The American Hospital Association (AHA) came out this week in support of H.R. 6346, bipartisan legislation spearheaded by the Wisconsin Hospital Association (WHA) and introduced by Rep. Ron Kind (D-Wisconsin) and Rep. Sam Graves (R-Missouri). The legislation was developed by WHA along with Kind to ensure certain provider taxes for Critical Access Hospitals (CAHs) are treated as an allowable cost for purposes of Medicare cost reports and, therefore, Medicare reimbursement.

"On behalf of our more than 5,000 member hospitals, health systems and other health care organizations, and our 40,000 individual members, the American Hospital Association (AHA) is pleased to support the Rural Hospital Protection Act (H.R. 6346)," read the AHA letter to Rep. Kind. "We applaud your commitment to America’s health care providers and stand ready to advocate for H.R. 6346."

H.R. 6346, known as the "Rural Hospital Protection Act," requires Medicare to recognize that health care provider taxes, like Wisconsin’s new Critical Access Hospital assessment, are real costs to CAHs, and when determining allowable costs for purposes of Medicare reimbursement, the Act would prohibit the Medicare program from offsetting against a provider tax certain payments that a CAH receives from the State, including increased Medicaid payments.

"We are grateful for Congressman Kind’s leadership on this important legislation," said WHA President Steve Brenton. "We are also pleased that AHA is making passage of this legislation a top priority."

Earlier this year in comments to its Fiscal Year 2011 Inpatient Prospective Payment System (IPPS) rule, the Centers for Medicare & Medicaid Services (CMS) stated that Medicare contractors will determine the allowability of provider taxes on a case-by-case basis, based on reasonable cost principles. The contractors were to determine if a reduction of the allowable tax expenses is necessary to account for payments providers receive that are associated with assessed taxes.

"Under current regulations, such provider taxes are clearly allowable, and the fact that there may be payments made by the state to the provider—or the fact that Medicaid payments from the state may be funded by the provider taxes—does not change this result," the AHA letter read further. "In addition, as long as the tax is a Medicaid-approved provider tax, CMS should not seek to impose a Medicare offset. The agency’s policy is jeopardizing the financial sustainability of CAHs."

Earlier this year, WHA aggressively advocated against the change on behalf of Wisconsin’s CAHs. WHA worked with members of Wisconsin’s Congressional Delegation, specifically Sen. Herb Kohl and Rep. Kind. In addition to submitting comment letters to the CMS with the Rural Wisconsin Health Cooperative, WHA organized a dear colleague letter onto which a bipartisan 41 Members of Congress signed.

WHA looks forward to working with our Members of Congress and the AHA to pass this legislation.

Over the next several weeks, The Valued Voice will feature interviews with some of our member hospitals that have been recognized for achieving an employee vaccination rate of at least 80 percent. We will also include resources related to health care employee influenza immunization programs that are new, or that have been submitted by WHA member hospitals. To share your success story or employee education materials, contact Mary Kay Grasmick at mgrasmick@wha.org or 608-274-1820.

Stoughton Hospital, the recent recipient of a Wisconsin Forward Award, is proud of their achievement in another area, too—their employee influenza vaccination rate of 86 percent for the 2009-2010 flu season.

"Immunizing our workforce against influenza is important to us," according to Infection Prevention Nurse Nancy Moskal, who leads the effort at Stoughton Hospital. "This is another major area for quality and patient safety improvement."

Moskal, who also coordinates performance improvement for Stoughton Hospital, said one of the biggest things that has helped them achieve record immunization levels is to take the vaccine to where the employees are.

"We are in all the patient care areas. We have nurse coordinators personally vaccinating their employees," Moskal said. "I like going to department and team meetings and immunizing in group settings where you can have some group pressure and encourage team spirit."

The idea is to promote the fact that, as a member of the team, individual members are accountable for not only keeping themselves well, but also making sure that they are doing their part to ensure the safety of their patients, their fellow employees and their own family members.

Employee education is key. "You have to drill the safety message home and dispel the myths," Moskal added. "The biggest myth is that the vaccine causes the flu. Busting that myth is huge. Attack the myth, challenge them with research."

UW Hospitals and Clinics broke the 80 percent mark last flu season, vaccinating 83 percent of their workforce. How did they manage to reach more than 6,142 employees? Thom Weiss, director of compensation and benefits, is a passionate leader for the immunization campaign at UWHC. He points to a number of factors that helped push UWHC past the 80 percent mark last year.

"We were very clear with our message last year. With H1N1 circulating in our state and no vaccine readily available during the early stages of the outbreak, we knew there were things we could not control associated with it," Weiss said. "However, we could control the regular seasonal flu and protect our patients, ourselves and our families."

Weiss recalled an especially memorable moment in the campaign last year when a manager stood up and did a testimonial at a department meeting about how she had personally come to believe that getting the seasonal flu vaccine is one of the most important steps health care workers can do for their patients.

"It is, above all, a patient safety issue," Weiss added.

For the latest information regarding the seasonal flu, visit: www.pandemic.wisconsin.gov.

NEW! Stoughton Hospital shares two employee education tools: an employee brochure (www.wha.org/qualityAndPatientSafety/pdf/InfluenzaVaccinationInformation.pdf) and a chart that tracks their progress, which is also shared with employees (www.wha.org/qualityAndPatientSafety/pdf/SeasonalFluRates.xls)

NEW! University of Wisconsin Hospitals and Clinics employee influenza education Myth v. Fact brochure: (www.wha.org/qualityAndPatientSafety/pdf/FluVaccineMythsFacts.pdf)

NEW! The Wisconsin Department of Public Health has a new video that debunks the common myths and concerns associated with the influenza vaccine. Ideally, the video would be posted to the employee intranet or other employee communication medium. The 13-minute video features Dr. Jeff Davis, the state epidemiologist. Here is the link: http://dhsmedia.wi.gov/main/SilverlightPlayer/Default.aspx?peid=2528a1223dfe4bfc9114aa5092f7ab2b&autoStart=true

The Wisconsin Hospital Association wrote to the Wisconsin Department of Commerce (Commerce) October 15 asking for modifications to the proposed administrative rules that, if promulgated, would make significant changes to the Wisconsin Building Code. Based on a review of the rules by Wisconsin Healthcare Engineering Association President Wade Rudolph, Sacred Heart Hospital, Eau Claire, WHA asked Commerce not to adopt the proposed new standards for certain ventilation systems in health care facilities.

WHA is concerned that the proposed rule would adopt ventilation standards that have undergone significant corrections since the standard’s publication date. The proposed rule would require heating and ventilation standards of health care facilities to conform to the Facilities Guidelines Institute’s Guidelines and Designs for Health Care Facilities. According to Rudolph, those proposed standards were not fully developed at the time of publication, and the adoption of those standards would be harmful to hospitals and not beneficial for patients.

Beyond the proposed standard still being reviewed and corrected by the Institute, hospital engineers believe the proposed standard would be difficult and extremely costly for hospitals to meet. For example, because the proposed ventilation rates would require increased duct sizes, the new standards would force some facilities to build new surgical suites rather than renovate existing suites when there is a need.

"Forcing an unnecessarily expensive choice when hospitals are focused on prioritizing health care costs and improving efficiencies would be an unfortunate outcome of this rule change," said Rudolph. According to Rudolph’s review of the substantiating study for the change, the proposed standards would not improve patient safety.

We will hold our Annual Business Meeting this year via conference call/webinar.

WHA Chair David Olson and Chair-elect Nick Turkal request that you plan to attend. Information will be sent to you soon.

Steve Brenton
WHA President

Over the next six weeks, WHA will be offering a variety of virtual WHA Member Forums to share important information on several current hot topics. They will each be offered via webinar at the dates and times noted below and will be offered at no cost to WHA hospital members. Pre-registration is required and is available online for each of these sessions.

This webinar will provide a review and update for nurse leaders and HR professionals of the conditions, rules and restrictions of a compact license. Jeff Scanlan from the Wisconsin Department of Regulation and Licensing will present a review of statutes and rules around compact licensing. This is a great opportunity to review your process for verifying licenses on hire and for ongoing attention to the specific constraints that apply to nurses licensed under compact rules. Online registration is available at:

www.wha.org/education/nurseLicensure11-10-10.aspx.

The Medical Education Process and Its Affect on the Physician Shortage
November 16, 9:00-10:30 am

Hospital CEOs and other senior leaders can enhance their knowledge of the process of educating and training physicians, how medical education is regulated, and how medical education is financed in Wisconsin. Learn about the challenges to changing the environment and how it contributes to the current and projected physician shortage. In addition, learn about potential solutions to the shortage and activities currently in play in Wisconsin to help alleviate the projected shortage. Online registration is available at: www.wha.org/education/medicalEducation11-16-10.aspx.

A RAC Review and Look Ahead
November 18, 12:00-1:00 pm

The Recovery Audit Contractor (RAC) program is in full swing nationally and in Wisconsin. Learn what’s happening across the country and in our Region B. Issues discussed will include which issues the RACs are focusing on, how many claims are being appealed, and what is the administrative burden to hospitals. In addition, recent hospital survey results from AHA’s RACTrac program will be shared, along with Wisconsin-specific RAC activities and updates. Online registration is available at: www.wha.org/education/RACwebinar11-18-10.aspx.

For registration questions on any of the virtual WHA Member Forums, contact Lisa Littel at llittel@wha.org or 608-274-1820.

Columbus Community Hospital is a 25-bed, Joint Commission Accredited, acute care facility offering a wide range of inpatient and outpatient services, and serves a population of 27,000. Columbus Community Hospital also offers a wide variety of Community Education programs for all ages to provide community members with quality programs ranging from babysitting, stress management, cardiac rehab, CPR, and First Aid.

For more information, visit http://careers.besmith.com/CommonPages/SearchJobs/JobDetail.aspx?joid=2607 or to apply for this position, email your resume to talent@besmith.com.

Shawano Medical Center (SMC), and ThedaCare have signed a letter of intent to integrate.

Following six months of discussion, SMC’s Board of Trustees agreed unanimously September 30 on the decision, and ThedaCare’s Executive Committee approved it on October 5. Dorothy Erdmann, SMC CEO, and Dr. Dean Gruner, president/CEO of ThedaCare, signed the letter of intent October 11. The agreement means the two have agreed on the core elements of integration that are good for them both.

"It makes sense to come together," said Erdmann. "For the past several years, we have been competitors, with mixed results for both parties. We can accomplish more by working together, and the clear winner will be the Shawano community. Shawano Medical Center and ThedaCare physicians are the family doctors for nearly three-quarters of the residents of the Shawano area. They expect their clinic and hospital staff to work together seamlessly, and a new partnership will help accomplish this."

"Our shared commitment to strengthening local care brought us together," Erdmann added. "This new relationship will reduce service duplication and costs and expand services in the Shawano area, including cardiology, oncology and rehab medicine. Just as important, Shawano Medical Center will continue to have a community board of directors looking out for what is in the best interest of our local community when this integration is completed."

In addition, ThedaCare has committed to planning and building a replacement hospital in Shawano. The new facility will be efficient, patient-centered and will eliminate duplication. Both ThedaCare and the hospital will commit capital funds to the project. Planning will begin in 2011.

The Wisconsin State Health Plan describes exposure to toxic substances, noise, vibration and other hazardous agents in the environment or the workplace as contributing to disease. Hospitals work diligently to protect the health of their employees by ensuring that they provide a safe, environmentally-friendly workplace. They also share this knowledge with the community by sponsoring activities that encourage the safe disposal of mercury thermometers, medications and “sharps.”

Free Medication Take Back Day nets 283 lbs of medicine for disposal

Sauk Prairie Memorial Hospital & Clinics’ (SPMHC) pharmacy staff coordinated a free Medication Take Back Day on Saturday, April 17. Nearly 350 households took advantage of the drive-thru medication drop off site at the hospital, where staff collected and safely disposed of any old, unneeded or expired vitamins, herbals, over-the-counter and prescription medications. All told, 283 lbs of medicine was collected for safe disposal. 

This program was sponsored by the SPMH Foundation as part of its From the Heart series. Special thanks to the Sauk City and Prairie du Sac Utilities, and SPMHC volunteers.

Sauk Prairie Memorial Hospital & Clinics, Prairie du Sac

Fort HealthCare honored for “making medicine mercury-free”

Fort HealthCare has been recognized for its efforts to reduce mercury by Practice Greenhealth, a national membership organization for health care facilities committed to environmentally-responsible operations. The award, “Making Medicine Mercury-Free” designates exceptional efforts to rid the health care sector of the harmful chemical mercury, commonly used in medical care.

The Practice Greenhealth Making Medicine Mercury-Free award recognizes facilities that have virtually eliminated mercury from their facilities and have demonstrated a commitment to continue to be mercury-free. Award criteria include mercury-free management and purchasing policies, and recycling programs.

“Our concern about mercury use in health care began when it was identified as a threat to public health and the environment,” said Fort HealthCare’s sustainability coordinator, Margaret Martin. “Fortunately, our industry and manufacturers have responded to this issue, and it’s getting easier to find safer, cost-effective alternatives. To minimize mercury’s effect, Fort HealthCare has set standards that go beyond regulatory reductions. It hasn’t been an easy process, but we believe a healthier patient and staff environment is more than worth the effort.”

      Fort HealthCare, Fort Atkinson

Raising awareness of the dangers of radon

A recent report by the La Crosse County Health Department of 2,000 homes showed 20 percent had dangerous levels of radon. Radon, a naturally occurring gas found in soil, is the second leading cause of lung cancer in the United States, killing more than 21,000 people a year. So, Gundersen Lutheran teamed up with the county to raise awareness about the dangers of radon in the home including a free informational program, “Got Radon? How to Fix Your Home,” and offered low-cost test kits to the public.

Gundersen Lutheran Health System, La Crosse

Aur ora Health Care’s Good Neighbor Day

Hundreds of Aurora Health Care caregivers braved cold and windy conditions on Saturday, November 15 to offer residents in communities across eastern Wisconsin the chance to drop off items to de-clutter their own lives, as well as help others. Despite the cold, nearly 1,200 residents dropped off carloads of items that were either recycled or redistributed to domestic abuse shelters, Goodwill Industries, the Salvation Army, Lions Clubs and environmental groups.

Aurora’s “Good Neighbor Day” expanded upon America Recycles Day. Aurora caregivers teamed with local Boy Scouts, Girl Scouts, school groups, and community volunteers who were recruited to staff the collection sites and evaluate, sort, bundle and properly recycle or re-distribute a wide variety of items. For many residents who responded to Aurora’s Good Neighbor Day, it was a relief to be unburdened of the responsibility to properly dispose of old computers, microwave ovens and outdated medications. Items collected included:

·         Medication – 1,630 pounds (54 drums)

·         Walkers, crutches, wheelchairs and other home medical equipment – 451

·         Microwave ovens – 78

·         Eyeglasses – 810 pairs

·         Cell phones – 607

·         Used clothing – 12,135

·         Televisions – 236

·         Coloring books and crayons – 327

·         New teddy bears and stuffed animals – 571

·         Personal care items, snacks, new clothing and undergarments – 1,439

·         New hats, mittens and children’s books – 1,342

·         Computers – 428

·         Electronics – 876

Many of the reusable items found their way to new homes or uses throughout eastern Wisconsin, for example:

·         Walkers, crutches and other home medical equipment were made available to free clinics

·         Personal care items, new clothing and snacks were delivered to Aurora’s Sexual Assault Treatment Center to provide basic reinforcements for women

·         Cell phones were re-purposed for use by women at shelters to escape abusive situations

·         Used clothing was donated to Goodwill Industries and the Salvation Army

·         New hats, mittens and books were distributed by Aurora Family Service to children in disadvantaged circumstances

·         Old medications were sent for proper disposal to keep them from our lakes, rivers and streams

Aurora Health Care, Milwaukee

 
Submit community benefit stories to Mary Kay Grasmick, editor, at mgrasmick@wha.org.

Read more about hospitals connecting with their communities at www.WiServePoint.org.

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