Hospitals
In an effort to make our website more useful, we have pulled specific resources and information that we thought would be useful to rural hospitals in the state.
The Wisconsin Office of Rural Health receives grant funding from the Federal Office of Rural Health Policy (FORHP) for the Medicare Rural Hospital Flexibility (Flex) Program. The Flex Program, established by Congress in 1997, assisted small hospitals in converting to a Critical Access Hospitals (CAH) designation – decreasing rural hospital closures and improving rural health care access. The Flex Program has evolved over recent years, and now assists CAHs with quality improvement, financial and operational improvement, population health, and integration of Emergency Medical Services (EMS).
The Wisconsin Office of Rural Health’s Flex Program has received national recognition for Medicare Beneficiary Quality Improvement Project (MBQIP) performance. The Health Resources and Services Administration announced that Wisconsin Critical Access Hospitals have the highest reporting rates and levels of improvement nationally over the past year.
For more, please see this list of Critical Access Hospitals in Wisconsin, a directory of their websites, and a map of Wisconsin's CAHs.
- General information on Critical Access Hospitals.
- State Operations Manual: Chapter 2-- The Certification Process: This document from the Centers for Medicare and Medicaid Services (CMS) reviews the requirements for initial certification as well as guidance for relocating CAHs.
- Appendix W of the State Operations Manual: Survey Protocol, Regulations and Interpretive Guidelines for Critical Access Hospitals (CAHs) and Swing-Beds in CAHs
- CMS Transmittals: CMS communications on new or changed policies and procedures.
- A "Swing Bed" is a hospital room that can switch from acute care status to skilled care status. Here is a fact sheet about swing beds.
Location and Distance Regulations:
- Critical Access Hospital Compliance with Location and Distance Requirements
- Critical Access Hospital Re-classification from Urban to Rural
More Questions?
We recently held our Rural Hospital Finance Workshop, which can answer many of your financial questions for critical access hospitals.
The federal guidance for the Flex Program requires states to undertake programs and activities that support Quality Improvement (QI) activities of Critical Access Hospitals (CAHs). The Wisconsin Flex Program assists CAHs with various aspects of quality improvement activities, including program planning, data submission, data management and analysis, and best practice development. And, the Wisconsin Flex Program works with the following partners and uses these additional resources to assist CAHs with quality improvement activities.
Organizations and Partners in Quality
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Statewide:
- Wisconsin Hospital Association (WHA)
- Metastar - Wisconsin's quality improvement organization (QIO) that works with health care providers to improvement quality of care.
- Rural Wisconsin Health Cooperative - Offering quality improvement services and programs geared to WI's rural hospitals and CAHs.
- Wisconsin Collaborative for Healthcare Quality (WCHQ)
- Wisconsin Hospital Association (WHA)
- Nationwide:
- National Rural Health Resource Center - Resources, tools, and webinars focusing on rural hospital and Critical Access Hospital quality improvement.
- American Heart Association
- National Rural Health Association
- National Rural Health Resource Center - Resources, tools, and webinars focusing on rural hospital and Critical Access Hospital quality improvement.
Quality Improvement Resources
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Centers for Medicare and Medicaid Services (CMS) - Rules, regulations, tools, resources, and policy briefings directly related to Medicare, Medicaid, and their impacts on CAHs.
- Hospital Compare - CMS' public quality measures data reporting tool.
- QualityNet - Established by CMS and includes health care quality improvement research, news, data reporting tools, and other information used for health care quality improvement.
- Joint Commission - Includes quality improvement certification, standards, and measurement criteria for hospitals, including CAHs.
- Flex Monitoring Team - This website includes CAH specific quality and patient safety data, reports and studies.
- Agency for Healthcare Research and Quality (AHRQ) - Provides tools and research aimed at quality improvement and patient safety, health care coverage expansion, and addressing the Triple Aim.
We have created a separate page for resources related to MBQIP. Click here to access it.
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MBQIP is a federal quality improvement initiative utilizing measures deemed relevant to rural settings. In Wisconsin, the project is managed by the WI‑ORH. Rural hospitals report measures in the areas of HCAHPS, Emergency Department Transfer Communications (EDTC), outpatient, and influenza immunization.
All hospitals, regardless of size and organizational structure, benefit from analyzing financial and operational performance. The Wisconsin Flex Program identifies financial and operational strengths and challenges in CAHs to implement activities designed to increase profitability.
Performance Improvement Resources and Links
- American Hospital Association - Performance improvement policy briefings, reports, and resources.
- County Health Rankings (CHR) - Measures vital health factors and outcomes in every state on a county-by-county level, and provides a useful way to explore the size and nature of health disparities in Wisconsin. It also emphasizes how state and community leaders can take action to create healthier communities.
- Flex Monitoring Team - Performance improvement data, research and policy briefings related to Critical Access Hospitals.
- National Rural Health Resource Center - Resources, tools, and webinars focusing on rural hospital and Critical Access Hospital performance improvement.
- Financial Data Reports on Wisconsin's Critical Access Hospitals
- Rural Health Information Hub (RHIhub) (formerly the Rural Assistance Center, or RAC) - A rural and social services online library that focuses on funding opportunities, tools, resources, studied and other publications, events, and news.
- Wipfli LLP - Educational events for CAHs.
Billing and Coding Regulations:
- Medicare Billing Information for Rural Providers and Suppliers
- ICD 10 Regulations and Information - Rules, regulations, and the latest news on ICD-10.
