AHA Award Nominations Open

June 8, 2009 Volume 16, Number 21 AHA Award Nominations Open Nominations are open for the 2009 Arkansas Hospital Association (AHA) awards program. The A. Allen Weintraub Memorial Award and Distinguished Service Award will be presented during the AHA s 79 th Annual Meeting Awards Dinner Thursday, October 8, at the Peabody Hotel in Little Rock. Arkansas C. E. Melville Young Administrator of the Year will be recognized by the Arkansas Health Executives Forum (AHEF); and the Diamond Awards, cosponsored by the Arkansas Society for Healthcare Marketing and Public Relations, also will be presented at the awards dinner. In addition, the ACHE Regent s Awards will be presented at the ACHE breakfast meeting that same morning. Criteria for each award are: The A. Allen Weintraub Memorial Award, named for Allen Weintraub, long-time administrator of St. Vincent Infirmary Medical Center in Little Rock, is the highest honor bestowed upon an individual by the AHA. Those nominated for this honor should be hospital chief executive officers who are contributing to their hospitals and communities in much the same manner as did Allen. Those who remember him always mention his care and concern, not only for hospital patients, but also for his employees; his passion for quality healthcare for Arkansans; his recognition of duty to the community; and his visionary influence. The AHA's Distinguished Service Award is presented to individuals who, while not necessarily AHA members, have promoted a cause of the healthcare industry, thereby becoming entitled to special recognition. Examples of those eligible for this award are physicians, nurses, trustees, auxilians, community leaders and other deserving individuals. (The 2009 recipients of the Weintraub and Distinguished Service Awards will be chosen by the AHA Board of Directors from those nominated.) The C. E. Melville Young Administrator of the Year Award is named for the late C. E. Melville, administrator of Jefferson Regional Medical Center in Pine Bluff. The award recipient is selected by the AHEF s Awards Committee. The award recipient must be under age 40, a resident of Arkansas for at least two years, employed by an Arkansas healthcare institution and meet requirements for active membership in the Arkansas Health Executives Forum. The 2009 Diamond Awards honoring excellence in hospital marketing and public relations will be presented in several categories, such as advertising, annual report, Internet Web site, publications, special video production and writing. Diamond Awards (for hospitals with 0-99 beds, 100-249 beds, and 250 or more beds) will be presented in each category. Entries were accepted in the spring and have been judged individually by a panel of judges not affiliated with any Arkansas hospital. The 2009 ACHE Regent s Awards will honor outstanding healthcare executive leadership in two areas early career and senior level. The two recipients, selected by the AHEF s Awards Committee, will be presented their awards at the ACHE Breakfast during the AHA Annual Meeting and recognized at the annual Awards Dinner that same evening. Paul Cunningham, Editor Phil E. Matthews, President/CEO; 419 Natural Resources Drive; Little Rock, Arkansas 72205; 501-224-7878; facsimile 501-224-0519

AHA Notebook 2 June 8, 2009 AHA Submits Ideas For Bending The Cost Curve Congressional leaders and the White House have assigned a top priority to healthcare reform in an effort to push it through this year. To show support, five healthcare organizations representing six different sectors of the healthcare industry, including the American Hospital Association (AHA), committed last month to help achieve the Administration s goal of decreasing the annual healthcare spending growth rate by 1.5 percentage points saving $2 trillion or more. The groups then structured individual sets of specific steps that they can take to accomplish that goal. The groups submitted a letter to the President officially sharing their initial ideas on June 1 (see www.aha.org and look under What s New to find the letter). For its part, the AHA suggested hospital initiatives for bending the cost curve which address immediate and longer-term cost savings. The ideas for immediate savings developed after consulting broadly with the AHA membership and allied associations cover eight specific areas: Reduce surgical infections and complications Reduce central line-associated blood stream infections (CLABSI) Reduce Methicillin-resistant Staphylococcus aureus (MRSA) Reduce clostridium difficile infections (c diff) Reduce ventilator-associated pneumonia (VAP) Reduce catheter-associated urinary tract infections; Reduce adverse drug events from high-hazard medications (e.g., anticoagulants, narcotics, opiates, insulin, sedatives) Reduce pressure ulcers All focus on expanding efforts which already have been tested and adopted by hospitals and health systems. AHA will launch a national campaign to build upon those efforts and will ask each hospital to choose the order in which they tackle issues on the list. The overall goal is to accelerate the pace of improvement, while broadening and deepening the success across the field. Longer-term cost savings would come from future AHA-coordinated campaigns to help promote initiatives for improving care coordination, implementing Health Information Technology (HIT), promoting efficient resource utilization, preventing patient falls, improving perinatal care and reducing supply costs. Arkansas Hospitals Receive Quality Awards Nineteen Arkansas hospitals were among more than 50 healthcare facilities to receive Quality Awards from the Arkansas Foundation for Medical Care (AFMC) in recognition of their commitment to excellence in healthcare. The awards were presented during AFMC s 16 th Quality Conference, held May 19-20 at the Hot Springs Convention Center. Winning healthcare providers earned the awards either through their performance on specific measures of healthcare or by creating innovative new programs. Four types of Quality Awards were presented to hospital organizations: Best Achievement, Most Improved, Validation and Innovator. Results for Best Achievement, Most Improved and Validation were based on quality of care data submitted to the Centers for Medicare & Medicaid Services. Innovator Awards were presented to hospitals that shared innovative and successful strategies with their peers and acted as mentors to other facilities. Several hospitals received awards in multiple categories. Awards were presented to: Arkansas Methodist Medical Center (Paragould) Innovator Baptist Health hospitals (Little Rock, North Little Rock, Heber Springs, Arkadelphia) Innovator

AHA Notebook 3 June 8, 2009 Baptist Health Medical Center (Arkadelphia) Best Achievement, Critical Access Hospital (CAH) (1 st place); Most Improved, CAH (1 st Place) Forrest City Medical Center Best Achievement, PPS (1 st place); Validation, PPS (2 nd place) Helena Regional Medical Center (Helena-West Helena) Validation Award, PPS (1 st place) Lawrence Memorial Hospital (Walnut Ridge) Most Improved, CAH (2 nd place); Validation, CAH (2 nd place); Innovator Medical Center of South Arkansas (El Dorado) Innovator Ozark Health Medical Center (Clinton) Validation Award, CAH (1 st place); Innovator Saline Memorial Hospital (Benton) Innovator Sparks Regional Medical Center (Fort Smith) Most Improved, PPS (2 nd place); Innovator St. Anthony s Medical Center (Morrilton) Best Achievement, CAH (2 nd place); Validation, CAH (2 nd place); Innovator St. Bernards Medical Center (Jonesboro) Innovator St. Joseph s Mercy Health Center (Hot Springs) Best Achievement, PPS (2 nd place); Most Improved, PPS (1 st place); Innovator Summit Medical Center (Van Buren) Innovator White County Medical Center (Searcy) Innovator White River Medical Center (Batesville) Innovator Home health agencies competed for three types of Quality Awards: Best Achievement, Most Improved and Innovator. In the Best Achievement and Most Improved categories, awards were presented for small, medium and large agencies and were based on quality of care data. Innovator Awards were presented to home health agencies that demonstrated a system change that resulted in improved processes and outcomes. Agencies also had to serve as a mentor to other agencies in implementing similar changes. Hospital-based Home Health Agencies that received awards are: Arkansas Methodist Medical Center Home Health Agency (Paragould) Innovator Baptist Health Home Health Network (Little Rock) Innovator Baptist Health Home Health Network (Arkadelphia) Innovator Crittenden Regional Hospital Home Health (Marked Tree) Best Achievement Award, Small Agency (2 nd place); Most Improved, Small Agency (2 nd place); Innovator Crittenden Regional Hospital Homecare (West Memphis) Best Achievement Award, Medium Agency (1st place); Most Improved Award, Medium Agency (1 st place); Innovator Bill Would Aide Rural Hospital Payments Sens. Kent Conrad (D-ND), Pat Roberts (R-KA), Tom Harkin (D-IA) and John Barasso (R-WY) have introduced legislation that would improve Medicare reimbursements to rural hospitals. The Craig Thomas Rural Hospital and Provider Equity Act (S.1157) provides for a temporary payment increase for hospitals with low-volume inpatient discharges. The bill also would continue allowing direct payments to independent laboratories for the technical component of pathology services and the 5% rural add-on payment for home health services. In addition, it would extend the outpatient hold-harmless provision for sole community hospitals and rural hospitals with fewer than 100 beds, remove the cap on disproportionate share adjustment percentages for all hospitals and improve payments for ambulance services in rural areas.

AHA Notebook 4 June 8, 2009 Pryor Bill Eases CAH Requirement Arkansas Senator Mark Pryor is hoping to re-open the opportunity for small rural hospitals to be designated with Critical Access Hospital (CAH) status in an effort to prevent them from closing or reducing patient services for people in their communities. Pryor joined with Sen. Sam Brownback (R-KS) to introduce the bipartisan Critical Access Flexibility Act of 2009, which would waive a provision in the Medicare law that requires a CAH to be 35 miles away from another healthcare facility. Specifically, the legislation restores a state s authority to waive the mileage requirements if all other requirements are met and the state designates the facility as a necessary provider. Two Arkansas hospitals have expressed interest in CAH designation, but do not qualify because of their proximity to another healthcare facility. Twenty-nine Arkansas hospitals are CAHs, which allows them to receive cost-based Medicare reimbursement. Some of those facilities gained CAH status under a previous program that allowed states to set them aside as medically necessary hospitals, despite the fact that they did not meet the Medicare distance requirement. States ability to make such designations expired a few years ago. Sen. Pryor s bill would resurrect it. Sparks Sale To GA Company Off Sparks Health System (SHS) of Fort Smith, which operates the 492-bed Sparks Regional Medical Center, has had a change of plans regarding its sale to Jackson Healthcare LLC, an Alpharetta, GA company. Sparks officials made a June 1 announcement that the proposed change of ownership will not occur. The SHS Board of Directors said last March that the hospital system would be purchased by Jackson Healthcare. No terms of the deal were disclosed, but both parties indicated at the time a desire to close the deal no later than June 30, 2009. SHS CEO Ted Woodrell noted that the System s situation has improved since earlier this year with increased patient volumes and gains in both nurse and physician recruiting. While citing no specific reasons for the change in direction, Woodrell said that it was a business decision based solely on what was the right thing for Sparks and the community. Sparks Health System is a private, non-profit organization that is managed by QHR. Legal Note: Fraud Enforcement & Recovery Act of 2009 On May 20, 2009, President Obama signed the Fraud Enforcement and Recovery Act (FERA). Although it was primarily directed toward mortgage fraud, the FERA also amends the civil False Claims Act (FCA) to significantly expand potential FCA liability and gives the government enhanced investigative powers. It therefore has particular significance to healthcare entities. One of the most important FCA amendments in the FERA is the creation of liability for knowingly and improperly avoiding or decreasing an obligation to pay money to the federal government, which includes the retention of any overpayment. While statements on the House and Senate floors indicated that the retention of an overpayment in routine reconciliation processes will not rise to the level of improper conduct, this distinction is not expressly stated in the statute itself. This new law reinforces the importance of establishing and closely following a program to detect, track and return overpayments, as failure to return overpayments promptly may result in a false claim violation.

AHA Notebook 5 June 8, 2009 The FCA also was expanded to include any false or fraudulent claim for government money or property regardless of whether the claim was submitted directly to the government. FCA liability will attach to government funds received through one or several intermediaries if the funds are spent on the government s behalf or to advance a government program or interest. The American Hospital Association has cautioned that hospitals should anticipate greater scrutiny of their vendor relationships whether as the provider or recipient of services under this FERA provision. The FERA also expands the U.S. Attorney General s authority to issue civil investigative demands and broadens the government s authority to share documents obtained through subpoena with qui tam relators and others. These and other FERA provisions are discussed in an excellent Legal Advisory published by the American Hospital Association, which is available to its members via Hospital Connect located at http://www.hospitalconnect.com/oam/login.jsp?domain=aha. Hospitals are strongly encouraged to review this advisory as well as other information available on the FERA in order to better prepare for the government s increasing focus on healthcare fraud and compliance issues. Suggested topics for the Legal Note may be submitted to elisawhite@arkhospitals.org. The Legal Note is provided solely for informational purpose and does not constitute legal advice. Readers are encouraged to consult with their own attorneys about any legal issues, including those discussed in this article. RAC Seeking Hospital Contact Info Connolly Consulting Associates (CCA), Inc., the Medicare Recovery Audit Contractor (RAC) for the southeastern U.S region, wants to hear from all hospitals and other affected providers in its region in order to identify a point of contact for future RAC-related correspondence such as demand letters and medical records correspondence. Please visit the CCA Web page at http://www.connollyhealthcare.com/rac/pages/provider_contact_information.aspx to find and download the company s Provider Contact Form and Multi-Provider Contact Spreadsheet for Facilities and Offices with Multiple Providers/NPIs. These forms should be completed and faxed back to CCA as soon as possible. Connolly has indicated that supplying this information in advance is extremely important in preparing for any potential RAC activities involving hospitals. Connolly is to begin its Arkansas operations in August, but may not begin requesting records until after provider outreach sessions are held. LTCH Rule Cuts FY 2009 Rates On May 29, CMS issued an interim final rule cutting current FY 2009 rates for Medicare s longterm care hospital (LTCH) prospective payment system, effective Wednesday, June 3. According to CMS, its own analysis of the LTCH final rule for FY 2009 contained an error in the reweighting of the LTCH MS-DRGs. CMS believes this error has already resulted in overpayment of $130 million. While CMS will not take steps to recapture this amount, they re implementing a payment reduction for the remainder of FY 2009 to reduce LTCH payments by $43 million, or 0.9%. The agency is accepting comments on the interim final rule through July 29. The new rule is likely to be addressed during the upcoming LTCH Advocacy Day planned for June 23 in Washington. The meeting will be held at the Washington Court Hotel, although time is set aside for Hill visits with members of states Congressional delegations, too. All LTACs in the state should have received an invitation to this meeting from the American Hospital Association. The day is geared to seeking co-sponsors for H.R. 2124 and S. 935, companion bills that would extend from three years to five years the delay in application of the 25% patient threshold payment adjustment and other LTCH policies. Find out more about the bills at http://thomas.loc.gov/.

AHA Notebook 6 June 8, 2009 NewsNotes About Arkansas Folks Joseph T. Hammond, FACHE has been named CEO of Fulton County Hospital in Salem. He succeeds Angela Richmond, CEO of Community Medical Center of Izard County in Calico Rock, who was also serving as CEO of the Salem facility. Hammond is a former administrator of Eureka Springs Hospital. He also has held various positions with several Mississippi hospitals and was a consultant with Community Healthcare Systems, Inc. Jim Maddox has retired as regional administrator for St. Edward Mercy Health System after a 34-year career with the system. Since 1999, he has had responsibility for the operations and directions of three critical access hospitals and three clinics. He began his career as a medical technologist and later became the managerial director of nursing service for St. Edward Mercy Medical Center in Fort Smith. Maddox has been active in Arkansas Hospital Association activities including the Arkansas Valley District and the critical access hospital program. Ron Summerhill has been named to succeed Jim Maddox as regional administrator for St. Edward Mercy Health rural network. He has assumed duties as administrator over North Logan Mercy Hospital in Paris, Mercy Hospital of Scott County in Waldron and Mercy Hospital Turner Memorial in Ozark, and affiliated rural health clinics in Waldron and Mansfield, Arkansas. Summerhill was most recently vice president of human resources for St. Edward Mercy Health System in Fort Smith where he has been employed for 35 years. Steven B. Webb has been named administrator of Baptist Health Medical Center Stuttgart. He succeeds Troy Wells, vice president for clinical services for Baptist Health, who had overseen hospital operations at Stuttgart since Baptist Health leased the facility in January and will now be responsible for Practice Plus and Arkansas Health Group. Prior to joining Baptist Health, Webb was CEO of Good Shepherd Medical Center in Linden, Texas. He is a graduate of the UALR health administration program and served as an administrative fellow at White County Medical Center in Searcy. Governor Mike Beebe recently appointed Elisa White, AHA vice president and general counsel, as a Commissioner on Uniform State Laws. As a commissioner, White will serve as one of Arkansas representatives to the National Conference of Commissioners on Uniform State Laws (NCCUSL), a non-profit association comprised of state commissions on uniform laws from each state, the District of Columbia, the Commonwealth of Puerto Rico, and the U.S. Virgin Islands. Since it was formed in 1892, the NCCUSL has drafted more than 200 uniform laws on numerous subjects, including the Uniform Probate Code, the Uniform Child Custody Jurisdiction Act, the Uniform Partnership Act, the Uniform Anatomical Gift Act, and the Uniform Interstate Family Support Act. The AHA Calendar June 2009 16 Advancing the Community Benefit Mission: The Current Challenges and Implications of New Reporting Requirements Webinar 16 Inpatient Rehab Coding Update: 2009 Webinar #T2503 16 2009 Mid-Management Leadership Series for Managers & Supervisors: Dealing with Conflict, AHA Classroom, Little Rock 17 2009 Mid-Management Leadership Series for Managers & Supervisors: Building Influence and Credibility, AHA Classroom, Little Rock 17-19 Hospital Executive/Trustee Leadership Conference, Perdido Beach Resort, Orange Beach, Alabama