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Flex Program

Upcoming Flex Events

Past Flex Events

  • On November 11th and 12th, 2010, representatives from 21 Critical Access Hospitals (CAHs) joined the Office of Rural Health and a national expert on Swing Beds, Mary Guyot from Stroudwater Associates, for an informative 1.5 days on all aspects of swing-bed methodology, utilization and program improvement. Participants learned valuable lessons about documenting outcomes and promoting this service. Participants learned how to be comfortable with admission criteria, document to support medical and physical rehabilitation, appropriately incorporate nurses and therapists into the interdisciplinary team, and bill for the services. Participants also became more knowledgeable about the Centers for Medicare & Medicaid Services conditions of participation and how to grow “the business” to make it a financially viable program.

  • November 5, 2009, 9:00 a.m.— 11:30 a.m., Flex Advisory Committee Meeting (Open to Critical Access Hospital participants only)
    ORH's Community Grants Coordinator provided a brief update on the Flex program and discussed funding opportunities for the ‘09-‘10 grant year. A panel of local hospitals discussed their efforts in implementing an electronic medical record (EMR), including how to choose a vendor, negotiate a contract, and tips on how to effectively rollout an EMR within your hospital. We also had a presentation on Quality Leadership for CAHs in Turbulent Times by Ira Moscovice, Mayo Professor and Head, Division of Health Policy and Management, University of Minnesota. The presentation discussed:
    • the implications of health care reform for rural health quality;
    • how critical access hospitals, both individually and collectively with other hospitals, can take a leadership role in quality measurement and improvement;
    • the role of Health Information Technology in rural health policy.
  • November 5, 2009,7:30 — 9:00 p.m., Non-Profit Board Training Workshop Reforming Board Healthcare: A Lighthearted Prescription for Common Board Ailments

    Author and consultant Bill Charney explored commonly accepted behaviors that preclude board effectiveness. In addition to insights and humor about “what is,” Charney offered suggested prescriptions to help resolve the ailments and help boards achieve the strategic leadership roles they should fulfill.

  • ORHQN RPM Benchmarking Meeting
    The Oregon Rural Healthcare Quality Network offered a dinner and program sponsored by the Oregon Office of Rural Health on October 8th, to coincide with many Oregon attendees at the NRHA’s annual CAH conference in Portland Oct 7 – 9. Among the topics shared were the top findings from the site optimization visits currently underway, advances in our benchmark report for the entire network, comprehensive use of board reports, and examples of effectively linking strategic plan to RPM.
    ORHQN Presentation Slides
    PMI Slides
  • Lean Workshop and Cost-Based Reimbursement Workshop
    The Office of Rural Health and the Oregon Association of Hospitals and Health Systems put together a couple of great workshops during September 2009 prior to the Rural Health Student Recruitment BBQ at Willamette Park. These workshops were focused on rural providers with no charge to CAHs or RHCs.

    Workshop Day 1: September 10th from 12:30 pm to 5 pm

    Introduction to Lean for Hospital Leadership - This 4 hour session conducted by Kari Penca from Oregon Manufacturing Extension Partnership (OMEP) was targeted specifically at senior hospital leadership and included:
    • A hands on introduction to Lean concepts and their potential impact on any organization.
    • Exercises to begin connecting the general Lean learning to your hospital including identifying specific wastes in your hospital and exploring a few Lean tools that may minimize or eliminate these wastes.
    • An overview of a senior leader’s role in transitioning to and sustaining a Lean culture.
    We're Not Toyota

    Workshop Day 2: September 11th from 9 am to 3 pm

    Maximizing Cost-Based Reimbursement – This workshop conducted by Mike Bell, CPA included a focus on how to receive EMR funding through the stimulus package along with the latest updates on standard billing procedures and RHC regulations.

    Stimulus Bill 9
    RHC - PB Clinic - FQHC Tables
    Strategies - Opportunities Under Cost-Based Reimbursement Tool
    New Updates - 2009
    Provider-Based RHCs and Provider-Based Clinics

  • Quality Improvement Project: AMI and Chest Pain in the Emergency Department
  • Oregon EMS Mass Casualty Incident Plan and EMS Communications Plan Meetings
    The EMS and Trauma Systems Program and Oregon Office of Rural Health jointly convened four meetings across the state to discuss the Oregon EMS Mass Casualty Incident Plan and EMS Communications Plan. The meetings included a facilitated discussion of the elements in the plan. For a copy of the draft plan, please see the Documents below. For more information, please contact , (503) 494-4450.
    Documents
    EMS MCI Plan Draft
    March 6, 2008 Meeting Agenda
    March 6, 2008 Meeting Slides
  • CAH Revised Relocation Guidance and Jan. 1, 2008, Rule Changes (sponsored by the Washington State Office of Community and Rural Health)
  • Telehealth Training Series for Critical Access Hospitals and Rural Health Clinics
  • OAHHS Lean Repository

HIT Toolkits and Additional Information

HRSA is pleased to inform you that the Kid's Toolbox (3 modules) and the ORHP Toolbox (6 modules) have been made publicly available. A blurb for each of the toolboxes have been added to the AHRQ-NRC Health IT Tools Page. Also, links to these toolboxes have been added to the "Related Links" portlet on the Health IT Adoption Toolbox page.

Below are links to each of these toolboxes:

CAH Information

  • List of Current CAH Hospitals in Oregon
  • Materials for Participation—detailed information
  • Provision of Observation Services in Critical Access Hospitals
  • The revised Rural Health Bookmark (April 2009), which provides information about educational resources that are available to the rural health community, is available in downloadable and print formats.
  • The Rural Health Fact Sheet Series (Summer 2009), which provides information about rural facility types and coverage and payment policies, is available in CD-ROM format. The following publications are included in the fact sheet series:
    • Critical Access Hospital;
    • Federally Qualified Health Center;
    • Medicare Dependent Hospital;
    • Medicare Disproportionate Share Hospital;
    • Rural Health Clinic;
    • Rural Referral Center;
    • Sole Community Hospital;
    • Swing Bed; and
    • Telehealth Services.

To access the downloadable version of the Rural Health Bookmark, visit CMS' website. To place your order for the print version of the Rural Health Bookmark or the Rural Health Fact Sheet Series CD-ROM, visit CMS' website, scroll down to “Related Links Inside CMS” and select “MLN Product Ordering Page.”

Flex Program Poster

 2007 Flex Program Poster

Please click on the image above for a larger image in Adobe Acrobat (pdf) format.

Flex Monitoring Team Reports

The Rural Health Research Centers at the Universities of Minnesota, North Carolina, and Southern Maine, under contract with the federal Office of Rural Health Policy are cooperatively conducting a performance monitoring project for the Medicare Rural Hospital Flexibility Program (Flex Program).

The monitoring project assesses the impact of the Flex Program on rural hospitals and communities and the role of states in achieving overall program objectives, including improving access to and the quality of health care services; improving the financial performance of Critical Access Hospitals; and engaging rural communities in health care system development.

Oregon Rural Healthcare Quality Network

A group of interested rural hospitals, state agencies, and other constituents have been working since 2005 to develop the Oregon Rural Healthcare Quality Network (ORHQN).

This network was formed with the goal of improving the quality and safety of rural health care in Oregon. The network will help rural providers overcome common challenges including geographic isolation, lack of opportunity to participate in a larger system, economic challenges, limited educational opportunities, smaller patient census, and limited information technology. The group was awarded federal funding to engage in the process of planning for the network over the next year.

Community Health Improvement Partnership

The Community Health Improvement Partnership (CHIP) develops ways to improve local health care and is about people becoming involved in health policy decisions both as individuals and as concerned community members.