Arkansas Hospitals, Winter 2022

LEGISLATIVE SESSION PREVIEW

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.

Matt

Matt Mozzoni

Stephanie Farmer Broker Associate

Sidney Roach

Linda Hinton

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

David Deaton, Clinton

Phil Gilmore, Crossett

James Magee, Piggott

Guy Patteson, Jonesboro

Gary Paxson, Batesville

Eric Pianalto, Rogers

Robert Rupp, Mena

Judy Shaffer, Mountain Home

Brian Thomas, Pine Bluff

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

Seeking Payment and Policy Reform

As 2022 draws to a close, the pandemic’s backlash continues, and our hospitals face a daunting financial crisis. Hospital staff are leaving the field in massive numbers due to burnout, causing hospitals to employ high-cost contract labor and their staffing budgets to skyrocket. Material and supply costs are up, the cost of medication is up, inflation affects every part of hospital operations. For months, we’ve been sounding the alarm that payment reform and other financial help for our hospitals is needed.

Limited reform has been enacted, but much more is needed. At the federal level, the Centers for Medicare & Medicaid Services (CMS), after engagement with the American Hospital Association, raised both Medicare inpatient and outpatient payment rates. Importantly, it has agreed to use more recent data in its future calculations, which should more accurately reflect the effects of inflation and rising costs hospitals are experiencing today.

We await a Senate vote on prior authorizations (HR 3173), which have become an administrative nightmare for hospitals. CMS’s proposed rule would remove inappropriate barriers to patient care by streamlining the prior authorization process for some health

insurance plans, including commercial insurers and Medicare Advantage plans. This should reduce dangerous delays in care for patients and, at the same time, reduce unnecessary costs to the health care system.

Here is where advocacy – and your voice – make a difference. As the 2023 Legislative Session and the 118th Congress approach, we’ll be asking you to get in touch with your elected officials at both the state and national levels. You can support your local hospital and the hospitals of Arkansas by telling your elected officials how proposed legislation will directly affect your community hospital. You’ll be giving the message they need to hear: Their action has a direct impact on your community hospital’s viability.

At the state level, we’ll be conducting Advocacy Days at the Capitol, where you can deliver hospitalspecific information in person. (See page 11.) This year, we’re watching for possible changes to the Medicaid program, particularly after a rate review is completed and results are published. We’re working for new ways to maximize supplementary payments by addressing Upper Payment Limits. We will also support legislation that addresses concerns with prior authorizations at the state level currently required by commercial insurance plans.

Our hospitals find ways – somehow – to continue forward through surge after surge of COVID, and they’re bursting at the seams today not only with COVID patients but also with those who have contracted RSV or influenza. So far, Arkansas hospitals are keeping their doors open despite extreme challenges resulting from a perfect storm caused by the pandemic, supply chain disruptions, inflation, staffing shortages, and rising costs.

Our hope for 2023 is that we will see a turnaround in our hospitals’ financial challenges. We’ll continue to advocate – and ask you to add your voice – as policy makers seek ways to ease hospitals’ acute financial burden.

Bo Ryall President and CEO Arkansas Hospital Association

Facing the Unknown

The unknown, in all its uncertainty, can be terrifying. I first learned this as an eager freshman English major at UCA, when I decided to jump right into the deep end and begin my studies with Early English Literature. It was in that class – taught by a wonderfully animated, knowledgeable, bespectacled, and bearded professor – that I grasped this aspect of human nature in a way I can’t forget.

I’m sure many of you read the AngloSaxon epic poem Beowulf at some point in your schooling, so I’ll dispense with a lengthy plot summary. It’s enough, for our purposes, to know that the poem’s “Big Bad,” as the kids say these days, is Grendel.

In our very first group discussion, my ruddy-cheeked professor prodded us with the same question over and over, “Why is Grendel so scary?” We called out our answers: He’s a demonic presence! He’s terrorizing people! But we sensed that none of our answers was quite right. It was difficult to verbalize why Grendel was such a captivating villain.

Then, at last, my professor unlocked the answer: “Grendel is scary because the poet never offers us a visual description. In place of the unknown details, we automatically draw in our own worst nightmares.”

The unknown ignites the imagination. Uncertainty challenges our sense of stability and control.

In the hospital world, the unknown is ever-present. When it comes to patient care, our quality professionals put systems in place to help caregivers

face whatever unknowns arise on a given shift. Facility managers, too, must have plans B, C, D, and E ready at all times. Hospital administrators must be agile, flexible, and responsive to regulatory changes, financial demands, and the needs of employees.

If a poet writing in the early 700s knew the power of the unknown, how are hospital workers – constantly confronted with the unknown – not entirely paralyzed with fear? What makes hospitals different?

I believe the answer is mission. They have chosen, as their life’s work, to wrangle with the terrifying unknown, to prepare for the worst while giving their best. They are driven by the mission of providing superior care to patients who, themselves, are facing the terrors of uncertainty.

As part of the community that surrounds our state’s hospitals, we

know that uncertainty is compounding as financial pressures continue to mount. This is the moment that today’s – and tomorrow’s – challenges push us to advocate more loudly than ever for our hospitals.

On page 43 of this issue, AHA Executive Vice President Jodiane Tritt previews the upcoming legislative session, and she details areas where our voices are needed. We invite you to use the link in that article to join our advocacy community. You’ll receive updates on the session as it unfolds.

The same community that works within – and advocates for – hospitals met in person for the first time in two years this November. It was an Annual Meeting like no other. People were hungry to find answers to the questions keeping us all up at night. How do we keep staff members engaged? How can we meet the mental and physical needs of our overworked staff? How can we improve our hospital culture? Are we equipped to recognize staff members and patients who suffer from trauma? And what can we do to keep hospitals’ doors open during a financial crisis?

One thing is certain: the community that supports health care and works within health care is determined. We are prepared to speak up for our hospitals, our staff members, and our patients. And your voice is needed. Health care’s future uncertainties may still be unknown, but we will identify and challenge them. We will work together to face down health care’s many Grendels.

Ashley Warren Editor in Chief

HOSPITAL NEWSMAKERS

Arkansas Hospice brightened the holidays this season for patients facing life-limiting illnesses. Its Elf Squad delivered gifts like socks, slippers, blankets, and largeprint puzzle books that were donated by members of the public. This was the second year the Elf Squad was in action.

Mark Amox, MBA/MHA, has been named President and CEO of Unity Health in Searcy. He previously worked with HCA Health care as Chief Operating Officer at hospitals in California and Nevada, as President and CEO of El Paso Children’s Hospital, and as Administrator of UF Health Shands Children’s Hospital in Florida. He also served for eight years as Administrator of the UAMS Department of Pediatrics in Little Rock.

The Arkansas Center for Health Improvement (ACHI) held its Friends of ACHI Appreciation Event October 19 to celebrate all those whose extraordinary efforts and ongoing sacrifices during the COVID-19 pandemic positively impacted Arkansas families and communities. Expressions of gratitude for pandemic efforts dominated this year’s event, which was held at the Clinton Presidential Library. The annual event featured a spoken word poem reflecting on the challenges of the past few years. The poem, “The Second Mountain,” was written for ACHI by nationally acclaimed poet Chris James and was performed by the author.

The Sevier County Medical Center officially opened in early December with a special ceremony that included building tours for the community. The $24 million hospital, located just north of DeQueen, was funded by a 1% sales tax approved by Sevier County voters in 2019. The hospital has 10 rooms in its emergency department, 15 inpatient beds, and employs 115 people.

April Bennett, MSN, CHFP, RN, has been named the new president of Baptist Health Medical Center – Conway She most recently served as Chief Nursing Officer of the hospital for two years. Prior to joining Baptist Health in 2020, she served as Vice President of Nursing Services at Freeman Health System in Joplin, Missouri.

CHI St. Vincent Director of Oncology Services Dr. Peter Emanuel has been appointed Vice President of Oncology for the CommonSpirit Health system, formed in 2019 with the alignment of Catholic Health Initiatives (CHI) and Dignity Health. Dr. Emanuel will continue in his leadership role with the oncology program at CHI St. Vincent , which is part of CommonSpirit Health, while also serving as lead physician for CommonSpirit Health as it launches its first nationwide Oncology Clinical Institute.

The American Hospital Association has recently updated Bridging the Sectors: A Compendium of Resources , which links to a host of tools, assessments, case examples and evidence-based studies. You’ll find practical information, strategies, and tools on everything from aligning goals between organizations and calculating return on investment to using publicly available data sources and ensuring equitable health outcomes. Find the resource at aha.org.

James Magee recently celebrated 25 years as Executive Director of the Piggott Community Hospital (now Piggott Health Systems ). Under his leadership, the system has grown to include satellite health clinics, specialty services, telemedicine, and building expansions.

Poet Chris James performs his poem, “The Second Mountain,” at Friends of ACHI Appreciation Event.

BARTEK RECXN

For the first time, National Park Medical Center (NPMC) and CHI St. Vincent Hot Springs will join forces to present the 2022–2023 American Heart Association (AHA) Hot Springs Sweethearts program. This year’s program, which welcomes 41 young women from the Garland County area, marks its 17th year. The Hot Springs Sweethearts consist of high school sophomores and juniors who have committed to improve heart health in their community by learning about cardiovascular diseases, leading healthy lifestyles, and participating in heart healthy activities.

health care workers in Texas. Since international travel is so common and imported cases are a risk, the Arkansas Department of Health is sharing resources on the disease so that facilities may be prepared. A CDC outbreak update for hospital staff and signage for your hospital’s ER and other entries are available. Please contact ADH. ORSNurses@arkansas.gov or ADH.HAI@arkansas.gov for these resources or if you have any questions.

Kathy Thomas, MSN, RN, CPHRM, CHC, is the new Vice President and Chief Operating Officer at Stone County Medical Center in Mountain View. A registered nurse for 33 years, Thomas has served in varying leadership roles at SCMC’s parent organization, White River Health . She most recently served as Executive Director of Risk Management/Compliance at White River Medical Center in Batesville, where she previously served as Medical Surgical Nursing Director.

The Children’s Tumor Foundation (CTF) and the University of Arkansas for Medical Sciences (UAMS) announced the opening of the first CTF-sponsored, fully multidisciplinary clinic dedicated to the care of adults with neurofibromatosis (NF) in December. The clinic operates at the UAMS Winthrop P. Rockefeller Cancer institute and is the first NF clinic for adults in Arkansas (and surrounding states).

Loren J. Miller , LCSW, has been named Administrator of Advanced Care Hospital of White County in Searcy. He previously served for four years as Assistant Vice President, Behavioral Health Services for Unity Health. He earned his Bachelor of Science degree in Psychology from the University of Central Arkansas, and his Master of Social Work degree from the University of Arkansas at Little Rock.

Jeremy D. Capps , RN, has been named CEO of Delta Health System in Dumas. He previously served as Administrator at St. Bernards Five Rivers Medical Center in Pocahontas. His Master’s degree in Business Administration, Management, and Operations was earned at Western Governors University and his nursing degree at Arkansas State University.

The World Health Organization calls the Ebola outbreak in Uganda “rapidly evolving,” noting that it currently poses a risk within Uganda and to its neighbors. During the last major Ebola outbreak in West Africa, the United States saw several imported cases and local transmission to two

Mental Health and Substance Use Disorder Services and Resources from National Rural Health Day

The Health Resources and Services Administration (HRSA) celebrated National Rural Health Day in November.

This year’s focus was on behavioral health, highlighting the innovative ways rural communities are expanding access to mental health and substance use disorder services for those who need them the most.

Scan the QR code to browse recorded webinars from this year's event and to find other useful resources.

2022-2023 American Heart Association Hot Springs Sweethearts.

2023 Winter Calendar

JANUARY

January 12

Provision of Care in Safe Environment: Update on Patient Rights & Suicide Prevention Webinar

January 12

AHAA Board Meeting AHA Boardroom In-person event

January 13

AHA Board Meeting AHA Boardroom In-person event

January 17 340B January 2023 Quarterly Meeting Virtual event

January 19 Quality Forum Virtual event

January 20

Arkansas Association of Health care Engineers (AAHE) 2023 Winter Conference Conway Regional Medical Center In-person event

January 26

Survey Readiness Webinar

FEBRUARY

February 10

AHA Board Meeting AHA Boardroom In-person event

February 16 Quality Forum Virtual event

February 23

Nursing Services Conditions of Participation Webinar MARCH March 2

Arkansas Hospital Association Workers’ Comp Self-Insured Trust (AHAWCSIT) Quarterly Board Meeting Virtual event

March 9

AHAA Board Meeting AHA Boardroom In-person event

March 10 AHA Board Meeting AHA Boardroom In-person event

SAVE THE DATE!

2023 AHA Annual Meeting November 1-2 Little Rock Marriott

Join us for the 2023 Annual Meeting featuring Boomer Esiason as our Keynote Speaker! Boomer Esiason, Sports Broadcaster, NFL Football Legend

Scan this code for our event page

March 16

Quality Forum Virtual event

March 28 Discharge Planning Webinar

March 31

Arkansas Society for Directors of Volunteer Services (ASDVS) 2023 Spring Conference AHA Classroom In-person event

Annual Meeting 2022

After two years on hiatus due to COVID-19, it was especially invigorating to finally come together face-to-face at the AHA’s Annual Meeting on November 9-10. Health care professionals from all parts of the state gathered in Hot Springs to advance their skills, network with fellow hospital leaders, and re-inspire their work.

ENGAGEMENT WORKSHOP

Dr. Tom Atchison kicked things off with “Employee Engagement: A Guide to Rediscovering Purpose and Meaning in Health Care,” a full-day workshop that gave us a new model for creating sustainable engagement. We all know that burnout is a major issue in hospitals today and that finding new ways to keep employees engaged is essential to every hospital’s viability. Exploring the psychology of why and how people deeply commit to their work gave us new insight. And exposing the myths about what cements engagement was both surprising and helpful. We’re grateful to Tom for sharing his expertise and experience.

After the workshop on the first evening, attendees enjoyed a member reception, where we congratulated the incoming AHA board members and mingled with friends and colleagues both new and old.

KEYNOTE PRESENTATION

You don’t need a wake-up call when The Rodney Block Collective is performing bright and early! The band kicked off day two of the meeting with some foot-tapping jazz, launching us into our welcome from AHA President and CEO Bo Ryall and Board Chairman Ron Peterson, President and CEO of Baxter Health care in Mountain Home.

We always enjoy having the state’s hospital volunteers join us for the Keynote Session, and a highlight of the morning was the announcement of the Arkansas Hospital Auxiliary Association’s (AHAA) Administrator of the Year Awards, presented for both 2021 and 2022. Peggy Abbott, President and CEO of Ouachita County Medical Center in Camden, introduced AHAA President, Carol Evans, who made the four presentations.

Congratulations to Kevin Storey, Baptist Health Medical Center-Heber Springs, the recipient of the 2021 award for hospitals under 100 beds, and to Samuel Lynd, NEA Baptist Memorial Hospital, Jonesboro, the recipient of the

2021 award for hospitals over 100 beds. Congratulations to Brian Miller, DeWitt Hospital & Nursing Home, the recipient of the 2022 award for hospitals under 100 beds, and to Dr. Doug Ross, CHI St. Vincent Hot Springs, recipient of the 2022 award for hospitals over 100 beds. The awards were presented by Carol Evans, 2021-2022 President of AHAA, representing North Arkansas Regional Medical Center in Harrison. Because she was dispatched unexpectedly at the last minute, Chief Meteorologist and Managing Editor of the Climate Unit for ABC News Ginger Zee made her presentation virtually while tracking Hurricane Nicole in Florida. Her presentation included a remarkable openness about her struggles with mental health combined with her determination to enjoy life and share her adventures with her viewers.

EDUCATIONAL SESSIONS

Hot Topics for the morning educational sessions included diversity and equity, trauma and resilience, and AI Copywriting Tools for Hospitals. Afternoon sessions focused on human trafficking, the “No Normal,” and crucial conversations for mastering dialogue, which was the ACHE face-to-face workshop for 2022. Our thanks to Dr. Kevin Ahmaad Jenkins, Dr. Tania Glenn, Beth Ziesenis, Holly Austin Gibbs, Ryan Colaianni, and Dr. Stacy Nelson for sharing their knowledge and expertise with us.

AWARDS LUNCHEON

Presentation of the AHA’s awards for outstanding service is always a highlight of the Annual Meeting. This year’s Awards Luncheon also saw the presentation of the Diamond Awards for excellence in hospital marketing and public relations; the Guido Ritchie Duo provided musical entertainment.

A. ALLEN WEINTRAUB MEMORIAL AWARD

2022

Brian Thomas , President/COO, Jefferson Regional, Pine Bluff

ACHE REGENT’S AWARDS

2022

April Bennett , MSN, CHFP, RN, Early Career Executive, President, Baptist Health Medical Center-Conway

Peter G. Austin , FACHE, Senior Career Executive, Senior Vice President/Chief Operating Officer, Jefferson Regional, Pine Bluff

C.E. MELVILLE YOUNG ADMINISTRATOR OF THE YEAR AWARD

Cody Walker , President/Administrator, Baptist Health Medical Center-North Little Rock

Top: Peter Austin (left) with Greg Crain (right). Austin is the 2022 ACHE Regent's Award for Senior Career Executive.

Bottom: Greg Crain (center) with Cody Walker, C.E. Melville Young Administrator of the Year, and April Bennett, ACHE Regent's Award recipient for Early Career Executive.

DISTINGUISHED SERVICE AWARDS

Barney Larry , Vice President of Business Development and Executive Director of Baxter Regional Hospital Foundation, Baxter Regional Medical Center, Mountain Home

Erin Bolton , Director, Quality Management/Regulatory, Jefferson Regional, Pine Bluff

NARMC COVID Committee, Jennifer Sadler, MD, Brent Rosson, MD, Brandon Hicks, MD, North Arkansas Regional Medical Center, Harrison

STATESMANSHIP AWARD

Arkansas Governor Asa Hutchinson

From top: Diamond Awards were presented to hospital marketing and public relations teams for excellence in health care marketing.

Brian Thomas with Erin Bolton. Thomas is the 2022 A. Allen Weintraub award recipient, and Bolton received a Distinguished Service Award at this year's awards luncheon.

DIAMOND AWARDS

Arkansas Hospice, North Little Rock Baptist Health, Little Rock The BridgeWay, North Little Rock CHI St. Vincent, Little Rock

Conway Regional Health System, Conway Howard Memorial Hospital, Nashville Jefferson Regional, Pine Bluff McGehee Hospital, McGehee

Mississippi County Hospital System, Blytheville North Arkansas Regional Medical Center, Harrison St. Bernards Five Rivers, Pocahontas

Stone County Medical Center, Mountain View UAMS Medical Center, Little Rock

Unity Health, Searcy Unity Health, Newport White River Health System, Batesville

Barney Larry (left) with Ron Peterson. Larry earned a Distinguished Service award at the 2022 AHA Awards Luncheon.

Below: CEO Sammie Cribbs (left) with the NARMC COVID Committee, which earned a Distinguished Service Award.

QUALITY CARE... THAT FEELS LIKE HOME.

The Greenhouse Cottage model is reinventing long-term care. Each community is centered around loving homes where elders are supported by quality care, have day-to-day freedom, and positive relationships are nurtured. In each cottage you will find 12 private, spacious rooms, each with its own private bathroom. This model allows a higher staff-toelder ratio, providing the direct care and attention they need to thrive. Our caregivers are dedicated to the people they serve, helping to create genuine, meaningful relationships. With eight facilities across the state, we are conveniently located to serve your loved one while still being close to home.

ONE, CLOSE

We are family focused. As a family member or friend, you are welcome to visit, eat meals and participate in daily activities at the cottages. We are just like home. Elders who live at our cottages should feel at home and just like at home, choose when they want to wake, eat, participate in activities, etc. We are holistic. Our facility is equipped to provide each elder with a customized and holistic care plan uniquely designed for them. Because of this, the Green House Cottage model offers better elder outcomes compared to traditional nursing homes

2022 ANNUAL MEETING WEEK

MEET OUR SPONSORS

We are thrilled that we were able to gather with you in person for this year’s Arkansas Hospital Association Annual Meeting. Many of our sponsors’ representatives joined us for the event so that they could learn more about the special challenges our hospitals are facing and speak with hospital leaders face-to-face to help them discern whether their products or services are right for their facility.

Here, as we have for the past two years, we once again offer our Sponsors and Supporters a chance to connect with you from a distance. They continue to support AHA and offer services to our member hospitals, and we remain grateful for their partnership. Please dive right in and learn more about some of the companies that are valued supporters of our state’s hospitals.

DIAMOND LEVEL, p. 22

PLATINUM LEVEL, p. 26

GOLD LEVEL, p. 29

SILVER LEVEL, p. 32

SUPPORTERS, p. 35

THANKS, DIAMOND LEVEL

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 drive 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.

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? Here is a list of just some of the challenges you may be facing and for which we provide solutions.

EDUCATION

• Online Continuing Education

• Talent Management

• Clinical Student Orientation

• Patient and Workforce Violence Training

• Resources for Pricing, Price Transparency, Coding, Reimbursement and Compliance

FINANCE & OPERATIONS

• 340B Split Billing

• 340B Contract Pharmacy

• 340B Consulting and Solutions

• Class Action Settlement Claims Management

• Medical Waste Management Services

• Provider Enrollment Services

• Resources for Pricing, Price Transparency, Coding, Reimbursement and Compliance

• Supply Chain and Operational Solutions

• Third-Party Liability and Workers' Compensation Claims Recovery Services

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

Tina Creel, President, AHA Services, Inc.

As Arkansas’s 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 nearly 75 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.

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.

Arkansas 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 health care providers

Health care 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 health care providers, sharing claims data, exploring new technologies, and collaborating on ways to make the health care system more efficient and effective. Their shared goal is to ensure that each member receives highquality, 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 grants to thousands of health-promoting 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.

Starting with a single van in 2012, Taylor Chunn worked to grow his medical waste business from scratch. “I drove around – in a suit and tie in Louisiana’s sweltering heat – pulling medical waste, handing out business cards, and banging on doors,” he recalls.

Today, Medical Waste Management is a burgeoning player that handles more than 10 million pounds of medical waste annually. The firm is based in the New Orleans area and serves the Gulf South Region, including Texas, Louisiana, Mississippi, Alabama, Georgia, Tennessee, Florida, and now Arkansas. MWM is also proud to work with organizations across the country on a consulting basis.

Medical Waste Management serves clients including multi- and single-tiered health care systems,

surgery centers, nursing homes, funeral homes, jails, and all entities that generate medical waste.

A NEW APPROACH

The Integrated Cost Solutions platform is MWM’s niche. Through outside-thebox thinking, this innovative company finds ways to help save its partners money while helping them meet their sustainability goals. Through recycling or a waste reduction program which utilizes reusable equipment to divert waste from landfills, MWM is demonstrating success in driving down customers’ costs. In a market where costs are increasing across the board, MWM strives to ensure each customer receives steady and transparent pricing.

“Most people think of medical waste as blood and needles,” says Mark Steffan, Integrated Waste

MEDICAL WASTE MANAGEMENT’S

CUSTOM SOLUTIONS

Celebrating

MWM has significantly expanded its services: We offer an Integrated Waste Stream Management program that utilizes an array of highly specialized solutions for the health care industry.

MWM is proud to be recognized as a competitor in the industry and a viable option for managing all waste streams in any size facility.

We are proud of our client service and our stewardship of the environment. In an industry with ever-changing, strict regulatory guidelines, Medical Waste Management makes it a top priority

Executive. “We think of medical waste as anything that comes out of a health care facility. The customer wants to know they have a partner to handle all of their waste needs, not just the basics.” This approach has helped grow MVM service lines.

In an industry formerly driven by longtime executives utilizing longtime solutions, MWM brings its fresh take to solving customer challenges, and does it through leaders dedicated to innovation and creativity.

CUSTOMER-FIRST MINDSET

Another driving force behind MWM's success is its focus on customer service. The medical waste industry once had a gap in dedication to true customer service. "Since day one, MWM has consistently demonstrated that customer care is our priority," says Chunn. "We focus on being a single point of contact, meeting with each of our customers on a local basis."

Through hard work, excellent customer service, and its development of innovative ways to streamline customer needs, MWM has earned two Waste360, 40 Under 40 awards. The team from MWM looks forward to offering the same level of service to the members of the Arkansas Hospital Association.

For more information, please contact:

Taylor Chunn, SVP 17950 Fabrication Row, D6 Covington, LA 7435 985.951.9026 ph 888-959-2783 fax

Taylor@medwastemgmt.net www.medwastemgmt.net

Founded as a small construction company in 1949, Nabholz is a team of industry-leading professionals serving our clients, communities, and each other. Through the decades, we've grown into a national multi-service contractor offering a full range of construction, industrial, excavation, and environmental services. In locations across seven states, we carry on our founder, Bob Nabholz's, vision of a company committed to its guiding principles of service, quality, innovation, and integrity. We operate today with a simple purpose in mind: to grow our people, serve our clients, and build our communities.

We've always believed relationships are built by consistently performing on every project and finding solutions within every client's budget. Of course, there may be no ribbon cuttings for installing a singular MRI, redoing the nurses' station, or even retrofitting light fixtures for LED bulbs. Still, we know every investment in your facility affects employee and patient morale. That's why our goal is to meet you where you are and perform work that makes day-to-day operations smoother for everyone.

We've dedicated time and money to becoming experts in health care construction so we can help our clients stay in step with changing technology and patient demands. We've also diversified our service line to be a single-source provider of all construction and facility maintenance services for health care clients. We promise that even though it's hard to spell, our name is the only one you need to remember to get things done. Our capabilities include:

ARKANSAS HEART HOSPITAL | LOBBY RENOVATION | LITTLE ROCK

THANKS, PLATINUM LEVEL

WELCOME TO CADENCE INSURANCE

BXS Insurance is pleased to introduce you to Cadence Insurance. The new name and brand reflects the merger of our parent companies, BancorpSouth Bank and Cadence Bank. As our organizations come together, we are transitioning BXS Insurance to Cadence Insurance. We are poised better than ever to provide solutions and expertise in risk management, insurance, and employee benefits. Our expanded offerings, provided by the same insurance professionals you already know and trust, allow our clients to focus on what matters most for their businesses and personal exposures.

Rest assured that the same team you’ve come to know and trust and the same spirit of excellence continues to define and shape how we provide services to you.

William "Bill" Birch Sr. Vice President Risk Consultant

BXS Insurance

8315 Cantrell Rd., Suite 300 Little Rock, AR 72227

(O) (501) 614-1170

Cadence Insurance is a wholly owned subsidiary of Cadence Bank. Insurance products are: Not a deposit. Not FDIC insured. Not insured by any federal government agency. Not guaranteed by the bank. May go down in value. Cadence Insurance is an insurance agent and not an insurance carrier. Always review your policy for coverage terms and conditions.

(M) 501-454-8687 (F) 501-614-1470 Bill.Birch@cadenceinsurance.com

Health care organizations are challenged by economic, social, financial, and operational challenges – being nimble and adapting to best serve patients is critically important for health care providers now and into the future. Now, leaders must shift even greater focus toward transformation, innovation, and preservation to meet growing demands for improved care, quality, outcomes, transparency, and access. Health care advisors at FORVIS are here to help inform, guide, and assist your health care organization through current and future disruptions and challenges. With our commitment to client experiences deeply rooted in our firm values guiding the actions of our team, FORVIS’s dedicated health care professionals can leverage their industry insights, experience, and expansive resource pool to deliver the future-visioning strategies health care executives desire. Discover the difference our health care solutions can mean for your organization!

Youtube Video: Derek Pierce, CPA Partner

Derek.pierce@forvis.com

LinkedIn.com/company/forvis

Whether you are a hospital, physician group, health care provider, or a company that serves provider organizations, you know that the demands on the health sector are complex. At Friday, Eldredge & Clark, our health law practice encompasses a wide range of legal services to address not only issues that arise in the highly regulated health care industry, but also the counsel to handle business operation needs, as well.

Our health care lawyers have the insight, capability, and experience to effectively address the complex issues inherent in the health care industry, including regulatory and compliance matters, contract negotiations and preparations, reimbursement issues, and audit reviews and appeals.

The practice group includes Attorneys Lynda M. Johnson, Timothy C. Ezell and Amie K. Wilcox. For more information, visit www.fridayfirm.com/healthlaw.

Friday, Eldredge & Clark

Lynda M. Johnson ljohnson@fridayfirm.com

Timothy C. Ezell tezell@fridayfirm.com

The Gallagher Advantage

Our Commitment to Healthcare

400 West Capitol Avenue, Suite 2000 Little Rock, Arkansas 72201-3522 | www.FridayFirm.com 501-376-2011

The Gallagher Advantage

Achieve Your Goals with World-Class People Solutions

From battling the pandemic and revenue erosion, to ensuring employee safety, to managing burnout—healthcare organizations face challenges now like never before.

Optimize your organizational wellbeing to support patient care using our wide range of people solutions.

Achieve

Amie K. Wilcox awilcox@fridayfirm.com

From battling the pandemic and revenue erosion, to ensuring employee safety, to managing burnout—healthcare organizations face challenges now like never before.

Optimize your organizational wellbeing to support patient care using our wide range of people solutions.

Gallagher can help you to face the future with confidence.

Our Healthcare practice works with:

• Hospitals and health systems

• Senior living and long-term care

• Physicians and medical groups

Our Commitment to Healthcare

Gallagher can help you to face the future with confidence.

Our Healthcare practice works with:

• Hospitals and health systems

Gallagher is one of the world’s largest insurance brokerage, risk management, and consulting firms. As a community insurance broker and trusted local consultant, we help people and businesses move forward with confidence. With more than 39,000 people working around the globe, we’re connected to the places where we do business and to every community we call home. Managing risk with customized solutions and a full spectrum of services, helping you foster a thriving workforce, and always holding ourselves to the highest standards of ethics to help you face every challenge – that’s The Gallagher Way.

As your experienced health care partner, Gallagher provides employee benefit strategic planning, plan design and cost control strategies, benefit administration support, compliance consulting and financial management, budgeting, and funding options. Strengthen your organization with a strategic, comprehensive, and competitive total rewards program that attracts and retains the top talent needed to deliver on your mission and commitment to the community.

For more information, contact Chris Newkirk

Gallagher | 6325 Ranch Drive | Little Rock, AR 72223 501.485.3075 | chris_newkirk@ajg.com

PLATINUM

At Qualified Plan Advisors, we truly believe that every organization deserves to work with participant-driven fiduciaries who engage in meaningful conversations, who care deeply about participant success, and who understand the steps needed to successfully reach retirement. Our team is built to serve and make a difference.

Managing Partners, Little Rock Prime Capital Investment Advisors | Qualified Plan Advisors 6325 Ranch Drive, Little Rock, AR 72223 p: 501.823.4637 | f: 501.823.0941 | PCIAWealth.com

Qualivis Workforce Management Program is an all-encompassing solution for health care staffing including clinical and non-clinical staffing, locum tenens, interim, international, and permanent hiring. Qualivis provides a simple and efficient model designed to deliver high-quality talent and streamline operations. Qualivis provides one contract, point of contact, software, and invoice to service all needs with over 200 pre-vetted agency partners. As a national provider of health care workforce solutions, Qualivis works to simplify staffing and help hospitals build a better workplace to improve patient care.

Jonnathan Davis, AIF®

Brennan McCutchen, AIF®

Jason Gerber, CFP®, MS, AIF®

We are AFMC. A Little Rock-based, national nonprofit health care company dedicated to working with consumers, health care professionals, businesses, and communities. We improve health and experience of care, while reducing costs.

For the past 50 years, AFMC has been at the forefront of health care reform and practice transformation as a 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

• Public Health Services

• Virtual Event Hosting

• Call Center Services

• Quality Improvement

We would like to extend a special thank you to the Arkansas hospitals for partnering and participating with AFMC on our quality projects.

Visit www.afmc.org to learn more.

AHA Connectivity Consortium

Contact us today to see how much extra USAC funding your sites are eligible for. Consortium participants have the opportunity to receive higher funding amounts, more services covered, and help with managing program compliance. Did you know that data equipment which supports your data circuits, and services to maintain and manage a health care network, are eligible for the 65% subsidy? The fund year begins annually in July, and once you are approved, the funding is disbursed on a quarterly basis. Schedule a meeting with us today to receive a no-cost individual analysis of your hospital’s participation in the Rural Health care Program.

HOW CAN I PARTICIPATE? Join the consortium! Consortia can have higher funding amounts, cover more services, manage program compliance and provide guidance.

WHAT IS ELIGIBLE FOR THE 65% SUBSIDY? Data services and equipment which support, maintain and manage a health care network.

WHEN DO I RECEIVE THE FUNDING? The program year runs from July through June every year. Once approved, the funding is disbursed on a quarterly basis to the vendor, who then credits your account.

WHAT IS THE NEXT STEP? Schedule a meeting with FFG, the consortia agents who facilitate the program.

ARORA is Arkansas’s largest 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 at any Arkansas DMV office, at one of ARORA’s new mobile registration kiosks, or by visiting donatelifearkansas.org. 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

The Application Window is OPEN! Contact: info@fedfunding.net

Connectivity Consortium

ESS has been providing specialized management and staffing for emergency departments and inpatient hospitalist programs for more than 20 years. We’re also the only ED/Hospitalists provider that offers 24/7 Case Management as part of our comprehensive services.

Our ability to provide partner facilities and physicians with immediate attention and prompt response is a direct reflection of our outstanding management team. We bring the talent, knowledge, and resources of a larger organization to communities that often struggle to attract or retain doctors.

Our Customized Programs:

• Emergency Departments

• Hospitalist/Inpatient Program

• Hybrid ED/Hospitalist Program

• Dual ED/Hospitalist Program

• 24/7 Case Management

HORNE Healthcare

To learn more about our company and our services, visit essdoc.com or call 888-931-8882.

Contact Crystal Mata, V.P. of Business Development, at cmata@essdoc.com.

Today’s health care 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 health care landscape. In addition to traditional health care accounting services like reimbursement, audit, and tax, we offer fund management, health care valuation, HIPAA privacy and security, outsourced accounting, and health care data analytics through REDi Health.

HORNE Health care serves 600 clients nationwide, including hospitals and health systems, physicians, and long-term care facilities. Our 70-plus employees are dedicated solely to working with health care clients. At HORNE, we deliver with care.

Contact: Laura Gillenwater, CPA Office: 501-226-2997, Direct: 601-326-1378

1023 Main Street, Suite 202, Conway, AR 72032 | 1-888-821-0202

HSS Risk Consulting & Training (RCT) is your one-stop shop for compliance, education, and mitigation solutions to keep your organization safe and prepared.

RISK ASSESSMENTS – Regardless of size or organization complexity, HSS security professionals assess the current status of a security program while creating a longer-term security master plan that meets the standard.

WORKPLACE VIOLENCE PREVENTION TRAINING – HSS’s nationally-recognized, award-winning Techniques for Effective Aggression Management (TEAM ®) training program takes the guesswork out of compliance with OSHA, CMS, DNV, and TJC requirements.

ACTIVE SHOOTER TRAINING & PREVENTION – HSS active shooter exercises and response training saves lives and improves staff confidence while reducing turnover and psychological trauma. Realistic, memorable exercises and trainings resonate with everyone from frontline staff to senior leadership.

Contact: Seth Karnes, Senior Director, Risk, Consulting, & Training skarnes@hss-us.com | 720.641.5209

Ritter Communications, headquartered in Jonesboro, Arkansas, is the largest privately held fiber broadband and telecommunications service provider serving exclusively the Mid-South, offering world-class fiber internet, telecom, video, cloud, and data center services. The company is now serving over 100 communities and more than 45,000 customers in Arkansas, Texas, Missouri, and Tennessee.

The 100% Ritter-owned network and 99.99% uptime has played an integral role in our continued success with enterprise and wholesale customers. The resilient, reliable fiber infrastructure is geographically diverse with redundant paths, ensuring that your services are available when you need them most. With speeds up to 10G, your Ritter Communications team will create a scalable solution that works best for your business.

Ritter Communications ri tterbusiness.co m | 888-336-4249

Link edIn.com/company/ritter-communications

340B. Simplified. SUNRx partners with Covered Entities and Pharmacies to manage the complexities of the 340B program, continuously evolving solutions that provide choice and promote transparency in decision-making.

SUNRx provides a complete 340B Solution. We:

• Work collaboratively to improve 340B performance.

• Combine our technology and expertise to streamline processes.

• Provide knowledge and insight for informed decision-making. www.sunrx.com LinkedIn.com/company/SUNRx340B

In 1994, Vantage Health Plan was formed by physicians who wanted to provide quality health care through the teamwork of physicians and their patients. Vantage’s membership has grown steadily over the past 20 years, now providing health insurance coverage for nearly 40,000 members and contracting with over 15,000 health care providers. Vantage prides itself in offering friendly, excellent customer service and quality health care products.

Vantage continues the belief that health insurance should be affordable, and customer service should be local and compassionate. With the corporate offices in Monroe, Louisiana, Vantage has expanded with locations in Baton Rouge, Shreveport, Hammond, and more! With products including Individual, Medicare Advantage, and plans for Louisiana State employees with the Office of Group Benefits, Vantage has health insurance for everyone!

Vantage Health Plan 888.823.1910 130 DeSiard Street, Suite 300 Monroe, LA 71201 www.vantagehealthplan.com

Vizient, Inc., the nation’s largest health care performance improvement company, serves more than 50% of the nation’s acute care providers, which includes 97% of the nation’s academic medical centers and more than 20% of ambulatory care providers. Vizient provides expertise, analytics, and advisory services, as well as a contract portfolio that represents more than $130 billion in annual purchasing volume. Vizient’s solutions and services improve the delivery of high-value care by aligning cost, quality, and market performance. Headquartered in Irving, Texas, Vizient has offices throughout the United States.

To learn more, visit www.vizientinc.com

AHEF, the local chapter of the American College of Health Care Executives (ACHE), is a forum for professional development for the state’s health care executives.

Since its inception, the association has expanded its membership to all those involved in healthcare-related professions including students in health care management programs. Visit ahef.ache.org or ache.org for more information.

CareSource PASSE –Reimagining Health Care

CareSource is a nonprofit, multi-state health plan recognized as a national leader in managed care. Founded in 1989, CareSource administers one of the nation’s largest Medicaid managed care plans and offers a lifetime of access to care through health insurance, including Medicaid, Health Insurance Marketplace, Medicare Advantage, and dualeligible programs. Headquartered in Dayton, Ohio, CareSource serves more than 2 million members in six different states.

Jennifer Daniel Brezee

Director of Network Development, Arkansas

425 W. Capitol Ave., Ste. 3000 | Little Rock, AR 72201 Provider Services 1.833.230.2100 c. 501.351.2508 | CareSourcePasse.com

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 health care environment to serve Arkansas’s 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

With Evident, you gain a partner that will meet your expectations for health care delivery. With fully integrated solutions, our EHR delivers one, comprehensive patient record across the care continuum. And with complementary budgeting, workforce management, and RCM software and services, you can have confidence in maintaining solid business operations because your finances are as important as the people you treat.

www.evident.com

Contact: Evident 6600 Wall Street Mobile, AL 36695 (800) 711-2774 | www.evident.com | @evidenthealth

Health care Associates Credit Union is a not-for-profit financial cooperative providing financial products and free financial literacy resources and tools to those who serve or support health care at no-cost to the organization or employee. HACU is a free, no-cost benefit for AHA member hospitals and partners and is offered because of your partnership with AHA.

To learn more visit hacu.org or email Jaimee Hartman at jhartman@hacu.org

1151 E. Warrenville Rd. Naperville, IL 60563

Facebook page: @bankhealthy

Our team focuses on specific skills and expertise needed for long-term success – tapping into our deep pool of jobs and candidates. We are dedicated to permanent physician and advanced practice job searches and have developed a methodology that results in the placement of the highest quality clinicians and physician leaders across the complete spectrum of health care delivery systems.

Jeff Waddill

AMN Leadership Solutions Merritt Hawkins

Regional Vice President Direct: 469-524-7462 | Cell: 972-742-2480

Corporate Headquarters

8840 Cypress Waters Blvd., Suite 300 Dallas, Texas 75019 800-876-0500 | 469-524-1400 | 469-524-1421 fax info@merritthawkins.com

merritthawkins.com linkedin.com/company/merritt-hawkins @MerrittHawkins

THANKS, SILVER LEVEL

The Mitchell Williams team of health care lawyers understands the challenges and rapidly changing regulations of the health care industry. We assist hospitals and health systems with:

• Risk management and compliance

• Physician contracts and non-compete agreements

• Fraud and abuse claims and investigations

• Legislative and health care public policy

• Health care real estate transactions and leasing

• Employment and labor matters

Megan Hargraves

Mitchell Williams Law Firm

425 W. Capitol Ave., Suite 1800, Little Rock, AR 72201 501-688-8800 | Mitchellwilliamslaw.com

PARAREVENUE, a CorroHealth Company, was founded in 1985 to provide reimbursement, pricing, coding, and contract management services to hospitals. Our services encompass all aspects of the health care revenue cycle, and we also provide services to physician practices, ambulatory care centers, skilled nursing, and independent testing facilities. During the past 37 years, PARAREVENUE services have resulted in significant improvement for health care providers across the nation.

SHARE (State Health Alliance for Records Exchange) securely gathers medical information from different health care providers and creates a more complete picture of Arkansans’ health. This helps providers coordinate care and reduce mistakes, especially in emergencies. Providers may already share health records through fax and postal mail when needed for care. SHARE makes it easier, faster, and more secure for providers to securely exchange health information.

Violet Archuleta-Chiu

Senior Account Executive Office: 800-999-3332 ext. 219

Violet.Archuleta-Chiu@CorroHealth.com www.CorroHealth.com

State Health Alliance for Records Exchange (SHARE)

1501 N. University Ave., Suite 420 | Little Rock, AR 72207 (501) 410-1999 | sharearkansas.com

Facebook @SHAREarkansas, Twitter @SHAREarkansas, LinkedIn.com/company/ar-share

Contact Tina Creel

Arkansas Mutual Constellation (952) 847-4397

Ryan Schott, Business Support ryan.schott@constellationmutual.com constellationmutual.com

When you require high-quality construction, have an aggressive project schedule that needs to be met, and are looking for a contractor that provides competitive pricing, C.R. Crawford delivers. Renovations, expansions, and new construction, with 60+ health care industry projects completed – we have the experience. Our client-focused way of doing business is something you won’t find with anyone else – and we are ready to serve you!

Jordan Ligon | Leigh Ann Showalter C.R. Crawford Construction www.crcrawford.com | 479-251-1161 1102 S. Happy Hollow Road, Fayetteville, AR 72701

THANKS, SUPPORTERS

careLearning is an online education company designed to help health care organizations by providing reliable, trusted, and easily accessible talent management solutions. When you work with us, you gain access to our Learning Management System (LMS), our Competency and Performance Management Solution, a full course catalog, and much more. Please contact us to learn more!

Tony Wegmann

Client Engagement Specialist

careLearning 866-617-3904 101 Stockton St. Charleston, WV 25387

www.carelearning.com

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 health care clients in Arkansas and around the nation.

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.com/company/crews-&-associates

Twitter: @CrewsAssoc

Highlands Oncology Group’s medical clinic and office building in Springdale.

Engelkes

Felts & Barnhardt Ltd

Certified Public Accountants

1225 Front Street Conway, AR 72032 Phone: (501) 329-5613

Hospital Services Corporation (HSC) is an NCQAcertified CVO since 1997. We deliver industry-leading turnaround times for Credentials Verification and Provider Enrollment. HSC’s secure system portal and expertise goes beyond automation to solve your most complex and complicated cases. We can cover primary and multiple sources verification with file maintenance service to keep your information current and compliant. With customers in 19 states, we have the experience to navigate diverse processes. Let us be the solution for your team!

Bernadette Armijo, Business Relationship Specialist

Hospital Services Corporation

7471 Pan American West FWY NE, Albuquerque, NM 87109 P.O. Box 92200, Albuquerque, NM 87199-2200 1-866-908-0070 | 505-346-0201 | barmijo@nmhsc.com

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.

Morgan Hunter HealthSearch provides leadership recruitment services exclusively for the health care industry. Our expertise is at the director-level and above, for both interim and permanent positions. We are a proud partner of AHA Services, Inc.

Barry Jackson, President

Morgan Hunter HealthSearch

Main: (800) 917-6447 | Cell: (816) 868-9633 www.mhhealthsearch.com

Rich & Cartmill, Inc.

Scott Selman

2738 E. 51st St, Suite 400 Tulsa, OK 74105 www.rcins.com Direct: 918.293.7189 Fax 918.744.8429 sselman@rcins.com

TM

Your employees know about risks before you do. Mitigate your risk by empowering them to share information with you – safely and anonymously. STOPit is the only simple and effective mobile platform and phone tip line helping modern workplaces address issues such as:

• Compliance Risk

• Sexual Harassment

• Hostile Workplace

• Ethics Issues

• Theft / Fraud

• Whistleblowing

• Discrimination and Harassment

TruBridge helps health care organizations of all sizes clear the way for care. We understand many things get in the way of providing great patient care. TruBridge’s portfolio of RCM products and services help stabilize revenue cycle operations because we believe when you get paid on time and in full, the path to great patient care gets a bit easier.

TruBridge 877-543-3636 6600 Wall Street Mobile, AL 36695 www.trubridge.com

Voyce brings together the convenience of modern technology and the quality of a trusted, certified interpreter.

We are a technology company deeply committed to helping people in need facing language barriers, enabling them to easily and quickly communicate and get help. Our professional and qualified interpreters provide interpretation across a variety of technology and telehealth platforms in 240+ languages and dialects, including American Sign Language.

Danny Chang, Partnerships

Voyce, Inc. (519) 990-3416

danny.chang@voyceglobal.com

+1 (855) 568-6509

1580 Sawgrass Corporate Pkwy., Sunrise, FL 33323 web.voyceglobal.com

Welch, Couch & Company, PA is a full service accounting firm offering a wide range of services to the health care industry.

• 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 health care 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

A Common Cause

By Nancy Robertson

Ron Peterson, President and CEO of Baxter Health in Mountain Home, began his term as Chair of the Arkansas Hospital Association Board of Directors in the fall of 2021. Like Chris Barber of St. Bernards Health before him, his leadership commenced during one of the most trying times AHA members have faced in the organization’s 93-year history.

Now, with a year as Chair under his belt, we caught up with him in mid-December. Our main question: How does one approach leadership during the dual crises of the COVID pandemic and its financial fallout?

“First, I’d like to say that it is an honor to serve as Chair,” Peterson says. “Though I have served on the Board for several years, this is my first time as Chairman. Board members have long realized that the AHA staff does so much for our hospitals, and does so daily, but I think we all see hospital challenges from a different perspective these days, and the staff’s dedication is seen in a new light.”

For at least the last 20 years, hospital and health system leaders have been fighting ever-tougher battles on behalf of

their hospitals, staff members, and patients. The challenges escalated during the pandemic and, with the resulting financial repercussions, are now at an all-time high.

“Every hospital leader is doing a balancing act,” he explains. “We’re juggling patient care, finding (and affording) the proper staffing, and managing our budgets. Finances for hospitals across the state were difficult before the pandemic, but today they are dire.”

UNPRECEDENTED CONDITIONS

The AHA collected data from members in all regions of the state earlier this year to see what effect the COVID pandemic has had on their margins. On average, hospitals surveyed saw a total margin decrease of 3.5% between early 2019 and 2022. This downshift left a full 52% of them in the red.

“We used to be concerned that our razor-thin margins of 1-2% left hospitals little room for buying equipment or making improvements,” Peterson says. “These days, our hospitals are lucky if they are not operating in the red.”

The question isn’t whether new projects can be undertaken; instead, it’s “Can we keep our doors open?”

Many hospitals have seen nurses, physicians, and other skilled experts leave the state for more lucrative contracts elsewhere. “People burn out, and others are needed to replace them,” Peterson says. “As more and more hospitals are forced to rely on traveling nurses and physicians, staffing costs (usually about 50% of a hospital’s budget) go up. And inflation is having a real impact on health care. With the cost of medications, equipment, and supplies rising due to shortages of ingredients or parts and the supply chain problem, there isn’t an end to these price hikes in sight.”

An illustration might help. Say “Hospital A” has a mission of and is dedicated to, above all else, providing excellent patient care. Doing this requires hiring qualified and experienced professional staff. But when staff members leave due to burnout, or to accept more lucrative contracts elsewhere, “Hospital A” must fill its staff openings with more expensive contract labor from the pool of traveling nurses and/or physicians. “Hospital A’s” leaders must ask themselves: Can we afford to hire this person at the higher rates at which travelers are paid? Can we afford not to?

Peterson says the AHA Board’s perspective results from real needs in the field and dilemmas like this that every hospital executive is facing.

AHA BOARD SEEKS SOLUTIONS

“Our discussions are necessarily very focused on finances right now,” he says. “The Board provides direction to the AHA staff on what is needed to keep hospitals in operation. The staff is well-versed in state and federal

programming that can assist hospitals, and they connect member hospitals with those funding streams almost as soon as the programs are created.”

He recalls the first monies that were allocated to hospitals through the Coronavirus Aid, Relief, and Economic Security (CARES) Act, which was enacted in late March of 2020. “The CARES Act set aside both state and federal monies for provider relief, and they were much-needed by hospitals already at that time,” Peterson says. “One thing the AHA does very effectively is advocate for legislation that helps hospitals, and the AHA staff have been on top of this COVID-related advocacy, as well as advocacy in other areas at the federal and state levels, for years now.”

He says that the early days of the pandemic, when the CARES Act was launched, were a time of great support

for hospitals and caregivers. “I think people recognized the dedication and determination of hospital workers in those early days,” he says. “People appreciated the sheer exhaustion our caregivers were suffering, and they did all they could to show that appreciation and give support.

“But today, nearly three years on, hospitals and our caregivers feel more of a burden. People in the public have moved on, and some have even begun to question hospital workers’ decisions or motivations. They are frustrated with an unyielding virus that continues to mutate and cause surge after surge. They might not want to wear masks in our facilities. They might be tired of being urged to get vaccinations. Or they might be frustrated by the long waits today’s ‘Tripledemic’ of COVID, flu, and RSV is causing in our ED. We see a rising level of violence

Every hospital leader is doing a balancing act. We're juggling patient care, finding (and affording) the proper staffing, and managing our budgets.

We Asked...

What’s on your music playlist?

Mellow 70’s.

What is the best advice you were ever given?

Surround yourself with people smarter than you.

What do you like to do in your down time? Golf.

What’s on your desk right now?

The budget.

Where would you travel if you could go anywhere?

Tahiti, and/or any beach.

What is the most valuable lesson COVID has taught you?

Be nimble, be prepared, be humble, and be caring. Thank God for every opportunity and every day he gives you.

against hospital workers, and this affects everyone from nurses and doctors to environmental services to food services. Everyone feels the ramifications of this stress. Every worker knows our budgets are stretched past the point of no return. The public’s frustrations and the financial realities in health care today are a cause for alarm at every level.”

Peterson says that not everyone realizes hospitals cannot just flip a switch and raise prices to cover costs. “Health care reimbursements come, in great part, from the government by way of Medicare and Medicaid payments,” he says.

“The rest comes from contracts negotiated with commercial insurers or from direct payments by patients.

For years, Medicare and Medicaid reimbursements have not paid for the services they’re meant to cover, and hospital margins have been dropping more and more each year.

And today, as we know, too many of our hospitals are operating in the red with all reserves spent and no ready remedy on the horizon.”

EVERY VOICE IS NEEDED

That’s why he urges all hospital workers, patients and families in each community, and everyone who utilizes health care, to become knowledgeable about the financial

threats that hospitals in Arkansas, and the entire nation, currently face. “Communication is key, here,” he says. “Right now, each one of us needs to communicate that message, let our community and state elected officials know what’s happening and that their hospitals need help. Every hospital leader needs to communicate their local concerns to the AHA staff and Board, so we can then consolidate these messages and speak together with the same message.

“The AHA staff is great about giving us the right words for explaining hospitals’ difficulties to legislators, and it’s great about working with us to suggest to legislators possible solutions that will meet hospitals’ needs.”

In fact, he says, that’s one reason he enjoys working as a part of the Board: “We lay out the concerns and the challenges hospitals face, and we, along with and advised by the AHA staff, take these concerns to elected officials so that we can help our hospitals survive.”

A MATTER OF SURVIVAL

He sees 2023-24 as a watershed for Arkansas’s hospitals. “The current financial situation is going to get worse quickly when COVID money runs out,” he says. “Hospitals with any reserves left will quickly go through that to keep normal operations running. It’s going to be a time unlike any other our hospitals have experienced in several generations. It’s going to be a time when we’re fighting for our hospitals’ survival. I’m afraid that if legislation to protect hospitals isn’t enacted, a number of hospitals –even here in Arkansas – will be forced

to close. The financial impact on the communities where this happens will be great, and the impact on the hundreds of workers every hospital employs will be even greater.”

Hospitals have felt financial distress before, but Peterson says this time just feels different. “So much is riding on the state’s, the nation’s, ability to solve this financial crisis,” he discloses. “Our very survival is at stake. I have seen an intense involvement of Board members in discussions about the

current challenges. We see other administrators coming to us with their concerns and their ideas. And that’s what we need! We need every hospital administrator in Arkansas to be involved, because these financial issues touch people’s lives – and organizations’ viability – every day.

He says there was also a different feeling among colleagues at this year’s AHA Annual Meeting, the first inperson gathering in three years. “Every person had concerns about that same

balance I spoke of earlier, the balance between patient care, staffing, and the financials. We are all asking ourselves, ‘How can we manage? What can we do to preserve our state’s hospitals?’”

Peterson recalls past meetings where people concentrated on networking, on sharing best practices, on learning about new innovations. “This year, our full concentration was on staffing and the cost of wages; policies that add cost burdens to hospitals, such as pre-authorization; and the need for payment reform.”

LOOKING AHEAD

CHALLENGING DISPUTES RESOLVE YOUR MOST

He has great hopes for 2023 and legislation that can be enacted. “We definitely need to seek financial reimbursement appropriate to cover the cost of providing care,” he says. “We want to find ways to rejuvenate our staff members, who have given their all surge after surge after surge. We understand why they’re burning out, and we want to find ways to help.”

And he wants to find ways to return the public’s consciousness to seeing our hospital workers as heroes. “They’ve been at the center of caregiving 24/7 for nearly three years with no break,” he emphasizes. “No wonder they’re burning out. It’s up to each of us, as hospital leaders, to remind the public about hospital workers’ sacrifice, and to remind people that it is never right to take their own frustrations out on health care workers.” He hopes that legislation in the coming legislative session might address the rise in health care workplace violence.

“Above all,” Peterson smiles, “I want to thank every health care worker across Arkansas for their resilience, compassion, and their ability to be nimble. There has been tremendous pressure on our caregivers and on the health care system. So, I want to say, ‘Thank you,’ caregivers, administrators, support staff; and let’s make sure we’re still out there

Mitchell, Williams, Selig, Gates & Woodyard, P.L.L.C | Jeffrey Thomas, Managing Director MitchellWilliamsLaw.com

Megan Hargraves Ben Jackson Graham Talley

Nancy Robertson, MAC , is Senior Editor of Arkansas Hospitals magazine.

2023 Arkansas Session Outlook

By Jodiane Tritt, Executive Vice President, Arkansas Hospital Association

Hospitals are experiencing the most crushing economic stress of our lifetimes. Costs of supplies and medications are at an all-time high, as are the costs of personnel – the lifeblood of our hospitals’ ability to care for patients.

Reimbursement from both government payers (Medicare and Medicaid) and commercial insurance has not increased to cover those costs. Therefore, it is no surprise that the top priorities for the legislative session will be to continue Medicaid Expansion (now known as AR HOME), to seek opportunities to increase reimbursement, and lower those administrative costs that do not positively and efficiently impact patient care – and to protect, retain, and grow our health care workforce.

Not only will the members of the 94th general assembly have many new members – 26 members who will serve their first term in the House of Representatives and 12 members who will serve their first term in the Senate – but Arkansas will also have its first female Governor taking over the reins of the Executive Branch.

As exciting as it is to have new faces in the marble halls of the Capitol, Arkansas hospitals must accept the Herculean responsibility of educating our elected officials on what health care facilities are facing: the current financial conditions they are enduring and how these dire financial conditions negatively impact patient care.

MEDICAID EXPANSION PROTECTION

The Medicaid program is optional through Title XIX of the Social Security Act of 1965, and Arkansas exercised its option to participate in 1970. Our state’s eligibility criteria for the program have been among the most restrictive in the nation. Prior to Arkansas’s Private Option – the launch of the Medicaid Expansion program in Arkansas – almost all Medicaid patients were children from low-income families, people with complex disabilities, and frail, elderly people with extremely limited financial resources.

Because funding for the program is shared between the state and federal governments, implementation of state Medicaid policies must be acceptable to the federal government. Prior to 2013, care provided to Arkansans who were underinsured, uninsured, or otherwise had no means to pay for medical care was increasing dramatically – especially because the Affordable Care Act required reductions in the Medicare program for hospitals. The Arkansas Private Option allowed hospitals to recover a portion of the cost of providing care to those Arkansans living under 138% of the federal poverty level and who received hospital care. Uncompensated care dropped by almost half in the first years of the program.

As the program evolved from the Private Option to Arkansas Works and now, to Arkansas Health and Opportunity for Me (ARHOME), it remains critical that care for these Arkansans remains accessible. More than 300,000 Arkansans have access to covered services that won’t exist if expansion goes away.

Jodiane Tritt, Executive Vice President of the Arkansas Hospital Association, at the Arkansas Capitol.

REIMBURSEMENT RATES

Medicaid rates for inpatient general acute care hospitals were last changed in 2007 when they were increased to a cap of $850 per day from $675 per day. Medicaid outpatient rates were last changed in 1992, and that change was a decrease in reimbursement. It is imperative that Arkansas hospitals receive more favorable reimbursement from Medicaid in order to remain viable to care for Arkansas patients.

Each state Medicaid program is different and is funded in unique ways. One of the safety net accounts for the Medicaid program is the Medicaid Trust Fund. The portion of the Medicaid Trust Fund that allows for offcycle payments or unexpected costs on behalf of Medicaid beneficiaries is funded by a Soft Drink Tax that was originally enacted in a Special Session of the legislature in 1992.

The soft drink industry tried to remove the tax through a referendum, or direct vote, by the people of Arkansas in 1994, and Arkansans voted to keep the tax. The federal government allows proceeds from that tax to be matched and used for the benefit of Medicaid recipients and providers who serve them. For that reason, Medicaid providers fight the repeal of that tax unless another special revenue source, providing the same benefits, can be identified.

Using the state legislative process to increase reimbursement rates from commercial insurance payers is more complicated. Rates are – in

YOUR VOICE IS NEEDED!

Join us for Advocacy Days on January 25, February 21, and March 15 at the Capitol in Little Rock. You will meet with our state legislators, each of whom has a major impact on health care in Arkansas. Key advocacy priorities include:

• Sustaining the gains made in health coverage.

• Protecting patient access to care.

• Addressing health care worker shortages.

• Protecting health care workers from violence.

• Providing relief to hospitals facing financial crisis.

Sign up here (using the QR Code above) for AHA Advocacy Updates and Alerts!

Contact Jodiane Tritt at jtritt@arkhospitals.org with questions.

Medical professionals really are the foundation of health care. We can be your strength, too, for new construction and other projects. Count on Crews for industry experience, capital structures and the client-first approach your organization deserves.

theory – privately negotiated contracts. What becomes critical to hospitals, from a state legal perspective, is limiting administrative burdens imposed by commercial payers that create barriers to patient care. Hospitals are not alone in this advocacy. Many health care providers share the same frustrations with commercial payer policies that effectively ration care or create underpayments to providers who are providing care in good faith.

HEALTH CARE WORKFORCE

The health care professionals who work in Arkansas’s hospitals are every hospital’s most important resource. As COVID surged through the world, it took a dramatic toll on all hospital personnel. Health care heroes are leaving their professions at a rapid pace. The number of students interested in health care careers is declining, and the faculty available to teach and train new health care staff is becoming scarcer.

Added to that, reports of violence inside hospitals are on the rise. Hospitals must have resources to adequately compensate health care professionals and to keep them safe while they are working inside our buildings, improving the health of our patients.

Arkansas hospitals are the backbone of the health care system. They complement and amplify the effectiveness of many other parts of the health system, providing continuous availability of services for acute and complex conditions. Hospitals are also major economic engines in communities. In all advocacy efforts, these facts must be articulated, and it is AHA’s honor to carry these messages on behalf of the entire hospital industry.

Jodiane Tritt, JD serves as Executive Vice President of the Arkansas Hospital Association.

Strength in Numbers

Join the movement to gather data that will help hospitals improve performance, better hold commercial payers accountable

By Travis Gentry, CEO, and Kari Kemper, Vice President of Client Services, Hyve Health

Editor’s Note: The AHA Vitality Index™ is a program of the American Hospital Association. It is not to be confused with the Arkansas Hospital Association’s data program, through which we support member hospitals by providing access to timely and accurate data and statistics. When used together, the information gleaned from the two programs can supercharge your perspective on your hospital's priorities.

Now more than ever, hospitals and health systems need operational and financial data they can trust and better understand how they are performing compared to the rest of the field. That’s where AHA Vitality Index™, which allows hospitals to anonymously benchmark their operational performance, can help.

With just a few clicks, hospitals can uncover how often their organization's payment claims are denied, determine if those denial rates vary by payer service line, and compare their organization’s metrics to other deidentified providers and peer groups. A hospital can determine how to address an issue by understanding the cause. Is it an internal operational issue impacting just their hospital? Is it a payer-specific issue in which the hospital is being treated unfairly versus its peers?

Scan this QR Code to read Addressing Commercial Health Plan Challenges to Ensure Fair Coverage for Patients and Providers

DELAYING AND DENYING COVERAGE

Part of a high-functioning revenue cycle is the ability to get appropriately reimbursed for the care provided. In recent years, it has become apparent that certain commercial health insurer practices are delaying and denying coverage for medically necessary care.

This year, the American Hospital Association (AHA) released two reports on these burdensome practices that have garnered significant media attention by showing how some commercial health insurers, including Medicare Advantage plans, can cause dangerous delays in care, place undue burden on the health care workforce, and add billions of dollars in unnecessary costs to the health care system. These include things like inappropriate and excessive use of prior authorization, mid-year changes in coverage that restrict where patients can access care (i.e., site of service and pharmaceutical white bagging policies), and unwarranted requests for additional medical records and other tactics to delay payment. Indeed, hospitals report a significant increase in accounts receivables as they await payment for medically necessary, covered care.

Scan this QR Code to read Commercial Health Plans’ Policies Compromise Patient Safety and Raise Costs

Government officials have taken note. The Office of Inspector General for the U.S. Department of Health and Human Services recently found that a large portion of denied prior authorization requests and claims for payment for care provided to Medicare Advantage enrollees should have been approved. Another report from the U.S. Surgeon General citing concerns about health care worker burnout pointed to some of the administrative burdens placed on providers, such as prior authorizations, as one of the major drivers of provider fatigue. Recently, the state of Georgia issued a substantial fine against a large payer for several conduct issues.

HERE, THE VITALITY INDEX CAN HELP TOO

Using data in the Vitality Index, hospitals and health systems can better prepare themselves for discussions with payers about appropriate performance on various revenue cycle metrics. For example, hospitals will be better equipped to discuss standards regarding the timeliness of payments, acceptable rates of accounts receivables, and more. These new data points will take the conversation from what historically has been anecdotal and provide empirical

To learn more, contact Mark Brand, American Hospital Association Licensing Account Manager at mbrand@aha.org or 312-893-6810 or scan the QR code to fill out the “Request Demo” form online.

evidence providers can use to prove that negative payer behaviors are occurring.

In addition, with a critical mass of hospitals participating, the Vitality Index may offer a statistically valid sample of payer performance data at the state and national levels to help inform policymakers and government oversight bodies.

State hospital associations are always close partners of the AHA and its work. We see the ability to take the data and the insights gained as a resource to the state hospital associations and their members as they engage with state lawmakers and policy leaders to shed light on these burdensome commercial payer practices.

How can hospitals and health systems get involved? We have created a process designed to make it very easy to participate. We are very sensitive to the fact that hospitals have many operational demands, often juggling multiple IT projects. We do not ask participants for custom extracts, which would take additional time and resources to create. Instead, we ask participants to submit the raw data for three years of historical claims and remits. Data transmission is via The PHI Scrubber™, a utility software solution that deidentifies specific elements in health care claim and remit files, ensuring that all Protected Health Information is removed before leaving the hospital environment, maintaining compliancy with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Safe Harbor Rule. The data is normalized across all participating deidentified hospitals, allowing for meaningful and actionable analysis.

Take a Closer Look

RECOVER.

EVERY. DOLLAR.

Gaps in reimbursement strategies are causing you to lose millions of dollars each year. Staffing issues, new processes and government regulations all contribute to reimbursement dollars falling through the cracks, going uncollected.

In less than 3 years, HORNE has recovered more than $33 million in unreimbursed Medicare funds for 33 hospitals.

HORNE experts understand both Medicare reimbursement and data in the healthcare industry. We use proprietary analytic tools to resolve discrepancies, identify missed value and, most importantly, find those dollars.

The dollars are there, let us take a closer look. We can help.

HORNE.com/medicare-reimbursement

The Perfect Storm of Staffing Shortages

by Kay Kendall

Is your organization experiencing staffing shortages, not just among clinical staff but also in other areas? If so, you’re not alone – especially in Arkansas, according to recent data. Health care, among other industries, continues to be in the throes of a staffing storm, and there doesn’t seem to be a letup in sight.

Data from several recently published studies suggest that the nursing shortage is projected to intensify in the next 18 months, with one-third of nurses planning to leave their jobs by the end of 2022. While pay and benefits are cited as two of the conditions leading to this exodus, the reasons nurses cite for leaving are burnout and continually working in extremely high-stress environments. Projections indicate these aggravations will only be exacerbated as shortages stress health care staff who choose to remain.

America’s increased number of rural hospital closures also increases care burdens for the remaining hospitals – burdens felt by staff, administrators, providers, and ultimately patients and other stakeholders. The continued presence of COVID, its new variants, and now influenza and RSV are all taxing a health care industry that is already at a breaking point.

What’s your plan? Do you know the specific underlying causes of your hospital’s staffing shortages? Different root causes often require different corrective actions and innovative solutions. Are you relying on exit interviews alone? Studies show that they are often an extremely unreliable source of credible information as many departing employees are fearful of “burning bridges” when they leave.

THESE TOOLS CAN HELP

There are free resources recently made available from a collaborative effort between the Department of Commerce, the National Institute of Standards and Technology (NIST), and the Baldrige Performance Excellence Program ® . These include the Job Quality Toolkit and eight case studies from organizations across a variety of industries, including health care.

The Job Quality Toolkit is rooted in the Baldrige Excellence Framework . For more than 34 years, the Baldrige Performance Excellence Program® has provided the globally recognized and emulated Criteria for Performance Excellence , which are regularly updated to ensure that they incorporate the leading edge of validated leadership and management practices proven to help enhance organizational performance and sustainability. When you download the toolkit, you’ll find a how-to section for its use; also included is an in-depth review of the drivers of employee engagement and specific ideas for using the toolkit at your organization. (https://www.commerce.gov/work-us/ job-quality-toolkit )

The Job Quality Toolkit is organized around eight drivers of employee engagement; it provides practical strategies and actions, as well as links to additional resources for each driver. The eight drivers are:

• Recruitment and Hiring

• Benefits

• Diversity, Equity, Inclusion, and Accessibility (DEIA)

• Empowerment and Representation

• Job Security and Working Conditions

• Organizational Culture

• Pay

• Skills and Career Advancement

Please note that “Pay” is the seventh driver. Study after study shows that pay is one of the least sustainable drivers of engagement, and many health care organizations are not in a financial position to keep bumping up wages. So, it is wise to explore other drivers of engagement that will help keep your employees in place.

FOLLOWING A TRUSTED LEADER

demands seemed unrealistic, but any pushback or complaining was countered with this question, “If not this, then what?” We seldom found a better alternative, so we learned the discipline of following someone with more experience and wisdom than we had.

What does that story have to do with the Job Quality Toolkit ? If you’re in the majority of organizations currently facing staffing challenges (including the Great Resignation and the Quiet Quit), these challenges are unlikely to solve themselves without some consideration of new approaches and bold leadership.

What are your plans and strategies to stem the tide of staff resignations and minimal productivity? How will you encourage those employees who stay and help them manage their burnout and stress? I hope you’ll tap into the wisdom and solutions offered in the Job Quality Toolkit . It’s an excellent resource as you face staffing challenges that will continue into the new year.

Scan this QR Code to get the took kit today.

Early in my career as a quality professional leading quality organizations, I reported to a very strong-willed executive who had high expectations for what we would achieve in terms of product and service quality. Some of his

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

Applications Now Open

HealthTech Arkansas and SymBiosis have come together to create BioAR Trial, an accelerator program to help biotherapeutics companies in late pre-clinical stages of development bring groundbreaking therapies to market faster, while increasing Arkansans’ access to cutting-edge clinical care and innovative medicines.

BioAR Trial will focus on deploying advanced and emerging therapeutic modalities—such as precision medicines, biologics, cell therapies, and genetic medicines—to treat serious and life-threatening diseases in oncology, immune disorders, and cardio-metabolic disease.

The application for BioAR Trial is now open through January 15, 2023.

IN PARTNERSHIP WITH

bioarkansas.co/trial

To learn how your organization can participate, please contact Jeff Stinson at jeff@healthtecharkansas.com

Antimicrobial Stewardship Joint Commission Updates: Is Your Hospital Ready for 2023 Requirements?

By Marsha Crader, PharmD, FASHP

Antimicrobial Stewardship (AS) remains essential to ensure that all health care settings maintain antibiotic viability in combatting infections. During the COVID-19 pandemic, the United States demonstrated increased community- and hospital-acquired multi-drug resistant infections with more significant increases in hospital-onset infection resistance.1 Although Arkansas decreased its community antibiotic prescriptions per 1,000 population, from 1,028 in 2019 to 927 in 2021, it remains the 6th highest in antibiotic prescribing in the nation, which supports the need for continued improvement.2-3

The Infectious Diseases Society of America (IDSA) first introduced AS guidelines in 2007.4 Beginning in 2017, the Joint Commission (JC) and the Centers for Medicare and Medicaid Services initiated AS regulatory requirements impacting various health care settings. These regulatory bodies focus on the Centers for Disease Control and Prevention (CDC) AS core elements.5-7

Beginning January 1, 2023, all inpatient and outpatient areas surveyed at JC-accredited hospitals and critical access hospitals are required to meet MM.09.01.01 Elements of Performance (EP) 10-21 aligning with the CDC’s updated 2019 AS core elements.8

HOSPITAL LEADERSHIP COMMITMENT

5-9

The JC expects hospitals to allocate financial resources for AS addressed through appropriate staffing and information technology (IT) (EP10). Additional suggested support includes the naming of senior executive “champions,” the employment of microbiology rapid diagnostic equipment, and other methodologies.

ACCOUNTABILITY

AND PHARMACY EXPERTISE

5-10

Hospitals must have a multidisciplinary committee that oversees the antimicrobial stewardship program (ASP) (EP13). The committee may include part-time or consultant staff participating on-site or remotely. Representation may include medicine, pharmacy, nursing, infection prevention and control, quality improvement, microbiology, IT, and other appropriate disciplines.

The hospital governing body must officially appoint a physician and/or pharmacist to lead the ASP (EP11). AS training must be provided if appointed leaders are not

The CDC produced several infographics and toolkits for use by hospitals and medical facilities beginning with U.S. Antibiotic Awareness Week in late November. Combatting antibiotic resistance and improving patient safety are the hoped-for outcomes of the program.

qualified through education, training, or experience in infectious diseases or AS. Multiple training options are available; CDC AS training and the Stanford AS online continuing medical education course are options at a free or reduced cost.

Appointed leaders are responsible for creating a program based on nationally recognized guidelines to monitor and improve antibiotic usage, including CDC AS core elements and IDSA guidelines (EP12). Leaders are responsible for ensuring appropriate communication and coordination with medicine, nursing, pharmacy, infection prevention and control, and quality improvement leadership and staff (EP 12, EP14). This may be accomplished through committee appointments, interdisciplinary leadership liaisons, etc.

ACTION: IMPLEMENT INTERVENTIONS TO IMPROVE ANTIBIOTIC USE

5-10

The JC expects hospitals to act on improvement opportunities identified through the ASP (EP21). It requires implementing one or both of the following: 1) preauthorization for specified antibiotics before use, or 2) prospective review and feedback of antibiotic prescribing (EP17). Pre-authorization optimizes initial therapy, while prospective review and feedback improves ongoing treatment. Optimal antibiotic usage rather than cost reduction should be the ASP focus to help avoid suboptimal therapy, adverse effects, or resistance development.

ASPs are required to implement at least two evidence-based guidelines to improve antibiotic use for common indications (EP18). The recommendations must be based on national guidelines, local antibiotic susceptibilities, and formulary options. Guideline examples include C. difficile , community-acquired pneumonia, urinary tract infections, skin and soft tissue infections, and antibiotic surgical prophylaxis.

Beginning January 1, 2023, all inpatient and outpatient areas surveyed at JC-accredited hospitals and critical access hospitals are required to meet MM.09.01.01 Elements of Performance (EP) 10-21 aligning with the CDC’s updated 2019 AS core elements.

TRACKING ANTIBIOTIC USE

AND OUTCOMES

5-10

ASPs are required to document antibiotic stewardship activities and evidence-based use of antibiotics in all hospital departments and services (EP12, EP15), including adult and pediatric inpatient units, emergency rooms, surgical centers, clinics, etc. If an address is submitted with the JC accreditation application, that location falls under JC requirements. ASPs must monitor antibiotic usage by submitting data through CDC’s National Health care Safety Network’s Antimicrobial Use (NHSN AU) Module or calculating antibiotic days of therapy per 1000 days present or 1000 patient days (EP16). NHSN AU reporting is optimal for hospital comparative data but may require additional software for data submission. When NHSN AU submission is not an option, IT can build an antibiotic usage report with accounting providing estimated patient days to determine standardized antibiotic usage.

Monitoring must include evaluating adherence to at least one of the evidence-based guidelines that the hospital implements (EP19). Adherence can be done through sampling and must include antibiotic selection and duration but should consider the appropriate diagnosis. Adherence measurement is required at the unit, clinician sub-group, or individual prescriber level.

References

REPORTING ANTIBIOTIC USE AND OUTCOMES

5-10

ASPs are required to collect, analyze, and report data to leadership and prescribers (EP20), including antibiotic prescribing practices, antibiotic-resistant patterns, or evaluation of stewardship actions and initiatives. Multiple forms of dissemination are optimal – the many options include committee/staff meetings, continuing medical education, newsletters, and other forms of in-house communication.

EDUCATION

5-10

Competency-based staff training and education, including medical staff, on the practical applications of AS guidelines, policies, and procedures is required (EP12). The JC expects staff to demonstrate the ability to apply knowledge requiring a validation process (e.g., post-test). This may be addressed through Credentialing or Education Departments applicable to medicine, pharmacy, and nursing staff. Education could incorporate the 5 D’s of AS: diagnosis, drug, dose, de-escalation, and duration.

Marsha Crader, PharmD, FASHP, is Associate Professor of Pharmacy Practice, UAMS College of Pharmacy, and Antimicrobial Stewardship Co-leader for St. Bernards Medical Center. She is a Subject Matter Expert and collaborative partner with AFMC in the area of Antimicrobial Stewardship.

1. CDC. COVID-19: U.S. Impact on Antimicrobial Resistance, Special Report 2022. Atlanta, GA: U.S. Department of Health and Human Services, CDC; 2022. Available at: https://www.cdc.gov/ drugresistance/pdf/COVID19-impact-report-508.pdf [accessed 7 Nov 2022].

2. Centers for Disease Control and Prevention. Outpatient antibiotic prescriptions – United States, 2019. https://www.cdc.gov/antibiotic-use/pdfs/Annual-Report-2019-H.pdf [accessed 7 Nov 2022].

3. Centers for Disease Control and Prevention. Outpatient antibiotic prescriptions – United States 2021. https://www.cdc.gov/antibiotic-use/pdfs/Annual-Report-2021-H.pdf [accessed 7 Nov 2022].

4. Barlam TF, Cosgrove S, Abbo LM et al. Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Health care Epidemiology of America. Clin Infect Dis. 2016; 62(10): e51–e77.

5. Centers for Disease Control and Prevention (CDC). Core Elements of Hospital Antibiotic Stewardship Programs. Available at: https://www.cdc.gov/antibiotic-use/coreelements/hospital.html [accessed 7 Nov 2022].

6. Centers for Disease Control and Prevention (CDC). Implementation of Antibiotic Stewardship Core Elements at Small and Critical Access Hospitals. Available at: https://www.cdc.gov/antibioticuse/core-elements/small-critical.html [accessed 7 Nov 2022].

7. Sanchez GV, Fleming-Dutra KE, Roberts RM et al. Core Elements of Outpatient Antibiotic Stewardship. MMWR Recomm Rep. 2016; 65(No. RR-6):1–12.

8. The Joint Commission. New and Revised Requirements for Antibiotic Stewardship. R3 Report. 2022; 35:1-5. Available at: https://www.jointcommission.org/media/tjc/documents/standards/ r3reports/r3_antibioticstewardship_july2022_final.pdf [accessed 7 Nov 2022].

9. National Quality Partners. National Quality Partners Playbook: Antimicrobial Stewardship in Acute Care: A Practical Playbook. Available at: https://www.qualityforum.org/Publications/2016/05/ National_Quality_Partners_Playbook__Antibiotic_Stewardship_in_Acute_Care.aspx?utm_source=internal&utm_medium=link&utm_term=ABX&utm_content=Playbook&utm_campaign=ABX9 [accessed 7 Nov 2022].

10. Agency for Health care Research and Quality. Antibiotic Stewardship Toolkits: Acute Care Hospital, Ambulatory Care, and Long-term Care. Available at: https://www.ahrq.gov/antibiotic-use/ index.html [accessed 10 Nov 2022].

ANTIBIOTIC RESISTANCE THE GLOBAL THREAT

Antibiotic resistance – when bacteria change and cause antibiotics to fail – is happening RIGHT NOW, across the world

The full impact is unknown. There is no system in place to track antibiotic resistance globally

Without urgent action, many modern medicines could become obsolete, turning even common infections into deadly threats.

A GROWING CRISIS WORLDWIDE

In the EUROPEAN UNION, antibiotic resistance causes 25,000 deaths per year and 2.5m extra hospital days 1

In INDIA, over 58,000 babies died in one year as a result of infection with resistant bacteria usually passed on from their mothers 2

In THAILAND, antibiotic resistance causes 38,000+ deaths per year and 3.2m hospital days 3

CAUSES OF ANTIBIOTIC RESISTANCE

CAUSES OF ANTIBIOTIC RESISTANCE

Over-prescribing of antibiotics

Over-prescribing of antibiotics

Patients not taking antibiotics as prescribed

Patients not taking antibiotics as prescribed

Unnecessary antibiotics used in agriculture

In the UNITED STATES, antibiotic resistance causes 23,000+ deaths per year and >2.0m illnesses 4

CAUSES OF ANTIBIOTIC RESISTANCE

Poor infection control in hospitals and clinics

Poor infection control in hospitals and clinics

Poor hygiene and sanitation practices

Poor hygiene and sanitation practices

Lack of rapid laboratory tests

Lack of rapid laboratory tests

HOW CAN WE STOP IT?

HOW CAN WE STOP IT?

1. Improve labs: Countries need medical labs to identify bacteria and choose the right drugs to treat them.

1. Improve labs: Countries need medical labs to identify bacteria and choose the right drugs to treat them.

2. Collect and share data: Countries need systems to track cases and report results globally to make better policy decisions.

2. Collect and share data: Countries need systems to track cases and report results globally to make better policy decisions.

3. Use antibiotics wisely: To ensure antibiotics are here when we need them, they must be prescribed and taken correctly now.

3. Use antibiotics wisely: To ensure antibiotics are here when we need them, they must be prescribed and taken correctly now.

4. Take measures to prevent infections: Especially in healthcare settings, good infection control practices are critical to stopping spread of resistant germs.

4. Take measures to prevent infections: Especially in healthcare settings, good infection control practices are critical to stopping spread of resistant germs.

FEARLESS HEALTH.

Arkansas Blue Cross and Blue Shield is committed to the health of Arkansans. A whole person approach to health, including physical and behavioral well-being. And we recognize that total health is influenced by many factors, including medical history, genetics, lifestyle, environment, nutrition, safety and physical activity. We also realize it will take all healthcare providers working together to ensure future generations of Arkansans are their healthiest so they can fear less and live their best life. Fearless health.

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From interactive preconstruction meetings to extensive renovations and new construction, Nabholz has over 70 years of experience delivering quality commercial construction.

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Nabholz owns an impressive fleet of equipment available for rent, including a large variety of cranes manned by NCCCO-certified operators.

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First to hit the job site, this group performs excavation, groundwork, utility work, and paving. Additionally, they complete standalone heavy highway, infrastructure, and roadwork.

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Our industrial team transports, assembles, and maintains clients’ most crucial pieces of machinery. From setting an MRI to transporting and assembling a 20-ton injection mold machine, they can do it all.

MAINTENANCE & REPAIRS

Working as an extension of your maintenance staff, Nabholz offers a comprehensive array of maintenance and handyman services, ranging from emergency repairs to total renovations.

Nabholz is your integral partner for all your construction and maintenance needs. With 70+ years of experience we understand every aspect of construction, renovation, and maintenance.

Nabholz is ready to work for you immediately. Even better, we tailor our services to fit your needs.