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Arkansas Heart Hospital Bryant, Arkansas
HELPING BUILD A HEALTHIER ARKANSAS. Clark Contractors is proud to be a part of creating the healthcare infrastructure essential to the well-being of our state and our people. We thank you for your confidence and look forward to continuing our efforts to build a healthier Arkansas.
Specializing in mental health treatment for children and adolescents Pinnacle Pointe Behavioral Healthcare System is located in Little Rock and is one of Arkansas’ largest behavioral health facilities. We oﬀer acute inpatient and residential services for children and adolescents ages 5-17 who are struggling with emotional or behavioral health issues.
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Death Disease-Modifying Treatment Hospice Care Palliative Care
Bereavement Support Terminal Phase of Illness
Figure 1: Integrated Model of Palliative Care
National Quality Forum, 2006
ARKANSAS HOSPITAL ASSOCIATION . 11
Palliative Care Programs in U.S. Hospitals with 50 or more beds, 2000-2016 Count of Hospitals with Palliative Care Program Percent of Hospitals with Palliative Care Program
2002 2004 2006
2008 2010 2012
Figure 2. American Hospital Association Annual Hospital Surveys for FY2000 to FY2016 and data from the CAPC National Palliative Care Registry
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ARKANSAS HOSPITAL ASSOCIATION . 13
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Med Mal 101 is a 12-part series produced by the Medical Malpractice Attorneys with Friday, Eldredge & Clark. Delivered monthly via email to subscribers, it is designed to give physicians and other healthcare providers information they need to know about malpractice litigation.
Part 1 of 12: How a Lawsuit Gets Started When a patient sues a medical care provider for malpractice, the patient must initiate the lawsuit by filing a formal document called a “complaint.” There are some exceptions for cases that involve children, but a complaint generally must be filed within two years of the date of alleged injury. A complaint must include information about who is bringing the lawsuit (the “plaintiff”), the parties being sued (the “defendants”), the court where the case is filed, and “facts upon which relief can be granted” under Arkansas law, which is typically a brief recitation of the errors alleged.*
READ THE FULL STORY ONLINE
Our patients place their trust and health in our hands, and caring for patients is a privilege and a responsibility we never take for granted. We are committed to our mission — to provide quality healthcare and improve the health of our communities.
Want more? Subscribe to MED MAL: 101 & receive our monthly article via email.
SUBSCRIBE to MED MAL 101
Text “MEDMAL” to 42828 or visit www.FridayFirm.com/MedMal to sign up
Attorneys at Law I Little Rock I Rogers I Fayetteville *The information was written by the attorneys in the Medical Malpractice Group at Friday, Eldredge & Clark, LLP and is not a substitute for legal advice and should be considered for general guidance only.
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BeneďŹ ts of For the
Hospital Hospice and
Improve and streamline post-acute care transitions
Gain access to more patients who will benefit from hospice care
Decrease length of stay (LOS) by transitioning hospice-eligible patients to appropriate venues of care
Access a new venue to provide GIP level of care
Improve value-based purchasing scores with decrease in 30-day readmissions, improve CAHPS scores, and reduce Medicare Spending Per Beneficiary
Educate hospital staff on the holistic approach of hospice and palliative care
For hospitals with ACO/CIN: Decrease utilization and achieve cost savings
Gain access to the hospitalâ€™s resources and create further partnerships within the health system
Realize new stream of income for patients transitioned to GIP within the hospital
Understand the unique challenges of acute care hospitals
Educate staff in end-of-life care
Achieve more timely and appropriate hospice referrals through improved integration
Gain access to bereavement services for families of mutual patients provided by hospice provider at no cost to hospital
Establish or participate in development of hospital-based palliative care programs
30% 25% 20% 15% 10% 5% 0%
30-Day Readmission Rate by Post-Discharge Medical Service Use Percent
Home with hospice care provider 4.6%
Home with home health care provider 13.3%
Nursing Home 24.1%
Data taken from the Journal of Palliative Medicine.
ARKANSAS HOSPITAL ASSOCIATION . 17
Arkansas Medicare Hospice Days Per Patient (ALOS) 80 70 60 50 40 30 20 10 0
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
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NEW LOOK. ARKANSAS HOSPITAL ASSOCIATION
SAME MISSION. Serving you since 1929.
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INVITE OTHER DECISION MAKERS Who do you rely on to
help you make important decisions?
ASSESS UNDERSTANDING OF PROGRESS Can you share with me what
you think is happening with your illness and the treatments?
IDENTIFY GOALS OF CARE What is most important to
you right now?
What are you worried
about now? In the future?
REFRAME GOALS I wish we could find a new
treatment that would cure
your disease. Even though a
cure is not possible, I think we can meet some of your other
goals, like staying at home to spend time with your family.
IDENTIFY NEEDS FOR CARE What is your life like when
you are at home? How are you and your family managing?
Are you experiencing pain
or other symptoms that are bothering you?
INTRODUCE HOSPICE The hospice team specializes
in caring for seriously ill patients at home.
RECOMMEND HOSPICE From what you have shared
with me today, I recommend
hospice as a way of helping you
meet the goals that are important
to you. I know this is a big decision, and I want you to know that the decision is yours.
1 in 5 Arkansans struggle with hunger every day. Arkansas ranks second in food insecurity. Arkansas is No. 6 in senior hunger nationally.
100,000 200,000 300,000 400,000 Meals Packed
…to those who we worked alongside in communities throughout the state to pack more than 1.1 million meals in the Fearless Food Fight to support local food shelters helping our neighbors in need. You helped us exceed a goal of 700,000 500,000 600,000 700,000 Meals Packed Meals Packed Meals Packed meals in celebration of our 70th anniversary. And to the thousands of doctors, nurses, therapists, pharmacists, counselors, hospitals, medical suppliers and many other healthcare providers who have cared for our members and their families for seven decades, thank you! You play a critical role in ensuring our members receive quality, compassionate care during some of their most vulnerable moments in life. As a not-for-profit, mutual insurance company, our commitment to investing in Arkansas, its people and its healthcare delivery system began in December 1948 and will continue.
MPI 7882 11/18
Our work is not done, but by facing the future together, we can keep our great state strong.
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ARKANSAS HOSPITAL ASSOCIATION . 27
How To Talk To Your Doctor Discussing end-of-life care with your doctor, nurse, or other health care provider is important, too.
Improving the state of medicine here in the Natural State.
NYIT College of Osteopathic Medicine at Arkansas State is committed to alleviating the shortage of primary care physicians here in Arkansas and the greater Delta region. Our campus in Jonesboro â€” in proximity to substantial health care needs â€” is uniquely situated to improve the Natural State of medicine. Our students and faculty are eager and ready to address these needs with research, outreach, wellness initiatives, and superior patient care. Training physicians in Arkansas for Arkansas.
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151-300 beds Public
300+ beds For-Profit
NPCRC, 2015 data
ARKANSAS HOSPITAL ASSOCIATION . 33
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AAHQ Arkansas Association for Healthcare Quality
ARKANSAS HOSPITAL ASSOCIATION . 35
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C O&MExpansion ING SOON Robinson Center Renovation Little Rock, AR CARTI CANCER CENTER
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to order free health care resources and tools! Go to afmc.org and get instant access to information that health care providers like you need every day. Youâ€™ll find free tools available for order and download, details about AFMCâ€™s quality improvement and disease prevention projects, survey results, professional publications geared toward Arkansas health care providers and MORE!
REVISED SEPTEMBER 2017
be you. be well.
Whatever you want to be, it helps to be well. We offer tips and support to quit smoking and address health conditions like diabetes and high blood pressure. Itâ€™s never too late to make decisions to help you be healthier.
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ARKANSAS HOSPITAL ASSOCIATION . 45
a l t h c a re S o l u t i
Building Partnerships. Delivering Excellence. The professional liability and property protection for your healthcare facility deserves the expertise of specialists. The Healthcare Division of BXS Insurance is one of the largest and most experienced group of medical professional liability and property specialists for hospitals, PHOs, IPAs, surgery centers, clinics, physicians, surgeons, and nursing homes in the Southeast. Call Tom Hesselbein today for more information at (501) 664-7705.
Professional Liability | Property | Loss Control | TPA Services 1. BXS Insurance is a wholly owned subsidiary of BancorpSouth Bank. 2. Insurance products are • Not a deposit • Not FDIC insured • Not insured by any federal government agency • Not guaranteed by the bank • May go down in value. 3. BXS Insurance is an insurance agent and not an insurance carrier. 4. Always read your policy for coverage terms and conditions.
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IMMEDIATE PHYSICIAN OPENINGS OB/GYN Family Medicine Family Medicine with OB Benefits include: • Paid Leave & Extended Illness Leave • 401K with match & 457(b) Retirement Plans • Hospital-paid Life/LTD/AD&D • Medical, Dental and Vision Plans • Competitive Compensation • Relocation Allowance • CME Allowance • On-site Fitness Center
Physician opportunities await in Harrison, Arkansas! www.narmc.com 46 . SPRING 2019
GUIDE TO ADDRESS HOUSING INSTABILITY
We've got you Covered! The BridgeWay is now a Medicaid provider for all adults covered by the PASSE, including Arkansas Total Care, Empower Healthcare Solutions and Summit Community Care. To learn more about our programs and services: Call: 1-800-245-0011 | Visit: TheBridgeWay.com To learn more about PASSE, visit: https://humanservices.arkansas.gov/about-dhs/dms/passe-provider-info/passe-resources-for-providers
Captions for your phone calls.
Captioned Telephone service from Arkansas Relay offers the ability for anyone with hearing to phone communicate Captions forloss your calls. on the telephone independently. LISTEN, READ and Captioned Telephone service from phone! Relay offers RESPOND to your callers with ease on the CapTel®Arkansas
the ability for anyone with hearing loss to communicate
If you have a hearing loss and are eligible to use LISTEN, the READ and on the telephone independently. CapTel service, contact Telecommunications RESPOND to yourarkansasrelay.com/captel callers withAccess ease on the CapTel® phone! Program (TAP) and a representative will loss provide you a If you have a hearing and are eligible to use the CapTel service, contact Telecommunications Access CapTel phone at no cost*.
Program (TAP) and a representative will provide you a
CapTel phone at no cost*. Captions for your phone calls. ■ 800-981-4463
Captioned Telephone service from Arkansas Relay offers ■ 800-981-4463 ■ www.arkansasrelay.com/tap (TAP Information) the ability for anyone with hearing loss to communicate ■ www.arkansasrelay.com/tap (TAP Information) ■ (CapTel on the www.arkansasrelay.com/captel telephone independently. LISTEN, READ and Information) ■ www.arkansasrelay.com/captel (CapTel Information) RESPOND to your callers with ease on the CapTel® phone!
If you have a hearing loss and* are eligible to use the CapTelCapTel service, contact Telecommunications Access is a registered trademark of Ultratec, CapTel is aInc. registered trademark of Ultratec, Inc. Program (TAP) and a representative will provide you a CapTel phone at no cost*. ■ ■ ■
“Housing and the Role of Hospitals” is the second guide released by the AHA, HRET and ACHI in a series educating hospitals about how they can address the social determinants of health. Approximately 1.5 million people experience homelessness in the U.S. each year. In addition, some individuals are not homeless but live in unstable conditions. Housing instability — a term for the continuum between homelessness and stable, secure housing — can include physical conditions such as poor sanitation, lack of heating and cooling, exposure to allergens or pests, and substandard housing structures. Unstable access to housing and severe rent burden also contribute to housing instability. Where and how people live directly affects their well-being. Research shows that individuals experiencing housing instability have limited access to preventive care and are more likely to have infectious diseases and chronic health conditions like diabetes, cardiovascular disease, and chronic obstructive pulmonary disease. Homeless individuals also have a shorter lifespan. This guide highlights a web of interrelated socioeconomic factors that contribute to housing instability and influence health outcomes. Hospitals and health systems can implement strategies and programs to improve housing stability, such as neighborhood revitalization, home assessment and home repair programs, and care transition programs. This guide recommends a step-by-step path for hospitals to consider when developing housing programs.
800-981-4463 www.arkansasrelay.com/tap (TAP Information) www.arkansasrelay.com/captel (CapTel Information)
* CapTel is a registered trademark of Ultratec, Inc.
NEWS STAT ARKANSAS HOSPITAL ASSOCIATION . 47
2019 Governor’s Quality Award Healthcare Seminar
The Unconscious Barriers to Workforce Quality Tuesday, June 18 | Embassy Suites Hotel, Little Rock | 8:45 a.m. – 3 p.m. 5.5 hours pending from the National Association for Healthcare Quality and Office of Long Term Care
AGENDA 8:45 a.m. – 9 a.m. 9 a.m. – 10:15 a.m.
10:15 a.m. – 10:30 a.m.
Welcome “The Unconscious Barriers to Workforce Quality” Hugh Brown, Chief Executive Officer St. David’s Georgetown Hospital, Austin, Texas Break
10:30 a.m. – 11 a.m.
“How the Governor’s Quality Award Process Engages Your Workforce: Examples from a 2018 Award Recipient” Steven Webb President and CEO, Unity Health
11 a.m. – 12 p.m.
“Supporting Your Workforce and Improving Patient Outcomes through Trauma-Informed Care Practices” Nicola (Nikki) Edge, PhD Professor/Associate Director, Research and Evaluation Division/Department of Family and Preventive Medicine/University of Arkansas for Medical Sciences
12 p.m. – 1 p.m.
1 p.m. – 2 p.m.
“How to Build and Sustain a Culture of Excellence” Jimmy K. Duncan, SHRM-SCP, SPHR Chief People Officer, Arkansas Children’s
2 p.m. – 3 p.m.
“Impairment in the Workplace: See Something? Say Something! Do Something!” Tonya S. Gierke JD, BSN, RN Arkansas State Board of Nursing (ASBN)/ Assistant Director Arkansas Nurses Alternative to Discipline Program (ArNAP)
Hugh Brown, Chief Executive Officer
Hugh Brown has served as Chief Executive Officer of St. David’s Georgetown Hospital since 2007. He assumed his role shortly after the hospital was acquired by St. David’s HealthCare, a partnership between HCA and the Austin-based St. David’s Foundation. In 2014, St. David’s HealthCare received the Malcolm Baldrige National Quality Award, the highest quality award given to any business by the federal government. In addition, for the past six years St. David’s Georgetown Hospital has specifically been recognized as a “100 Top Hospital” and as a “Top 5% Hospital in the U.S.” for clinical quality.
Steven Webb, President & CEO
Steven Webb is the President and CEO of Unity Health which has grown from a county hospital to an entire system, consisting of three hospital campuses and 20 clinics serving communities in eight counties. Unity Health – White County Medical Center received the 2018 Governor’s Quality Award for Performance Excellence. The system is a member of the Mayo Clinic Care Network and home to the second largest Graduate Medical Education program in the state.
Nicola (Nikki) Edge, PhD
Nikki Edge, PhD, is a Professor at the University of Arkansas for Medical Sciences in the Department of Family and Preventive Medicine. She directs an Early Childhood Mental Health Consultation program in Arkansas, called Project PLAY, as well as a teacher training and coaching program, called REACH. She is co-director of AR BEST (Arkansas Building Effective Services for Trauma).
Jimmy K. Duncan, SHRM-SCP, SPHR
Jimmy Duncan is the Senior Vice President: and Chief People Officer for Arkansas Children’s in Little Rock. This position champions the Arkansas Children’s System culture effort to become an integrated “One Team” made up of hospitals, research, foundation, and care networks.
ARKANSAS HOSPITAL ASSOCIATION
Tonya S. Gierke JD, BSN, RN
Tonya Gierke recently joined the Arkansas State Board of Nursing as the Assistant Director over ArNAP (Arkansas Nurses Alternative [to Discipline] Program). She is an RN and a licensed attorney. Her bedside nursing career includes pediatric oncology, emergency room, and flight nursing. She has practiced law in the areas of insurance defense and health care regulation. She has over a decade of experience as a risk manager, health care compliance officer, and privacy officer.
50 . SPRING 2019
POST-HOSPITAL MRSA INFECTIONS REDUCED BY 30 PERCENT Rehospitalizations for infections caused by Methicillin-resistant Staphylococcus aureus (MRSA) were reduced by 30 percent through a three-step treatment plan for patients known to carry the bacteria on their body, according to a new AHRQ (Agency for Healthcare Research and Quality) study. The treatment cleanses the bacteria from patientsâ€™ skin, mouths, and noses, according to the research. Patients were treated with a combination of an over-the-counter antiseptic, for bathing or showering, prescription antiseptic mouthwash, and antibiotic nasal ointment. The study, published in the February 14, 2019 issue of the New England Journal of Medicine, included more than 2,000 patients with MRSA who were discharged from Southern California hospitals between 2011 and 2014. Patients in one group received an educational binder with recommendations for preventing infections via personal hygiene, laundry, and household cleaning. A second group received the same educational materials but, for six months, also took steps to remove MRSA from their skin and noses with chlorhexidine antiseptic for bathing, chlorhexidine mouthwash, and the nasal antibiotic ointment mupirocin. In the overall treatment group, the 30 percent reduction in MRSA infections was accompanied by a 17 percent reduction in all infections, according to the study results. Of note, participants who followed the treatment completely had a 44 percent reduction in MRSA infections and a 40 percent reduction in all infections.
NEWS STAT ARKANSAS HOSPITAL ASSOCIATION . 51
Percent Medicare 47 46.5 46 45.5 Arkansas
Median Length of Service
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MEASLES STRIKING THE U.S. IN 2019 From January 1 to March 21, 2019, 314* individual cases of measles were confirmed in 15 states. The states reporting cases to CDC are Arizona, California, Colorado, Connecticut, Georgia, Illinois, Kentucky, Michigan, Missouri, New Hampshire, New Jersey, New York, Oregon, Texas, and Washington. Six outbreaks (defined as three or more cases) have been reported in the following jurisdictions: • New York State, Rockland County • New York City • Washington • Texas • Illinois • California
HPCAA Leaders Providing National Leadership in Comfort Care The Hospice & Palliative Care Association of Arkansas is honored to provide leaders to the National Hospice and Palliative Care Organization (NHPCO). Three leaders from our association are currently serving terms on the NHPCO Board of Directors. We appreciate their many contributions to advancing the practice of hospice and palliative care for patients and families in Arkansas – and the nation.
Greg Wood, MS, LSW Executive Director, Hospice of the Ozarks; Chairman, NHPCO Board of Directors
Dr. Brian Jones President and CEO, SHARE Foundation; National Director, NHPCO Board of Directors
Carla Davis CEO, Heart of Hospice; Appointee, NHPCO Board of Directors
These outbreaks are linked to unvaccinated international travelers who brought measles back from other countries, such as Israel and Ukraine, where large measles outbreaks are occurring. It is important for all travelers to be vaccinated against the measles before traveling internationally. Spread of Measles • Most people who got measles were unvaccinated. • Measles is still common in many parts of the world, including some countries in Europe, Asia, the Pacific, and Africa. • Travelers with measles continue to bring the disease into the U.S. • Measles can spread when it reaches a community in the U.S. where groups of people are unvaccinated. For more on the current state of measles outbreaks in the U.S., go to www.cdc.gov* and search “Measles.”
NEWS STAT ARKANSAS HOSPITAL ASSOCIATION . 53
You take care of your patients & we’ll take care of your practice We’ve been addressing the legal needs of the healthcare industry for 119 years. • • • • • • • • • •
Medicare/Medicaid Reimbursement Stark I and II & Anti-Kickback Compliance Contracts & Business Transactions Government Regulations Operations & Management Licensure Matters & Board Hearings Employment Issues HIPAA Compliance & Training Medical Malpractice Defense Medical Device & Pharmaceutical Products Defense
Let us put our experience to work for you.
54 . SPRING 2019
MEASURING HEALTH CARE DISPARITY?
FINANCING IS THE FIRST STEP.
The National Healthcare Quality and Disparities Reports provides a unified web tool for use by policymakers, health care researchers and analysts, health care stakeholders, media professionals, members of the public, and health care workers who are seeking to improve the health status and quality of care for vulnerable populations. The NHQR/DR provides up-to-date quality and disparities reports and fact sheets for investigating disparities in the ambulatory, home health, hospice, nursing home, and hospital settings. It incorporates features not only from the national reports but also from state snapshots and the NHQR/DR query tool. Allowing users to drill down from the broadest picture of health care quality and disparities on the national and state levels, the web tool helps users view detailed analyses of specific measures at those levels. Itâ€™s also possible, through the data query feature, to examine data across specific sociodemographic fields. Access the web tool by visiting the AHRQ website at ahrq.gov, searching for National Healthcare Quality and Disparities Reports.
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NEWS STAT ARKANSAS HOSPITAL ASSOCIATION . 55
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WE ARE HERE FOR YOU. To receive our advocacy updates, register at: votervoice.net/ARHA/home
Engage with us on social media:
Request our weekly newsletter, The Notebook, by emailing firstname.lastname@example.org
ARKANSAS HOSPITAL ASSOCIATION
ARKANSAS HOSPITAL ASSOCIATION . 63
Hospice and Palliative Care
IN ARKANSAS TODAY
â€˘ 37 Arkansas hospitals offer palliative care services in the hospital, system, or through a joint venture.
â€˘ 43 Arkansas hospitals offer hospice services in
the hospital, system, or through a joint venture.
16,080 Arkansans 15,000 Medicare Payments Totalling $152,088,6442
In 2016, 16,080 Arkansans received hospice services through Medicare, with Medicare hospice payments totaling $152,088,644.2
48% of Arkansans covered by
Medicare who died in 2016 were using hospice services at the time of death.2
Average age: 80
Primary diagnoses of AR Medicare hospice users2
Demographics of AR Medicare hospice users2
Assisted Living or Nursing Facility
Primary place of service of AR Medicare hospice users2
AHA Annual Survey, 2017 Centers for Medicare and Medicaid Services Hospice Public Use File, 2016 1
ST. BERNARDS MEDICAL CENTER HEART CARE RENOVATION Jonesboro, Arkansas
E N V I R O N M E N TA L
WE WORK IN EXISTING SPACES to deliver amazing results When long-time client St. Bernards Medical Center needed to renovate its heart care center, there was a catchâ€”the facility needed to remain in operation during the project. Nabholz rose to the challenge for our client, adding a hybrid and cath lab into the existing space, all while the building remained open to the public.
1.877.NABHOLZ | www.nabholz.com
S P E C I A LT Y