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Kentucky Office of Rural Health

Top Flex Activities

CAH Quality Improvement

The Kentucky Flex Program will be working on the following quality improvement activities: 

  • Provide internal quality improvement training and resources through a sub-contract with Cynosure. Two in-person meetings will also be held throughout the year as well as web-based training opportunities. 
  • Provide critical access hospitals (CAHs) Medicare Beneficiary Quality Improvement Project (MBQIP) technical assistance on an as-needed basis
  • Provide Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) training and stroke education

CAH Operational and Financial Improvement

The Kentucky Flex Program will be working on the following financial improvement activities: 

  • Annual on-site hospital visits
  • Provide personalized financial technical assistance through a sub-contract with Blue and Company, where hospitals will be able to choose from a training menu that includes but is not limited to swing bed analysis and education, clinical documentation improvement (CDI) review and education, 340B Drug Pricing Program revenue maximization and education, revenue cycle walkthrough, Chargemaster reviews, and bad debt compliance.
  • Provide support to CAH and rural health clinics (RHC) networks.  Meetings are scheduled regularly throughout the year. 
  • Provide scholarship support to hospitals looking to attend educational events related to the overall objectives of the Flex program. 
  • Host the 2020 Kentucky Telehealth Summit and RHC Summits.
  • Provide two CAH security risk analyses to ensure Health Information Portability and Accountability Act (HIPAA) compliance.

CAH Population Health Improvement

The Kentucky Flex Program will:

  • Provide board training to the state's 27 CAHs.
  • Involvement with three rural health networks not facilitated by the KORH, and attending and supporting those networks as needed.

Rural Emergency Medical Services (EMS) Improvement

The Kentucky Flex Program will be working on the following EMS related activities:

  • 2020 EMS-specific grant writing workshop
  • Hosting a compliance and finance workshop for EMS providers and leaders
  • Up to 4 mental health first aid trainings to CAH communities across the state
  • Hosting a training institute for future EMS leaders in Kentucky
  • Provide multiple statewide EMS listening sessions in early 2020 to create an action to plan addressing identified issues 

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.

Their project focuses on improving out-of-hospital sudden cardiac arrest survival rates among rural counties served by one of Kentucky’s 27 designated rural CAHs by way of a phased rollout of Cardiac Arrest Registry to Enhance Survival (CARES) along with an emphasis on increasing bystander CPR training at the community level and automated external defibrillator (AED) registry promotion throughout the targeted communities. 

They are partnering closely with the Kentucky Board of EMS as well as other vested partners across the state. 

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

The Kentucky Flex Program and KORH as a whole are very involved in a variety of rural health networks across the state. They personally host and facilitate the South Central Hospital Network meeting as well as the Western and Southeastern Rural Health Clinic Network meetings. They are also at the table for a variety of other networks across the state, many of those involving community-based division grantees.

Program Statistics

Do you have any hospitals interested in converting to CAH status?:
Type of Organization University
Staffing (FTE) 3.5
Website Organization Website
Number of CAHs 27

Flex Program Staff

Ernie Scott
State Office Director, Kentucky
(606) 439-3557

Specialty Areas / Background

  • Federally Qualified Health Centers (FQHCs)
  • Rural Health Clinics (RHCs)
  • Electronic health records
  • Grants/project management, contractual agreements
  • Critical access (CAHs) and small rural hospitals
  • Rural health policy
  • Stakeholder relations
  • Contractual agreements
  • Strategic planning
  • Quality improvement
  • Registered Radiologic Technologist

State Office Director since November 2013

Kayla Combs
Flex Coordinator, Kentucky
(606) 439-3557

Specialty Areas / Background

  • Quality Improvement
  • Critical Access and Small Rural Hospitals
  • Rural Health Networks
  • Grants management

Flex Coordinator since January 2013

Caleb Williams
Rural Project Manager, Kentucky

Rural Project Manager since February 2020.

Scott Helle
Rural Project Coordinator, Kentucky
(606) 439-3557 Ext. 83687

Specialty Areas / Background

  • Emergency Medical Technician
  • Certified Ambulance Coder (CAC)
  • Certified Ambulance Compliance Officer (CACO)
  • Rural EMS Operations

Rural Outreach Coordinator since December 2018.

Lisa Garza
Rural Project Manager, Kentucky
(606) 439-3557

Specialty Areas/Background

  • Small Hospital Improvement Program (SHIP)
  • State Loan Repayment Program (SLRP)

Rural Project Manager since January 2019

Mike McGill
Rural Project Manager, Kentucky

Specialty Areas/Background

  • State Loan Repayment Program
  • National Health Services Corps
  • Marketing
  • Journalism
  • Publishing

Rural Project Manager since May 2018

Marcus Pigman
Rural Project Manager, Kentucky
(606) 439-3557, ext. 83583

Specialty Areas/Background

  • Rural Health Clinics
  • Health Care Policy
  • Rural Health Networks
  • RHC and CAH Finance

Rural Project Manager since February 2014

Alice Combs
Administrative Support Associate I, Kentucky
(606) 439-3557

Specialty Areas / Background

Administrative office management

Staff Support Associate I since January 2008 

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.