MHA Today | July 29, 2016

July 29, 2016

MHA Today: News for Healthcare Leaders

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Herb Kuhn, MHA President & CEO

If there was a time of great opportunity for skilled health care workers, it is now. The economy has improved, the health care sector is leading in job creation and demand for health services continues to increase. Unfortunately, what’s good for the worker isn’t always good for the organization as a whole.

This year’s MHA workforce report finds high rates of turnover in the state’s health care workforce — exceeding 18 percent in aggregate — and at 17.9 percent on average for R.N. staff nurses, statewide. That’s not particularly good news.

Some of the highest turnover positions are in less skilled areas. However, the high turnover rates for the clinical mainstays of hospital care, including R.N.s, are particularly troubling.

Vacancy rates are high as well. Although switching jobs between hospitals and within other care settings most likely reflects movement by current employees, high vacancy rates signal a different problem — workforce inadequacy. The R.N. staff nurse vacancy rate statewide was 9.2 percent and the rate for behavioral health R.N.s was more than 10 percent. Although the turnover rate for physician assistants was less than 10 percent, the vacancy rate was greater.

The message is clear. Missouri isn’t producing or attracting enough skilled health care workers.

The news isn’t all bad. There’s a lot of work being done to strengthen and enlarge the workforce. MHA’s Grow Your Own Program and the current Hospital Employee Scholarship Program are two examples of investments hospitals are making communitywide.

MHA is participating in several other initiatives to build the statewide workforce. As a partner, MHA is supporting the work of the Missouri Healthcare Workforce Coalition. The coalition held a primary care summit earlier this year to identify opportunities and challenges in the primary care workforce and collaborate on solutions. One of the goals of this group was accomplished through legislation this session — a health care workforce database — and other initiatives are being pursued.

Earlier this year, the Missouri Department of Social Services was awarded a nearly $15 million, five-year grant to support job training in health-related fields that are expected to either experience a labor shortage or be in high demand. The Health Professions Opportunity Grant will provide support for low-income Missourians in the St. Louis, Kansas City and central Missouri regions to enter health professions. MHA is supporting this work statewide.

We’re making progress in bringing the right organizations together to ensure resources aren’t wasted or duplicated. However, there’s much work to be done.

The vacancy and turnover rates outlined in this year’s report aren’t sustainable. Unfortunately, many of the high-vacancy, high-skill professions require years of training before they arrive at the bedside. The turnover churn that is occurring may slow. However, as long as hospitals are competing for talent in an insufficient candidate pool, skilled workers will benefit from the shortage.

Our historic hospital investments in expanding the educational pipeline, strengthening preceptor activities and engaging staff in skills-improvement, have provided a foundation for the future. Better coordination with all stakeholders will support additional and more targeted investment.

This year’s report underscores the immediate workforce challenges. The subtext is that health careers have a bright future.

Let me know what you’re thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
CMS Issues Final Rules For Medicare Hospice, SNFs And Inpatient Rehabilitation
MHA Issue Brief Assesses Medicare PPS Psychiatric Update
CMS Issues QIO Short-Stay Review FAQs
Local Transmission Of Zika Reported In Florida
Osage Beach Center For Cognitive Disorders Names New CEO

state and federal health policy developments

CMS Issues Final Rules For Medicare Hospice, SNFs And Inpatient Rehabilitation

Staff Contact: Daniel Landon

The Centers for Medicare & Medicaid Services released final Medicare rules for fiscal year 2017 for hospices, skilled nursing facilities and inpatient rehabilitation facilities. MHA will publish issue briefs next week.

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MHA Issue Brief Assesses Medicare PPS Psychiatric Update

Staff Contact: Daniel Landon

MHA has published an issue brief on the Medicare fiscal year 2017 payment update for the Medicare inpatient psychiatric facilities prospective payment system. CMS has posted a fact sheet.

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Regulatory News
the latest actions of agencies monitoring health care

CMS Issues QIO Short-Stay Review FAQs

Staff Contact: Daniel Landon

The Centers for Medicare & Medicaid Services has posted an FAQ document regarding the May 2016 suspension and subsequent reexamination of Medicare Part A short-stay reviews by its beneficiary and family-centered care quality improvement organizations. The review of claims will be limited to a six-month “look-back” period.

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Quality and Population Health

Local Transmission Of Zika Reported In Florida

Staff Contact: Jackie Gatz

The Centers for Disease Control and Prevention has released information on the first locally-transferred cases of Zika in Florida. Prior to these findings, all U.S. cases were travel-associated.

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CEO Announcements

Osage Beach Center For Cognitive Disorders Names New CEO

Staff Contact: Carol Boessen

Lorri Steffen was named CEO/Administrator of Osage Beach Center for Cognitive Disorders, effective July 18. She served as Chief Operating Officer since November 2015 and was the Registered Nurse Charge Nurse since July 2014. Steffen replaces David Garvin, who had served as CEO/Administrator since July 2014. A list of CEO changes is available online.

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Did You Miss An Issue Of MHA Today?

July 28, 2016
CMS Issues Psychiatric PPS Payment Update
MHD Announces Ambulance Payment Increases
OIG Renders Advisory Opinion On Hospice Payments
MLN Connects Provider eNews Available

July 27, 2016
Issue Brief Describes Proposed Coordinated Care Models
MHA Updates Self-Assessment Checklists For CAHs
CMS Issues Guidance On Care Of Justice Involved Individuals
CMS Announces Reconsideration Requests For Hospices
Trajectories — Diabetes: Population Health Improvement
CMS Publishes Initial Hospital Quality Star Rating Data
MHA Releases 2016 Annual Workforce Report

July 26, 2016
Federal Legislation Would Delay Star Quality Ratings
CMS Expands Coordinated Care Models
Missouri FLEX Program Awarded National Certificate Of Excellence

July 25, 2016
President Approves New Opioid Abuse Law
CMS Reports On Program Integrity Results
OIG Report Assesses Rehabilitation Hospital Patient Harms
MHD Announces Rate Increase For Adult Day Care Waiver
HRSA Hosts Workshop On Rural Health Funding Opportunities

Consider This ...

The average financial loss from registered nurse turnover per hospital is between $4.9 million and $7.6 million annually.

Source: MHA’s 2016 Annual Workforce Report