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Monday, November 29, 2004
Appropriations Bill Positive for Hospitals
The recently passed federal appropriations bill for 2005 has some good news for hospitals. The bill will delay implementation of new regulations defining rehabilitation hospitals as having 75 percent of patient admissions under certain diagnosis related groups. The moratorium is effective until the Government Accountability Office completes a formal assessment of the rule’s impact on access to services.

The omnibus spending bill also increases spending for nurse education and Nurse Reinvestment Act programs by $10 million to $151.9 million, and includes $303.2 million for Children’s Hospitals Graduate Medical Education Payment Program, which pays to train nearly 4,000 pediatricians and other doctors throughout the nation’s children’s hospitals. Earmarked for rural hospital outreach and other programs is $88.1 million. The bill reduces spending for the National Bioterrorism Hospital Preparedness Program to $495.4 million from $518 million, but the decrease is not expected to have a significant impact because hospitals have already completed much of the preparation work. Final allocations for some of the programs will be reduced after a 0.8 percent across-the-board spending cut for all non-defense, non-security programs. OHA's federal advocacy efforts on behalf of hospitals will continue as the 109th Congress begins in January, and staff will keep members apprised of key legislation. (Jonathan Archey, jonathana@ohanet.org)

ODH Begins Flu Vaccine Allocation
Having received approval from Governor Taft, the Ohio Department of Health (ODH) is now working to implement its flu vaccine redistribution plan. Working through the Center for Disease Control and Prevention (CDC) and Aventis Pasteur, the plan includes filling hospital orders for 113, 031 doses of vaccine first and completely. Hospitals should receive a call from a regional distributor (FFF Enterprises, ANDA, ASDA or Dubin Medical) for payment and shipment processes and can expect their vaccine orders within the next several weeks. Any hospital needing vaccine that has not placed an order should contact Carol Jacobson at OHA immediately at carolj@ohanet.org or 614.221.7614 as final shipments will occur in January.

According to CDC, flu activity remains low in Ohio and throughout the U.S., though it is beginning to pick up in several regions of the country. OHA and allied organizations will monitor the situation in Ohio and, if necessary, request permission from ODH and the Centers for Medicare and Medicaid Services to use rehabilitation and skilled nursing beds. For more information on this season’s flu vaccine shortage, visit www.ohanet.org/flu/. (Carol Jacobson, carolj@ohanet.org)

Tuesday, November 30, 2004
Ruling Protects Hospital Physician Credentialing Files
A state appeals court ruled last week that a law enacted in 2002 protects previously available documents relating to a hospital’s credentialing of physicians. The judgment was in response to a medical malpractice lawsuit filed against Summa Health System and a physician, alleging physician malpractice and hospital negligence in granting staff privileges to the physicians.

The statute cited in the court’s decision was established by Senate Bill 179, legislation introduced at OHA’s request during the 124th General Assembly. It presumes a hospital is not negligent in its credentialing of an individual who applies for staff membership or professional privileges, and grants hospitals civil immunity for omissions of a peer review committee. Because the above case’s dispute arose after the April 9, 2003 effective date of the statute, the three-judge appellate panel unanimously overturned a Summit County common pleas judge’s ruling that portions of a doctor’s credentialing file were subject to disclosure. The 7th District Court of Appeals made a similar ruling in September based on the new law, unanimously deciding to deny a plaintiff access to incident reports. (Rick Sites, ricks@ohanet.org)

After the Elections: Medical Liability Insurance Crisis Remains a Top Priority in Ohio
As the 125th General Assembly prepares recess for the final time and the newly elected and re-elected Ohio Supreme Court justices elected by voters this month settle in for a new term, the medical liability insurance crisis remains a hot topic. The General Assembly is working to finalize related legislation before recessing and several pieces of previously enacted legislation may be working their way to the state supreme court.

To learn more about legislation the General Assembly may pass during the lame duck session this fall that could impact hospitals, and laws the state supreme court now in place will likely review, read OHA's November Healthbeat at www.ohanet.org/healthbeat/2004/1104.htm.

Hospital Receives Critical Access Designation
Community Hospitals and Wellness Centers Montpelier Hospital was granted Critical Access Hospital (CAH) designation, effective Oct. 1, 2004. The federal CAH program entitles select small, rural hospitals to Medicare cost-based reimbursement. To become a CAH, hospitals must provide 24-hour emergency services along with inpatient care, laboratory and radiology services, and meet other specific criteria.

Community Hospitals and Wellness Centers Montpelier Hospital is the 28th Ohio hospital to receive the designation. For a complete list of Ohio CAHs, go to www.ohanet.org/about_oha/cah.asp. (David Hendershot, davidh@ohanet.org)

Wednesday, December 1, 2004
OHA, ODI Collaborate on Reporting Rule
In response to OHA’s comments, the Ohio Department of Insurance (ODI) made several changes to a proposed rule requiring insurance companies and hospitals that self-insure their medical liability exposure to report 2005 closed claims to ODI.

OHA was concerned the initial version of the rule would be unworkable since it unfairly treated self-insured entities the same as commercial insurers. Self-insured hospitals track potential claims in a different manner than commercial insurers because of quality of care concerns rather than solely as liability exposures. Self-insured hospitals are also likely to manage claims and legal defense in a different manner from highly regulated commercial insurers. Consequently, to comply with the rule’s requirement, self-insured entities would have had to make costly changes to their internal processes. At OHA’s suggestion, the revised rule does not require reporting entities to submit information not already in possession or reasonably available to attain.

Insurance companies and self-insured hospitals will be required to submit a report by May 1 of each year, with the first report due in 2006 for claims closed during 2004. Noncompliance may result in a fine. The proposed rule was re-filed Nov. 22 with the Joint Commission on Agency Rule Review for a hearing Dec. 13 and becomes effective Jan.1. A copy of the rule and OHA’s comment letter are available online at www.ohanet.org/advocacy/state/Regulations/regulations.pdf. (Rick Sites, ricks@ohanet.org)

CMS Issues Guidance on Hospital Medical Staff Privileging
In a recent memo to state survey agency directors, the Centers for Medicare & Medicaid Services (CMS) clarified the responsibilities of a hospital's governing body in ensuring the qualifications and competencies of all practitioners who provide care in the hospital. CMS states the hospital governing body must determine which categories of practitioners are eligible to be on its medical staff or to have hospital privileges, and it must clearly delineate the scope of privileges for each category. Hospital medical staff must conduct individual reviews of practitioners at least once every two years to ensure they have the necessary qualifications and demonstrated competencies for the privileges granted, including education, licensure and current work practice and patient outcomes. Based on medical staff recommendations, the governing body must decide whether to grant, deny, continue, limit or revoke a practitioner's privileges, and must notify the appropriate state and federal authorities and registries if it has revoked or constrained a practitioner's privileges. The memo, effective Nov. 12, instructs state survey agency surveyors to assess whether hospitals’ privileging processes comply with CMS requirements. The memo is available at www.cms.hhs.gov/medicaid/survey-cert/sc0504.pdf. (Rosalie Weakland, rosaliew@ohanet.org)

Thursday, December 2, 2004
Wanted: Hospital Heroes
Nominators Apply Within
OHA is now accepting nominations for the 2005 Albert E. Dyckes Health Care Worker of the Year Award along with its other prestigious health care leadership awards.

The Health Care Worker of the Year Award honors caregivers who routinely go beyond the call of duty and give back to the community. Every hospital is encouraged to nominate one individual to represent the facility and be celebrated at the OHA Recognition Dinner June 20, in conjunction with the OHA Annual Meeting June 20-21, this year at a new location - the Hilton Columbus at Easton. The ultimate recipient of the award and four finalists will be named during the event.

Also honored at the dinner are recipients of OHA’s health care leadership awards including: Donald R. Newkirk Award, Distinguished Service Award, Meritorious Service Award, John Chapman Award, and William C. Kelley Safety Leadership Award.

Nomination materials were mailed to hospital public relations representatives this week and are available online at www.ohanet.org/annualmeeting/Awards/. Nominations for all awards must be submitted electronically by Feb. 11 using an official nomination form (one form for the Health Care Worker of the Year Award, a separate form for health care leadership awards) to Tiffany Himmelreich at tiffanyh@ohanet.org. Hospitals may submit a nomination for more than one health care leadership award, but are limited to only one nomination per facility for the Health Care Worker of the Year Award. (Tiffany Himmelreich, tiffanyh@ohanet.org)

New Quality Data On CMS Web Site
The Centers for Medicare & Medicaid Services this week updated its hospital quality Web site with the most recent data from hospitals participating in the Hospital Quality Alliance.

Quality data on how providers utilize ten measures proven to improve outcomes for heart attack, heart failure and pneumonia patients are available for more than 4,000 hospitals nationwide at www.cms.hhs.gov/quality/hospital/. In Ohio, 145 acute care and critical access designated hospitals are participating in the voluntary initiative. The current site is primarily for clinicians. A consumer-friendly site is planned for February. (Rosalie Weakland, rosaliew@ohanet.org)

Clarification on Flu Vaccine Allocation
The Ohio Department of Health (ODH) is working through the Center for Disease Control and Prevention (CDC) and Aventis Pasteur to fill hospital orders for 113, 031 doses of vaccine this month. Hospitals should receive a call from a regional distributor (FFF Enterprises, ANDA, ASDA or Dubin Medical) for payment and shipment processes and can expect their vaccine orders within the next several weeks. Any hospital needing vaccine that has not placed an order should contact Carol Jacobson at OHA immediately at carolj@ohanet.org or 614.221.7614 as final shipments will occur in January.

Friday, December 3, 2004
Revised HCAHPS Survey Released
The Centers for Medicare & Medicaid Services (CMS) has released a new, shorter version of the patient survey known as HCAHPS for public comment. Part of the voluntary Hospital Quality Alliance initiative, the survey is intended to produce an “apples to apples” comparison of patients’ perspectives of their hospital care, offering consumers a more complete picture of hospital quality. Based on feedback from hospitals, CMS shortened the survey from 32 questions to 25, including five questions on patient demographics. The public can comment on the survey, and its administration through the National Quality Forum (NQF), and NQF members will vote on whether to approve the tool as final. NQF held a public meeting of its review committee Dec. 1, and now plans to begin accepting comments on the survey. To view a Webcast of the Dec. 1 meeting or to view a copy of the revised survey, visit www.qualityforum.org. (Rosalie Weakland, rosaliew@ohanet.org)

New Forum to Reduce Seclusion, Restraint
A newly created organization, OHA’s Violence Free/Coercion Free Learning Community, gives licensed inpatient behavioral health unit employees a forum to share information and provides educational and training events promoting the voluntary reduction of seclusion and restraint.

Through a new Web site, designated behavioral health employees can enter data on seclusion and restraint prevention-based plans. The Web page was developed to facilitate development of uniform criteria for data collection, review and reporting. Data definitions are based on NASMHPD Research Institute measurements previously distributed to members of the community. For more information contact Berna Bell at 614.221.7614 or bernab@ohanet.org.

CEOs on the Move
Brian C. Lockwood, president and CEO of Community Health Partners in Lorain, has announced his retirement effective March 2005. James Brumlow, president of Wadsworth-Rittman Hospital, will retire this year, effective Dec. 31, after joining the hospital in 1986. The hospital has not yet chosen a replacement.

Earlier this year, the Cleveland Clinic Health System - East Region, announced A. Gus Kious, M.D., as the new Chief Administrative Officer of Huron Hospital effective Aug. 1. He replaced Beverly Lozar who accepted the position as Chief Administrative Officer at South Pointe Hospital.