-compensation-consulting or contact us at your nearest Gallagher office: 6325 Ranch Drive Little Rock, AR 72223 501.485.3075 © 2021 Arthur J. Gallagher & Co. GBS40693
26 WINTER 2021 | ARKANSAS HOSPITALS
• Outcomes-Focused:
We develop and implement participant solutions intended to make a difference in participants' futures. We don't merely hope your employees are okay in the future; we work with them in a way to drive better outcomes.
• Participant-Driven:
Prime Capital places participants at the core of its fiduciary responsibilities, just as ERISA directs. Our participant-driven approach provides trustees and other plan sponsor representatives with a proactive approach to risk management that focuses on participants' best interests.
• Consultative: We recognize that employer sponsored retirement plans do not exist in a vacuum. As retirement plan-focused consultant, we look to the bigger picture for our clients' business needs, the manner in which they use their benefit programs to recruit and retain talent, and how they can maximize the programs' value.
• Retirement Plan-Focused: Retirement plans are what we do. This means
our clients can rely on us to be out in front of emerging issues and to be current on the identification and implementation of best practices.
Prime Capital Investment Advisors Brennan McCutchen, Managing Partner
THANKS, PLATINUM LEVEL SPONSORS!
We realize that no one person can effectively address the many integrated strategies that are involved in making your retirement plans and goals a success. Prime Capital is an established fiduciary focusing on improving qualified plan health and participant education. Our goal is to help qualified plan participants retire with dignity. We pair comprehensive fiduciary services with thoughtful participant education and aim at one goal: Superior participant outcomes.
6325 Ranch Dr. Little Rock, AR 72223 501-823-4637 www.pciawealth.com
Qualivis Workforce Management Program is an all-encompassing solution for healthcare staffing and a national provider of healthcare workforce solutions that simplify staffing and help hospitals build a better workplace to improve patient care. Qualivis provides a multitude of customizable solutions including clinical and non-clinical staffing, locum tenens, interim, international, and permanent hiring.
2000 Center Point Road, Suite 2285 Columbia, SC 29210 803-995-8981 | www.qualivis.com LinkedIn: linkedin.com/company/27193031/admin/ Twitter: @qualivis | Facebook: @Qualivis
Qualivis offers a simple and efficient model designed to deliver high-quality talent and streamline operations. Facilities and administrations are provided one centralized contract, one point of contact, one inclusive software solution, and a single invoice. With over 200 pre-vetted agency partners, Qualivis is able to help hospitals build a better workplace to improve patient care. Qualivis partners with 27 state hospital and healthcare associations, including AHA. By offering accountable, scalable and flexible workforce solutions, Qualivis can provide the customized options to help meet the needs of your facility. To learn more about how Qualivis can work for your facility, please visit Qualivis.com or email info@ qualivis.com. ARKANSAS HOSPITALS | WINTER 2021 27
THANKS, GOLD LEVEL SPONSORS!
We are AFMC. A national, nonprofit health care company dedicated to working with consumers, health care providers, businesses, and communities. We improve health and experience of care, while reducing costs. At the forefront of health care reform and practice transformation, AFMC is an established, trusted partner in private, state, and federally led programs for Medicaid, Medicare and commercial payers.
Solutions include:
• Education and Outreach • Surveys/Data Mining/Analysis • HEDIS Measures/Abstraction • Medical Utilization Management • Pandemic Support Services (Contact tracing, case investigation, vaccination/testing teams) • Virtual Event Hosting • Call Center Services
Visit www.afmc.org to learn more about how AFMC can be your problem solver. The Arkansas Hospital Association formed the Connectivity Consortium to enable hospitals to receive more subsidies under the FCC’s Rural Healthcare Program. Many Arkansas hospitals participate currently, but almost none take full advantage. Millions of dollars are left on the table each year because of lack of applications for eligible products and services. The consortium’s processes, working with each hospital annually and individually, maximizes subsidies for each hospital. Our deep telecom expertise ensures nothing is left uncovered. Consortiums’ strength in numbers enable increased cap size for member’s infrastructure projects. If your participation in the Rural Healthcare Program could use a refresh or even a second look, please reach out to the Rural Healthcare Program experts at your Arkansas Hospital Association’s Connectivity Consortium! Randy Reznik Partner randyreznik@fedfunding.net | Phone: 303-882-0824 ARORA is the human organ and tissue procurement organization serving 64 of Arkansas’s 75 counties. ARORA’s mission is to restore lives through the recovery of lifesaving and life-enhancing organs and tissues for transplant. We achieve this mission because of the support of our many donation partners, who include hospital staff, coroners, funeral homes, medical examiners, and the Arkansas State Police. Up to eight organs can be recovered for lifesaving transplants; and eight different types of tissues can be recovered to heal patients. ARORA encourages all Arkansans to register to become organ, tissue and eye donors by visiting donatelifearkansas.org, at any Arkansas DMV office, or at one of ARORA’s new mobile registration kiosks. Visit arora.org for more information.
ARORA (Arkansas Regional Organ Recovery Agency) 501-907-9150 1701 Aldersgate Rd, Suite 4, Little Rock, AR 72205 www.arora.org Facebook: @DonateLifeArkansas/
28 WINTER 2021 | ARKANSAS HOSPITALS
GOLD LEVEL
ESS
Jessica Williams Vice President of Business Development (951) 323-8425 jwilliams@essdoc.com essdoc.com
HORNE Healthcare
Today’s healthcare environment is changing rapidly, and guidance through those changes requires more than a cursory understanding of healthcare. You need a collaborative partner with a solid record of performance in your industry. HORNE helps you anticipate emerging trends and position your organization for success in an increasingly complex healthcare landscape. In addition to traditional healthcare accounting services like reimbursement, audit and tax, we offer COVID response, healthcare valuation, HIPAA privacy and security, outsourced accounting, and healthcare data analytics through REDi Health. HORNE Healthcare serves 600 clients nationwide, including hospitals and health systems, physicians, dentists and long-term care facilities. Our 70-plus employees are dedicated solely to working with healthcare clients.
Contact: Laura Gillenwater, CPA Office: 501-226-2997, Direct: 601-326-1378. HORNE, 1023 Main Street, Suite 202, Conway, AR 72032 | 1-888-821-0202
Hospital employees are routinely exposed to volatile patients and visitors . This dynamic environment and its potential for violent disruptions have Healthcare leaders searching for answers. One of the more challenging tasks is training staff to recognize the signs of potential violence. Properly training staff to recognize, understand, react and manage aggressive behavior provides a safer, more productive environment for staff and patients. HSS’s TEAM® program has been designed for healthcare workers who may encounter angry, disruptive, or potentially dangerous individuals. Unlike generic programs, TEAM® is focused exclusively on situations healthcare workers, including medical, clinical, and professional support staff, are likely to encounter. TEAM® also is fully compliant with The Joint Commission, CMS, OSHA, DNV (NIAHO), and NIOSH guidelines. ARKANSAS HOSPITALS | WINTER 2021 29
GOLD LEVEL SPONSORS!
We help hospitals and health systems manage health care industry challenges while keeping their focus on serving and caring for patients. We assist with: • Health care risk management and compliance • Physician contracts and non-compete agreements • Regulatory and operational issues • Fraud and abuse claims and investigations • Legislative and health care public policy • Information security and privacy issues • Mergers, acquisitions and restructuring businesses The Mitchell Williams team of health care lawyers understands the issues, challenges and rapidly-changing regulations facing • Health care real estate transactions and leasing the health care industry today. To effectively operate in this • Employment and labor matters ever-shifting environment, hospitals and health systems need experienced legal and business counsel to address complex 425 W. Capitol Ave., Ste. 1800 Little Rock, AR 72201 regulatory, risk management, corporate and operational (501) 688-8800 | MitchellWilliamsLaw.com matters.
SUNRx - Advanced Claims Capture The need to optimize 340B savings is greater now than ever considering the Manufacturers’ constraints that have been added to the 340B program. SUNRx has been our long-standing business partner for 340B. As a 340B TPA pioneer, SUNRx has developed an industry-leading solution called Advanced Claims Capture, designed to help 340B Covered Entities compliantly capture all eligible 340B capturable claims, including referral and fall out claims, thus increasing the savings available.
Advanced Claims Capture includes:
• Available no cost annual independent Audit of Covered Entity’s 340B program • Recommendations for improvement of Covered Entity Policies & Procedures • Enhancing referral claims capture includes: • Data mining CE’s EMR data • Identification of referrals • Engaging with the referral providers • Obtaining the necessary documentation to support the compliant capture of these claims • Continual monitoring for optimization
Vizient brings unique capabilities and expertise unmatched in the industry. We commit to building on the strengths that differentiate us and best serve our members. By delivering integrated cost, quality and market performance solutions across the care continuum, we are able to provide consistent and exceptional member experiences. Let us help you to: • Optimize your supply operation • Improve Care Delivery • Evolve strategies to grow and compete • Maximize pharmacy performance Vizient is the nation’s leading health care performance improvement company…let’s work together!
To learn more, visit www.vizient.com 30 WINTER 2021 | ARKANSAS HOSPITALS
We would enjoy the opportunity to schedule a 30-minute meeting to discuss and explore how Advanced Claims Capture may provide a value for your entity. Please reach out with questions, or you may contact SUNRx to learn more: John Bretz | jbretz@sunrx.com | (267) 800-5390 Director of Strategic Relations at SUNRx
Contacts:
Jeneen Ablan Strategic Affiliate Manager 507-313-1185 jeneen.ablan@vizientinc.com Jason Ellis Sr. Director, Sales Jason.ellis@vizientinc.com 972.830.6922.
AHEF, the local chapter of the American College of Health Care Executives (ACHE) is a forum for professional development for the state’s healthcare executives. Since its inception, the association has expanded its membership to all those involved in healthcare related professions including students in healthcare management programs. Visit ahef.ache.org/ or www.ache.org for more information.
CareSource PASSE is the newest Provider-Led Arkansas Shared Savings Entity (PASSE) program in Arkansas! We are excited to serve Arkansans with complex behavioral health, developmental, and intellectual disabilities. This provider-led group includes healthcare and community leadership from across Arkansas with a shared commitment to transforming the delivery of care. CareSource PASSE will improve the lives of Arkansans by creating innovative community solutions focused on a person-centered approach and engagement through caregivers, providers and community-based organizations.
THANKS, SILVER LEVEL SPONSORS!
CareSource PASSE – Reimagining Health Care
AHEF Contact:
Lyndsey Dumas ldumas@arkhospitals.org (501) 224-7878 To learn more please visit www.CareSourcePASSE.com
CommerceHealthcare® provides automated receivables management and payment services, patient loan financing and lending solutions. Our team of healthcare and banking professionals understand the business of healthcare and the needs of patients. We can help you find cost savings, improve cash flow, reduce financial risk and create a better patient experience. CommerceHealthcare® is the specialty healthcare division of Commerce Bank.
CommerceHealthcare 1000 Walnut Kansas City, MO 64106 (816)760-3365 www.commercehealthcare.com linkedin.com/showcase/ commercehealthcare/
Cromwell Architects Engineers creates innovative, patient-focused designs for healing environments that address the needs of providers, clinicians, and caregivers; promote staff retention; and are also sensitive to costs. Our high-performance facilities are designed for best practices, the latest technologies, and patient safety. We focus on operational efficiencies that support adaptability and flexibility for growth within an ever-changing healthcare environment to serve Arkansas’ long-term needs. 1300 East 6th Street Little Rock, AR 72202 (501) 372-2900
109 W. Emma Avenue Springdale, AR 72764 (479) 841-2776
www.cromwell.com Facebook: @CromwellAE Instagram: @cromwellarchitectsengineers ARKANSAS HOSPITALS | WINTER 2021 31
SILVER LEVEL Evident is in the unique position of being able to apply 40+ years of experience delivering and supporting advanced EHR solutions specifically for community hospitals and clinics like yours. It’s an environment where resources are often limited, needs can be great and personal relationships mean everything. Contact: Evident 6600 Wall Street Mobile, AL 36695 (800) 711-2774 | info@evident.com
HealthCare Associates Credit Union is a not-for-profit financial cooperative providing financial solutions tailored to meet your employees’ needs and free financial literacy to those who serve or support healthcare. This FREE employee benefit is available to your organization now at no-cost thanks to the Arkansas Hospital Association. To learn more or to get started offering HACU today, visit hacu.org or call 630-276-5771. 1151 E. Warrenville Rd. Naperville, IL 60563 Facebook: @bankhealthy Instagram: @bankhealthy/ Twitter: @bankhealthy LinkedIn: linkedin.com/company/ healthcare-associates-credit-union/
For three decades hospitals have trusted PARA to help navigate through complex financial and reporting issues related to the revenue cycle. PARA’s reliability and expertise is unmatched. Today, hospitals face even more challenges keeping up with the myriad of changes in regulations, reporting requirements and consumer demands. By creating effective and unique partnerships, in a relentless pursuit of excellence, PARA achieves lasting results for hospitals. Violet Archuleta-Chiu Senior Account Executive PARA HealthCare Analytics, LLC. Phone# (800) 999-3332 ext. 219 Fax# (877) 284-7755 www.para-hcfs.com
32 WINTER 2021 | ARKANSAS HOSPITALS
SUPPORTERS
SHARE is the Health Information Exchange for Arkansas, a division within the Arkansas Department of Health. SHARE is the fastest, most secure way to exchange patient health records from one provider to another. With over 80% of Arkansas’s hospitals connected, SHARE gathers your patients’ clinical data from all participating health care providers to instantly give a holistic view of their health history, treatment, and progress.
State health Alliance for Records Exchange (SHARE)
1501 N. University Ave, Suite 420 Little Rock, AR. 72207 (501) 410-1999 | sharearkansas.com | SHAREhealth@arkansas.gov
Arkansas Mutual Constellation
Facebook @SHAREarkansas, Twitter @SHAREarkansas, LinkedIn linkedin.com/company/ar-share
(952) 847-4397 Ryan Schott, Business Support ryan.schott@constellationmutual.com constellationmutual.com
C.R. Crawford
Crews is a full-service investment banking firm headquartered in Little Rock, Arkansas. Our team includes knowledgeable and experienced professionals that specialize in the origination and distribution of tax-exempt and taxable revenue bonds, capital leases and other types of credit facilities. This knowledge and experience coupled with hard work, integrity and exceptional service allows us to be a reliable and unique funding source for our healthcare clients in Arkansas and around the nation.
(479) 200-2108 Jordan Ligon, Business Development jligon@crcrawford.com crcrawford.com
Contact: Paul Phillips, Senior Managing Director, Capital Markets (501) 978-6309 | pphillips@crewsfs.com 521 President Clinton Ave, Suite 800 Little Rock, AR 72201 www.crewsfs.com Facebook: @CrewsAssociates LinkedIn: @crews-&-associates Twitter: @CrewsAssoc ARKANSAS HOSPITALS | WINTER 2021 33
SUPPORTERS
Engelkes Felts & Barnhardt Ltd Certified Public Accountants 1225 Front Street Conway, AR 72032 Phone: (501) 329-5613
Rich & Cartmill Insurance & Bonds is one of the largest, privately held Trusted Choice® independent agencies in the country. Since 1922, we have been committed to assisting individuals and organizations find insurance options that protect their most precious assets. We pride ourselves on exceptional customer service. You can rest assured that choosing Rich & Cartmill is a step in the right direction for all your insurance needs.
Rich & Cartmill, Inc. 2738 E. 51st St, Suite 400 Tulsa, OK 74105 www.rcins.com Direct: 918.293.7189 Fax 918.744.8429 sselman@rcins.com Facebook: @RichandCartmillInsuranceandBonds Instagram: @richandcartmill | youtube.com linkedin.com/company/rich-&-cartmill-inc
Welch, Couch & Company, PA is a full service accounting firm offering a wide range of services to the healthcare industry. Boost productivity. Increase cash flow. Speed reimbursement. Enhance patient services. How? With TruBridge, your one source for the people, products and processes you need to more efficiently serve your community. Through our HFMA Peer Reviewed® products and services, TruBridge helps healthcare organizations of all sizes get paid faster and more. Contact: TruBridge 6600 Wall Street, Mobile, AL 36695 (877) 543-3635 | info@trubridge.com facebook.com/trubridgeservices
• Financial Statement and Employee Benefit Plan Audits • Medicare and Medicaid Cost Report Preparation • Reimbursement and Compliance Issue Consulting • Critical Access Hospital Consulting • Revenue Cycle Analysis • Feasibility Studies • IRS Form 990 Preparation • Strategic Planning for Acquisitions, Sales, Mergers and Expansions At Welch, Couch & Company, PA, we have made a commitment to providing professional services to the healthcare industry. Our experienced professionals work closely with clients and their staff to ensure they are receiving the level of service you should expect out of your CPA firm. Batesville, Arkansas Bill Couch, CPA, FHFMA (870) 793-5231 | www.welchcouch.com
34 WINTER 2021 | ARKANSAS HOSPITALS
LEADER PROFILE
Serving with Purpose By Ashley Warren
T
he first wave of COVID-19 swept the United States when Jay Quebedeaux, CEO of Mena Regional Health System, had held the position for just five years. Now, as he reaches his sevenyear mark at the helm, he remains focused on the challenges yet to come in the pandemic. “In the rural market, staffing is going to continue to be an issue. That’s one of the biggest things,” Quebedeaux says, echoing the concerns of hospital leaders nationwide. With all health care job openings at historic highs and the unemployment rate ranking low among all sectors, hospitals face a significant supply and demand imbalance. Mena Regional’s culture of individualized, patient-focused care makes that a top priority. In addition to limited staffing resources, Quebedeaux is preparing to treat more COVID-19 patients, with new variants, and surmount other unanticipated obstacles before the pandemic subsides. "We're adjusting to a new world in health care," Quebedeaux says, "We've got quite a few challenges coming, but I think health care in Arkansas is ready for the challenge."
TIME TO SHINE
Despite the devastating consequences of COVID on the community – and despite the hardship it’s caused for health care workers and hospitals, Quebedeaux says, there have also been positive outcomes in the past two years: “Because of COVID, we’ve found out how resilient we are and what kind of a great staff we have. When we give them a challenge, they’re able to rise to the occasion. It builds a sense of accomplishment and makes your organization stronger in the end.” It is encouraging, he says, to see “people genuinely here to help people.”
We've got quite a few challenges coming, but I think health care in Arkansas is ready for the challenge.
ARKANSAS HOSPITALS | WINTER 2021 35
Quebedeaux also notes that the pandemic pushed the hospital to advance in more tangible, practical ways, as well. “We had started the process of implementing telemedicine on the family practice side,” he says, “but COVID really put it on the forefront. It moved up the timetable on telemedicine modalities we weren’t using before. We got very creative there. Luckily, we had a good team, and we were able to get some things accomplished.” The community of Mena itself has a population just over 5,500, and it is the county seat of Polk County. Mena Regional is currently the only hospital in the county, and the service area for the hospital extends from western Arkansas into eastern Oklahoma. “This hospital has been around a long time. I think we’ve got a good rapport with our community,” Quebedeaux says, “and we’ve been very happy to serve them during this time. Obviously, during a pandemic is when a community truly needs a hospital, so it’s our time to shine.” Reflecting on the early days of the pandemic, Quebedeaux remembers that the most urgent priorities for community outreach were providing access to testing, access to care, and access to information. “I think the biggest role we’ve had in the community is as a trusted voice that people will listen to and a place for people to go when they’re concerned they may have COVID,” he says. It was also important to help people understand what their next steps should be if they have a positive test result. As the whole world anticipates new developments in the treatment of COVID-19, Quebedeaux says, he expects that, though it may take time for people in his community to research it and feel comfortable, people will ultimately be open-minded. “There can always be a hesitancy toward new things, but I think as time goes on people have become more accepting,” he says. “There was no playbook for COVID when it started, so I think the last two years 36 WINTER 2021 | ARKANSAS HOSPITALS
We Asked...
Who is someone you greatly admire, and why?
Though there are many people who have inspired me along the way, I would have to say I admire my father the most.
What would you be doing if you weren’t in healthcare? I would be a deep sea fishing guide.
What do you like to do in your down time? I enjoy spending time with my family.
What are you reading right now?
Make your Bed by Admiral William McRaven
Where would you travel, if you could go anywhere? I would visit Rome, Italy.
What’s a life-changing lesson COVID-19 has taught you?
Definitely to be prepared for the unexpected.
HHS PHASE 4 & ARP RURAL FUNDS
Do you have an analyticsdriven COVID response & recovery strategy? The Nov. 23, 2021 distribution of $7.5B in ARP Rural funds has created unprecedented have been new territory for everyone: a lot of new discussions and a lot of new things to deal with. I think, in general, people have been very good about it. It has been a disruption for everyone, but now we know it’s just something we have to deal with.”
A YEARNING TO SERVE
Both of Quebedeaux’s parents had careers in the medical field, and he started his own career in health care in 1992, as a medic in the army. After serving in the military, went back to school for business, and, for him, that ended up being the path back to health care. Though it’s been 20 years since he worked in a clinical function, he says his experience in the field does give him a deeper understanding of what health care workers go through: “I’ve been there, and I’ve done it; and I truly have a lot of empathy for what the nurses and the clinical staff go through. It’s a tough job.” As CEO, Quebedeaux seeks to emulate the leaders he has found most inspiring throughout the various stages of his life: “For me, it was the people who were always positive, who were always upbeat and just generally had a yearning to serve. Leadership is basically learning to serve. That’s been my driving force.” Considering the challenges of leading during such uncertain times, it must not always be easy to remain so positive and empathetic. When asked about how he maintains that spirit of service, Quebedeaux responds: “I think we have to remember that we’re in the business of taking care of people. At the end of the day, that’s what we do as a hospital.”
resources for strategic investments in analytics that create exponential value for years to come. Talk to our experts to learn how analytics can safeguard against the downside risk of COVID outbreaks including patient surges and supply shortages. Like a protective insurance policy, analytics can provide the assurance you need to operate with confidence that your teams and processes are healthy and capable of adjusting to uncertain changes like another COVID variant. Contact us today! 1.888.523.3002
hornellp.com/healthcare ARKANSAS HOSPITALS | WINTER 2021 37
Medicaid Policy
Approaches to Facilitating Access to Vaccines for Low-Income Children By Elizabeth Williams
F
ollowing the recent US Food & Drug Administration’s (FDA) authorization and the Centers for Disease Control and Prevention’s (CDC) recommendation, children ages 5-11 are now eligible to receive Pfizer-BioNTech’s COVID-19 vaccine. There may be unique challenges to vaccinating young children, particularly those from low-income families who may face additional barriers to access. Among all children ages 5-11, over one-third (36%) are covered by Medicaid, and 70% of children ages 5-11 with incomes below 200% of the Federal Poverty Level (FPL) are covered by Medicaid (Figure 1). State Medicaid programs and Medicaid managed care plans are looking at a range of policy options to facilitate access to vaccines for young, low-income children. Low-income children may face barriers to vaccine access. KFF polling recently found that parents of children ages 5-11 with household incomes under $50,000 are more likely than
38 WINTER 2021 | ARKANSAS HOSPITALS
those with higher incomes to say they are very or somewhat concerned about issues related to the coronavirus vaccine. In particular, low-income parents reported more concerns about accessing the vaccine, such as taking time off work or traveling to a place to receive a vaccine. Research prior to the pandemic similarly shows lower overall immunization rates for low-income children, likely stemming from difficulties with access such as a lack of information and outreach or transportation. Low rates of vaccination among low-income children could have implications for ongoing disparities in prevalence of COVID-19 among communities of color. KFF analysis of the 2021 Current Population Survey Annual Social and Economic Supplement (CPS ASEC) finds over two-thirds of children ages 5-11 covered by Medicaid are children of color, including approximately 37% who are Hispanic and 21% who are Black. Black and Hispanic people have been less likely than their White
counterparts to have received a vaccine over the course of the vaccine rollout; though the disparity is narrowing over time, disparities in children’s take-up of the vaccine could reverse that trend. States report adopting a range of Medicaid strategies aimed at increasing vaccine uptake, several of which could extend to low-income children covered by the program. The Centers for Medicare & Medicaid Services (CMS) has highlighted several Medicaid flexibilities and funding opportunities states can use to promote vaccine access. For example, states can request Medicaid administrative federal matching funds for state funded monetary incentives for enrollees to encourage vaccine uptake. In KFF’s annual budget survey, several states reported Medicaid managed care organization (MCO) activities and incentives to promote vaccine take-up among Medicaid enrollees, including financial incentives for MCOs that meet vaccination targets. States also report using member incentives, such as gift cards, and provider incentives. Given that MCOs provide services to over the vast majority of child Medicaid enrollees, these activities may reach many children and families covered by the program. Other state activities focus on using providers to address vaccine hesitancy, which may be especially needed for parents with young children; Medicaid options in this area include vaccine administrative payment rates and financial incentives for achieving or increasing vaccination rates. Strategies to target outreach can help improve vaccine uptake among lowincome children. CMS notes Medicaid
administrative federal matching funds can be used for beneficiary and provider community outreach such as disseminating information or materials and providing trainings. Several states in KFF’s annual budget survey reported using data collection and tracking to better target outreach and reduce disparities in COVID-19 vaccination rates. Strategies to employ trusted and diverse messengers of vaccine information can help with education and outreach to parental/caregivers (which is important because their consent for vaccines is required in all states, though DC and Philadelphia allow 11-year-olds to selfconsent for the COVID-19 vaccine). For example, MCOs in Michigan report using community health workers to provide education and outreach to address vaccine hesitancy. Further, KFF analysis from June 2021 found community health centers were vaccinating larger shares of people of color compared to overall vaccination efforts, reflecting their established trusted relationships with communities of color. While the cost of a COVID-19 vaccine is covered for all individuals, other policies can help to address additional barriers to accessing vaccines for low-income children. While
the federal government recently implemented a paid leave policy for federal workers taking their children to vaccine appointments, other employers have not, and lower income workers may have more difficulty taking time off to get their children vaccinated. Additionally, arranging transportation to and from a vaccine appointment may be difficult for some, especially if a vaccine provider is not close by. In KFF’s annual budget survey states reported including assistance with vaccination scheduling and transportation coordination to increase access, as well as partnering with community-based organizations to provide vaccines where people can easily access them. Strategies that help parents more easily make and travel to vaccine appointments can help increase vaccine uptake among low-income children and reduce disparities in COVID-19 vaccination rates.
The author originally wrote this article for KFF, a nonpartisan, nonprofit organization noted for its health policy analysis and health journalism. Their article is shared here with permission.
ARKANSAS HOSPITALS | WINTER 2021 39
AFMC TV: A NEW WAY TO REACH THE COMMUNITY By Michelle Rupp
“T
wenty inches of snow is great brainstorming weather!” During the snowstorm of 2021, the communications team at the Arkansas Foundation for Medical Care (AFMC) worked diligently from remote offices, brainstorming and creating the industry’s first internet-based health care show of this kind. “Television and creating content with viewer benefit is in my blood,” said Michelle Rupp, Vice President of Communications and Strategy at AFMC. “The team worked exceptionally hard in the spring. We launched AFMC TV in July.” AFMC TV provides health care and lifestyle content on a weekly basis. AFMC is a health care nonprofit leader. While most of the company’s contracts are with Arkansas state agencies, AFMC conducts business in nearly all 50 states and Puerto Rico. AFMC TV positions the company as a thought leader, both locally and nationally. Episodes are released every Wednesday morning. You can watch on AFMC.TV as well as AFMCs social media channels. The fall episodes featured an eight-week segment series, “Catch Up on Your Check-Up,” where different physicians came into the studio or were interviewed virtually to discuss the importance of checkups. “This series was of particular importance, since 4 in 10 adults in the U.S. avoided medical care due to the pandemic. It
40 WINTER 2021 | ARKANSAS HOSPITALS
AFMC TV's Michelle Rupp interviews Dr. Jeanne Wei of UAMS (top) and Dr. Stacy Smith-Foley of CARTI (bottom).
was important to highlight how critical these appointments are, now more than ever.” Some specialties featured included men’s health, women’s health, cardiology, dermatology, vision, hearing and dental. “AFMC TV allows us visibility beyond the Medicare/Medicaid sector,” said Ray Hanley, President and CEO. “One week, guests are discussing the escalated role of digital in health care visits, and the next week they have a hunter on talking about hunting season. They explore mental health and aging adult topics and occasionally provide recipes,” Hanley said. “You never know what you might learn with each episode.” AFMC TV is quickly becoming a trusted hub for health care information and resources that keeps our community informed in a convenient, meaningful, and virtual way. Guests include AFMC leadership and employees, community leaders, and experts in the areas of lifestyle, health, and wellness. The show is recorded and produced out of a brand new, state of the art studio located at the AFMC office in Little Rock. “Guests generally are surprised when they step into the studio for the first time. I don’t think they are expecting this caliber of production,” Rupp said. “We do not want to be boring. We talk to experts about life issues, and we have fun during the conversations.” Guests from UAMS, CARTI, Unity Health – White River Medical Center and other hospitals were featured in the first three months of production. “When we first approached Mr. Hanley with this innovative idea, we realized we could not find any organization in our industry communicating externally this way. To
set AFMC apart, AFMC TV needed to happen. If we didn’t do it, someone else would.” Rupp said. Each episode provides viewers about 18 minutes of content. Some episodes have three guests, while others have one. “The pandemic escalated the need for video, video production, live streaming, and internet-based programming. If a business isn’t regularly active on YouTube, they will play catch up to
those who are,” said Rupp. All episodes can be found at AFMC.TV. Endnotes From CDC Report: https://www.cdc.gov/mmwr/ volumes/69/wr/mm6936a4.htm
Michelle Rupp serves as Vice President of Communications and Strategy for the Arkansas Foundation for Medical Care (AFMC).
RESOLVE YOUR MOST
CHALLENGING DISPUTES
Health care is always complex – and often targeted for litigation. At Mitchell Williams, our health care litigation team includes nationally recognized litigators and top-ranked lawyers who understand the changing industry, as well as the challenges of a highly regulated environment. •
Commercial Litigation
•
Enforcement Actions
•
Civil Disputes
•
Regulatory Compliance
•
Government Investigations
T H E P OW E R OF E X PE R I E NC E
LITTLE ROCK
|
Ben Jackson
ROGERS
|
JONESBORO
Megan Hargraves
425 W. Capitol Ave., Ste. 1800
|
AUSTIN
Graham Talley
Little Rock, AR 72201
Mitchell, Williams, Selig, Gates & Woodyard, P.L.L.C
Scan the above QR code to link to AFMC.TV
|
|
|
(501) 688-8800
Jeffrey Thomas, Managing Director
MitchellWilliamsLaw.com ARKANSAS HOSPITALS | WINTER 2021 41
Conway Regional has been the community’s hospital for 100 years, providing high-quality, compassionate care. As our community continues to grow, we are growing alongside you to ensure all of your healthcare needs are met right here in Conway. When your family needs medical care, you can trust our award-winning team to provide the award-winning comprehensive care you deserve.
Best Place to Have a Baby Best Hospital Best Overall Company
42 WINTER 2021 | ARKANSAS HOSPITALS
COACH'S PLAYBOOK
The Positivity Factor:
A New Type of Burnout by Kay Kendall
W
e’ve all heard about the rise in burnout among health care workers during the COVID-19 pandemic. But I wasn’t expecting to hear about a new type of burnout expressed by the leaders of several health care organizations on a webinar I recently attended. One after another, they expressed what a challenge it is to show up every day and demonstrate positivity to keep their staff members calm and motivated enough to handle the challenges they’re facing. It reminded me of a time when I was a senior leader at a division in the Southwest that was undergoing constant, major change. We had four presidents in 13 months, and the last one (before I left and went to another company) was an “acting” president. The confusion, frustration, and skepticism were palpable among our employees. One of my colleagues (also a senior leader) said to me, “I come in every day and try not to spook the herd.” We laughed over that, but it was gallows humor.
A recent webinar, “How to Rediscover Joy at Work,” featured presenter Rebecca Newton, Ph.D. She’s an organizational and social psychologist, and a faculty member on the Accelerated Leadership Program at Harvard Law School. Some of her suggestions applied to leaders working in-person with their teams as well as those working virtually. I thought many of her suggestions worked well with the health care approach of rounding, especially rounding on employees. First, she suggested some introspection. What energizes and excites you at work? What is the opposite, what enervates you? She said that, according to research, there are approximately 120 different factors that energize people, with most people having around five that contribute the most to that energy. What was also encouraging to me was the finding that in a group of a dozen or so people, it’s highly unlikely that any two people will share the same five contributors. Why do I think that’s encouraging? Because
ARKANSAS HOSPITALS | WINTER 2021 43
it means that, in any of my groups, the thing that drains me is likely to be what energizes another member of my team. Hence the need for introspection first. For example, I really dislike dealing with people drama, but I love to crunch numbers to make meaning from data. If we could discover each other’s energizing factors, we could trade tasks at times and both of us could experience joy at work while making a contribution.
Another suggestion she had for leaders is to share your emotions with a trusted colleague rather than with your employees who are looking to you for positivity, reassurance, and empathy. On an IHI virtual huddle series I joined last year, the group heard about an ICU in a hospital nearly overrun with COVID cases. At the end of each shift, each staff member recounted one thing that had happened that day that made them smile – even briefly. The team reported
We provide peace of mind,
so you can, too.
that every shift ended with tears and laughter, and they all felt their spirits lifted before leaving for home. As always, whenever I approach a topic for this column, I try to identify its intersection with the Baldrige Excellence Framework. There is a perfect intersection for this topic in these times. 5.2b Organizational Culture. “How do you foster an organizational culture that is characterized by open communication, high performance, patient safety, and an engaged workforce? How do you reinforce your organizational culture? How do you ensure that your organizational culture supports your vision and values; promotes equity and inclusion; and benefits from the diversity of the ideas, cultures, and thinking of your workforce? How do you empower your workforce?” I think discussing these questions as part of your leadership team could pay huge dividends for your own psychological well-being and that of your employees. I invite you to share your thoughts and experiences on this topic with me for a future column.
We’ve been addressing the legal needs of the Arkansas healthcare industry for more than 120 years. • Medicare/Medicaid Reimbursement
• Licensure Matters & Board Hearings
• Stark I and II & Anti-Kickback Compliance
• Employment Issues
• Contracts & Business Transactions
• Privileging & Peer Review
• Government Regulations
• HIPAA Compliance & Training
• Operations & Management
• Medical Malpractice Defense
• Medical Device & Pharmaceutical Products Defense
• Drug Diversion Prevention
Your Arkansas Health Law Team
44 WINTER 2021 | ARKANSAS HOSPITALS
The team at BaldrigeCoach would be glad to help guide your hospital’s quest for process improvement. As CEO and Principal of BaldrigeCoach, Kay Kendall coaches organizations on their paths to performance excellence using the Malcolm Baldrige National Quality Award Criteria as a framework. Her team, working with health care and other organizations, has mentored 24 National Quality Award recipients. In each edition of Arkansas Hospitals, Kay offers readers quality improvement tips from her coaching playbook. Contact Kay at 972.489.3611 or Kay@Baldrige-Coach.com.
Supporting you, supporting patients. As the economy recovers from the COVID-19 pandemic, BKD continues to stand firm in our commitment to helping health providers mitigate the financial effects. When you’re looking for audit, reimbursement, and operational assistance, our trusted advisors are here to help you reach your goals.
Everyone needs a trusted advisor. Who’s yours?
bkd.com
ARKANSAS HOSPITALS | WINTER 2021 45
By Jodiane Tritt, Executive Vice President, Arkansas Hospital Association
T
he extended session of the 93rd General Assembly began on September 29 and ended on October 15, with the primary purpose of creating Arkansas’s Congressional districts based on the census numbers, though legislators did file bills outside of that scope. The AHA worked against legislation that would make it more difficult to comply with federal mandates for employee vaccination and fought to protect a hospital’s ability to require COVID-19 vaccination for hospital employees. SB 739 did become Act 1115, which requires that employers who mandate COVID vaccines for their employees must offer vaccine alternatives, including weekly testing (ultimately paid for by the employee if there are no other funds available) or positive antibody tests every six months. That act will become effective on January 13, 2022. The United States Constitution, Article VI, § 2 gives Congress and federal regulators virtually unlimited authority – if they choose to exercise it – to preempt state and local health laws. The CMS and OSHA regulations are clear that in cases of conflict for health care facilities, CMS regulations control. Further, both the CMS and OSHA regulations are clear that where state law or regulations are inconsistent, the federal regulations supersede the state. Congressional redistricting did occur, too. Redistricting for the United States House of Representatives is required by the United States Constitution, Article I, § 2. Congress is given authority to pass laws regulating elections and has provided that the 435 seats in the House should be reapportioned every ten years (also after the decennial census). The Arkansas General Assembly redrew the districts for the state’s congressional seats during the extended session of the General Assembly that adjourned sine die on October 15, 2021. Governor Asa Hutchinson also announced his intention to call a special session to take up tax cuts. That session is expected to begin on December 7, 2021. Our governor has consistently proposed more than $300 million in income tax breaks and, in late October, offered a threephase plan. Phase one would increase the tax credit for
46 WINTER 2021 | ARKANSAS HOSPITALS
low-income earners who make about $22,900 or less, from $29 to $60, which would cost $19.6 million annually. Phase two would combine lower and middle-class income tax brackets and would create a total reduction of $132.7 million in taxes for this group. The third phase would drop the upper income tax rate from 5.9% next year to 5.5% the following year at a cost of about $109.6 million. The rate would then drop to 5.3% the following year costing the state another $27.4 million in annual revenues. State officials project the plan would reduce general revenue by $133.25 million in fiscal year (FY) 2022, $293.9 million in FY 2023, and $321.3 million in FY 2024. The bulk of the tax cuts would impact those making $82,000 or less per year. Industry leaders are pushing legislators to also consider instituting a corporate tax cut, which is to drop from 6.2% to 5.9% on January 1, 2022, under a 2019 law; to 5.7% on January 1, 2024; and to 5.5% on January 1, 2025. Legislators and executive branch officials are continuing negotiations and are working to assure that the state can maintain its long-term reserve funds instead of using that fund to finance the proposed tax cuts. Tentative dates for the 2022 fiscal session budget hearings are set for Tuesday, January 11, 2022, though Thursday, January 20, 2022. Prefiling of appropriation bills begins January 10, 2022, and the fiscal session is set to begin on Monday, February 14, 2022. Outside the legislative sessions, Article 8 of the Arkansas Constitution requires redrawing the boundaries of the state’s 35 Senate districts and 100 House of Representatives districts following each federal decennial census. The Board of Apportionment, consisting of the Governor, Secretary of State, and Attorney General, was created in 1936 by Amendment 23 to the Arkansas Constitution to redraw all 100 House 35 Senate Districts so that each district meets various legal criteria, including that each district be comprised of about the same size population and may not be drawn to allow for discrimination based on race or ethnicity. The Supreme Court has ruled that when drawing state and local legislative districts, states may deviate
FINANCING IS THE FIRST STEP. Our Capital Markets professionals have the industry experience and client-first approach you need to complete upcoming projects. Planning new construction? Refinancing? Equipment leasing? We can customize the right capital structure. Call or click today and find out what Crews can do for you.
somewhat from perfect population equality to accommodate traditional districting objectives, among them: • Complying with the Voting Rights Act. • Preserving the integrity of political subdivisions. • Maintaining communities of interest. • Creating geographic compactness and contiguity. • Accommodating geographical barriers (e.g., national forests, military reservations, lakes, roadways, and rivers). These are guidelines – not hard and fast rules. Counties and cities have meandering boundaries along highways and rivers and are not compact. Municipal boundaries may cross county lines. Communities of interest must be identifiable and concentrated. Racial and language-based minority interests must be protected under federal law. All of these guidelines necessitate sound judgment, and the courts recognize that redistricting bodies must occasionally use discretion in such situations. Now that the lines have been drawn, incumbents are assessing whether they are willing and able to represent their “new” districts. As each legislative seat is open and all statewide offices are too, it is now as important as ever to reward those incumbent elected officials who have supported hospitals and to support candidates who commit to supporting hospitals during their elections. Thank your elected officials who have been strong supporters of our hospitals and be sure to vote in the upcoming elections!
INVESTMENT BANKING | PUBLIC FINANCE BONDS | LEASES | LOANS Paul Phillips
501.978.6309 pphillips@crewsfs.com
800.766.2000 | crewsfs.com Member FINRA & SIPC
Coronavirus Also Affects Minds That’s why we are available anytime from anywhere, offering all our services in the safest possible manner – Telehealth for: • Outpatient and school-based counseling • Kaleidoscope Grief Center group support • Methodist Behavioral Hospital physician services, family therapy, visitation through Arkansas Division of Child and Family Services, and court appearances • In-person psychiatric testing with plexiglass screen and PPE • Health screening admissions to acute, subacute and residential programs
Call 887-778-1197 info@MethodistFamily.org ARKANSAS HOSPITALS | WINTER 2021 47
WHERE WE STAND
This infographic, created by Ian M. Mackay, can be a useful tool for educating patients and community members on the role each risk reduction measure plays in preventing the spread of COVID-19. The graphic has been translated into multiple languages, and a link to the downloadable files is available on virologydownunder.com.
48 WINTER 2021 | ARKANSAS HOSPITALS
Are you or someone you love struggling with Alcoholism or Drug Addiction?
OUACHITA OFFERS HOPE · Medical detoxification · Inpatient & Outpatient Services · Free Assessments · Psychological Evaluation · Substance Abuse Professional Evaluations · Hope & healing for patients & families · Well-trained experienced staff · Free Lifetime Aftercare Program · Saving lives since 1985
The mission of Ouachita County Medical Center is to provide accessible, personal and quality health care in a safe and confidential environment, with courtesy, friendliness and respect. Amy DeLuca, M.D., Medical Director and Teresa Roark, Program Director.
Chemical Dependency Treatment Program Camden, Arkansas 1-800-232-1289 • www.ouachitamedcenter.com
Camden, Arkansas
ARKANSAS HOSPITALS | WINTER 2021 49
C OCNOS N TS RT U RC UT C IO TN I O N|
TS RT IA |I N D I NUDS U R LI A L|
CX AC VA AV TA IO |E X E TN I O N|
N ET N AT L A L| |E N EVNI R VO I RNOMNEM
WE WE BUILD BUILD PLACES PLACESOF OFHEALING HEALING
TheThe Children’s Center for for Health & Wellness is aisfive-story, 86,000-square-foot medical office Children’s Center Health & Wellness a five-story, 86,000-square-foot medical office building adjacent to Arkansas Children’s Northwest. The modern design includes an building adjacent to Arkansas Children’s Northwest. The modern design includes an outdoor playplay areaarea accessible to the building’s variety of tenants — all outdoor accessible to the building’s variety of tenants — of allwhom of whom are are dedicated to the wellbeing of Springdale’s youngest citizens. dedicated to the wellbeing of Springdale’s youngest citizens.
1 . 81 7. 8 77 . N7 A b ah bo hl zo.lczo. cmo m . NBAHBOHLOZ L |Z n| a n
RE VR IC |S E S V EI C E
