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South Dakota Department of Health

Top Flex Activities

CAH Quality Improvement

South Dakota Flex Program activities:

  • Assisting critical access hospitals (CAHs) with building capacity and reporting the Medicare Beneficiary Quality Improvement Project (MBQIP) measures in all four quality domains
  • Supporting collaborative projects to assist CAHs with improving MBQIP by providing Clinical Improvement Coordinator assistance through the hospital association, providing Healthcare Quality Principles training to CAH quality staff, providing CAH quality leaders NAHQ education and training for Certified Professional in Health Care Quality coursework and certification
  • Support QI with peer-to-peer roundtable calls
  • Support a pilot cohort of 5 hospitals working in Antibiotic Stewardship

CAH Operational and Financial Improvement

South Dakota Flex Program activities:

  • Work with the South Dakota Healthcare Financial Managers Association (HFMA) to host a CAH Revenue Cycle A-Z webinar
  • Collaborate with the South Dakota Association of Healthcare Organizations (SDAHO) to provide a Chargemaster reporting tool to benchmark charges against state averages
  • Support CAH activities in the areas of revenue cycle assessments, work flow analysis, cost report review, and Chargemaster reviews

Rural Emergency Medical Services (EMS) Improvement

The South Dakota Flex Program supports EMS by providing a .5 FTE for a state trauma coordinator, supporting data collection in the state Patient Care Reporting System, providing Trauma Nurse Core Course education to CAH nurses, providing Emergency Nurse Pediatric Course, supporting trauma performance improvement webinar series, conducting EMS trauma designation assessments, and supporting the annual Trauma Summit. 

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

The South Dakota Flex Program actively partners with the South Dakota Healthcare Financial Management Association (SDHFMA). Membership in SDHFMA includes the state’s CAHs, the hospital system, state hospital association, and South Dakota Association of Healthcare Organizations (SDAHO). The State Trauma Council partners with the Department of Health and Public Safety in the development and implementation of the statewide Trauma System. Members of the State Trauma Council represent statewide stakeholders across the continuum of trauma services that include the state hospital association, the state’s hospital systems, trauma surgeons, ambulance services, and community and patient representatives.

Please provide information about cross-state collaborations you may be working on related to the Flex Program.

The South Dakota Flex Coordinator is working with the Arizona and North Dakota Flex Programs to provide assistance to Indian Health Service hospitals transitioning to a Critical Access Hospital in technical assistance with revenue cycle and billing and coding, creating a cohort workgroup for discussions. 

Program Statistics

Do you have any hospitals interested in converting to CAH status?:

Yes, at this time there is one IHS hospital transitioning to CAH status and two PPS hospitals have submitted documentation for transitioning to CAH status.

Type of Organization State Government
Staffing (FTE) 1.5
Website Organization Website
Number of CAHs 38

Flex Program Staff

Kaitlin Thomas
Administrator, Office of Rural Health, South Dakota
(605) 367-5043

State Office Director since June 2020

Michelle Hoffman
Flex Coordinator, South Dakota
(605) 295-3065

Flex Coordinator since March 2018

Josie Petersen
Assistant Director, South Dakota
(605) 773-3517

Specialty Areas / Background

Josie is the Assistant Administrator of the South Dakota Office of Rural Health. She has worked in this office for over 15 years. 

Assistant Director since October 2017

Jamie Zilverberg
Trauma System Manager, South Dakota
(605) 773-3308

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.