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Georgia Office of Rural Health

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CAH Quality Improvement

The Georgia Flex Program partners with the Georgia Hospital Association (GHA) to provide its 30 Critical Access Hospitals quality improvement initiatives including support for the Medicare Beneficiary Quality Improvement Program (MBQIP). GHA develops and distributes comparative measure dashboards quarterly for all 30 CAHs for continuous monitoring and improvement. The hospital-specific dashboards are utilized to identify areas in need of improvement and to develop action plans.

Through Flex support, GHA provides webinars, monthly training, and coaching calls to educate CAHs on reporting techniques and best practices for quality improvement. These initiatives include:

  • A Professional Monthly Mingle where CAH quality improvement and infection prevention professionals meet virtually to network and learn best practices
  • Electronic Health Record (EHR) User Groups who share tips and best practices on getting the most benefit from their EHR systems
  • A collaborative learning framework focused on the implementation of the Core Elements of the Center for Disease Control’s (CDC) Antibiotic Stewardship Program
  • Extensive technical assistance and ad hoc training to support reporting including the Quality Professional Orientation where quality professionals new to their role are provided a “101” education and assistance with additional measure reporting
  • Support in Flex years one and two for 15 CAHs to participate in the Culture of Patient Safety Survey (CoPs)

Additionally, financial support is provided to CAHs for reporting core measures or eCQMs to regulating entities and technical support for reporting optional measures to QualityNet.

CAH Operational and Financial Improvement

The Georgia Flex Program partners with Georgia Southern University Research and Service Foundation (GSU) to implement CAH operational and financial improvement activities. In annual cohorts of 15, GSU conducts financial and operational hospital service-line assessments and SWOT (Strengths, Weaknesses, Opportunities and Threats) Analyses throughout the year. These analyses are utilized to develop hospital-specific action plans for improvement. GSU also facilitates three-year organizational strategic planning sessions and develops implementation plans for a cohort of at least nine CAHs annually.

Stakeholder and community engagement assessments with interventional action plans are also conducted for CAHS along with the provision of training on rapid cycle approaches for data-driven operational improvement. Leadership strategies are  implemented through workshops and seminars. Overall program evaluations are conducted annually to identify programmatic activities in need of modification or a redirected focus.

Ongoing technical assistance is provided to CAHs including the Community of Practice (CoP) Network Newsletter. The weekly newsletter published for CAH leadership provides education and available resources by topic every Wednesday relevant to CAH financial and operational performance. The CoP also serves as a platform for CAH leadership to interact, network, and share best practices and lessons learned.

CAH Population Health Improvement

In light of Georgia's dire need for behavioral health services, the Georgia SORH partners with HomeTown Health, LLC (HTH) to develop the Vision and Education for Rural Behavioral Health (VERB) Program. The goal of this program is to build capacity of CAHs to achieve measurable improvements in the health outcomes of their communities. Specifically, the program assists hospitals in engaging community stakeholders to address their population's behavioral health needs.

The VERB program empowers hospitals to take ACTION in the areas of: Abandoning Stigmas; Care and Case Management; Train Providers; Identify and Screen; Organize Resources, and Navigate Payments. HTH coaches CAHs in engaging with community stakeholders and public health experts to identify two behavioral health subcategories (i.e. addiction, suicide, depression, etc.) and provides education, support, and provider and staff training relative to the CAH's specific community behavioral health needs. Ongoing best practice sharing, peer networking, and community input guide the focus of additional program needs or realignment. The project goal is to provide a needed behavioral health service line or partnership that will serve to improve the mental health of the community.

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

To support the goal of maintaining and improving the financial viability of CAHs, the Georgia SORH partners with HomeTown Health, LLC (HTH) to provide its 30 CAHs and its 36 small rural prospective payment systems (PPS) hospitals a state-funded Swing Bed Management Program.

The Rural Swing Bed Management: Managing Change (RSBM) Program offers a combination of webinars, virtual facility check-ins, and in-person interactive workshops to discuss building and maintaining a swing bed program with measurable financial expectations and quality outcomes. The program is designed to provide interaction with other swing bed best practices, while also providing individual hospital assistance.

The RSBM program guides hospitals through changes brought about through the Centers for Medicare and Medicaid Services' (CMS) Patient Driven Payment Model (PDPM) and the subsequent changes to delivery of swing bed care brought on by COVID-19, taking account how the two may be affected differently by change.

The RSBM Program is one of Georgia’s most successful hospital services programs with 43 of our total 56 hospitals actively participating.

Program Statistics

Do you have any hospitals interested in converting to CAH status?:
Type of Organization State Government
Staffing (FTE) 1.5
Website Organization Website
Number of CAHs 30

Flex Program Staff

Dawn Waldrip
Flex Coordinator, Georgia and Director, Hospital Services
(229) 401-3088

Flex Coordinator since January 2019

Amanda Laughter-Sutton
Program Operations Specialist, Georgia
(229) 401-3092

Program Specialist since March 2020

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, $1,560,000 (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.