Minnesota Hospital Association


November 17, 2014

MHA Newsline: Nov. 17, 2014

In this issue 

CDC visits Minnesota’s designated Ebola care hospitals

Last week, the Centers for Disease Control and Prevention (CDC) met with each of the four hospitals designated to care for Ebola patients in Minnesota. The purpose of the visit was to review each hospital’s plan and provide feedback and input based on lessons learned at hospitals that have successfully cared for Ebola patients in the U.S. CDC team members included the Department of Health and Human Services assistant secretary for preparedness response, the CDC director of the Office of Blood/Organ and Tissue Safety and industrial hygienists from the National Institute for Occupational Safety and Health (NIOSH). CDC officials said they were impressed with the level of planning that has taken place in the state. Following the visits, the hospitals will debrief with the Minnesota Department of Health (MDH) on how their plans can be strengthened even further.   

Subgroups continue to meet to fine tune the state’s plan regarding EMS, personal protective equipment and lab services. MHA will continue to hold weekly conference calls with all Minnesota hospitals to ensure all hospitals have the latest information and are getting their questions answered. MDH also plans to release a PPE training video soon; it will be available on the MDH website and on the MHA Ebola resource page.   

Mali added to list for Ebola screening 
Beginning today, CDC added Mali to the list of countries from which travelers will be screened for Ebola. Mali was added to the list following a number of confirmed cases of Ebola in the country. Travelers will be subject to the same screening being used for travelers from Liberia, Sierra Leone and Guinea and will be required to enter the U.S. through one of the five designated airports. Learn more herereturn to top   

Member news: Allina Health names new CEO

Allina Health announced last week that Kenneth Paulus, chief executive officer and MHA board chair, is retiring at the end of 2014. Dr. Penny Wheeler, Allina Health’s president and chief clinical officer, has been appointed the next CEO.   

Dr. Wheeler assumed the role of chief clinical officer in 2006, having served previously on the board of directors of the company, where she chaired the Quality Committee. In 2013, she was named president, expanding her responsibilities to include hospital operations while continuing to advance the organization’s clinical quality and performance improvement agenda. Dr. Wheeler has led many successful initiatives while at Allina Health, including the merger of Courage Center with Sister Kenny Rehabilitation Institute to further integrate care for those with disabilities, and the partnership with Children's Hospitals and Clinics of Minnesota to create the Mother Baby Centers. Additionally, she has supported the development of specialty clinical service lines to assure consistently exceptional care.   

During his tenure at Allina Health, Paulus has led numerous growth initiatives, including joint ventures, strategic partnerships and acquisitions. Paulus joined Allina Health in 2005 after serving as CEO of Massachusetts-based HealthOne Care System. Paulus has served as the MHA board chair for the past year. return to top   

HPE pilot period extended

The Department of Human Services (DHS) is extending the hospital presumptive eligibility (HPE) “pilot” period for meeting performance metrics from six months to one year. The pilot period gives hospitals the opportunity to implement HPE without punitive measures for failing to meet the requirements that 80 percent of HPE eligible individuals complete a full MNsure application, and that 80 percent of that group be eligible for Medical Assistance. DHS is currently unable to get accurate data from the MNsure system regarding which programs or assistance some HPE-eligible individuals are eligible for. Therefore, DHS cannot provide accurate information to hospitals regarding whether some of their HPE-eligible patients were eligible for programs other than Medical Assistance and are unable to determine if these individuals would count towards or against the 80 percent requirement. The period is extended to June 30, 2015.   

Hospitals will be contacted by DHS for assistance and follow up if errors are found in HPE applications. DHS is particularly concerned with hospitals meeting basic HPE eligibility requirements: checking for HPE coverage in the past 12 months; checking for current MA or MinnesotaCare coverage; ensuring the basis of eligibility (income, eligibility group); MN residency; and checking qualifying immigration status. Hospitals are strongly encouraged to use the eligibility determination worksheets available here to help make correct determinations. Hospitals can also contact Health Care Eligibility Operations (HCEO) at 651-431-3480 or 888-702-9968, option 1, with HPE questions.   

As of Sept. 30, 2014: 

  • 1,919 individuals were approved for HPE 
  • 78 hospitals were certified to make HPE determinations 

Additional HPE update information is available in this power point or visit the HPE website.   

For more information contact Jen McNertney, MHA policy analyst, 651-659-1405. return to top   

MedPAC proposes DRG for short-stay hospital admissions

Medicare Payment Advisory Commission (MedPAC), recently proposed the creation of a set of diagnosis related groups (DRGs) to clarify some of the ambiguities around the medical necessity for short stays of less than two midnights.   

MedPAC suggested creating specific DRGs that would focus on one-day admissions to inpatient care facilities. It cited current CMS policies regarding short-term hospital stays are "ambiguous and open to interpretation” and could place a large financial burden on patients.   

Hospitals have complained that such stays are an overt focus of recovery audit contractors, or RACs. MedPAC observed that the large number of appeals by hospitals of short-stay payment claw backs have overwhelmed the system. Additionally, patients held in observation care, who are then transferred to a skilled nursing facility (SNF), are not covered by Medicare for their nursing home stay. About 11,000 patients a year who were transferred to SNFs do not qualify for Medicare coverage, MedPAC said.   

MedPAC ran a simulation of a one-day DRG and concluded that hospitals with a large number of short stays would see a reduction in payments, while those with smaller numbers of short stays would mostly be unaffected. Altogether, the average payment differential between observation care and a one-day stay with the DRG in place would be $910, while the differential between a one-day and a stay of two days or more would be $3,210.   

For questions, contact Joe Schindler, MHA vice president of finance, 651-659-1415. return to top   

AHA tool kit provides guidance on hiring veterans

The American Hospital Association (AHA) has developed a tool kit, Hospital Careers: An Opportunity to Hire Veterans that provides guidance on recruiting and hiring veterans specifically qualified as licensed practical nurses; nurse practitioners; physician assistants; and registered nurses. Many veterans have the necessary credentials and licensure to practice immediately on separating from the military and bring talent and leadership skills beyond their medical credentials.   

The tool kit was developed as part of AHA’s support of the Joining Forces Initiative and continued efforts to help hospitals recruit and hire veterans in health care professions. return to top   

MDH to phase out quarterly licensure fee payment option

The Minnesota Department of Health (MDH) last week mailed license applications for the following provider types: 

  • Boarding Care and Nursing Home Licensees 
  • Hospital Licensees 
  • Outpatient Surgical Center Licensees 
  • Supervised Living Facility Licensees

Included in the licensure renewal notices was a memo announcing that MDH will be phasing out the option to pay annual licensure fees on a quarterly payment schedule. MDH no longer has authority to collect licensure fees on a quarterly basis due to the fact that the 2002 law authorizing such payments was not reauthorized. To ease the transition, MDH will still allow a quarterly payment schedule in 2015, with completion of a Quarterly License Fee Rationale Form.   

The 2015 licensure application is available here. For questions, contact Mary Absolon, manager, licensing and certification program compliance monitoring division, MDH, 651-201-4100. return to top