September 21, 2018

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

Insights

Earlier this week, the Centers for Medicare & Medicaid Services announced a new initiative to streamline regulations for hospitals and ambulatory surgical centers. The reforms are part of CMS’ “Patients over Paperwork” initiative.

It’s nearly impossible to find anyone in health care who doesn’t have a strong opinion about the proliferation of regulation and regulatory overreach. The health care system has evolved significantly throughout the past decades. During this time, regulation often was piled on regulation, without significant attention to relevance, cost to manage or whether they continued to benefit patients.

As I was thinking about the CMS initiative, an old joke came to mind: “Everyone talks about the weather, but no one does anything about it.” Sure, we’d like a better system with fewer burdensome regulations, but given the scope of the problem, it could appear insurmountable.

As it turns out, it isn’t. It’s nearly impossible to predictably change the weather. The real issue — jokes aside — is how we react to the weather. And, that’s where the CMS initiative, and changes we’ve seen in Missouri, are very promising.

As of July, compliance with the CMS Conditions of Participation will constitute compliance with Missouri hospital licensure standards. In addition, the state cannot promulgate regulations that are contrary to, or duplicative of, CMS CoPs without specific statutory authorization. New standards for stroke, STEMI and trauma centers also are in place, ensuring that national designation, and compliance with national accreditation standards, will govern state designation where the national designation is in place.

Missouri lawmakers get it. They’ve worked hand in hand with hospitals to lessen the burden. And, these are only a few of the most recent changes that are moving Missouri in the direction of simplified, streamlined and consistent regulations.

The new federal energy in reducing the regulatory burden isn’t happenstance. MHA and Missouri’s hospitals have been deliberately working to reduce the burden so hospitals can focus away from compliance for compliance sake, and toward the activities that improve patient health and care.

Earlier this year, MHA hosted four CMS officials at our annual summer leadership
conference — two from the CMS central office in Baltimore and two from the Kansas City regional office — who spent nearly two hours with more than 60 rural hospital administrators. Following that session, the CMS team spent a full day in a Missouri rural hospital meeting with administrative and clinical staff. We know that the CMS staff, as a result of these engagements, have followed up with Missouri hospital administrators to seek additional input on the regulatory relief agenda.

Obviously, there’s a lot of work to be done. The forecast is improving.

Complaining about the weather never changed it. The deluge of regulations that accompany major health care system changes are, if not inevitable, at least expected. However, when you’ve built a sound shelter, there’s less turbulence.

Let me know what you’re thinking.

P.S. Notwithstanding the aforementioned comments about the weather, we’ve all been stunned by the aftermath of Hurricane Florence and the flooding on the east coast, particularly in North Carolina. As reported in MHA Today on Wednesday, the North Carolina Hospital Foundation, the 501(c)(3) affiliate of the N.C. Healthcare Association, established a disaster relief fund to support North Carolina’s health care workers and their communities as they begin the process of rebuilding. Donations will support recovery efforts for hospital and health system employees and their communities affected by Hurricane Florence. Donations can be contributed online.

Herb B. Kuhn
MHA President and CEO

In This Issue


Illinois Supreme Court Upholds Hospital Tax Exemption Statute

Mercy Rehabilitation Hospital St. Louis Names New CEO

Health Law Insight

Illinois Supreme Court Upholds Hospital Tax Exemption Statute

Staff Contact: Jane Drummond

The Illinois Supreme Court finally resolved a dispute dating to 2012 over an Illinois statute purporting to grant a property tax exemption to nonprofit hospitals. The statute was a bipartisan effort to clarify the standards nonprofit hospitals must meet to be exempt from property taxes. Shortly after its passage, an individual taxpayer challenged the law on the grounds that it did not incorporate the constitutional requirements for exemption. The trial court dismissed the case, and the appellate court upheld the dismissal. Both courts presumed that compliance with the constitutional requirements was implied in the law.

The Supreme Court agreed with those rulings. The Illinois Hospital Association worked closely with the Illinois Department of Revenue and Attorney General to defend the statute, resulting in millions of dollars of tax savings to nonprofit hospitals in the state.

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CEO Announcements

Mercy Rehabilitation Hospital St. Louis Names New CEO

Staff Contact: Carol Boessen

Jerald W. Rumph has been named CEO of Mercy Rehabilitation Hospital St. Louis, effective Monday, Sept. 17. Rumph has more than 22 years of comprehensive health care experience, most recently serving as vice president of operations/COO at SSM Health St. Joseph Hospital – Lake Saint Louis. He replaces Donna Flannery who was promoted to vice president of operations – south for Kindred Hospital Rehabilitation Services in February. Julie Bantle, COO, has been serving as Interim CEO since February. A list of CEO changes is available online.

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Did You Miss An Issue Of MHA Today?

September 17, 2018

CMS Proposing To Lift Unnecessary Regulations And Ease Burden On Providers
WPS Begins S-10 Audits In Missouri
HIDI Releases Third Quarter FFY 2018 Inpatient, Outpatient, Missouri Databases

September 18, 2018

U.S. Senate Approves Opioid Legislation
AHA Releases 340B Good Stewardship Principles
MHA Distributes Analysis To Final Rule For FFY 2019 IPF PPS
Issue Brief: CMS Proposes To Lift Unnecessary Regulations And Ease Burden On Providers
MHD Increases Reimbursement For Dental, Optical, Audiology And Therapy Services
TJC Releases Specifications Manual Addendum 2018A1

September 19, 2018

MHA Comments On Medicare Outpatient Proposed Regulations
HHS Awards More Than $1 Billion To Combat The Opioid Crisis
MHA Distributes Analysis For FFY 2019 Final IRF PPS
Trajectories — Integrating Evidence-Based OUD Treatment: A Medication First Model
CMS Selects Hospitals For OQR CY 2020 Validation
North Carolina Hospital Foundation Establishes Disaster Relief Fund

September 20, 2018

MHA Distributes Analysis For FFY 2019 Medicare Final LTCH PPS
MLN Connects Provider eNews Available
AHA Discusses The Growing Importance of Workforce Planning in Health Care
Critical Access Hospital Executives Gather For In-Person Meeting

Consider This …

Between 2000 and 2016, death rates for five of the 12 leading causes of death increased: unintentional injuries, Alzheimer’s disease, suicide, chronic liver disease and septicemia.

Source: Centers for Disease Control and Prevention