MHA Today | June 7, 2019

June 7, 2019
MHA Today: News for Healthcare Leaders

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June 7, 2019

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 Today’s St. Louis Business Journal cover story reports on the status of the St. Louis hospital workforce. The story builds on the report MHA issued earlier this week that looks at the status of the current workforce and demand for health workers in 2030. The 2019 workforce report is the final installment of a three-part series from MHA to lay the groundwork for a broader discussion about both the value and necessity of hospitals and health care in Missouri.

Hospitals and health care are among the largest employers in the state. In virtually every city with a hospital, the hospital — or the community of hospitals that serve in the state’s metros — is the largest employer. Outside of cities with hospitals, smaller towns benefit from the economic, health and social value of the workers who staff clinics or live in bedroom communities.
Past and Projected Employment in Missouri
Despite hospitals’ status as large and stable employers, they face ongoing workforce shortages. Employment in health care has grown 52 percent since 2000, and this continues to trend upward. The health care sector — including but not exclusively hospitals — is projected to be 83 percent larger in 2030 than 2000. The demand for health care workers outpaces traditional industries and Missouri employment as a whole.

The report finds that turnover and vacancy remain a significant problem. Of the 28 hospital occupations surveyed, all of them indicated an employee turnover rate of more than 7 percent. Among these same occupations, 23 had a vacancy rate of more than 5 percent. The R.N. turnover rate is 15.2 percent. This presents a significant challenge given the cost and time associated with attaining the education necessary to serve as a hospital R.N. Moreover, nurses are the single largest category of hospital employees, so a high rate and a high “n” in proportion to the workforce as a whole, matters.

Number of Physicians per Missouri county A similar challenge exists in the physician workforce. In many parts of the state, there’s already a physician shortage. The new research projects that it will intensify. This is bad for patients, hospitals and the health care system. As it turns out, it also is a significant loss for Missouri’s economy. Our report on the economic value of physicians found their contribution to Missouri’s Gross State Product was more than $12.3 billion — approximately 7.2 percent of total GSP. The 15,590 physicians practicing in Missouri support nearly 130,000 jobs through their direct, indirect and induced effects on the economy. Physicians pay approximately $6.746 billion in wages. As these wages move through the economy, they support $3.2 billion in additional income for Missourians, totaling $9.9 billion.

The most important message from both reports is that, as a state, we have work to do to ensure an adequate workforce. Missouri’s health status and health outcomes are poor. The state’s demographics point to an increased need for health services, as well. And, that can only happen if hospitals have the staff they need to deliver those services.

Number of Physicians per Missouri county Although the health care sector is seeing a phenomenal level of growth, this can result in workforce shortages across several essential hospital workforce categories. To meet the existing and projected imbalance, hospitals, health systems and workforce stakeholders are launching innovative programs to address the supply and demand disparities. There isn’t a single solution to delivering the necessary workforce. In fact, the research suggests that often workers get their health care training locally, and remain local after. This could account for some of the regional variation in vacancy and turnover, and suggest that workforce stakeholders focus additional resources on identifying local systems for education, recruitment and retention.

The health of the hospital workforce, the communities hospitals serve and the economic health of the state are intertwined. Each of these reports provides evidence that investment in hospitals and health care is not only sound, but necessary.

Let me know what you’re thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
CDC Issues Recommendations Anticipating TB Antigen Shortage
CMS Issues EMTALA And Death Reporting Guidelines
MHA Promotes Safe Care Environments On National #HAVhope Day
CHNA Implementation Plan Templates Available For Chronic Diseases

Regulatory News
the latest actions of agencies monitoring health care

CDC Issues Recommendations Anticipating TB Antigen Shortage

Staff Contact: Sarah Willson or Jackie Gatz

The Centers for Disease Control and Prevention issued an official Health Advisory on the nationwide shortage of tuberculin antigen used in testing for tuberculosis. There only are two manufacturers approved by the United States Food and Drug Administration. One of the manufacturers anticipates a shortage as soon as November 2019, although it could occur before then. The shortage can be monitored by visiting the FDA’s Center for Biologics Evaluation and Research-Regulated Products: Current Shortages web page. Annual TB testing of health care personnel is not recommended except under certain circumstances.

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CMS Issues EMTALA And Death Reporting Guidelines

Staff Contact: Sarah Willson

The Centers for Medicare & Medicaid Services issued a Quality, Safety & Oversight memo outlining new investigation timelines for complaints related to Emergency Medical Treatment and Labor Act, and deaths in restraint and seclusion complaint investigations. The change brings the timelines for EMTALA and death in restraint and seclusion complaint investigations into line with that of other investigations. Now, the Regional Office and State Survey Agency surveyors must be on site within two business days, rather than complete the investigation in five working days.

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Quality and Population Health

MHA Promotes Safe Care Environments On National #HAVhope Day

Staff Contact: Jackie Gatz
Healing Happens Here resources
Today, hospitals across the country recognize the American Hospital Association’s National #HAVhope Day, highlighting efforts by individual hospitals to reduce the prevalence of violence in workplaces and communities. A hospital’s primary mission is to ensure safe, appropriate and quality care for patients.

Earlier this year, MHA released customizable resources to help hospitals educate patients, visitors and caregivers about the attitudes and behaviors that are expected in Missouri hospitals.

On #HAVhope Day and every day, thank you to all who deliver high-quality patient care in a safe environment.

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CHNA Implementation Plan Templates Available For Chronic Diseases

Staff Contact: Stephen Njenga

MHA developed ready-to-use Community Health Needs Assessment implementation plan templates on diabetes and heart disease. They highlight key strategies, action plans, internal and external partners, process and outcome measures, and a timeline. The templates are based on the most current best practice strategies to address those key health issues using a multifaceted approach. For additional CHNA resources, visit MHA’s website.

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Did You Miss An Issue Of MHA Today?

June 3, 2019
MHA Submits Comments On Interoperability Proposed Rules
SCOTUS Issues Ruling About Medicare Disproportionate Share Rate
MHA Offers Resources During Community Health Improvement Week

June 4, 2019
Congressional Subcommittee Reviews DSH Cut And Behavioral Health Bills
MHD Updates Ambulance Reimbursement Policy
MHA Distributes Analysis Of The Proposed FFY 2020 IPF PPS
HIDI Releases Second Quarter FFY 2019 Inpatient, Outpatient, Missouri Databases
MHA Resource Available To Implement CHNAs

June 5, 2019
Report Shows Present And Future Opportunities Within Missouri Health Careers
VA Issues Final Rules On Access To Community And Urgent Care
MHA Distributes Analysis For FFY 2020 Proposed Medicare IRF PPS
Rural And Nonurban Missouri Hospital Mobile Assets Participate In Communications Exercise
exploreMOhealth Platform Available To Assist with CHNAs
CMS Reminds Hospitals Of HCAHPS Submission Deadline

June 6, 2019
CMS Issues RFI On Patients Over Paperwork Initiative
MLN Connects Provider eNews Available
Spotlight Hospitals Integrate CHNAs And Implementation Plans To Improve Community Health
CMS Releases IPFQR Program Manual Version 5.0
CMS Announces IQR Education Session

Consider This ...

Today is National Donut Day. According to a survey of 1,000 Americans, more than half of survey respondents said they would think highly of someone who brought donuts to the office.

Source: National Today