Regulations, Forms & Other Useful Documents
2007 Rural Hospital Replacement Facility Study: How Replacement Facilities Impact Operations and the Bottom Line: Findings From the Field
Author(s): Stroudwater Associates
Reports on rural communities that replace aging hospital facilities with new Critical Access Hospitals. Covers impact of new facilities on local use of services, quality and performance improvement, and financial performance.
Date: 2007
340B Drug Pricing Program: Results of a Survey of Eligible but Non-Participating Rural Hospitals
Author(s): Andrea Radford, Rebecca Slifkin, Marianne Baernholdt, Claudia Schur, Karen Cheung
Sponsoring organization: North Carolina Rural Health Research and Policy Analysis Center (Cecil G. Sheps Center)
Summarizes the results of a survey of pharmacy directors at rural hospitals eligible to participate in the 340B program but identified as not participating at the time of the survey. The purpose of this study was to understand why rural hospitals that are eligible for the program are not participating and to determine whether there are specific program features that present barriers to participation.
Date: 01 / 2007
340B Drug Pricing Program: Results of a Survey of Participating Hospitals
Author(s): Claudia Schur, Karen Cheung, Andrea Radford, Rebecca Slifkin, Marianne Baernholdt
Presents the results of a survey of pharmacy directors at rural hospitals currently buying discounted outpatient drugs through the 340B program. The purpose was to understand the perspectives of pharmacy directors on the 340B program in general, the financial impact of the program, and which specific program features presented barriers to its broader implementation. A joint paper from the NORC Walsh Center for Rural Health Analysis and North Carolina Rural Health Research & Policy Analysis Center.
Date: 05 / 2007
American Hospital Association Section for Small or Rural Hospitals 2006 Annual Report
Author(s): AHA Section for Small or Rural Hospitals
Sponsoring organization: American Hospital Association
Describes advocacy and other efforts taken by the American Hospital Association and its Section for Small or Rural Hospitals in 2006 to address the needs of rural hospitals.
Date: 2006
Assessing the Financial Effect of Medicare Payment on Rural Hospitals: Does the Source of Data Change the Results?
Author(s): Li-Wu Chen, Susan Puumala, Keith J. Mueller, Liyan Xu, Kathy Minikus, Catherine Makhanu,
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Describes how predictions of changes
in hospital financial performance as a result of change in Medicare payment differ when comparing results using data from the Medicare Cost Report (MCR) to results using data from the audited hospital financial statement.
Date: 11 / 2005
Balanced Scorecards for Small Rural Hospitals: Concept Overview and Implementation Guidance
Sponsoring organization: Health Resources and Services Administration
Describes the process of implementing a Balanced Scorecard (BSC) initiative in a small rural hospital setting. Includes a Balanced Scorecard example. Lists common terminology with definitions.
Date: 2005
Beyond Health Care: The Economic Contribution of Hospitals
Sponsoring organization: American Hospital Association
Discusses economic impact of hospitals to communities, including rural communities.
Date: 04 / 2008
CEO Recruitment Guide: Practical Step-by-Step Information for Recruiting a Hospital Administrator
Author(s): Linda Powell, Dave Berk, Rural Health Financial Services
Provides practical advice and tools
to recruit a qualified hospital administrator or chief executive officer.
Date: 2001
Community Leader's Guide to Hospital Finance: Evaluating How a Hospital Gets and Spends Its Money
Author(s): Sarah Gunther Lane, Elizabeth Longstreth, Victoria Nixon
Sponsoring organization: Harvard School of Public Health
A guide to hospital finance that provides: a vocabulary to help you understand information about a hospital's financial performance; tools that can be used to evaluate a hospital's charitable commitment to the community; and,
tips on how groups can engage hospital leadership
in meaningful discussions of hospital financial performance.
Date: 2001
Conducting Hospital Employee Satisfaction Surveys: Practical Step-by-Step Information for Assessing Employee Perceptions
Author(s): Linda Powell, Mountain States Group
Overview of how to conduct a hospital employee satisfaction survey. Includes a sample survey and discusses how to administer the survey and report the results.
Date: 2001
Corporate Responsibility and Health Care Quality: A Resource for Health Care Boards of Directors
Author(s): Arianne N. Callender, Douglas A. Hastings, Michael C. Hemsley, Lewis Morris, Michael W. Peregrine
Sponsoring organization: U.S. Department of Health and Human Services
Resource guide designed to help health care organization boards ask appropriate questions related to health care quality requirements, measurement tools, and reporting requirements.
Date: 2007
Cracks in the Foundation - Averting a Crisis in America's Hospitals
Sponsoring organization: American Hospital Association
Discusses a number of critical issues affecting hospitals including: worker shortages, emergency department overcrowding, regulatory burdens, rapidly rising costs, growing number of uninsured people, and payment shortfalls for Medicare and Medicaid government programs.
Date: 08 / 2002
Critical Access Hospital Program Fact Sheet
Sponsoring organization: Centers for Medicare & Medicaid Services
A general summary about the Critical Access Hospital (CAH) program that includes, the requirements for a facility to become a CAH, Medicare reimbursement for CAHs, and a list of rural health websites.
Date: 03 / 2007
Dartmouth Atlas of Health Care
Sponsoring organization: Robert Wood Johnson Foundation
The Dartmouth Atlas project is a funded research effort of the faculty of the Center for the Evaluative Clinical Sciences at Dartmouth Medical School. The Atlas project brings together researchers in diverse disciplines - including epidemiology, economics, and statistics - and focuses on the accurate description of how medical resources are distributed and used in the United States.
Does Hospital Size Affect Our Ability to Accurately Identify High Quality Care in Pay-for-Performance Programs?
Sponsoring organization: Upper Midwest Rural Health Research Center
Discusses the issue that smaller hospitals experience much greater variability in performance scores as a result of statistical sampling characteristics than larger hospitals.
Date: 05 / 2007
Financially Distressed Rural Hospitals in Four States
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
Policy brief discussing the impact of the outpatient Prospective Payment System (OPPS) on the financial performance of rural hospitals in Iowa, Texas, Washington, and West Virginia.
Date: 01 / 2004
Focus on Health Care Finance White Paper I: Financing Options for Nonprofit Rural and Community Hospitals
Author(s): Thomas R. Green
Sponsoring organization: Lancaster Pollard
Outlines several programs and financial options available to non-profit community and rural hospitals. Discusses a hospital's strategic plan for future and financial operations.
Date: 10 / 2005
Forward Momentum: Hospital Use of Information Technology
Sponsoring organization: American Hospital Association
Describes a survey which asked hospitals about use of specific kinds of IT, financing of IT systems, barriers to greater use, and involvement in arrangements to share clinical information.
Date: 10 / 2005
Hometown Hospitals: The Weakest Link? Bioterrorism Readiness in America's Rural Hospitals
Author(s): Elin A. Gursky
Sponsoring organization: Center for Technology and National Security Policy
Profiles of five rural hospitals and how they are addressing bioterrorism issues. Includes discussion of the challenges facing rural hospitals related to preparedness.
Date: 06 / 2004
Hospital Governing Board Assessment: A Self-Help Guide
Author(s): Linda Powell, Carol Taylor, Mountain States Group
Overview of why and how hospitals should evaluate governing board performance. Includes a sample assessment and guidelines for reporting findings from the assessment.
Date: 2004
Hospital Language Services for Patients With Limited English Proficiency: Results From a National Survey
Author(s): Romana Hasnain-Wynia, Julie Yonek, Debra Pierce, Ray Kang, Cynthia Hedges Greising
This report describes current practices, common
barriers, and the specific resources and tools
needed to provide language services to patients
with LEP. The results of the survey will inform
federal policymakers, practitioners, providers, and others of the issues and potential solutions facing hospitals as they work to improve language
services for all patients with LEP.
Date: 10 / 2006
Hospital Quality Improvement: Strategies and Lessons From U.S. Hospitals
Author(s): S. Silow-Carroll, T. Alteras, J. A. Meyer
Sponsoring organization: Commonwealth Fund
Focuses on the dynamics of hospital performance: how hospitals achieve and sustain improvements over time.
Date: 04 / 2007
Hospital Size, Uncertainty and Pay-for-Performance
Author(s): Gestur Davidson, Ira Moscovice, Denise Remus
Sponsoring organization: Upper Midwest Rural Health Research Center
Discusses hospital quality issues, hospital size, and pay-for-performance.
Date: 02 / 2007
How Will Elimination of Hospital Bad Debt Reimbursement Affect Rural PPS Hospitals?
Author(s): Janet P. Sutton, Alene Kennedy, Lucia Hammer, Grace Yang
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
Policy brief examining the financial effect that changes in current Medicare bad debt payment policy, as proposed in the FY2007 budget, might have
on rural hospitals.
Date: 07 / 2007
Implementation of Pay-For-Performance in Rural Hospitals: Lessons from the Hospital Quality Incentive Demonstration Project
Author(s): Walter Gregg, Ira Moscovice, Denise Remus
Sponsoring organization: Upper Midwest Rural Health Research Center
Reports the findings of a national study designed to identify institutional, organizational, and environmental factors that influence the experience of rural hospitals in the Hospital Quality Incentive Demonstration Project.
Date: 09 / 2006
Implementing A New USDA Rural Development Program Targeting Small Rural Hospitals and Their Communities: Recommendations of the RUPRI Health Panel
Author(s): Andrew F. Coburn, A. Clinton MacKinney, Timothy D. McBride, Keith J. Mueller, Rebecca T. Slifkin, Mary K. Wakefield
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Lists recommendations for implementing a new USDA
Rural Development program, included in the Senate Farm Bill proposal, should it be enacted into law. The goal of this program is to strengthen rural health care delivery systems, to provide necessary health care services to rural residents in a cost-effective manner.
Date: 03 / 2008
Market Survey Construction Kit: Practical Step-by-Step Information for Assessing Community Perceptions About Local Health Care Services
Author(s): Linda Powell, Mountain States Group
Guide for conducting a market survey of local residents' utilization of, attitudes toward
and satisfaction with local hospital and health care services. Includes a sample survey and guidelines for conducting and reporting the results from the survey.
Date: 2000
Medicare Disproportionate Share Hospital Fact Sheet
Sponsoring organization: Centers for Medicare & Medicaid Services
Overview of the Medicare Disproportionate Share
Hospital adjustment and how a hospital can qualify to receive it.
Date: 03 / 2007
Medicare Payment Basics: Hospital Acute Inpatient Services Payment System
Sponsoring organization: Medicare Payment Advisory Commission
Overview of Medicare payments to hospitals for acute inpatient care. Include information on Medicare payments for medical education, payments to disproportionate share (DSH) hospitals, and special payments for rural hospitals.
Date: 09 / 2006
Medicare Payment Basics: Outpatient Hospital Services Payment System
Sponsoring organization: Medicare Payment Advisory Commission
Overview of Medicare payments for outpatient hospital services. Includes information on how payment rates are set.
Date: 09 / 2006
Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2008 Rates; Final Rule
Sponsoring organization: Centers for Medicare & Medicaid Services
Revises the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs. Implements
certain provisions made by the Deficit Reduction Act of 2005 (Pub. L. 109–171), the Medicare Improvements and Extension Act under Division B, Title I of the Tax Relief and Health Care Act of
2006 (Pub. L. 109–432), and the Pandemic and All Hazards Preparedness Act (Pub. L. 109–417). In the Addendum to this final rule with comment period, describes changes to the amounts and factors used to determine the rates for Medicare hospital inpatient services for operating costs and capital-related costs.
Journal citation: Federal Register Volume 72 Issue 162 Pages: 47129-48175
Date: 08 / 2007
National Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions
Author(s): Li-Wu Chen, Wanqing Zhang, Junfeng Sun, Keith J. Mueller
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Documents the national magnitude of charges associated with hospitalizations
due to ambulatory care sensitive conditions in rural hospitals.
Date: 12 / 2007
New Hospital Information Technology: Is it Helping to Improve Quality?
Author(s): Suzanne Felt-Lisk
Sponsoring organization: Mathematica Policy Research, Inc.
Study included a nationally representative survey of hospitals that asked senior hospital executives whether clinicians use six specific types of information technology (IT). The survey also assessed whether IT had advanced quality of care, and if so, the most important ways in which it had done so.
Date: 05 / 2006
Performance Management: Improving and Sustaining Performance in Rural Hospitals
Author(s): Terry J. Hill
Sponsoring organization: Center for Rural Policy and Development
Outlines strategies and frameworks for overcoming obstacles in order to maintain financial stability for small rural hospitals and to establish sustainable health systems for the future.
Journal citation: Rural Minnesota Journal Volume 2 Issue 2
Date: 2007
Physician Shortage and Distribution
Sponsoring organization: American Hospital Association
Brief overview of the physician shortage issues faced by rural hospitals. Includes information on current public policy, and resources for hospitals.
Preserving Local Healthcare: Case Studies of Rural Health Works Implementation in Three Communities
Author(s): Craig Williamson, Joy McGlaun
Sponsoring organization: Office of Rural Health Policy
Profiles three communities that have used the Rural Health Works' tools to conduct economic impact studies and to actively engage communities to preserve local health systems. Rural Health Works was a project formed to increase awareness of the economic impact of rural health care systems.
Prevalence of Evidence-Based Safe Medication Practices in Small Rural Hospitals
Author(s): Gary Cochran, Katherine Jones, Liyan Xu, Keith Mueller
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Describes the prevalence of evidence-based safe medication practices, including the use of voluntary medication error reporting, in small rural hospitals.
Date: 04 / 2008
Primer on Interpreting Hospital Margins
Author(s): Kathleen Dalton, Rebecca Slifkin
Sponsoring organization: North Carolina Rural Health Research and Policy Analysis Center (Cecil G. Sheps Center)
Explains the most commonly used measures of hospital profitability, and how they are used to inform policy changes. Particular emphasis on the different formulas as they impact rural versus urban hospital figures.
Date: 07 / 2003
Regional Variation in Rural Hospital Charges Due to Ambulatory Care Sensitive Conditions
Author(s): Li-Wu Chen, Wanqing Zhang, Junfeng Sun, Keith J. Mueller
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
Estimates and documents the regional magnitude of charges associated with hospitalizations due to ambulatory care sensitive conditions in rural hospitals.
Date: 12 / 2007
Report to the Congress: Rural Payment Provisions in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003
Sponsoring organization: Medicare Payment Advisory Commission
Examines the impact of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) provisions on rural hospital payments. Present the effect of eight MMA provisions
on Medicare inpatient and outpatient payments to traditional (non-CAH) hospitals. Summarizes the MMA changes to Critical Access Hospital (CAH) payment policies discussed in MedPAC's interim report. Examines the effects of higher payments on hospital costs.
Date: 12 / 2006
Rural Hospitals' Strategies for Achieving Compliance with HIPAA Privacy Requirements
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
Discusses a survey of hospital administrators in rural areas regarding the Health Insurance Portability and Accountability Act (HIPAA). Includes an overview of HIPAA compliance efforts in rural hospitals, as well as examples of specific strategies to meet HIPAA requirements.
Date: 03 / 2004
Rural IT: Information Technology Challenges in the Heartland
Sponsoring organization: American Hospital Association
Special supplement issue advising small and rural hospital executives on the information technology (IT) challenges they face and helping identify strategies to promote adoption. Includes articles on funding and connectivity issues.
Journal citation: Hospitals and Health Networks
Date: 08 / 2006
Rural Perspective Regarding Regulations Implementing Titles I and II of the Medicare Prescription Drug, Improvement, and Modernization Act Of 2003 (MMA)
Author(s): Curt Mueller, Keith Mueller, Janet Sutton
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
Identifies sections of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) that might be of special concern to rural Medicare beneficiaries, medical care providers, and policymakers. Includes guidance regarding provisions in the Proposed Rule "Establishment of the Medicare Advantage Program," which implements Title II of the MMA, with a focus on its impact on rural health service delivery.
Date: 08 / 2004
Rural Referral Center Fact Sheet
Sponsoring organization: Centers for Medicare & Medicaid Services
Overview of the Rural Referral Center program, which supports high-volume rural
hospitals that treat a large number of complicated cases.
Date: 02 / 2007
Sole Community Hospital Fact Sheet
Sponsoring organization: Centers for Medicare & Medicaid Services
A general summary about Sole Community Hospitals that includes a list of helpful rural Health websites.
Date: 02 / 2006
Transforming Hospitals: Designing for Safety and Quality
Sponsoring organization: Agency for Healthcare Research and Quality
Reviews the case for evidence-based hospital design and how it increases patient and staff satisfaction and safety, quality of care, and employee retention, and results in a positive return on investment.
Date: 09 / 2007
Understanding the Role of the Rural Hospital Emergency Department in Responding to Bioterrorist Attacks and Other Emergencies: A Review of the Literature and Guide to the Issues
Author(s): Claudia L. Schur
Sponsoring organization: NORC Walsh Center for Rural Health Analysis
Overview of bioterrorism preparedness issues facing rural hospitals, including physical capacity, sufficiency of health personnel, preparedness plans, disease surveillance systems, and communication/coordination. Detailed review of the literature, with discussion.
Date: 04 / 2004
