Minnesota Hospital Association


February 09, 2015

MHA Newsline: Feb. 9, 2015

In this issue 

Funding for Ebola discussed as budget hearings continue

Last week the Senate completed overview hearings on the governor’s budget recommendations. The House and Senate Health and Human Services committees passed several bills relating to ambulance services. The Senate Finance committee passed legislation including $2 million for Ebola related costs for EMS providers and the four Ebola treatment hospitals (S.F. 174 – Sen. Cohen – St. Paul). This legislation was passed to the Senate floor. The House Health and Human Services Reform committee passed legislation to expand the rural loan forgiveness program (H.F. 211 – Rep. Kiel – Crookston).  

Upcoming hearings of interest
On Monday, Feb. 9 at 10:15 a.m., the House Ways and Means Committee will hold a hearing on legislation to provide funding to EMS providers and the four Ebola treatment hospitals (H.F. 264 – Rep. Knoblach – St. Cloud). At noon, the Senate Health, Human Services and Housing Committee will hold a hearing on the Interstate Physician Licensure Compact (S.F. 253 – Sen. Sheran – Mankato), and legislation to create a task force to review health care regulation with a report due in 2016. As introduced, MHA would appoint one of the 22 members to the task force.  

On Tuesday, Feb. 10 and Wednesday, Feb. 11 at 12:45 p.m., the House Health and Human Services Finance Committee will hold a meeting to hear public testimony on the governor’s budget. MHA will testify at one of these hearings. On Tuesday, Feb. 10 at 2:45 p.m., the House Health and Human Services Reform Policy Committee will hold a hearing on legislation to fund a portion of the poison information center (H.F. 346 – Rep. Hoppe – Chaska). The committee will also consider legislation to require EMS providers to develop stroke transport protocols (H.F. 513 – Rep. Zerwas – Elk River). 

On Wednesday, Feb. 11 at 8:15 a.m., the House Aging and Long Term Care Policy Committee will consider legislation to expand the loan forgiveness program (H.F. 627 – Rep. Franson – Alexandria) and legislation to develop a grant program to further long term care careers (H.F. 614 – Rep. Baker – Willmar). 

Legislation of interest
New bills introduced last week included: A bill to permit medical assistance coverage for certain mental health services provided by physician assistants in outpatient settings (S.F. 453 – Sen. Clausen – Apple Valley). 

For a complete list of 2015 legislative bills MHA is tracking, visit the Member Center. For assistance accessing the Member Center, contact Ashley Gauster, MHA member services and communications specialist, 651-603-3545. return to top   

DHS shares Medicaid rates for PPS hospitals

In a Feb. 6 webinar, Department of Human Services (DHS) staff provided hospital-specific impact numbers showing the transition to a reformed Medicaid inpatient fee-for-service payment system using APR-DRGs. DHS’ contractor, Navigant, was on hand to go through the details of the various policy adjusters that were used to help mitigate potentially detrimental payment swings related to key service areas such as mental health, pediatrics, and obstetrics in rural Minnesota.    

DHS is also pursuing development, with input from hospitals, to create a more sensible disproportionate share hospital (DSH) add-on payment system. This effort is intended to reinforce critical services and access for Medical Assistance patients.   

The critical access hospital (CAH) payment methodology is still under development for implementation later this year. They intend to create a cost-based methodology similar to Medicare’s to ensure rural access. CAH payment rates will continue using the current payment methodology, at least through September 2015.   

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

Don’t miss the chance to earn recognition for your hospital

MHA Awards nominations due Friday, Feb. 20
Is your hospital a best Minnesota workplace? Do you have an innovative patient safety program or exemplary caregiver who deserves recognition? If so, consider submitting a nomination for MHA’s annual awards program. MHA award categories recognize excellence involving community health, workforce issues, patient care and career promotion, for example. Honors for individuals recognize trustees, volunteers, hospital executives, caregivers and public officials. 

Entries are due by Friday, Feb. 20; find the entry form here: MHA Awards: Nomination Form  

A reception and dinner will take place Friday, April 24 at the Metropolitan Ballroom in suburban Minneapolis. All MHA members and associate members are invited and encouraged to attend the awards ceremony. 

Additional information on the categories and judging criteria can be found on MHA’s website, and for more information, contact Sarah Bohnet, MHA visual communications specialist, 651-603-3494. return to top   

Legislation reintroduced to remove 96-hour certification requirement for CAH; protect access to outpatient therapeutic services

U.S. Senate and House legislation was recently reintroduced that would remove the 96-hour physician certification requirement as a condition of payment for critical access hospitals (CAHs). 

Sens. Amy Klobuchar and Al Franken, and Reps. Collin Peterson and Tim Walz are co-sponsors of S. 258/H.R. 169, the CAH Relief Act. MHA has requested the remainder of the delegation to sign onto the bills. The legislation is also supported by the American Hospital Association. 

Medicare currently requires physicians to certify that patients admitted to a CAH will be discharged or transferred to another hospital within 96 hours in order for the CAH to receive payment under Medicare Part A. The Centers for Medicare and Medicaid Services has not historically enforced the requirement, but in recent guidance related to its two-midnight admissions policy implied that it will, a situation that could threaten patients’ access to longer care when needed. 

The legislation would not remove the requirement that CAHs maintain an average annual length of stay of 96 hours, nor affect other certification requirements for hospitals. In addition, legislation was reintroduced in the U.S. Senate that would allow general supervision by a physician or non-physician practitioner for many outpatient therapeutic services. Sens. Klobuchar and Franken are co-sponsors of the bill. 

S. 257, the Protecting Access to Rural Therapy Services (PARTS) Act, would require CMS to adopt a default setting of general supervision (rather than direct supervision) for outpatient therapeutic services, and create an advisory panel to establish an exceptions process for risky and complex outpatient services that may require a higher, direct level of supervision. The legislation would also hold critical access hospitals harmless from civil or criminal action regarding CMS’s retroactive reinterpretation of “direct supervision” requirements for the period 2001 through 2015. 

For more information contact Ann Gibson, MHA vice president of federal relations and workforce, 651-603-3527. return to top   

CMS rescinds letters requesting eligibility information from CAHs

MHA recommends CAHs take immediate steps to locate original documentation of eligibility
Last week, the American Hospital Association (AHA) alerted critical access hospitals (CAHs) that the Centers for Medicare and Medicaid Services (CMS) was sending letters asking for information related to each hospital’s eligibility for the CAH program.   

In conversations with AHA, CMS clarified that these letters were only sent to CAHs in North Carolina and Tennessee and CMS has now rescinded all letters.   

CMS has the authority to request this documentation, and may do so through the standard CAH survey process in the future, but has not regularly asked for this information in the past. MHA recommends that all CAHs take the necessary steps to retrieve the original paperwork confirming CAH status whether it is through necessary provider status or the federal mileage requirements.   

If CAH members are having difficulty locating their documentation they can contact Judy Bergh, Minnesota rural hospital flexibility and critical access hospitals, Office of Rural Health and Primary Care, Minnesota Department of Health, 651-201-3843.   

AHA continues to meet with CMS to encourage the agency to provide guidance and specifics on the documentation they may be looking for in the future. Locally, MHA is in close communication with the Office of Rural Health and Primary Care along with AHA on this issue and will provide additional information as it becomes available.   

For more information, contact Ann Gibson, MHA vice president of federal relations and workforce, 651-603-3527. return to top    

MHA advocates for rural PPS legislation

This week MHA submitted a request to the Minnesota congressional delegation to co-sponsor legislation that will make permanent both the Medicare-dependent hospital (MDH) and the enhanced low-volume Medicare payment adjustment (LVA) for small, rural prospective payment system (PPS) hospitals.   

The current short-term extension of these programs is scheduled to expire on March 31.   

Minnesota has 25 LVA and three MDH hospitals. These designations are particularly important for hospitals that are too large to qualify for critical access hospital status, but would be/are challenged to thrive under PPS without the additional support.   

This legislation also has the support of the American Hospital Association.   

For more information, contact Ann Gibson, MHA vice president of federal relations and workforce at 651-603-3527. return to top    

Hospitals collaborating on Minnesota’s response and preparation for Ebola

MHA recognizes the commitment of Minnesota hospitals to ensure the state stands ready should a Minnesota Ebola case develop. For months, you have been training and drilling caregivers and staff on how to deliver optimal care safely; communicating and coordinating efforts with the Minnesota Department of Health (MDH), MHA and other health care providers; evaluating facilities for appropriate isolation space; and ensuring that the necessary personal protective equipment (PPE) and supplies are available. 

Working closely with MDH, MHA has proactively engaged its members to develop a statewide plan for management of suspected and confirmed cases of Ebola Virus Disease (EVD) in Minnesota. Last Tuesday, senior MHA leaders met with MDH and the four designated Ebola assessment and treatment facilities through the Minnesota Collaborative for Healthcare Response to Ebola. 

During this meeting, MHA and members provided feedback to help shape MDH’s Concept of Operations (CONOPS) for Management of Suspected and Confirmed Cases of Ebola Virus Disease (EVD), including a situation overview, collaborative charter, purpose and scope, key organizations with respective assignment of responsibilities, detailed guidance on specimen collection, packing and shipping for Ebola virus testing, in addition to personal protective equipment (PPE) guidelines to be used and on the processes for donning and doffing (i.e., putting on and removing) PPE for all healthcare workers entering the room of a patient hospitalized with confirmed EVD. 

MHA’s role in the collaborative is to support the collaborative by leveraging resources that will increase overall infrastructure alignment and promote sustainability among the four Ebola Treatment Centers; facilitate on-going communication and situational awareness with all MHA members; serve as a trusted partner for information and guidance; as well as serve as an advocate for the collaborative hospitals. “The state of readiness in Minnesota is high thanks to the continued engagement and hard work being done by our hospitals,” said Tania Daniels, MHA vice president for patient safety. 

The next all-hospital call on Minnesota’s Ebola preparations takes place Thursday, Feb. 12 at 3 p.m. To join the call, contact Karen Olson, MHA patient safety/quality coordinator, 651-603-3521. return to top   

Healthcare Leadership Institute participants to explore role of telemedicine; framework for patient safety

The American College of Healthcare Executives (ACHE) Minnesota Health Care Group has developed two panel discussions at MHA’s Healthcare Leadership Institute in March.   

The first panel discussion, “Health Care Safety — Protecting Patients and Front Line Staff,” will present a framework for a patient safety program that protects patients and health care providers from preventable injury. You will hear from health care professionals who have implemented programs and will provide you with lessons learned and what organizational infrastructure is required to successfully implement an effective safety program.   

Panelists include: 

  • Laura Keithahn, senior operations leader for acute care hospitals, HealthEast Care System, St. Paul; 
  • John Strange, president and CEO, St. Luke’s Hospital, Duluth; 
  • Steve Underdahl, CEO, Northfield Hospital; and 
  • Beth L. Heinz, vice president, operations and chief quality officer, Regions Hospital, St. Paul (moderator). 

During the second panel discussion, “Telemedicine in the Health Care Delivery System,” panelists will explore the current and future role of telemedicine in the delivery of health care and will delve into how well this technology has been utilized and received by clinicians and patients. Technical, operational, regulatory and financial aspects of the development of telemedicine programs will be investigated.   

Panelists include: 

  • Maureen Ideker, R.N., BNS, MBA, director of Telehealth, Essentia Health-Graceville; 
  • Kelly Rhone, M.D., Avera McKennan Hospital, Sioux Falls, S.D.; and 
  • Steven Mulder, M.D., president and CEO, Hutchinson Health (moderator). 

Both sessions have been approved by ACHE for 1.5 ACHE Face-to-Face credits. Participants do not need to be ACHE members to attend these sessions as they are geared toward all senior leadership. The conference will also feature sessions on professional resiliency and physician leadership. The March 4-6 program will take place at the Crowne Plaza Minneapolis West in Plymouth.   

For more information, download the brochure. return to top   

In memoriam: Ken Bank

Ken Bank, who served as president and CEO of Northfield Hospital and Clinics from 1988-2010, passed away unexpectedly at his home in Tucson, Arizona recently.   

Ken was a thoughtful, progressive leader who was instrumental in positioning Northfield Hospital and Clinics to grow and thrive in a challenging health care environment. During his tenure, he presided over the development of the Center for Sports Medicine and Rehabilitation, the expansion of surgical services and diagnostic imaging, the development and construction of a new hospital and the development of a primary clinic network. He was also active in many community projects. Ken was very involved with MHA and a great supporter of the organization. MHA extends our condolences to Ken’s family and friends. return to top