{"id":13524,"date":"2025-06-04T14:56:19","date_gmt":"2025-06-04T19:56:19","guid":{"rendered":"https:\/\/blogs.und.edu\/for-your-health\/?p=13524"},"modified":"2025-06-04T14:56:19","modified_gmt":"2025-06-04T19:56:19","slug":"raising-the-standards","status":"publish","type":"post","link":"https:\/\/blogs.und.edu\/for-your-health\/2025\/06\/04\/raising-the-standards\/","title":{"rendered":"Raising the standards"},"content":{"rendered":"

UND Center for Rural Health Flex and SHIP programs help provide quality healthcare in rural North Dakota.<\/p>\n

Lifestyles can look very different based on where you live. Driving through rush hour to get to and from work is a daily reality for many people who live in urban areas, while the same commute to work can take rural residents past fields of wheat, pastureland, or the scattered farmstead.<\/p>\n

Likewise, careers that are bountiful in rural locations dissipate as the population density increases.<\/p>\n

But one facet of life that shouldn\u2019t differ based on where you live is the quality of healthcare available.<\/p>\n

Fortunately, federal grants such as the Medicare Rural Hospital Flexibility Grant<\/a> (Flex) Program and the Small Hospital Improvement Program<\/a> (SHIP) help sustain the quality of care provided in rural hospitals.<\/p>\n

The power of collaboration<\/strong><\/p>\n

Flex is a national program whose purpose is to assist rural hospitals and improve access to health services in rural communities. Quality Improvement (QI) is just one of multiple areas of focus for Flex. It also supports the operational improvement for both Critical Access Hospitals (CAHs) and Rural Health Clinics (RHCs) \u2014 and provides support for rural EMS networking and CAH designation.<\/p>\n

Housed at the Center for Rural Health<\/a> (CRH), located within the UND School of Medicine & Health Sciences, the Flex Program recently celebrated its 25th anniversary of aiding North Dakota healthcare providers, communities, and residents.<\/p>\n

Jody Ward, grant program director at CRH and principal investigator of Flex, explains that in her many years of working with the Flex Program, the North Dakota Critical Access Hospital Quality Network has been one of the most successful implementations.<\/p>\n

\u201cBy using Flex dollars, the North Dakota CAH Quality Network supports North Dakota hospitals, without charging for membership, to provide technical assistance to ensure they are able to collect data specific to CAHs on quality measures,\u201d Ward says. \u201cFlex staff work with each hospital to make sure they are able to have programming and activities around capturing patient safety information.\u201d<\/p>\n

\u201cCritical Access Hospital\u201d is a specific designation provided by the Centers for Medicare & Medicaid Services. Among other qualifications, a CAH must have 20 or fewer inpatient beds and be located more than 35 miles from another hospital. North Dakota currently has 37 CAHs.<\/p>\n

This collaborative network has transformed the relationship among CAHs in the state. With better channels of communication, hospitals can share resources, strategies for improvement, and ultimately provide a higher level of care to their patients.<\/p>\n

Each year, a list of the top performing CAHs in the nation is released by the Chartis Center for Rural Health. Based on how hospitals manage risk, achieve higher quality, secure better outcomes, increase patient satisfaction, and operate at a lower cost than their peers, the list represents a who\u2019s who of rural facilities.<\/p>\n

\u201cNorth Dakota has consistently had multiple representatives on that list,\u201d Ward says proudly. \u201cThat speaks to our success in financial and operational improvement, QI, and patient safety measures across the state.\u201d<\/p>\n

Impactful programming<\/strong><\/p>\n

The Flex Program also facilitates grant funding available to North Dakota CAHs. Mountrail County Medical Center (MCMC), located in Stanley, N.D., is one CAH that has received Flex funding for various projects.<\/p>\n

Stephanie Everett, CEO of MCMC, explains that the funds they receive \u201callow us to complete needed quality projects that we could not afford on our own, due to budget constraints. It has allowed us to internally complete 340B audits, financial and operational assessments, and chart audits. This helps us improve our services to our community.\u201d<\/p>\n

On the other side of the state, Northwood Deaconess Health Center has also benefitted from the Flex Program.<\/p>\n

\u201cIn rural healthcare, resources and financial capacity can be very limited, and Flex has allowed us access to resources that we likely wouldn\u2019t have been able to use otherwise,\u201d says Brock Sherva, CEO of Northwood Deaconess Health Center. \u201cThis program has been vital for us in a couple of ways. The Flex Program has provided funding to cover registration and travel expenses for rural health conferences that we wouldn\u2019t have been able to attend.\u201d<\/p>\n

With Flex\u2019s support, the CAH was able to host a presentation for its staff by Brian Lee, a speaker from Custom Learning Systems. As part of this experience, staff at Northwood Deaconess Health Center reviewed results from their Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), a survey of patients\u2019 perspectives of hospital care.<\/p>\n

\u201cThis presentation focused on building a culture of compassion and healing by interpreting feedback from HCAHPS scores,\u201d shares Sherva. \u201cSince the seminar, we\u2019ve moved forward with Custom Learning Systems and become a Five Star Facility of Choice. Without Flex, we wouldn\u2019t have been exposed to this program.\u201d<\/p>\n

Another metric that Flex has been working with rural hospitals on is the Antibiotic Stewardship Program, which focuses on responsible prescribing of antibiotics, tracking antibiotic resistance, and educational training.<\/p>\n

Supporting rural communities<\/strong><\/p>\n

Alongside Flex, another federal effort is supporting rural hospitals: the Small Hospital Improvement Program (SHIP). SHIP is an initiative that supports Flex\u2019s programming in quality and financial\/operational improvement. SHIP, like Flex, is funded by the Federal Office of Rural Health Policy, under the Health Resources and Services Administration.<\/p>\n

The SHIP Program supports eligible hospitals in meeting value-based payment and care goals for their respective organizations, through purchases of hardware, software, and training. SHIP also enables small rural hospitals to: become or join accountable care organizations (ACOs); participate in shared savings programs; and purchase health information technology, equipment, and\/or training to comply with QI activities, such as advancing patient care information, promoting interoperability, and payment bundling.<\/p>\n

\u201cWhere Flex\u2019s scope is limited to CAHs and CAH-owned RHCs,\u201d explains Nicole Threadgold, grant program director at CRH and principal investigator of SHIP, \u201cSHIP is open to all small rural hospitals \u2013 hospitals that have 49 beds or fewer. North Dakota is unique in that there aren\u2019t any small rural hospitals in the state.\u201d<\/p>\n

Of North Dakota\u2019s 37 CAHs, SHIP has helped 15 in value-based purchasing; 23 in activities regarding ACOs or shared savings investments; and 15 in payment bundling or Prospective Payment System investment activities in the last completed grant year.<\/p>\n

\u201cSHIP is an important program,\u201d Threadgold says. \u201cFor small rural hospitals, expenses such as hardware, software, and training can sometimes be difficult to budget when there are other priorities. SHIP funding allows for these important items to be supported in order for a CAH to continue advancing in these areas.\u201d<\/p>\n

Sustaining excellence in rural health<\/strong><\/p>\n

Over the past 25 years, the Flex Program has impacted countless rural residents through its programming.<\/p>\n

\u201cWhat we are doing, in helping these facilities to better meet requirements and standards, is saving lives and protecting patients who enter clinics and health systems,\u201d Ward says. \u201cI am so proud of the program we have. Not every Flex Program in the nation looks the same. When I came on board, I had to learn from a few other programs that were excelling. So, although we look different, we\u2019ve remained strong.\u201d<\/p>\n

Without the Flex Program\u2019s support, care in rural North Dakota could look very different.<\/p>\n

\u201cSmall Critical Access Hospitals would not be able to do the quality projects such as the ones MCMC has been able to do without the help of funds from the Flex Program,\u201d Everett emphasizes. \u201cWe are so grateful for the opportunities presented to us.\u201d<\/p>\n

By Jessica Rosencrans<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

UND Center for Rural Health Flex and SHIP programs help provide quality healthcare in rural North Dakota. Lifestyles can look very different based on where you live. Driving through rush hour to get to and from work is a daily reality for many people who live in urban areas, while the same commute to work […]<\/p>\n","protected":false},"author":36,"featured_media":13540,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[7],"tags":[2430,245,2325,838,1534,3622,3620,3621],"class_list":["post-13524","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","tag-center-for-rural-health","tag-crh","tag-flex","tag-medicaid","tag-medicare","tag-rural-hospital-flexibility-grant","tag-ship","tag-small-hospital-improvement-program"],"acf":[],"yoast_head":"\nRaising the standards - For Your Health<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.und.edu\/for-your-health\/2025\/06\/04\/raising-the-standards\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Raising the standards - For Your Health\" \/>\n<meta property=\"og:description\" content=\"UND Center for Rural Health Flex and SHIP programs help provide quality healthcare in rural North Dakota. 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