For Your Health

News from the University of North Dakota School of Medicine & Health Sciences

Added training = added value

Rural providers look to professional development opportunities to help employees, health facilities, and entire communities.

When Corey Ulmer first began working at Ashley Medical Center in 2019, he had high hopes for the future. Although he initially took a position as a Certified Nursing Assistant, Ulmer was ambitious to move quickly up the ranks.

“I was simultaneously working to earn my Nursing Home Administrator license,” he said.

After a few years of dedication, his hard work has paid off.

“I am now being mentored for our Chief Financial Officer (CFO) position, as our current CFO will be retiring in the near future,” Ulmer stated. “I have had the privilege of working alongside him for the past two years, learning the duties and responsibilities that I will one day inherit.”


Offering a New Opportunity

As part of his preparations to become CFO, Ulmer has been participating in the National Rural Health Association (NRHA) Rural Hospital CFO Certification Program. This eight-month course is specifically designed to prepare participants for success in the rural context. The curriculum is based on four building blocks: leadership, operational, financial, and clinical. Each block has its own training module and speakers with expertise in that area.

As a way to strengthen rural North Dakota healthcare facilities and increase the wealth of knowledge within their walls, the North Dakota Medicare Rural Hospital Flexibility Grant Program (Flex) has provided funds to help cost-share program fees for continuing education programs within various topics.


Flex Program Areas

Flex has six program areas: Critical Access Hospital (CAH) Quality Improvement, CAH Operational and Financial Improvement, CAH Population Health Improvement, Rural Emergency Medical Services Improvement, Innovative Model Development, and CAH Designation.

“The Quality Improvement and Operational and Financial Improvement program areas are required to be addressed through programming, while the other areas are optional,” Nicole Threadgold, senior project coordinator with Flex, said. “North Dakota Flex provides programing for all six areas.”

The NRHA Rural Hospital CFO Certification Program falls under the CAH Operation and Financial Improvement program area.

“Without Flex, I may not have been able to have this experience,” Ulmer said with a smile. “I am extremely grateful for the North Dakota Flex program and Ashley Medical Center for granting me access to this wealth of knowledge and relationships. It will be a tremendous asset in helping me to advance my career and, in turn, my life.”


Importance of Continuing Education

The first time the North Dakota Flex program cost-shared with participants for the NRHA CFO Certification Program was in 2022.

“Based on positive feedback from the 2022 participants, North Dakota Flex offered the opportunity for a second year to North Dakota CAH CFOs,” said Threadgold. “The next cohort begins in March 2023, and there will be four additional CFOs from North Dakota participating in this cohort.”

Margaret Fontana, CFO at Langdon Prairie Health, is another participant of the CFO Certification Program who has benefitted from North Dakota Flex’s cost sharing.

“I wasn’t aware there was financial assistance until I was attending the program,” she said. “The other North Dakota CFOs brought it to my attention and Flex was able to partially reimburse Langdon Prairie Health. I have been very grateful for the support.”

In addition to Ulmer and Fontana, Amanda Loughman, a CFO from Southwest Healthcare Services in Bowman, N.D., is participating in the CFO Certification Program.

“I recently completed my Nursing Home Administrator’s license and was interested in another continuing education program,” Loughman said. “This program seemed interesting and was streamlined to help a CFO succeed in their day-today operations.”

The North Dakota Flex program is also helping nurses attend the Iowa Online Nurse Residency Program (IONRP). The program offers new registered nurses (RNs) 12 months of competency-related curriculum. The curriculum helps new nurses gain confidence as well as competence while they are working as a nurse. Flex support for the IONRP is currently slated to last from October 2022 to October 2023.

Stacy Kusler, workforce specialist with the UND Center for Rural Health, noted the appeal of IONRP.

“The IONRP program was developed with rural facilities in mind, and enrolled nurses complete a combination of didactic content, discussion groups, and guided professional experience. We are looking forward to feedback from the nurses, as well as the sites, to determine if this is a program to continue offering support for.”


‘Train to retain’

The ultimate goal is to strengthen CAHs by training key employees, leading to improved operations and decreased employee turnover.

“New nurse graduates are entering the workforce looking for residency programs,” continued Kusler. “It can be overwhelming and expensive for facilities to develop and operate their own program, so the IONRP is a great fit. Rural sites can enroll as few as one nurse at a time. The idea is ‘train to retain,’ meaning the nurses will gain confidence and competence at the rural workplace and have a desire to stay.”

Overall, participants of these continuing education programs are grateful for the opportunities and excited for what the future holds.

“I’ve benefitted most from the program through the networking and brainstorming with the other students,” said Loughman. “We all come from different backgrounds and different areas. Our expertise is very different from each other, and it really is interesting to hear us all come together and discuss a brainstorming topic.”

Ulmer also mentioned the value he has gained from the experience: “This cohort has monumentally accelerated the learning curve process that I needed to take place in order to feel comfortable in the CFO position. It has also connected me with twenty like-minded peers who share similar goals and obstacles as I do. I plan to network with this group of people for the rest of my career.”

By Jessica Rosencrans