Federal Flex Updates: September 2016

September 2016

This marks the end of month one of the new budget year which puts us squarely in the middle of the three-year Flex Program cycle. At this point I hope you've all had a chance to log in to the Performance Improvement Measurement System (PIMS) to review your critical access hospital (CAH) list and start pulling together the data for your PIMS report. We had a good Q&A call about PIMS on September 15. The PIMS reporting instructions and the recording of the September 15 call are both posted in the Flex Program Forum and don't hesitate to contact your project officer if you have more questions. 

I want to remind you to share the IMM-2 measure reporting instructions with your CAHs. Yvonne Chow from the Federal Office of Rural Health Policy (FORHP) sent a detailed explanation on September 14, but the gist of it is that CAHs should follow the Centers for Medicare & Medicaid Services (CMS) data collection instructions for the Inpatient Global Measure Set that includes IMM-2. This means that they should report every quarter, including June through September (Q2 and Q3) when the abstracted cases will be excluded from IMM-2.

Wakina Scott, FORHP, provided a September 2016 policy update that includes the newly published final rule on Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers. This rule requires that all facilities develop and maintain an emergency preparedness plan based on an all-hazards approach, this includes hospitals, CAHs, rural health clinics (RHCs) and federally qualified health centers (FQHCs). These plans must be in place by November 15, 2017. The rule requires cooperation with local, tribal, regional, state, and federal emergency preparedness officials and, when applicable, participation in collaborative and cooperative planning efforts.

I enjoyed seeing many of you last week in Kansas City at the National Rural Health Association (NRHA) CAH Conference. Several presentations highlighted state Flex work, including Marilyn Grafstrom's SAFER Care presentation about Minnesota CAHs improving quality and patient safety, Dave Pearson's report on Flex-funded financial improvement cohorts for Texas CAHs and Graham Adams and Melinda Merell's update on South Carolina's Rural hospital transformation plan.

Congratulations to everyone who shared your great work at the conference!

As always, please let me know if you have questions or suggestions for improving the Flex Program. 

Sarah Young

Flex Program Coordinator, FORHP


This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,009,121 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.