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I. Provider Of Choice / Patient Experience

#
Survivability Success Factor
The Hospital / Health System I am rating:
Rating
1
Inpatient (HCAHPS) Patient Experience Star Rating
Provides a consistent 5 Star patient experience, as reported on Hospital Compare.com, and via its own patient experience survey.
2
Emergency Department (ED CAHPS) Patient Experience Star Rating
Provides a consistent 5 Star patient experience, as reported via its own patient experience survey.
3
Medical Clinic Scores (CG CAHPS) Patient Experience Star Rating
Provides a consistent 5 Star patient experience, as reported via its own patient experience survey.
4
Ambulatory Surgery Scores (OAS CAHPS) Patient Experience Star Rating
Provides a consistent 5 Star patient experience, as reported via its own patient experience survey.
5
Outpatient Patient Experience Star Rating
Provides a consistent 5 Star patient experience, as reported via its own patient experience survey.
6
Home Health Scores (HH CAHPS) Patient Experience Star Rating
Provides a consistent 5 Star patient experience, as reported via its own patient experience survey.
7
Long Term Care Scores Resident Experience Star Rating
Provides a consistent 5 Star patient experience, as reported via its own patient experience survey.
8
Patient Experience Measurement Improvement
Has coordinated an engaging process to ensure the effective utilization of patient experience measurement surveys and the corresponding leader’s, provider’s, and frontline staff’s literacy of these reports.
9
Social Media Reputation
Has a positive 5 Star patient experience, as reported on social media such as Google, Facebook, Rate MDS, Yelp etc., and an active process for using this feedback for continuous improvement.
10
Community Branding
Has a positive image and reputation in the primary and secondary market it serves.
11
Frontline Patient Experience Education
Invests a minimum of 3 hours a year educating everyone on skills, best practices, and processes to continuously improve the patient experience, based upon the organizations Mission, Values, and Service Standards.
12
Frontline, Peer Based, Train-the-Trainer Model
Annually recruits its brightest and best frontline employee to teach patient experience improvement to their peers, as well as coach them on the daily process of continuous improvement.
13
Frontline Engagement and Empowerment
Has effectively engaged and empowered frontline caregivers to own the relationship with their patients and families.
14
Nursing Patient Experience Education
Ensures nurses have been educated on a broad range of communication skills that overlap with clinical in such areas as Communication about Medicine, Communication with Nurses, Discharge Information, Pain Care, Responsiveness, and Transition of Care.
15
Emergency Department Process Improvement
Continuously assesses its throughput processes and caregiver education and engagement, for the purpose of sustaining a 5 Star service level and follows best practice benchmarks for patient’s time at key bottlenecks within the process of care.
16
Emergency Department Patient Experience Education
Invests a minimum of 3 hours a year educating Emergency Department caregivers on skills, best practices, and processes to continuously improve the ED patient experience, including topics such as Throughput Management and Collaboration with other depts such as Imaging, Lab, Med Surg, etc.
17
Medical Clinic Process Improvement
Continuously assesses and improves its access management, people, paper flow processes, caregiver education, and engagement for the purpose of sustaining a 5 Star service level.
18
Medical Clinic Patient Experience Education
Invests a minimum of 3 hours a year educating Clinic caregivers on skills, best practices, and processes to continuously improve the patient’s experience, including topics such as access management, and Physician/Advanced Care Practitioner communication skills.
19
Inpatient/HCAHPS Improvement Leadership Education
Has successfully educated leaders at every level on the specific skills and best practices of improving Inpatient/HCAHPS scores.
20
Patient Experience/Service Excellence Council
Leads the patient experience improvement initiative through an effectively chartered, Patient Experience/Service Excellence Council.
21
Core Best Practices.
Has implemented foundational core best practices such as Huddles, DO ITs, Service Recovery, Service Standards, Key Words/Sentence Starters, etc.
22
Nursing Kindness Culture Best Practices
Has hardwired key nursing-based best practices such as Nurse Leader Rounding, Purposeful Hourly Rounding, Bedside Reporting, and Post Discharge Calls, etc.
23
Nursing Staff Efficiency
Through the use of Huddles, Process Improvement meetings or other similar LEAN systems, continuously improves nurse work process to ensure patient safety, communication, reduction of paperwork and compliance.
17%

II. Employer Of Choice / Employee Engagement

#
Survivability Success Factor
The Hospital / Health System I am rating:
Rating
1
Employer of Choice Culture
Is perceived by its employees, leaders and physicians to be a supportive, team-based place to work, and enjoys a reputation for a positive culture on websites such as Indeed and Glassdoor.
2
Employee Engagement Survey
Measures employee engagement and job satisfaction annually, and uses the feedback to continuously improve, and earn a 5 Star rating from its caregivers.
3
C Suite Currency of Trust
Has a CEO, C Suite, and Leadership team that are respected, trusted, and skilled at valuing and engaging their frontline and consistently implements key communication best practices such as Quarterly Town Hall Forums and Daily Leadership Huddles.
4
Leadership Communication
Values the importance of good communication with their caregivers and embraces key best practices such as Daily Staff Rounding, Huddles, and Inspiring Staff Meetings.
5
Leadership Accountability
Has effectively installed an annual system to hold leaders accountable for their employee retention and morale, and patient experience scores.
6
Leadership Empowerment Skills Education
Consistently invests at least 2 days a year educating leaders at every level on the skills and best practices of how to motivate and engage their people.
7
Employee Turnover
Has a stable workforce of engaged staff as measured by Total Annual Turnover. 1 Star = >35%, 2 Star = 29-35%, 3 Star = 22-28%, 4 Star = 15-21%, 5 Star = <15%
8
Onboarding, Retention & Recruitment
Has a systematic process for successfully engaging, onboarding, retaining, and recruiting employees.
9
Human Resources Policy and Performance Appraisal
Has a progressive set of policies and protocols that attract and retain good people such as Effective Leader Performance Appraisal, Corrective Action Coaching, etc.
10
Awards and Appreciation
Has an effective ongoing process to acknowledge and appreciate its caregivers for service “above and beyond” for patients and peers.
11
Workforce Availability
Adequate workforce supply, not requiring any significant use of Agency.
12
Effective Board Leadership
Has a knowledgeable Board, that understands its role in setting policy and its fiduciary responsibility.
13
IT/Electronic Medical Record Support
Has an effective EHR system in place and provides its caregivers, providers, and leaders with timely effective IT support.
14
Break Down Inter-Departmental Barriers and Silos
Has created cross-functional teamwork that has broken down needless interdepartmental communication barriers and enhances a seamless patient experience.
34%

III. Physician Engagement

#
Survivability Success Factor
The Hospital / Health System I am rating:
Rating
1
Physician Engagement
Has successfully educated and engaged Physicians and Advanced Care Practitioners who have bought into the mission of continuously improving the patient experience.
2
Provider Staffing
Is adequately staffed with sufficient Physicians and Advanced Care Practitioners. Start at 5 and deduct one star for every unfilled vacancy, to a minimum of 1.
3
Provider Productivity Incentives
Operates its Clinic(s) with employed Physicians and Advanced Care Practitioners, with an incentive-based compensation plan (i.e. RVUs).
4
Robust Specialist Clinic
Has a robust diversity of visiting specialist physicians.
5
Physician/ACP Kindness Culture Plan
Has implemented a set of key best practices to continuously improve the patient experience such as Comparative Ranking of provider patient experience scores and setting an annual threshold goal.
51%

IV. Clinical

#
Survivability Success Factor
The Hospital / Health System I am rating:
Rating
1
Clinical Excellence
Delivers excellence in clinical quality and earns a 5 Star rating on CMS Hospital Compare Overall Star Rating or The Joint Commission. One star for each Hospital Compare star awarded.
2
Patient Safety
Has earned a 5 Star or “A” rating for patient safety as reported on LeapFrogGroup.org or HealthGrades.com. One star for each grade increment: 1 Star = F, 2 Stars = D, 3 Stars = C, 4 Stars = B, 5 Stars = A
3
Telehealth
Has a strong telehealth affiliation with a tertiary hospital.
68%

V. Growth

#
Survivability Success Factor
The Hospital / Health System I am rating:
Rating
1
Market Share
Is experiencing market share growth in its primary and secondary market areas.
2
Competition
Has limited nearby competition (i.e. none within 30 miles).
3
Inpatient Volume Growth
Has a consistently improving inpatient volume for the past 3 years.
4
Outpatient Volume Growth
Has a consistently improving outpatient volume for the past 3 years.
5
Emergency Department Volume Growth
Has a consistently improving emergency volume for the past 3 years.
84%

VI. Financial

#
Survivability Success Factor
The Hospital / Health System I am rating:
Rating
1
Net/Operating Margin
Has achieved a positive net/operating margin, as noted below. 1 Star = 1%-10% negative, 2 Star = 1% negative – break even, 3 Star = break even, 4 Star 0% – 2% positive, 5 Star = >2% positive
2
Days Cash on Hand
Has a positive # days cash on hand as noted: 1 Star = <50, 2 Star = 51-100, 3 Star = 101-150, 4 Star = 151-200, 5 Star = >200
3
Uncompensated Care
Has a manageable level of uncompensated care as noted: 1 Star = >5%, 2 Star = 4-5%, 3 Star = 3-4%, 4 Star = 2-3%, 5 Star = <2%
4
Days Patients Accounts Receivable
Has a positive management of # days of patient accounts receivable, as noted: 1 Star = >75, 2 Star = 65-75, 3 Star = 55-64, 4 Star = 45-54, 5 Star = <45
5
Debt-to-Capitalization Ratio
Has a manageable debt-to-capitalization ratio.
6
Age of Physical Plant
Has continuously invested capital in its facilities and concurrently addresses all infrastructure needs.
7
New Technology
Is able to continuously invest in new technology through purchase or lease.
8
Average Daily Census (ADC)
Has a stable or growing inpatient census (including swing beds), as noted: 1 Star = <3 ADC, 2 Star = 4-6 ADC, 3 Star = 7-9 ADC, 4 Star = 10-12 ADC, 5 Star = 13+ ADC
9
Tax Support
Receives significant tax support via a county affiliation, elected tax district, or local sales tax.
10
Critical Access Hospital Cost Report Reimbursement
Receives meaningful financial benefit from the Critical Access Hospital Cost Report as noted by the Medicare mix: 1 Star = <35%, 2 Star = 35-44%, 3 Star = 45-54%, 4 Star = 55-65%, 5 Star = >65%
11
Upper Payment Limit
Is located in a state that permits rural hospitals to benefit from the Upper Payment Limit affiliation with skilled nursing homes. 1 Star – no, 5 Star – yes
12
Long-Term Care
We operate a long-term care/skilled nursing facility that has a negative/positive impact on our net margin. 1 Star = negative financial impact, 5 Star = positive financial impact
13
System Affiliation
Realizes significant financial stability and benefits due to its affiliation with a hospital system. 1 Star – no, 5 Star – yes
14
Fundraising Foundation
Has a strong, active fundraising foundation that raises significant capital for plant and equipment on an ongoing basis. 1 Star = no foundation, 2 Star = not effective foundation, 3 Star = helpful foundation, 4 Star = very effective foundation, 5 Star = outstanding foundation
15
Rural Health Clinic Status
Has one or more medical practices certified as a Rural Health Clinic. 1 Star – no, 5 Star – yes
16
340B Drug Program
Has been approved for the 340B Drug Program rebate. 1 Star – no, 5 Star – yes
17
Medicaid Expansion
Is located in a state that has enrolled in Medicaid Expansion. 1 Star – no, 5 Star – yes
18
Healthy Payor Mix
Has a healthy payor mix, including a significant number of commercially insured patients with private policies. 1 Star = poor payor mix, 5 Star = strong payor mix
19
Population Growth
Primary and secondary market area has a stable or growing population. 1 Star = declining, 2 Star = stable, 3 Star = 0% - .4%, 4 Star = .5% - 1%, 5 Star > 1%
20
Unemployment Rate
Has a stable or declining unemployment rate, compared to the state average. 1 Star = high unemployment, 5 Star = low unemployment
21
Per capita Income
Operates in a county(s) with a stable or growing per capita income. 1 Star = low per capita income, 5 Star = high per capita income
22
Has an OB Unit
Has an OB unit with an annual delivery volume. 1 Star = 10-20, 2 Star = 21-30, 3 Star = 31-40, 4 Star = 41-50, 5 Star = > 50
23
Financial Management
Has competent, stable, experienced financial management staff. 1 Star = ineffective, 5 Star = effective
24
Effective Cost Control
Has a comprehensive tracking system by service line to accurately capture, track and manage costs. 1 Star = ineffective, 5 Star = effective