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North Dakota Flex State Profile

The Technical Assistance and Services Center (TASC), a program of the National Rural Health Resource Center, provides technical assistance for the Rural Hospital Medicare Flexibility (Flex) Program in the form of information, tools and resources. State Flex Programs benefit from sharing information with one another and the Flex State Profiles are meant to be a method to encourage that sharing.

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State Contacts

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Survey Results


In each core area, what are the top Flex activities in your state?

Core Area 1: Support for Quality Improvement
  • Encourage public quality reporting.
  • Encourage (maintain) critical access hospital (CAH) participation in the Medicare Beneficiary Quality Improvement Project (MBQIP).
  • Use ND CAH Quality Network to identify specific quality benchmarking and quality improvement activities.
  • Collaborate with other quality improvement-related initiatives involving ND CAHs and emergency medical services (EMS).

 

Core Area 2: Support for Operational and Financial Improvement
  • Assist CAHs in identifying potential areas of financial and operational improvement.
  • Support revenue cycle management analysis to increase hospital revenue and cash flow.
Core Area 3: Support for Health System Development and Community Engagement
  • Support the inclusion of emergency medical services (EMS) into local and regional trauma systems of care.
  • Support critical access hospitals (CAHs) and communities in conducting assessments to identify unmet community health and health service needs.
  • Support CAHs and communities in developing collaborative projects to address unmet health and health service needs.
  • Support for the sustainability and viability of EMS within the community.
Please describe a success story or innovative program from the Flex program in your state:

North Dakota has 36 critical access hospitals (CAHs). The ND Flex program is 1 of 16 Flex programs with 100% participation in the Medicare Beneficiary Quality Improvement Project. We also had 100% CAH data submission for the inpatient hospital measures reporting to the CMS Clinical data warehouse for Quarter 2, 2012. The success of the Network is a result of a strong collaboration with our state quality improvement orgranization (North Dakota Health Care Review, Inc.). The partnership has included joint individual visits to all CAHs, quarterly technical assist calls and regional, state and national data review.

No two Flex programs are alike! What is one unique thing that you would like others to know about your Flex program?

The sustainability and success of the North Dakota Critical Access Hospital (CAH) Quality Network has been a significant contribution to all of ND health care. The Network is supported by Flex funding and other funding secured through the Network’s efforts. All 36 of the state's CAHs are members and over the past five years regional networking between CAHs and large referral centers has strengthened tremendously due in part to the efforts of the Network. Projects over the past two years have included: development of a ND Uniform Initial Credentialing form; participating in statewide systems of stroke care; maintaining a standard checklist for CAHs to use in managing their CMS Conditions of Participation; development of a highly utilized list serve and other modes of communication including a web site and newsletter. The Network has developed a reputation as the go-to place for CAH quality questions; there is trust amongst the members, Network staff are highly regarded and a trusted resource, and CAHs are moving in a positive direction toward improving quality outcomes. This Network is successful because of its members and partners – CAHs helping CAHs and remaining true to their mission.

State Contact Details

Gary Hart, PhD

Director, Center for Rural Health, North Dakota
(701) 777-3899

Specialty Areas / Background

Rural health, health workforce (physician, nurses, oral health personnel), rural geographic taxonomies, access to care, rural state and federal policy, and rural healthcare for the elderly, infants, and the underserved.

Center for Rural Health Director since October 2010 

 

Lynette Dickson

Associate Director,Center for Rural Health, North Dakota
(701) 777-6049

Specialty Areas / Background

Masters Nutrition and Dietetics, Licensed

Associate Director since March 2003 

 

Brad Gibbens

Deputy Director, Center for Rural Health, North Dakota
(701) 777-2569

Specialty Areas / Background

Master Public Health

Deputy Director since May 1986 

 

Jody Ward, RN, BSN

Flex Coordinator, Center for Rural Health, North Dakota
(701) 858-6729

Specialty Areas / Background

Nurse

CAH Quality Network Coordinator since May 2008 

 

Shawnda Schroeder, PhD

Project Coordinator, Center for Rural Health, North Dakota
(701) 777-0787

CAH Quality Network Coordinator since April 2011

 

Angie Lockwood

Project Assistant, Center for Rural Health, North Dakota
(701) 777-5381

Project Assistant since January 2011

 
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