Ohio Department of Health


United States

Top Flex Activities

CAH Quality Improvement

The Ohio Flex Program collaborates with the quality improvement organization (QIO) for Ohio, IPRO, to improve patient safety in critical access hospitals (CAHs) and the community by ensuring all health care providers and eligible patient populations receive their influenza vaccinations. 

The Ohio Flex Program seeks to improve the transitions of care with emergency department transfer communication (EDTC) from the CAHs to other health care settings in order to improve patient outcomes and increase the percentage of CAHs reporting EDTC measures.

The Ohio Flex Program continues to maintain and support the Flex Quality, Financial and Operational Improvement Network (Flex QI Network) with the use of a consultant for quality improvement services and training for CAHs. The Flex QI Network has existed since 2004 and is supported by subcontractors in benchmarking, web-based reporting, quality measures improvement, technical assistance, and training.

CAH Operational and Financial Improvement

The Ohio Flex Program is focused on the following financial and operational improvement projects:

  • Conducting a financial and operational assessment with use of a consultant
  • Maintaining and supporting the financial and operational workshops within the Flex QI Network
  • Facilitating the sharing of best practices, resources, and expertise regarding financial and operational projects within the Flex QI Network
  • Utilizing the tools purchased through the Small Rural Hospital Improvement Grant Program (SHIP) funding for quarterly benchmarking and individual analysis of financial and operational improvement with the Flex subcontractor
  • Providing two workshops and/or webinars with experts to educate CAHs on financial and operational evidence-based practices
  • Conducting a financial and operational in-depth assessment and action plan with the use of a subcontractor

Rural Emergency Medical Services (EMS) Improvement

The Ohio Flex Program is engaged in population health management and EMS integration through the following activities: 

  • Implementing the six recommendations from the community-level EMS assessment
  • Providing paramedic refresher courses for rural providers
  • Providing both in-person and webinar-based EMS continuing education courses

If your Flex Program was funded for one of the eight competitive Flex EMS awards, please describe your project, your partners, and intended long-term outcomes.

The Ohio Flex Program is funding three community paramedicine rural pilot programs with the intended goal of self-sustainment at the end of the three-year grant. The models will be disseminated so other EMS agencies and hospitals can replicate them. The Ohio Department of Public Safety, local EMS agencies, and local hospitals are all important partners for this effort. The three metrics that will be closely monitored are EMS runs, emergency department (ED) avoidances, and 30-day readmissions.  

Please provide information about network activities in your state to support Flex Program activities.

The Ohio Flex Program created the Flex QI Network in 2004, which has grown and maintained momentum and continued participation. The Flex QI Network focuses on quality, financial, and operational improvement through training and technical assistance. There are over 55 participants, including chief executive officers (CEOs), chief financial officers (CFOs), directors of nursing, and other quality staff from all 33 CAHs.

Program Statistics

Do you have any hospitals interested in converting to CAH status?:
Type of Organization State Government
Staffing (FTE) None
Website Organization Website 
Number of CAHs 33


Organization Contacts

Daniel Prokop

SORH Director / Interim Flex Coordinator, Ohio
(614) 728-0519

Specialty Areas/Background

  • Master of Science in Health Systems Administration
  • Lean Six Sigma Green Belt
  • Worked in project management at two large health systems
  • Managed a housing program at a small AIDS Service Organization
  • Grant management experience

SORH Director since July 2022

Shane Ford

State Office Director, Ohio
(614) 752-5133

State Office Director since October 2017


Melissa Gustin

Flex/SHIP Coordinator, Ohio

Flex/SHIP Coordinator since November 2022