- Telehealth Study Recruiting Veterans Now
- USDA Delivers Immediate Relief to Farmers, Ranchers and Rural Communities Impacted by Recent Disasters
- Submit Nominations for Partnership for Quality Measurement (PQM) Committees
- Unleashing Prosperity Through Deregulation of the Medicare Program (Executive Order 14192) - Request for Information
- Dr. Mehmet Oz Shares Vision for CMS
- CMS Refocuses on its Core Mission and Preserving the State-Federal Medicaid Partnership
- Social Factors Help Explain Worse Cardiovascular Health among Adults in Rural Vs. Urban Communities
- Reducing Barriers to Participation in Population-Based Total Cost of Care (PB-TCOC) Models and Supporting Primary and Specialty Care Transformation: Request for Input
- Secretary Kennedy Renews Public Health Emergency Declaration to Address National Opioid Crisis
- Secretary Kennedy Renews Public Health Emergency Declaration to Address National Opioid Crisis
- 2025 Marketplace Integrity and Affordability Proposed Rule
- Rural America Faces Growing Shortage of Eye Surgeons
- NRHA Continues Partnership to Advance Rural Oral Health
- Comments Requested on Mobile Crisis Team Services: An Implementation Toolkit Draft
- Q&A: What Are the Challenges and Opportunities of Small-Town Philanthropy?
New Brief: Impact of CAH Participation in Flex Financial and Operations Improvement Activities on Hospital Financial Indicators
The Flex Monitoring Team has released a new policy brief, Impact of CAH Participation in Flex Financial and Operations Improvement Activities on Hospital Financial Indicators.
Under the Medicare Rural Hospital Flexibility (Flex) Program, states with Critical Access Hospitals (CAHs) are eligible to receive federal funds to support hospital improvement. In this brief, the Flex Monitoring Team explores the impact of participation in financial and operational improvement activities on key hospital financial indicators. Key findings include:
- Compared to CAHs with no participation, CAHs with two years of participation and three years of participation showed increases in total margin of 1.60 and 3.95 percentage points, respectively.
- Compared to CAHs with no participation, CAHs with three years of participation showed a 3.16 percentage point increase in operating margin.
- We found no evidence that one year of participation improved profitability indicators, suggesting that continued participation may be necessary to see changes in financial indicators.
- Because interventions were not randomly assigned, we were unable to determine whether there was a causal relationship between participation and financial performance. Results were sensitive to model specification and should be interpreted with caution.
This paper may be accessed via the link below or on the Flex Monitoring Team website.
Pennsylvania Governor Announces $450 Million Loan Program for Financially Strained Hospitals
There are more than 19,000 COVID-19 cases in the state as of midnight today with numbers expected to continue increasing, highlighting an even greater need to ensure that Pennsylvania’s hospitals are equipped to care for patients and workers. To assist, Governor Tom Wolf today announced a new loan program – the Hospital Emergency Loan Program, or HELP – that will provide short-term financial relief to Pennsylvania’s hospitals as they prepare for the growing surge of individuals infected with COVID-19 and the economic fallout of the nationwide pandemic.
“The combination of increased costs and reduced revenue has hurt many hospitals financially,” Gov. Wolf said. “We must support our hospitals through this unprecedented time. When this pandemic finally ends, we’re going to need hospitals to care for our regular medical needs, like heart attacks and broken bones. This new loan program will provide immediate relief to our hospitals, which are on the frontlines of this pandemic.”
The $450 million loan package will be available to the commonwealth’s hospitals to provide immediate financial support for working capital to ensure that these facilities have sufficient personnel, equipment, and personal protective equipment.
The funding was dispersed by the Pennsylvania Infrastructure Investment Authority (PENNVEST) and will be administered by the Pennsylvania Department of Community and Economic Development through the Pennsylvania First Program (PA First). It was approved by Treasurer Joe Torsella, who played a crucial role in the expedited release of this emergency funding.
“Hospitals across Pennsylvania should be focused on saving lives, not worrying about how to make ends meet until federal relief funds arrive months from now,” said Pennsylvania State Treasurer Joe Torsella, whose office must approve any investments made by the PENNVEST board. “I am proud to approve this prudent investment that will provide immediate, low-cost, and direct financing to enable hospitals to sufficiently staff their floors, purchase treatment supplies and protective equipment, and successfully prepare for the surge of COVID-19 patients in the coming weeks. I commend the PENNVEST board for taking this step, and Governor Wolf for his leadership and continued commitment to protecting Pennsylvanians throughout this crisis.”
Pennsylvania health care facilities licensed as hospitals by the Pennsylvania Department of Health under the Health Care Facilities Act of 1979 that are eligible to receive federal grant funding through the CARES Act are eligible for HELP. The maximum loan size is $10 million per hospital at an interest rate of 0.5 percent.
Applications will be available on DCED’s website starting at 10:00 AM April 13 through April 20. The costs must be incurred between March 1 and Sept. 1.
HELP will allow hospitals to take responsive action now until funding through the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act, which was signed into law on March 27, 2020, is dispersed completely, with the goal of easing the financial strain of the pandemic and smoothing the transition back into regular health care operation.
Permitted expenses under HELP will mirror those under the CARES Act, allowing hospitals to close out their loan with CARES funding once it is received.
‘It Really Is the Perfect Storm’: Coronavirus Comes for Rural America
Politico, April 15, 2020
In rural Washington, hospitals are faltering, stores can’t get supplies and people are staying closer to each other than you’d think.
Dr. Howard Leibrand has had two very different medical careers—29 years as an emergency room physician, then 12 as an addiction therapist. The challenge he’s facing now, as the novel coronavirus slams bucolic Skagit County, Washington, where he lives and works, is like both rolled into one. Covid-19 has struck fast and hard, like the car crashes and mishaps that send victims to the ER. And like opiate addiction, it has spread stealthily through the heartland, even as it was dismissed as a distant, urban problem.
“One of the negatives of living in a rural community is you think it protects you somehow,” says Leibrand, who for years has also been the health officer—a sort of local surgeon general—of the county, a sprawling expanse of rich alluvial farmland, exurban bedroom communities and steep Cascade peaks midway between Seattle and Vancouver, British Columbia. “We get a little bit cavalier, a little lazy about social distancing.” On April 1, Governor Kristi Noem of South Dakota—one of five states, all in the central heartland, without stay-at-home orders—defended her decision to leave South Dakotans “free to exercise their rights to work, to worship, and to play” by saying, “South Dakota is not New York City, and our sense of personal responsibility, our resiliency and our already sparse population density put us in a great position to manage this virus” without resorting to the “draconian” measures taken elsewhere.
Complacency is fast fading, however, as rural residents realize that, far from being immune, they may be uniquely vulnerable when the epidemic reaches them. Even as Noem spoke, Covid-19 was spreading at a Sioux Falls meatpacking plant that subsequently closed after more than 300 workers fell sick, and local officials across the state begged her to issue shutdown and shelter-in-place orders.
Census Response Rates
The 2020 Census is continuing even in the midst of a global pandemic. As of Sunday, the self-response rate for Pennsylvania was 49.7% with roughly 44.2% completed online. As comparison, the final 2010 self-response rate was 70%. Townships can go online at 2020census.gov/en/response-rates to keep tabs on their local response rates. The map is updated daily around 3 p.m.
2020 Census Makes Operational Adjustments Due to COVID-19
The U.S. Census Bureau temporarily suspended 2020 Census field data collection activities in March. Steps are already being taken to reactivate field offices beginning June 1, 2020, in preparation for the resumption of field data collection operations as quickly as possible. Read full story.
2020’s Best & Worst States for Children’s Health Care – WalletHub Study
With parents needing to safeguard their children against the coronavirus and Every Kid Healthy Week kicking off on April 24, the personal-finance website WalletHub today released its report on 2020’s Best & Worst States for Children’s Health Care as well as accompanying videos.
In order to determine which states offer the most cost-effective and highest-quality health care for children, WalletHub compared the 50 states and the District of Columbia across 33 key metrics. The data set ranges from share of children aged 0 to 17 in excellent or very good health to pediatricians and family doctors per capita.
|
Best States for Children’s Health Care |
Worst States for Children’s Health Care |
| 1. Massachusetts | 42. Louisiana |
| 2. Vermont | 43. Wyoming |
| 3. District of Columbia | 44. North Carolina |
| 4. Rhode Island | 45. Georgia |
| 5. New Jersey | 46. Arkansas |
| 6. New York | 47. Alaska |
| 7. Hawaii | 48. Indiana |
| 8. Connecticut | 49. Mississippi |
| 9. Maryland | 50. Oklahoma |
| 10. New Hampshire | 51. Texas |
Best vs. Worst
- Massachusetts has the lowest share of uninsured children aged 0 to 18, 1.30 percent, which is 8.2 times lower than in Texas, the highest at 10.60 percent.
- Hawaii has the lowest share of children aged 0 to 17 with unaffordable medical bills, 3.20 percent, which is 5.2 times lower than in Wyoming, the highest at 16.60 percent.
- The District of Columbia has the most pediatricians per 100,000 residents, 43.83, which is 19.7 times more than in South Carolina, the fewest at 2.22.
- Utah has the lowest share of obese children aged 10 to 17, 8.70 percent, which is 2.9 times lower than in Mississippi, the highest at 25.40 percent.
For the full report and to see where your state or the District ranks, please visit: https://wallethub.com/edu/best-states-for-child-health/34455/
Fighting COVID-19 Stigma in Pennsylvania
The Pennsylvania Department of Health has put out a document on stigma surrounding COVID-19.
“In public health, stigma occurs when a particular group of people are negatively associated with a specific disease. Fear and anxiety can cause stigma toward certain populations during a public health emergency, such as the COVID-19 pandemic.”
“Stigma, bias, discrimination and other types of aggressions are inappropriate responses to disease. These actions only worsen the threat to public health and make it harder to keep everyone healthy.”
Pennsylvania Launches COVID-19 Job Hiring Portal
The Pennsylvania Department of Labor and Industry has launched a new online job portal. People seeking employment can visit www.PAcareerlink.pa.gov and select the green “PA COVID-19 Jobs – Hiring Immediately” job portal banner to see active job openings. Selecting the “Apply Now” button for a listed position will redirect individuals to the employer’s website or email where they can apply directly with the employer and speed up the hiring process.
Life-sustaining businesses can feature their job openings on the portal through an easy to use online form. Businesses must meet the criteria of a life-sustaining business and must have more than 10 job openings. The PA COVID-19 job portal is updated daily so businesses in need are spotlighted and people searching for employment have the latest job information.
Resources Available for Farmers with Disabilities
AgrAbility PA is operational and providing services to farmers and agricultural workers during these times. Individuals can learn more about the project here: http://agrabilitypa.org/ and can contact the program with questions at any time. Please call the staff at 814-867-5288. AgrAbility also has two new educational publications, one on Cab Cameras and one on Hearing Loss on the Farm, both are attached and can be shared!
Below are a few other resources that might be especially helpful during these “stay at home” times:
The Pennsylvania Assistive Technology Foundation (PATF) provides education and financing opportunities for people with disabilities and older Pennsylvanians, helping them acquire assistive technology devices and services that improve the quality of their lives. Consider a Pennsylvania Assistive Technology Foundation (PATF) mini-loan. These loans (between $100 and $2,000) have a 0% interest rate and no fees. If considering a device or modification that costs more than $2,000, PATF can offer to extend a low-interest loan with an interest rate of 3.75%. Think hearing aids, iPads, mobility devices, accessible bathrooms, modified vehicles, ramps and more!
Who is eligible to apply? PATF is a program for Pennsylvania residents who need assistive technology devices and/or services. PATF helps people of all ages, income levels, disabilities, and health conditions. The organization’s website is www.patf.us. Contact them at (888) 744-1938, or patf@patf.us. PATF is also on Facebook and Twitter.
CaptionCall provides NO COST telephones and call captioning services to individuals who have difficulty using a phone due to hearing loss. The CaptionCall phone provides sound amplification, large print captions and many other features. Who is eligible to apply? Individuals who have hearing loss that necessitates the use of captions to use a phone effectively. WiFi internet is required. Applicants can sign up online at www.captioncall.com or over the phone. Once the customer name, address and phone is received, CaptionCall will call you to schedule your phone delivery, setup and train you on using the new phone all at NO COST. Learn more or order a phone at CaptionCall.com or by calling 1-717-468-5354.
FEMA: Coronavirus (COVID-19) Pandemic: HHS Letter to Hospital Administrators
Release date:
April 10, 2020
Release Number:
HHS Letter
Dear Hospital Administrator:
First, I want to thank you for the work you are doing to provide treatment and care to Americans who have been impacted by COVID-19. Hospitals are key partners with the federal government as we work to ensure that the Whole of America response to COVID-19 which is locally executed, state managed, and federally supported.
On March 29, 2020, the Vice President sent you a letter requesting your assistance in reporting data that is critical for epidemiological surveillance and public health decision making for the COVID-19 pandemic. The data requested included daily reports on testing, capacity, supplies, utilization, and patient flows to facilitate the public health response to COVID-19. I understand that many non-federal entities may already be requesting this information, and I have received pleas from hospitals and states to minimize the burden of sharing this data and to reduce duplication of effort.
The enclosed Frequently Asked Questions (FAQs) document details the federal government’s data needs, explains the division of reporting responsibility between hospitals and states, and provides clear, flexible options for the timely delivery of this critical information. Our objective is to allow states and hospitals either to leverage existing data reporting capabilities or, where those capabilities are insufficient, to provide guidance in how to build on them. These FAQs will be updated if additional data delivery methods become available.
It is critical that all of the requested information listed in these FAQs is provided on at least a daily basis to the federal government to facilitate planning, monitoring, and resource allocation during the COVID-19 Public Health Emergency.
On behalf of President Trump and the White House Coronavirus Task Force, I want to thank you for the work you are doing to provide care to the American people during this critical time.
Sincerely,
Alex m. Azar II
COVID-19 Frequently Asked Questions (FAQs)
For Hospitals, Hospital Laboratory, and Acute Care Facility Data Reporting
On March 29, 2020, Vice President Pence sent a letter to hospital administrators across the country requesting daily data reports on testing, capacity and utilization, and patient flows to facilitate the public health response to the 2019 Novel Coronavirus (COVID-19). Many separate governmental entities are requesting similar information, resulting in stakeholder requests to reduce duplication and minimize reporting burden. This document details the Federal Government’s data needs, explains the division of reporting responsibility between hospitals and states, and provides clear, flexible options for the timely delivery of this critical information. The objective is to allow states and hospitals either to leverage existing data reporting capabilities or, where those capabilities are insufficient, to provide guidance in how to build upon existing capabilities. These FAQs will be posted to the various HHS and HHS division websites, and will be updated if additional data delivery methods become available.
It is critical to the COVID-19 response that all of the information listed below is provided on at least a daily basis to the Federal Government to facilitate planning, monitoring, and resource allocation during the COVID-19 Public Health Emergency (PHE).
Who is responsible for reporting?
By default, hospitals should report on at least a daily basis the detailed information listed below through one of the prescribed methods. However, we recognize that many states currently collect this information from the hospitals. Therefore, hospitals may be relieved from reporting directly to the Federal Government if they receive a written release from the State stating that the State will collect the data from the hospitals and take over Federal reporting responsibilities.
When are states permitted to provide such a written release to hospitals?
States must first receive written certification from their FEMA Regional Administrator affirming that the State has an established, functioning data reporting stream to the Federal Government that is delivering all of the information below at the appropriate daily (or higher) frequency.
States that take over reporting must provide this data, regardless of whether they are seeking immediate Federal assistance.
Capacity and Utilization Data
Capacity and utilization data: what to submit?
The following data will greatly assist the White House Coronavirus Task Force in tracking the movement of the virus and identifying potential strains in the healthcare delivery system. It is critical that this data be reported at the facility and county level of detail rather than just a total statewide summary. Data that is submitted directly as a file instead of through an online portal should be sent in Excel or CSV format rather than as a scanned image or any other format that is not directly importable into a spreadsheet format.
| ID | Information Needed | Definition |
| 1. | State | State where the hospital is located |
| 2. | Hospital name | Name of hospital and CMS Certification Number (CCN) |
| 3. | Hospital county and Zip Code | County and Zip Code where the hospital is located |
| 4. | All hospital beds | Total number of all staffed inpatient and outpatient beds in your hospital, including all overflow and surge/expansion beds used for inpatients and for outpatients (includes all ICU beds). |
| 5. | Hospital inpatient beds | Total number of staffed inpatient beds in your hospital including all overflow and surge/expansion beds used for inpatients
(includes all ICU beds) |
| 6. | Hospital inpatient bed occupancy | Total number of staffed inpatient beds that are occupied |
| 7. | ICU beds | Total number of staffed inpatient ICU beds |
| 8. | ICU bed occupancy | Total number of staffed inpatient ICU beds that are occupied |
| 9. | Mechanical ventilators | Total number of ventilators available |
| 10. | Mechanical ventilators in use | Total number of ventilators in use |
| 11. | Hospitalized COVID patients | Patients currently hospitalized in an inpatient bed
who have suspected or confirmed COVID-19 |
| 12. | Hospitalized and ventilated COVID patients | Patients currently hospitalized in an inpatient bed who have suspected or confirmed COVID-19 and are on a mechanical ventilator |
| 13. | Hospital onset | Patients currently hospitalized in an inpatient bed with onset of suspected or confirmed COVID-19 fourteen or more days after hospital admission due to a condition other than COVID-19 |
| 14. | ED/overflow | Patients with suspected or confirmed COVID-19 who currently are in the Emergency Department (ED) or any overflow location awaiting an inpatient bed |
| 15. | ED/overflow and ventilated | Patients with suspected or confirmed COVID-19 who currently are in the ED or any overflow location awaiting an inpatient bed and on a mechanical ventilator |
| 16. | Deaths: | Number of patients with suspected or confirmed COVID-19 who died in the hospital, ED, or any overflow location on the date for which you are reporting |
| 17. | On-hand supply of N95 masks (if available) |
|
Capacity and utilization data: where/how to submit?
Hospitals and other facilities should report daily capacity and utilization data through one of the methods below, or to their State if they have received a written release from the State and the State has received written certification from their FEMA Regional Administrator to take over Federal reporting responsibilities. If the State assumes reporting responsibilities, the State can also choose to utilize one of the below channels or through the State portal at Protect.HHS.gov.
Reporting options for hospitals and other facilities:
- Submit data to TeleTracking™. All instructions on the data submission are on that site. To become a user in the portal:
- Respond to the validation email sent to your administrator.
- Visit the Teletracking website and follow the specific instructions on how to become users.
- Each facility is allowed to have up to 4 users for both data entry and visual access to aggregated data in the platform.
- Users will be validated by the platform.
- Complete the National Healthcare Safety Network (NHSN) module daily per the Center for Disease Control’s (CDC’s) instructions.
- Authorize your health IT vendor or other third-party to share information directly with HHS. Use one of the above alternate methods until your FEMA Regional Administrator notifies you that this implementation is being received.
- Publish to the hospital or facility’s website in a standardized format, such as schema.org. Use one of the above alternate methods until your FEMA Regional Administrator notifies you that this implementation is being received.
Capacity and utilization data: how often to submit?
At least daily. These reporting options have been chosen to make submission as easy as possible, and the HHS portal has been set up to allow users to submit data updates in a matter of minutes for the whole process. The completeness, accuracy, and timeliness of the data will inform the COVID-19 Task Force decisions on capacity and resource needs to ensure a fully coordinated effort across America. Doing so will also ensure that hospitals are not facing data requests from a multitude of Federal, State, Local, and private parties, as having a full data set will allow HHS to put a stop to others asking for the same data, so that they can spend less time on paperwork and more time on patients.
Testing Data: Hospitals That Perform COVID-19 Tests Using anIn House Laboratory
How should hospitals that perform “in house” laboratory testing report this data?
In an effort to promote data reporting choices to hospitals and other acute and post-acute care facilities, below are the options to report testing data:
- A unique link will be sent to the American Hospital Association’s hospital points of contact. This will direct the POC to a hospital-specific secure form that can then be used to enter the necessary information. After completing the fields, click submit and confirm that form has been successfully captured. A confirmation email will be sent to you from the HHS Protect System. This method replaces the emailing of individual spreadsheets previously requested.
- If your hospital did not receive a link, please contact the FEMA/HHS COVID-19 Diagnostics Task Force for support.
- Provide directly to their State if the state is reporting complete information daily to the FEMA Regional Administrator and their state has shared a written notification from FEMA confirming the reporting requirements are being met.
- Authorize their health IT vendor or other third party to submit the “in house” testing data to HHS/CDC. Until this is confirmed in writing to be working successfully, use one of the other methods mentioned above.
What data should hospitals with in house laboratory testing expect to submit to the portal?
- New Diagnostic Tests Ordered (Midnight to midnight cutoff, tests ordered on previous date queried)
- Cumulative Diagnostic Tests Ordered (All tests ordered to date.)
- New Tests Resulted (Midnight to midnight cutoff, test results released on previous date queried)
- Cumulative Tests Performed (All tests with results released to date)
- New Positive COVID-19 Tests (Midnight to midnight cutoff, positive test results released on previous date queried)
- Cumulative Positive COVID-19 Tests (All positive test results released to date)
- New Negative COVID-19 Tests (Midnight to midnight cutoff, negative test results released on previous date queried)
- Cumulative Negative COVID-19 Tests (All negative test results released to date)
How often should hospitals submit the data?
This data should be submitted by 5PM ET daily. All testing data should include test results that were completed during the previous day with a midnight cutoff.
Testing Data: Hospitals that Perform a Portion of COVID-19 Tests Using an In House Laboratory
How should hospitals that perform a portion of tests “in house” and send a portion of tests to commercial labs and/or State Public Health Labs report this data?
The portion of tests that are performed “in house” should be reported through the HHS Protect System. See above for reporting details concerning “in house” tests. The portion of tests that are sent to one of the six commercial labs listed below or that are sent to your State Public Health lab do not need to be reported through the HHS Protect System. However, if your hospital send tests to a commercial lab not listed on the below list, you should report those tests using the HHS Protect System.
Testing Data: Hospitals that Send COVID-19 Tests to Commercial Laboratories
Do hospitals that send tests to commercial laboratories need to report data using this system?
All hospitals should report data on COVID-19 testing performed in
Academic/University/Hospital “in house” laboratories. If all of your COVID-19 testing is sent out to private labs and performed by one of the commercial laboratories on the list below, you do not need to report using the HHS Protect System.
If you have COVID-19 testing that is sent out to private labs and performed by a commercial laboratory not listed, you should report this testing using the HHS Protect System.
Commercial laboratories:
- LabCorp
- BioReference Laboratories
- Quest Diagnostics
- Mayo Clinic Laboratories
- ARUP Laboratories
- Sonic Healthcare
Testing Data: Hospitals that Send COVID-19 Tests Data to State Public Health Laboratories
Do hospitals that send tests to State Public Health Laboratories need to report data using this system?
All hospitals must report data on COVID-19 testing performed in Academic/University/Hospital “in house” laboratories. If all of your COVID-19 testing is sent out to and performed by State Public Health Laboratories, you do not need to report using the HHS Protect System.
How should hospitals that perform a portion of tests “in house” and send a portion of tests to commercial labs and/or State Public Health Labs report this data?
The portion of tests that are performed “in house” should be reported through the HHS Protect System. The portion of tests that are sent to one of the six commercial labs listed above or that are sent to your State Public Health lab do not need to be reported through the HHS Protect System. However, if your hospital send tests to a commercial lab not listed on the above list, you should report such tests using the HHS Protect System.
Technical Assistance for Hospitals
Who do hospitals contact if they experience any technical issues?
Please email your question to HHS Protect Service Desk. Your question will be answered as soon as possible.
For specific URLs and email addresses, Hospital Administrators and their staff should reference their emailed copy of this letter.
Last Updated:
April 11, 2020 – 12:38