President’s ReportTop CAHs AnnouncedPhysician RecruitmentAdd’l Educational OpportunitiesNDNPA 8th Annual Pharmacology ConferenceWashington Update2016 NDHA Convention Sponsors2016 NDHA PAC FundraisingOptions of CareNDHA Education Update

Clink on link to view attachments:http://www.ndha.org/resources/informerTop Critical Access HospitalsNDNPA 8th Annual Pharmacology ConferenceEmergency & Trauma Outreach SymposiumND Conference on Injury Prevention & ControlND HFMA Hot Summer, Hot Topics

Phone: 701-224-9732Fax: 701-224-9529Web Site: www.ndha.org

Jerry Jurena, PresidentTim Blasl, Vice PresidentCallen Cermak, Finance ManagerLori Schmautz, Executive AssistantPam Cook, Education Director

A portion of this publication is supported by The Center for Rural Health’s Medicare Rural Hospital Flexibility Program. Visit their site at http://rural-health.und.edu/projects/flex/.

The InformerPresident’s Report ~ Jerry JurenaIn This Edition:

Attachments:

NDHA Contacts

June 10, 2016

AHA Advocacy Agenda 2016: Here is the fifth and final area of AHA 2016 Agenda.

• Recovery audit contractors. AHA is urging Congress to pass the Medicare Audit Improvement Act (HR. 2156).• Two-Midnight 0.2% withhold. AHA has evaluated the 0.2% rule the court required CMS to promulgate and is awaiting the agency’s final decision.• HER Incentive Program. AHA continues to urge CMS to modify the Stage 3 rules.• Hospital realignment. AHA urges the Senate to pass the Standard Merger and Acquisition Reviews Through Equal Rules Act (S. 2102). • ICD – 10. AHA will continue to educate and inform members about the importance of proper documentation.• Administrative simplification. AHA will safeguard against excessive burden in  reporting requirements. • Fraud and abuse barriers to care transformation. AHA is urging Congress to modify the Stark Law and anti-kickback statute to facilitate financial relationships designed to foster collaboration in the delivery of health care.

Over the last five weeks I have given you an overview of AHA’s Advocacy Agenda. They are working non-stop for the benefit of all hospitals. I hope you appreciate all the work that is put into this agenda on behalf of your hospital. If you are a member, thank you for being part of the team. If you are not think about it. Everyone wins.

Senator Heitkamp: Last Friday Senator Heitkamp hosted a Roundtable in Mayville at Sanford Mayville Medical Center. The focus of the meeting was on the future of rural health care delivery. With Senator Heitkamp was Dr. Mary Wakefield and on a confer-ence line was Patrick Conway, Chief Medical Officer of CMS. Senator Heitkamp asked how can we change rural health care in the future. Consideration has to be given to reimbursement, access and quality. What is working and what can be done to make the delivery better. She said now is the time to suggest changes. Both Senator Heitkamp and Dr. Wakefield said they are willing and want to help make a difference going forward with new ideas.

After the meeting I visited with Senator Heitkamp about forming committee to de-velop ideas. She thought that would be a great start; she said they are looking for new ideas and would be interested in anything that we could come up with.

Workforce Committee: Met on May 26th. I have posted a copy of the “Draft Minutes” on our web-page. The minutes will not be approved until the next meeting of the full committee. If you have question regarding the Committee please call me.

Top Critical Access Hospitals Announced The 20 highest ranked critical access hospitals (CAHs) in the country, as recently determined by iVantage Health Analytics, will be honored at an awards ceremony dur-ing the National Rural Association’s Critical Access Hospital Conference in September in Kansas City, MO.

The ND Hospital Association is pleased to share with you that two of our North Da-kota hospitals have made the top 20 list. Congratulations to:

CHI Carrington Health, Carrington, NDSanford Mayville Medical Center, Mayville, ND

The May 9, 2016 news release is included in this weeks attachments for your review.

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Physician Recruitment ~ Kevin MaleeFinding Out Candidates.... More and more candidates are looking for opportunities sooner than in the past. This is good news and bad news for us who are looking to find and place physicians.

The good news is that we need to be prepared and have our ducks in a row. We need to be vigilant in our searches and always be looking down the road to our future provider supply and demand needs. We may not be looking for a candidate today, but we had better be looking for our physician, in that; the turnaround time is getting much longer, from search to placement.

The bad news for rural recruitment (rural is anything less than 100,000 population) is getting more difficult. We all know that the physician candidate pool looking for rural is small and this pool of candidates is getting smaller for all kinds of reasons. Now, more and more residents are looking earlier for placement after residency, which means our diminishing candidate pool, becomes even smaller.

Take away: Be looking today for your candidate that you will need in the future. If you are one provider away from crisis, (should a provider become sick, or leave your community) you need to be looking for your replacement today.

If I can assist you in your physician recruitment efforts, please contact me. I can be reached at northdakotarec@comcast.net or 701-320-2109.

SAVE THE DATE!QHA’s 2016 Quality Forum August 17, 2016

Ramkota, BismarckWatch for details coming soon!

Additional Educational OpportunitiesND HFMA Hot Summer, Hot TopicsJune 16, 2016 | Ramada Grand ForksSee brochure in this weeks Informer attachments.

Emergency & Trauma Outreach Symposium, Dickinson, NDAugust 24-25, 2016 | CHI St. Alexius HealthThis symposium offers physicians, nurses, pre-hospital providers and other healthcare team members the latest guidelines for pediatric practice through patient-centered presentations. See brochure in this weeks Informer attachments.

5th North Dakota Conference on Injury Prevention & Control - “Bringing the Pieces Together”August 10-11, 2016 | Radisson Hotel, Bismarck, NDThis conference is designed to provide attendees with innovative strategies and relevant information to reduce injury and violence in North Dakota. See brochure in this weeks Informer attachments.

NDNPA 8th Annual Pharmacology Conference The NDNPA is gearing up for their 8th Annual Pharmacology Conference to be held in Fargo on September 29-30. Included in this week’s attachments you will find a conference agenda as well an invitation to display at the conference. You can also use the following link to register online for the exhibits: http://ndnpa.org/conference/exhibitors/

For additional information, please contact Tina Lundeen at 701-231-7747 or email tina.lundeen@ndsu.edu.

Mark your calendars for NDHA’s 82nd Annual Convention and Trade Show October 4-6, 2016 @ the Hilton Garden Inn in Fargo!

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Washington Update ~ John Flink Lawmakers have less than four weeks before they adjourn for the national party conventions and the traditional August recess. While most of the media’s attention is on the presidential campaign, the House and Senate continue to work through important legislation.

The House of Representatives this week approved by voice vote legislation that would extend the time hospitals have to qualify to be grandfathered into the existing payment system for services provided in off-campus, provider-based clinics.

The bill revises the so-called “site neutral” provisions of the 2015 Bipartisan Budget Act, which mandates that hospitals are only reimbursed at the lower Medicare physician schedule for services delivered in off-campus, provider-based clinics after January 1, 2017. Hospitals already delivering these services as of November 2, 2015 are not affected by the policy change.

The bill moves the grandfather date from November 2, 2015 to December 31, 2016 or 60 days after enactment, whichever is later.

The bill also would require the Centers for Medicare & Medicaid Services to consider socio-economic factors in the Hospital Readmission Reduction Program.

The measure now moves to the Senate where the Finance Committee will consider it – probably after the summer recess. Meanwhile, Senate leaders continue to push forward on bills to appropriate funds for the federal government for FY 2017, which begins October 1. This week, the Senate Appropriations Committee, on which Sen. Hoeven serves, agreed to funding levels for the Department of Health and Human Services for FY 2017.

The action was somewhat historic. The HHS funding bill has often been the venue for partisan conflict; but this year, the Labor, HHS and Education Subcommittee leadership vowed to avoid such fights and struck a deal that sets the stage for the first Senate floor vote on the HHS spending bill in years.

According to a committee summary, the bill includes several significant funding increases including a boost of about $2 billion for the National Institutes of Health. The budget for opioid abuse programs would grow about 93 percent compared to last year and nearly 500 percent from two years ago. A small increase in funding for rural health programs is also provided.

Across the Capitol, the House Energy and Commerce Committee, on which Rep. Cramer serves, has scheduled action next week on a major mental health reform bill. The bill was approved early this year by the panel’s Health Subcommittee, but has been stalled while committee leaders attempted to work out final details.

We have stressed the importance of increasing the supply of mental health professionals and providing grants and other resources for innovative treatment approaches. We also have urged greater use of telehealth technology to increase access to mental health services in isolated areas.

House floor action is not expected until after the summer recess – and maybe not before a post-election session.

The Senate Health, Education, Labor and Pensions Committee has also approved a mental health reform measure, but it is stalled as committee leaders attempt to identify ways to offset the cost of the bill.

Finally, lawmakers are starting to attempt to reconcile differences between House and Senate versions of legislation aimed at addressing the opioid epidemic.

We remain concerned that once again Medicare reimbursement cuts will be considered as lawmakers look for ways to offset the cost of the mental health and opioid bills. Our message to the congressional delegation continues to be “don’t go there!!”

2016 NDHA Convention SponsorsThank you to the following companies who have committed to sponsoring NDHA’s 2016 Annual Convention!

HSI Solutions - Diamond Level MMIC Group - Bronze Level EAPC Architects - Bronze LevelHCIS/Coverys - Gold Level Blue Cross Blue Shield ND - Bronze Level Avera eHealth - Silver Level McGough Construction - Bronze Level NorthStar Technology - Bronze LevelQuality Health Associates of ND - Breakfast Myers Thompson, P.A. - Bronze Level

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NDHA Education Update If you would like to be added to an email distribution list to receive updates on specific education events, please email Pam at pcook@ndha.org. Follow this link to register for educational events: http://www.ndha.org/education/education-events/

• June 13 Hierarchical Condition Categories (HCCs) • June 15 Top 5 Strategies for Revenue Health During EHR Transitions • June 15 careLearning Informational Webinar • June 16 CAHs: Developing a Compliance Plan (Nursing CEU’s provided) • June 16 Integrating EMS for Care Coordination & Disaster Response • June 28 No Master Plan, No Mission, No Margin

2016 NDHA PAC Fundraising The NDHA Political Action Committee (PAC) gives individuals who care about hospital issues the opportunity to speak with a strong, unified voice. The NDHA PAC makes contributions to state and federal candidates, from both political parties, who sup-port the goals of hospitals. Fundraising activities are conducted jointly with the American Hospital Association PAC. Our goal this year is $15,700.

A special thank you to the following individuals for their leadership and support of this year’s fundraising campaign. Currently we have raised $3,450.

Jerry Jurena NDHAKeith Heuser CHI Mercy Health, Valley CityKurt Schley CHI St. Alexius Health, BismarckJeff Drop CHI - FargoTheo Stoller Jacobson Memorial Hospital, ElginGreg LaFrancois St. Aloisius Medical Center, HarveyJodi Atkinson St. Andrew’s Health Center, BottineauDarrold Bertsch S akakawea Medical Center, HazenJim Long West River Regional Medical Center, Hettinger

Options of Care Last month I attended the ND Long Term Care Association membership meeting and listened to a presentation on a new pro-gram called Options of Care by Dr. Attila Dalmi from Grand Forks. He has put together an “Expedia” type of search tool for hospi-tals to utilize when finding long term care placement for patients prior to discharge.

Basically how it works is long term care facilities go in daily to update their bed availability. When you log in to search for an opening, you can enter in preferences on location, services provided, etc. Take a moment and review the attached handout and click on the following link to watch a quick video – it’s a great demonstration of how the program works. https://youtu.be/1bDOWLz2iiY

This is a work in progress. ND long term care facilities are starting to get on board with this tool but to make it beneficial for them, hospitals need to use the program for their discharge planning. Approximately 120 long term care facilities have requested a username/password to manage their data, with about 50% actively updating their status.

Hospitals with swing bed can be listed as a facility and update openings daily, and also use it for discharge planning.

I am in the process of gathering names and email addresses of discharge planners and social workers from our members. This information will then be shared directly with them, but please feel free to forward to whoever is appropriate in your facility.

For questions, or to get your own username and password, contact Dr. Dalmi: Phone: 701-215-2009 or Email: adalmi@hotmail.com