CAH News Update

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ICAHN Staff Matt Comerford, Operations Coordinator; Todd Cooper, IT Coordinator; Don Evans, Education Coordinator Consultant; Carrie Galbraith, CARS;

    CAH News Update

    December 2007


    245 Backbone Road, Princeton, IL 61356

    Phone: 815-875-2999 Fax: 815-875-2990

    ICAHN Signs GPO Agreement OSF/Amerinet

    On October 22, 2007, ICAHN signed a 3- year agreement

    for Amerinet Inc., through a strategic affiliation with OSF

    Healthcare System, to serve as the exclusive purchasing

    group for the network. This is a great opportunity for

    ICAHN members who are able to participate in this national

    purchasing group organization. OSF/Amerinet was selected

    through an independent assessment committee comprised of

    member chief financial officers and purchasing directors who oversaw a thorough GPO assessment with the goal to determine which GPO had the greatest ability to save supply and service costs through their contracts. OSF/Amerinet proved to be a good fit providing flexibility to members as well as having outstanding programs, services and tools that will provide value and savings to participating member hospitals. ICAHN members also have access to a number of regional purchasing contracts for those products and services not covered by a national GPO. Please check the ICAHN website If there is a product or service not covered and

    would be a benefit, contact Tom Swank, ICAHN purchasing consultant, at

CMS Issues Final OPPS Rules Affecting CAHs November 1, 2007

    CMS published its final language for OPPS Rules in the Federal Register on November 1, 2007. CMS changed very little from the proposed rules issued in September other than to not include provider-based rural health clinics in the ruling on off-campus (250 yards from the main campus/hospital) locations and to apply the rule changes to CAHs and necessary provider CAHs. For CAHs to continue to meet the location requirements, a CAH can not co-locate with another hospital or CAH after January 1, 2008. Those current CAHs that are co-located with another hospital will not lose their status. In addition, CAHs can not operate a provider-based location, including a department or remote location, or an off-campus distinct part psychiatric or rehab unit that is created or acquired after January 1, 2008 unless the off-campus provider-based location is located more than a 35-mile drive or meets the secondary roads and mountainous terrain definition from another CAH or hospital. Provider-based rural health clinics are excluded. CAHs can continue to create and operate these types of services on campus without any problem or as a non provider-based entity. Those off-campus provider-based locations established prior to January 1, 2008 will not be affected. This ruling falls under Sec. 485.610 Condition of participation: status and location. For further information/details, please contact Pat Schou at the ICAHN office 815-875-2999.


Western IL AHEC Partners with ICAHN

    In 2008, Western Illinois AHEC will again partner with ICAHN to bring staff development programs to critical access hospitals via video conference. This year’s programs will focus on management skills and staff development, human resource basics and customer service. Dates for these programs will be announced after the first of the year. A special THANK YOU goes out to Telehealth Networks and Programs at SIU School of Medicine for their videoconference connection service and support. Deborah Seale and staff are wonderful partners who bring these programs to your door through videoconferencing.

    In addition, Western IL AHEC will offer a variety of professional education programs. These programs include:

    ; Creating and Building Professional Team Projects 6 part series, beginning Mary 5,


    ; Early Diagnosis and Prevention of Breast Cancer and the Genetics of Breast Cancer

    January 22, 2008, noon 1 pm

    ; Evaluation and Management of Common Breast Problems February 29, 2008, noon- 1


    ; Geriatric Education Services dates pending

    ; Mental Health Issues in Rural Hospitals dates pending

Interim Cost Report Software Uncovers Windfalls for CAHs

    When ICAHN endorses a product or service, it undertakes significant on-going evaluation to make sure hospitals are not disappointed. ICAHN recently conducted a confidential user survey on its Interim Cost Report (ICR) software developed by William A. Kramer and Associates. One of the findings revealed this information: Since we are in the implementation phase, I haven’t

    used it yet for the applications. However, it has been a tremendous benefit for us already. It has helped me find mis-allocations by independent auditor firms on past cost reports and has identified $250,000-$500,000 additional reimbursement for us, that we will be able to recoup via cost report re-openings.” ICR Users now have access to an electronic forum for exchange

    communications with other CAHs using the ICR program through For

    further information, contact the ICAHN office at 815-875-2999 or contact Bill Kramer at 812-246-5660.


    Do you or someone you know have expertise and a willingness to share knowledge with

    colleagues at rural hospitals? Western Illinois AHEC is accepting resumes from persons who are interested in preparing and delivering presentations around these topics: management basics for rural hospital managers; team building skills, human resources; and customer and service

    excellence for rural hospitals. Presenters will receive a stipend. Interested persons are

    encouraged to send their resume and 3 references to: Kathy Fauble, Director, Western IL AHEC, thndBroadway at 14 Street, 2 Fl., Quincy, IL 62301.


     Announcing…Rural Physician CME Opportunities

    ICAHN has initiated an exciting new chapter to its commitment to continuing efforts to provide clinical and physician educational opportunities. ICAHN, in cooperation with the National Center for Rural Health Professions for Illinois College of Medicine at Rockford, Department of CME at Southern Illinois University Medical School in Springfield and the Nurse Practitioner Healthcare Foundation in Seattle, WA, has developed and has plans for future evidenced based educational programs designed for rural healthcare professionals. These unique programs will be available for Illinois critical access hospitals. This fall, ICAHN will be offering three accredited rural health CME/CE programs on “Diabetes”, “Breast Cancer Prevention” and Smoking Cessation Strategies” that will earn the participant a total of 18 credits (AMA Cat. 1, AAFP and Nursing). These programs may be offered locally at your hospital using your own physician speakers or through an outside speaker bureau. Grant funds are available to those CAHs interested in providing a program locally for their medical staff. The three CME/CE programs will also be offered in free self-learning formats as printed enduring material, an SIU live video conference, an ICAHN web site program as well as a pod cast form UIC-COMR. For nursing, the material will be printed in the American Journal of Nurse Practitioners in the November and

    January issues. So far, nine (9) CAHs have taken advantage of this new grant program. Please contact Pat Schou at the ICAHN office if you are interested in these educational programs for physicians and nurse practitioners/physician assistants. There are a few grant awards left. If you are concerned about how to arrange for these physician educational programs, there is a staff person available to assist you.

Contracting TipWhen recruiting a new physician, it is very important for the physician

    to have the same contracts in place as the hospital does. This is critical to patient

    satisfaction and potentially could have an impact on referrals for outpatient testing. In a nut shell, you want to assure that all services are in-network for the patients; this simplifies

    things for everyone. These contract negotiations need to be started as soon as possible when

    a new physician has committed to relocate to your area. This process can take 90-180 days

    from start to finish including credentialing. This applies to a new physician establishing his or her own independent practice or a new physician billing under the hospital tax ID.

     Anton Payne, ICAHN Managed Care Consultant

Grants What’s next?

    ICAHN staff would like to thank the hospitals for submitting their final grant reports for FY 2007. The FY 2008 Small Hospital Improvement Performance (SHIP) individual hospital grants will be distributed in January 2008 so be watching for that information in your mail. The FY 2008 Flex Mini grants available will be announced early March 2008. There is no word yet on SHIP and Flex Grant funding for next fiscal year 2008-2009.

New Educational Offerings Corporate Compliance and Quality Improvement thGiven the success of the pre-workshop session on Corporate Compliance at the 7 Annual CAH

    workshop and the expressed interest by those attending the Quality Improvement breakout


    session presented by Darlene Bainbridge, ICAHN plans to sponsor a series of educational sessions for both corporate compliance and quality improvement in 2008. Arrangements are underway with Darlene Bainbridge to provide a series on making in-house quality improvement programs more effective as well as arrangements with the National Association for Corporate Compliance to provide an educational series and an in-house template. More to come in 2008…

Information Technology Special Flex HIT Project

    IT Services ICAHN received a special mail delivery this week the grant funds for the health

    information technology project, Patient Health Information Network or PHIN. Although much activity has been underway since notification of the award, specific purchase and contract negotiations have been on hold pending actual receipt of the funds. Purchase agreements now can be finalized and implementation timetables developed. Legal consultation is being provided by a firm in St. Louis that specializes in issues associated with health care and intellectual property rights. Project participants are anxious to move from the strictly planning phase of the project and begin the implementation phase.

Arm Band Safety Initiative

    ICAHN Nurse Leader’s group has raised the awareness of hospitals across the state on the need to

    standardize arm bands applied to hospital patients. A task force of CAH nurse leaders investigated other states’ programs to learn that a number of states have standardized types and/or colors of patient arm bands as well as emergency codes paged in the hospitals. The Illinois Hospital Association through its Patient Safety Task Force will explore how Illinois hospitals can standardize arm bands for these categories: Do Not Resuscitate, Fall Risk and Allergies. Several CAHs in a regional area have decided to explore the possibility of standardizing emergency paging codes. A special thank you goes to Kris Goodbred, CNE for Mendota Community Hospital who has championed these efforts on behalf of the CAH nurse leaders.


    ; Remember Physician Scarcity Area (PSA) bonus under Section 413(a) of the

    MMA will sunset after December 31, 2007. The PSA bonus is not payable for

    dates of service after December 31, 2007. Medlearn Matters: MM57111

    ; 2008 Annual Update for the Health Professional Shortage Area (HPSA Bonus

    Payment - Providers should review the 2008 Updated bonus files for services on

    or after January 1, 2008 through December 31, 2008 at the following website:

    ; National Government Services/AdminaStar Federal CAH Manual has just

    released its 2007 Revised CAH Billing Manual. Visit the web site or contact Pat Schou at the ICAHN office, and she can

    email you the manual in pdf format.

    ; CISHHRA /SIHHRACompensation Survey for Participating CAHs Now

    Available The CISHHRA/SIHHRA annual wage and salary survey for hospital

    departments has been carved out for CAHs. Those CAHs participating in the

    annual survey may receive a copy that identifies salaries and wages for IL CAHs.

    For further information contact Don Evans at

    ; Blue Cross and Blue Shield “Never Events”. BCBS plans to no longer pay for

    serious errors and hospital-acquired conditions, called “never events”. BCBS plans

    will need to build “never events” into the claims, which could include changing

    coding rules to make these events easier to identify in claims. This policy stems


    from CMS’ decision to no longer pay for “never events” beginning Oct. 1, 2008.

    Other major insurers have said they will adopt similar policies.

    ; Rural Health Book Mark. The Rural Health Bookmark, which offers Medicare

    providers, suppliers and physicians information about rural educational resources, is

    now available in print format from the Centers for Medicare & Medicaid Services

    Medicare Learning Network. To place your order, visit, scroll down to “Related Links Inside CMS,” and

    select “MLN Product Ordering Page.”

    ; Smoke Free Illinois Act (Public Act 95-0017, is effective January 1, 2008 and

    authorizes the Illinois Department of Public Health to enforce the provisions of the

    Act and to assess fines for violation of the Act. The Act prohibits smoking in public

    places, places of employment, and governmental vehicles. Smoking is prohibited in

    indoor public places and workplaces unless specifically exempted by Section 35 of

    the Act. Several CAHs, like Hillsboro Area Hospital, have implemented programs

    to help employees who smoke make the transition when the new Smoke Free

    Illinois Act takes place. Share your programs and ideas on the list serve to help

    others with the transition and implementation of this new public act.

    ; CAH Method II Billing Requires Annual Election In order to utilize Method II

    billing, the CAH must notify its fiscal intermediary that it has elected to bill for

    physician services pursuant to Method II and must submit copies of reassignment

    agreements. CAHs must notify their fiscal intermediary 30 days before the

    beginning of the cost reporting period in which the CAH wants to use the method.

    This is an annual election and is not an evergreen situation (on-going).

    ; New Illinois Facilities Planning Board Proposed Rules Proposed rules were

    published on the IDPH site the week of November 26, 2007. Visit - parts 1100 and 1110 as they relate to

    building projects, adding and replacing beds and staff vacancies.

Background on Rural Health Clinics and Federally Qualified Health Centers

    The Rural Health Clinic (RHC) Program was established in 1977 to address an inadequate supply of physicians who serve Medicare and Medicaid beneficiaries in rural areas. For RHC purposes, any area that is not defined as urbanized is considered non-urbanized. The U.S. Census Bureau Defines an urbanized city as a central city of 50,000 or more and its adjacent suburbs. Medicare payments are made on a cost-related basis for outpatient physician and certain non-physician services.

    The Federally Qualified Health Center (FQHC) benefit under Medicare was added effective October 1, 1991, when Section 1860 (aa) of the Social Security Act (the Act) was amended by Section 4161 of the Omnibus Budget Reconciliation Act of 1990. FQHCs are entities such as community health centers, public housing centers, outpatient health programs funded by the Indian Health Service, and programs serving migrants and the homeless. The main purpose the FQHC program is to enhance the provision of primary care services in underserved and rural communities. Medicare pays FQHCs, which are considered suppliers of Medicare services, an all-inclusive per visit amount based on reasonable cots. For additional information on RHCs and FQHCs, visit

ICAHN ANNUAL BUSINESS MEETING Mark your calendars for Tuesday,

    January 29, 2008. ICAHN will have its election of officers and board members as well as provide members with on member services and programs. In addition, there will be several special educational session and awards. This is a great chance to network with

    other CAHs. The meeting will be held at the INN at 835 in Springfield.


     If you are having trouble with accessing your list serve, please contact Matt

    Comerford at the ICAHN office at 815-875-2999.

     Check the ICAHN web site for all 2008 User Group and

    Educational Meetings!

    Upcoming ICAHN/CAH Meetings and Educational Programs

    Date Event Place

     ICAHN Board Meeting Crowne Plaza Hotel

    November 30, 2007 10 am 1:30 pm Springfield nd 2 Annual Nursing Workshop Crowne Plaza Hotel

    December 4, 2007 8an 3 pm Springfield

     MRSA /Nursing Home Transfer Call CEO

    December 10, 2007 2:30 pm Phone Conference Call

     Plant Managers Advisory Call

    December 17, 2007 2 pm ---new user group Phone Conference Call

     CFO User Group Northfield Inn

    January 11, 2008 9: 30 am 2 pm Springfield

     HR User Group SIU Telehealth

    January 17, 2008 10 am 2 pm Springfield

     ICAHN Board Meeting INN at 835

    January 28, 2008 6 pm Springfield th 4 Annual ICAHN Business Meeting INN at 835

    9:30 am 2 pm Springfield January 29, 2008

     Managed Care and Medicare Advantage

    February 8, 2008 Workshop TBA

     BO/HIM Meeting

    February 12, 2008 9:30 am - 2 pm TBA

     Pharmacy User Group

    February 13, 2008 10 am 2 pm Video Conference

     QI User Group

    February 19, 2008 9 am 12 noon TBA

     Ancillary Group Northfield Inn

    March 12, 2008 9:30 am 2 pm Springfield

     Facilities Workshop Northfield Inn

    March 27, 2008 8:30 am 3 pm Springfield

     Rural Health Clinic Workshop Northfield Inn

    May 13, 2008 8:30 am 3 pm Springfield

    ICAHN Staff Matt Comerford, Operations Coordinator; Todd Cooper, IT Coordinator; Don Evans, Education Coordinator Consultant; Carrie Galbraith, CARS; Holly Hammerich, Office Assistant; Lucas

    Kirkbride, IT Consultant; Mary Ring, PHIN Director; Bill Spitler, Special Projects Consultant; Tom Swank,

    Purchasing Consultant; and Pat Schou, Executive Director

    Happy Holidays to all of you!!!


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