MHA Today | May 19, 2017

May 19, 2017

MHA Today: News for Healthcare Leaders

twitter linkedin MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.


Herb Kuhn, MHA President & CEO

If a hospital was an engine, hospital staff would be the oil. Employees keep the incredibly complex parts of a hospital running smoothly and efficiently. And like engine oil, having too much or not enough can reduce performance or lead to system failure.

In recent years — even during the recession that began late in the last decade — hospital jobs have been plentiful, driven by a growing demand for health services. Filling the engine was seldom a problem. Yes, salary and benefits are the single largest category of cost for most hospitals, but revenue is entirely dependent upon staff to provide care. Demand for that care was driving the need for additional caregivers and the staff and professionals that support their work. In recent years, when the oil light flickered, it has generally signaled a shortage.

Early this week, MHA released the 2017 workforce report. It sent a strong signal — more than just an oil light; a check engine light. For the first time, the report found that staff registered nurses had a historic high vacancy level of near 16 percent. Among all 36 categories of staff surveyed, staff R.N.s led in vacancy.

Last year’s report indicated an all-time high level of turnover among staff R.N.s., and an 18 percent turnover among all positions statewide. Certainly these were troubling numbers at the time. While some staff positions, including unlicensed assistive personnel, generally have high turnover, staff nurse and licensed staff professional turnover is disruptive and expensive. Researchers estimate that the cost of each nurse turnover is between $37,700 and $58,400, and short-term solutions, including agency staff, add to the toll without solving the problem.

Although this year’s report shows vacancy up, turnover is down. Let me temper the good news on turnover. Vacancy rates often signal a problem in the equilibrium between supply and demand. Hospitals are having trouble hiring staff nurses. That’s obviously a big problem, given that staff R.N.s comprise 60 percent of the hospital workforce.

MHA continues to partner with government, workforce stakeholders and academia to build programs to foster growth of the hospital workforce. Some of the programs we’re engaged in are described in the report. As we’ve been visiting with members of MHA District Councils, workforce development has increasingly been mentioned as a priority. We’re actively pursuing new partnerships and innovative programs to strengthen and enlarge the pipeline to hospital professions — especially within the categories that require years of training to reach the hospital or bedside. And, the Health Professions Opportunity Grant programs are creating entry-level pathways to provide new opportunities in health care-related employment for low-income individuals.

As with the earlier “Grow Your Own” initiative, we’re focusing on opportunities for career pathways for incumbent hospitals employees, certificate holders and licensees. Moving workers up through the professions — and keeping them within the walls of the hospital — has promise in delivering the skilled workforce we’ll need to address the increasing demand and need for replacement workers as the aging workforce retires.

There’s much work to do. Our staff is engaged on multiple fronts, identifying new opportunities to bring skilled workers in and grow the workers who are already serving. However, as with the educational path to many hospital professions, it will take time to see results.

The warning lights on the dashboard are flickering. We’ve got the hood up, looking for causes, and short- and long-term remedies. Addressing workforce challenges should be part of regular hospital maintenance because the workforce is essential to keeping the system running, and to each hospital’s operational efficiency.

Missourians are pushing the gas pedal and the fuel tank is full. Demand for services isn’t the problem. To keep the engine running, we’ll need ample oil.

I’d like to hear what you think.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
Governor Nominates New Department Of Social Services Director
U.S. Senate Committee Approves Chronic Care Bill
CMS Announces Education Sessions
Mercy Names Johnston Regional President Of East Community

state and federal health policy developments

Governor Nominates New Department Of Social Services Director

Staff Contact: Daniel Landon

Gov. Eric Greitens has nominated Steve Corsi as Acting Director of the Department of Social Services. A clinical psychologist, Corsi currently serves as the Director of the Wyoming Department of Family Services.

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U.S. Senate Committee Approves Chronic Care Bill

Staff Contact: Daniel Landon

The U.S. Senate Finance Committee has unanimously approved legislation designed to expand treatment options for chronically ill patients. S. 870 also permits Medicare Advantage plans to have more flexible benefits for their chronically ill enrollees and expands a Medicare “Independence at Home” demonstration project, as well as expands Medicare coverage of telemedicine in Medicare health plans and accountable care organizations. The committee adopted an amendment giving Medicare prescription drug plans access to hospital and physician claims data to promote better integration of care.

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Quality and Population Health

CMS Announces Education Sessions

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services has scheduled the following outreach and education sessions for hospitals participating in the inpatient quality reporting and hospital value-based purchasing programs. Registration is available at the links provided.

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Mercy Names Johnston Regional President Of East Community

Staff Contact: Carol Boessen

Jeff Johnston, President of Mercy Hospital St. Louis, has been named Regional President for the East Community, effective May 18. Johnston joined Mercy in 2001 and has served as President of Mercy Hospital St. Louis since 2011. He will continue to lead Mercy Hospital St. Louis until his successor is named.

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Did You Miss An Issue Of MHA Today?

May 18, 2017
Letter Urges Action On AHCA Funding Equity
Governor Calls Special Session For State Legislators
U.S. Senate Committee Approves Regulatory Process Overhaul Bill
CMS Issues Another EPM Delay
MLN Connects Provider eNews Available
Saint Luke’s North Hospital Names Interim CEO

May 17, 2017
CMS Updates Marketplace Enrollment Process
MHA Provides Emergency Preparedness Resources
HIDI Releases Management And Productivity Report
HHS Provides Cybersecurity Updates In Wake Of WannaCry Attack
USDA Accepts Applications For Rural Telemedicine Grants
Excelsior Springs Hospital Names New CEO

May 16, 2017
MHA Publishes 2017 State Legislative Session Summary
Emergency Physicians Say Anthem ED Pay Policy Violates “Prudent Layperson” Standard
Hospital Associations And TJC Host Sleep Accreditation Webinar
DHSS Posts Home Health CoP Guide
CMS Clarifies Transfer And Discharge Requirements For LTC
CMS Issues State Innovation Waiver Checklist
MHA Releases 2017 Annual Workforce Report

May 15, 2017
MO HealthNet Releases Revised Electronic Signature Rule
MO HealthNet Updates Medicaid Provider Manual
CMS Offers Marketplace Coverage Enrollment Option For Small Business

Consider This ...

U.S. adults age 65 and older with diabetes are less likely to visit the dentist than adults without diabetes.

Source: Centers for Disease Control and Prevention