MHA Today | September 29, 2017

September 29, 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
Unfortunately, violence occurs in hospitals every day. What was once an aberration has become almost commonplace.

Several months ago, a Kansas City Star reporter called MHA looking for statistics about workplace violence. There have been local, state and national reports on the increase in violence in hospitals, and the inquiry wasn’t really a surprise. Rather than share data, we invited the reporter to attend a training session on de-escalation that MHA was sponsoring. Data can help explain what happened in the past. Alternatively, the program helps patients, staff and visitors from becoming a data-point.

The de-escalation training was a part of MHA’s S.A.F.E.R. initiative. The initiative provides resources to support workplace and community resiliency under five pillars, including safety programs, approaches to safer care, facts to inform decision-making, educational programming and regulatory requirements. These crosscutting pillars are implemented through regulatory, quality improvement and emergency preparedness initiatives, ensuring that S.A.F.E.R. reaches the entire hospital enterprise. In addition to the de-escalation training, there has been widespread participation in a program to respond to armed violent intruders.

These are important programs. However, organizations like MHA aren’t resourced to train Missouri’s entire health care workforce. The American Hospital Association has been working on the workplace violence issue as well. Their Hospitals Against Violence program provides resources to address violence in hospitals and within the communities they serve. More must be done.

On Monday, MHA and the Kansas Hospital Association sent a joint letter to the U.S. Department of Health & Human Services expressing concerns and asking for guidance and assistance. It’s time that the issue was addressed nationally, rather than looking at each staff member, each hospital or each incident as a separate case.

As we share in the letter, the U.S. Bureau of Labor Statistics finds that 52 percent of all workplace violence incidents are recorded in health care. The growing challenges of the opioid epidemic, limited access to mental health services, and other social pressures, have contributed to a steady rise in violence, exceeding the level of routine workplace challenges.

Two HHS grant-funded programs already offer limited focus and limited resources on workplace violence. The Centers for Medicare & Medicaid Services’ Hospital Improvement and Innovation Network includes two measures to understand the incidence of workplace injury and those caused by violence. In addition, the HHS ASPR Hospital Preparedness Program includes planning and preparation for responder safety and health with a goal of provider resiliency — including funding for the armed violent intruder and civil unrest planning and training.

Causes matter too. Through the Opioid State Targeted Response grant, provider training, medication-assisted treatment capacity and naloxone distribution is expanding. These strategies, along with decreased barriers to medication-assisted treatment, will begin to slow the incidence of opioid use disorder. However, the challenges of the nation’s broken behavioral health system extend far beyond opioid use and abuse, and should be addressed as well.

Finally, there are numerous examples of actions taken by regulatory officials following violent encounters requiring self-defense by the health care worker. These reviews can lead to potential immediate jeopardy status for the hospital, yet often lack specific direction on what actions staff should take to protect themselves and their patients when under assault. CMS survey teams should provide guidance on patient management during violent confrontations to help shape hospitals’ policies and staff training.

There’s much to do. Any harm to patients, staff or visitors is unacceptable. The policy and resources should follow to address this problem. Punitive measures without real investment or clear guidance are simply half-measures.

This isn’t a local problem. It’s a national crisis that will require national-level resources.

Let me know what you’re thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
HHS Delays 340B Pricing And Monetary Penalties Rule
MLN Connects Provider eNews Available
The Rehabilitation Institute Of St. Louis Names New CEO

Hurricane Response

  • Puerto Rico has received historic damage this month from hurricanes Irma and Maria. The island’s entire critical infrastructure network, to include power, water, fuel and communications systems, have been drastically impacted, projecting years of recovery efforts. Medical facilities have sustained major damage and are relying on backup systems to maintain operations and serve their communities. As transportation avenues are opened, disaster medical assistance teams from around the U.S. are deploying for extended tours to provide much needed medical support functions.
  • The American Hospital Association has activated The Care Fund to provide support to hospital employees in Puerto Rico affected by the storms. We will continue to provide updated information and opportunities for those interested to provide assistance as it becomes available.
  • MHA has numerous resources and guidance for hospitals regarding the recent hurricanes.

state and federal health policy developments

HHS Delays 340B Pricing And Monetary Penalties Rule

Staff Contact: Brian Kinkade

Today, the U.S. Department of Health & Human Services gave notice that it would again delay the implementation date of regulations on the calculation of 340B drug ceiling prices and manufacturer civil monetary penalties to July 1, 2018. MHA submitted comments in opposition of the delay.

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Regulatory News
the latest actions of agencies monitoring health care

MLN Connects Provider eNews Available

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services issues updates to MLN Connects Provider eNews. eNews includes information about national provider calls, meetings, events, announcements and other MLN educational product updates. The latest issue provides updates and summaries of the following.

  • Medicare clinical lab fee schedule: preliminary calendar year 2018 payment rates
  • Merit-based incentive payment system eligible measure applicability: new resources available
  • Home health agencies: quality of patient care star rating algorithm call – Tuesday, Oct. 10
  • Quality payment program: new resources and recordings of recent webinars available

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CEO Announcements

The Rehabilitation Institute Of St. Louis Names New CEO

Staff Contact: Carol Boessen

Mark Dwyer has been named CEO of The Rehabilitation Institute of St. Louis, effective Wednesday, Oct. 18. Dwyer has served as Director of Rehabilitation Services and Sports Medicine at Olathe Medical Center since 1999, and has been involved in the physical therapy field since 1987. He will succeed Tara Diebling, who served as CEO since December 2013. Diebling accepted the CEO position at Cardinal Hill Rehabilitation Hospital in Lexington, Ky., effective Sept. 17. She will serve as CEO at both hospitals until Mark Dwyer arrives on Oct. 18. A list of CEO changes is available online.

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Did You Miss An Issue Of MHA Today?

September 28, 2017
MO HealthNet Updates Applied Behavioral Health Precertification Form
CMS Allows Later Notice Of 2018 Premium Costs
U.S. Senate Unanimously Approves Chronic Care Legislation

September 27, 2017
DHHS Solicits FYs 2018-22 Strategic Plan Comments
MO HealthNet Gives Examples For Properly Billing Outpatient Drug Quantities
CMS Extends Worksheet S-10 Revisions Deadline
HealthCurve Analytics Schedules Readmission Penalty Predictor Pilot Program Webinar
Trajectories — Population Health: Models and Pillars for Success
TJC Announces Webinar Regarding Direct Submission Of eCQM Data
Free Opioid Training Available In Southeast Missouri
CDC Launches Opioid Awareness Campaign
New LTC Staffing Reporting Guidance Available
Lipstein Announces Retirement; Liekweg Will Lead BJC In 2018

September 26, 2017
Graham-Cassidy Bill Stalls In U.S. Senate
CBO Releases Preliminary Analysis Of Graham-Cassidy ACA Repeal Bill
CMS Releases Preliminary CY 2018 Clinical Lab Fee Schedule Payment Rates
TJC Announces Pioneers In Quality Webinar
CMS Selects Hospitals For OQR Validation

September 25, 2017
WPS Provides Teleconference About Changes In Medical Review
Commonwealth Fund Mongan Fellowship In Minority Health Seeks Applications
CMS Updates PSVA Tool
Fulton Medical Center Names New CEO

Consider This ...

From 2000 to 2015, death rates from chronic liver disease and cirrhosis in the U.S. increased 31 percent among those ages 45-64.

Source: Centers for Disease Control and Prevention