Rural Health Information Hub Latest News

New Flex Monitoring Team Website Launched

The Medicare Rural Hospital Flexibility Program (Flex) Monitoring Team (FMT) is pleased to announce the launch of its newly redesigned website. While the web address remains the same——the site has been completely updated and reorganized to focus on easing user experience and making the site accessible to all audiences.

On the new site, users can search through over fifteen years of evaluation of the Flex Program. The “Our Work” section of the navigation bar houses all current and past research on Critical Access Hospitals (CAHs) and rural health. The “Publications” page organizes all products by date, including national reports produced annually on quality improvement, community benefit, and financial performance data. Users can search and filter results to find more information on other topics ranging from EMS and hospital services to financial distress and evidence-based best practices. The homepage also highlights the most recent reports, briefs, and papers.

State-level analyses can be found through the new State Profiles section of the website, which includes a map that leads to individual state profiles, making it easier to find publications relating to a specific state in the Flex Program. For example, the Alabama state profile contains all HCAHPS, Hospital Compare, community benefit, and financial indicators reports produced for the state since 2004. The page also lists any other publications that mention Alabama.

Other new features include an interactive map of CAH locations and a sortable list of current CAH location data that is also available for download.

CAHMPAS remains a priority of the FMT, and now, on the new site, every page links to the data query tool for quick access to financial, quality, and community benefit data.

Over time, the FMT plans to add more resources to the website, including a news page to showcase the exciting work being done in the Flex Program. Stay tuned!

To learn more about the FMT and its staff, users can explore a detailed “About Us” section. If you have any questions or concerns about the new site, please feel free to contact the FMT’s communications staffer, Nichole Barnes.

CMS COVID-19 Stakeholder Engagement Calls – September

CMS COVID-19 Stakeholder Engagement Calls – September

CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.

Call details are below. Conference lines are limited so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser. You are welcome to share this invitation with your colleagues and professional networks. These calls are not intended for the press.

Calls recordings and transcripts are posted on the CMS podcast page at:

CMS COVID-19 Office Hours Calls (twice a month on Tuesday at 5:00 – 6:00 PM Eastern)

Office Hour Calls provide an opportunity for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems to:

  • Increase Hospital Capacity – CMS Hospitals Without Walls;
  • Rapidly Expand the Healthcare Workforce;
  • Put Patients Over Paperwork; and
  • Further Promote Telehealth in Medicare

Office Hours:

Tuesday, September 8th at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 6196045

Audio Webcast link:

Tuesday, September 22nd at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 2409459

Audio Webcast link:


Weekly COVID-19 Care Site-Specific Calls

CMS hosts weekly calls for certain types of organizations to provide targeted updates on the agency’s latest COVID-19 guidance. One to two leaders in the field also share best practices with their peers. There is an opportunity to ask questions of presenters if time allows.


Home Health and Hospice (twice a month on Tuesday at 3:00 PM Eastern)

Tuesday, September 8th at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 4165236 Audio Webcast Link:


Tuesday, September 22nd at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 1169237 Audio Webcast Link:


Nursing Homes (twice a month on Wednesday at 4:30 PM Eastern)

Wednesday, September 9th at 4:30 – 5:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 5475686 Audio Webcast Link:


Wednesday, September 23rd at 4:30 – 5:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 5839938 Audio Webcast Link:


Dialysis Organizations (twice a month on Wednesday at 5:30 PM Eastern)

Wednesday, September 9th at 5:30 – 6:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 6925269 Audio Webcast Link:


Wednesday, September 23rd at 5:30 – 6:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 7026727 Audio Webcast Link:


Nurses (twice a month on Thursday at 3:00 PM Eastern)

Thursday, September 10th at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 5767207 Audio Webcast Link:


Thursday, September 24th at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 5872398 Audio Webcast Link:


Lessons from the Front Lines: COVID-19 (twice a month on Friday at 12:30 – 2:00 PM Eastern)

Lessons from the Front Lines calls are a joint effort between CMS Administrator Seema Verma, FDA Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force. Physicians and other clinicians are invited to share their experience, ideas, strategies, and insights with one another related to their COVID-19 response. There is an opportunity to ask questions of presenters.


Next Lessons from the Front Lines:

Friday, September 18th at 12:30 – 2:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 4446447

Audio Webcast Link:


For the most current information including call schedule changes, please click here

To keep up with the important work the White House Task Force is doing in response to COVID-19 click here: For information specific to CMS, please visit the Current Emergencies Website.

EPA and USDA Announce Competition to Advance Agricultural Sustainability in the United States

The U.S. Environmental Protection Agency (EPA) and the U.S. Department of Agriculture (USDA) announced the Next Gen Fertilizer Challenges, a joint EPA-USDA partnership and competition to advance agricultural sustainability in the United States. The competition includes two challenges that seek proposals for new and existing fertilizer technologies to maintain or improve crop yields while reducing the impacts of fertilizers on the environment.

Along with EPA and USDA, the competition is coordinated with The Fertilizer Institute, the International Fertilizer Development Center, the National Corn Growers Association, and The Nature Conservancy.

The first challenge, the EEFs: Environmental and Agronomic Challenge, aims to identify existing Enhanced Efficiency Fertilizers (EEFs) that meet or exceed certain environmental and agro-economic criteria. EEF is a term for new formulations that control fertilizer release or alter reactions that reduce nutrient losses to the environment. This challenge will not have a monetary prize, but winners will receive scientific evaluation of their product and recognition from EPA, USDA, and other collaborators and participants.

The second challenge, the Next Gen Fertilizer Innovations Challenge, aims to generate new concepts for novel technologies that can help address environmental concerns surrounding agriculture practices while maintaining or increasing crop yields. A panel of expert judges will review the submissions. Each winner will receive at least $10,000.

The Next Gen Fertilizer Challenges open today, August 26, 2020. Registrants must submit their entries by October 30, 2020, for the EEFs: Environmental and Agronomic Challenge and by November 30, 2020, for the Next Gen Fertilizer Innovations Challenge. Winners will be announced in the winter of 2021.

An informational webinar will be held on September 24, 2020 at 10:00 – 11:00 a.m. ET.

More information about the challenges and the webinar is available at

Pennsylvania Governor Calls on Legislature to Act Immediately on COVID-19 Recovery and Government Reform

Pennsylvania Governor Tom Wolf presented his fall legislative agenda for worker and family support and protections, COVID-19 recovery, and government reform. The initiatives were introduced to focus the General Assembly after a spring and summer of Republican efforts to curtail the administration’s efforts to manage the pandemic and keep the public safe.

“House and Senate Democrats have been fighting for progress to protect families and businesses in these spaces since the beginning of the pandemic, but they have been stopped at every turn by the Republican majority focused on ignoring the public health crisis,” Gov. Wolf said. “That must stop now. The legislature must come back and take immediate steps to provide funding to frontline workers and businesses, put in place protections for families and our workforce, and make these commonsense reforms that can provide confidence in our government. Pennsylvanians need relief, they need reform, and they need it now.”

Governor Wolf called on the legislature to take immediate action on a series of proposals including:

Relief and Protection for Workers and Families
Families and workers throughout Pennsylvania are still struggling from the effects of COVID-19. The legislature must act to help provide hazard pay for frontline workers, more child care options, and safe workplaces for all Pennsylvanians.

Hazard Pay for Frontline Workers
$225 million to increase hazard pay to Pennsylvania workers, using the overall structure of the current PA Hazard Pay Grant Program administered through the Department of Community and Economic Development. This funding would cover a $3.00/hour increase for 208,000 frontline workers across the commonwealth.

Providing PPE to Frontline Workers
The governor is proposing $10 million for a PPE Reimbursement Program for employers to cover the cost of masks, face shields, cleaning supplies, hand sanitizers and soaps, and other industry-specific PPE in accordance with the Department of Health, Occupational Safety and Health Administration (OSHA), and the Centers for Disease Control and Prevention (CDC) recommendations.

Workers must have access to safety equipment and cleaning materials, and workspaces must be sanitized regularly to protect workers and customers. This program would provide grants of up to $5,000 in reimbursements for Pennsylvania-based small businesses with fewer than 150 employees, and for counties who make PPE available to election workers.

Expanding Access to Child Care
The governor is proposing a significant investment in child care, including $250 million for families with school-aged children in need of child care because of blended or remote in-person instruction models. The governor is also proposing $27 million to expand child care options in “deserts,” where few providers currently exist.

The governor’s proposal also includes $50 million in grants to part-day school-age programs serving low-income communities to support necessary health and safety updates and infrastructure to facilitate remote learning for school districts not returning to in-person instruction.

Paid Parental Leave for All Pennsylvanians
The governor announced the commonwealth’s new paid parental leave proposal, which will offer six weeks of paid leave to commonwealth employees who have been employed for a year or more. This leave will be separate and apart from any accrued sick or paid time off that the employee may have earned. The governor also called on the legislature to pass paid family and sick leave.

Helping Schools Deliver the Promise of Education
The governor is proposing $3 million for institutions of higher education to partner with local education agencies (LEA) to support educators during the 2020-21 school year. The goal of these partnerships is to provide targeted professional development and reduce learning gaps.

Providing Housing and Utility Assistance
The Pennsylvania Utility Commission (PUC) recently reported that at least 800,000 utility customers across the state are currently in active termination status and would be at risk of having their electricity, water, or gas shut off had the PUC not implemented a termination moratorium at the start of COVID.

The governor is proposing $100 million in grants to be divided between the Low-Income Home Energy Assistance Program (LIHEAP) and a new emergency water/wastewater program administered by PENNVEST to assist residential customers who would be subject to termination of service when the current PUC moratorium on terminations is eventually lifted.

The governor is proposing $100 million to be used to expand the PA Housing Finance Agency CARES Rent Relief Program to provide additional financial assistance on behalf of low- to moderate-income renters experiencing difficulty making rent payments as a result of the pandemic. Assistance will continue to be made available in the form of a grant and funds will be paid directly to landlords or property owners.

The governor is also calling on the legislature to increase the current $750 per month cap on assistance to renters, which has limited participation in the program, by instead linking assistance to the federal HUD index.

Providing Recovery for Small Businesses
By providing hundreds of millions of dollars of additional grants and loans for Pennsylvania businesses, the legislature can take immediate action to help Pennsylvania’s economic recovery. The legislature should also provide relief for bars and restaurants by canceling the alcohol tax and allowing businesses to buy at cost. Over time, this funding can be supplemented by legalizing recreational marijuana and dedicating a portion of the funding to historically disadvantaged businesses.

Grants and Loans for Businesses
Gov. Wolf is proposing $225 million in forgivable loans and grants to small businesses in Pennsylvania through the COVID-19 Relief Statewide Small Business Assistance Program. In addition, the governor is proposing $100 million in forgivable loans and grants for the hospitality, leisure, and service industries, including restaurants and bars, salons, and barber shops. This funding will provide critical working capital financing to the commonwealth’s small businesses adversely affected by the COVID-19 pandemic.

Alcohol Tax Cancelation or Reduction
The governor is calling on the General Assembly to pass legislation to revitalize Pennsylvania’s hospitality, leisure, and service industry by offering alcohol-tax cancelation or reduction for six months, and allowing the hospitality industry to purchase alcohol at or near cost for six months.

Recreational Marijuana Legalization to Fund Ongoing Business Grants and Restorative Justice
The governor is calling on the legislature to legalize recreational marijuana with the proceeds going to existing small business grant funding. Fifty percent of the funding would be earmarked for historically disadvantaged businesses. Along with the call to the General Assembly to pass legislation legalizing the sale and use of recreational marijuana, the governor proposes that a portion of the revenue be used to further restorative justice programs that give priority to repairing the harm done to crime victims and communities as a result of marijuana criminalization.

The governor also wants the General Assembly to pursue criminal justice reform policies that restore justice for individuals convicted of marijuana-related offenses.

Reforming Government, Protecting Elections
The COVID-19 pandemic exposed the heightened need for government reform. Gov. Wolf knows we need immediate reforms to our election and voting systems so that people can vote safely, and broader government reforms so Pennsylvanians know that their state elected officials are working on behalf of them and not special interests.

Banning Gifts for Public Officials
Gov. Wolf banned members of his administration from accepting gifts and believes that all public officials should be held to the same standard. Pennsylvania is one of 10 states with no specific law limiting gifts to public officials. Outside the executive branch, politicians in Harrisburg can take unlimited gifts from special interests. The governor wants the gift ban he put in place to be made permanent and expanded so all state elected officials are accountable to it.

Curbing Special Interest Influence 
Pennsylvanians need to have confidence that decisions made by their government are made on behalf of constituents, not rewards for the special interests with the deepest pockets.

Campaign Finance Reform – Enacting new campaign finance laws that would place limits on contributions to candidates seeking elected office, implement aggregate limits for races, place sensible restrictions on Political Action Committees (PACs), and strengthen reporting and disclosure requirements across the board to restore confidence in government, and curtail the role of campaign spending in our political process.

Outside Income Transparency – Requiring public officials to disclose sources, type of work, and amount of outside income received.

Ensuring Safe and Secure Elections
The governor is asking the General Assembly for legislation to allow ballots to be counted as long as they are postmarked on election day and received by the Friday after the election.

He also is calling on the legislature to allow the pre-canvassing of ballots 21 days before the election, while providing counties flexibility to fill vacant poll worker positions earlier than the five days prior to an election currently allowed.

The funds for these initiatives would come from the $1 billion in CARES Act funding that has been placed in reserves, as well as the revenue generated from the legalization of recreational marijuana, which will take an act of the General Assembly to become law.

“If we want our economy to become strong again, the legislature needs to take action now,” Gov. Wolf said.

Penn State Releases Results of Child Care Study 

The Pennsylvania Department of Human Services (DHS) released a Penn State University study about the impact of the COVID-19 pandemic on the state’s child care industry. The study was included in legislation that passed the General Assembly this spring as part of negotiations around allocation of federal stimulus dollars.

Prior to the health crisis, Pennsylvania had more than 7,000 licensed child care providers operating. However, as of July more than 200 of those providers indicated they plan to permanently shut their doors. Further, the study estimates that about 1,000 additional providers are at risk of closure without financial assistance.

The study and recommendations will be used by Pennsylvania’s Office of Child Development and Early Learning (OCDEL) to guide the distribution of $116 million in federal CARES funding for child care. The state previously released just over $100 million in federal stimulus funding specific to the Child Care Development Block Grant. The additional $116 million was secured as part of advocacy work done by the Start Strong PA and Pre-K for PA campaigns this spring.

CMS Releases Additional FAQs on Provider Relief Funds and PPP Payments

The Centers for Medicare & Medicaid Services (CMS) released an additional list of Frequently Asked Questions (FAQs) to Medicare providers regarding the Department of Health & Human Services’ (HHS) Provider Relief Fund and the Small Business Administration’s Paycheck Protection Program payments, also referred to as the coronavirus disease 2019 (COVID-19) relief payments. The FAQs provide guidance to providers on how to report provider relief fund payments, uninsured charges reimbursed through the Uninsured Program administered by Health Resources and Services Administration, and Small Business Administration (SBA) Loan Forgiveness amounts. The FAQs also address that provider relief funds should not offset expenses on the Medicare Cost Report.

The FAQs discussed above can be found on page 99 of the document.

On August 25, 2020, the Centers for Medicare & Medicaid Services (CMS) announced sweeping regulatory changes that require nursing homes to test staff and offer testing to residents for coronavirus disease 2019 (COVID-19). Laboratories and nursing homes using point-of-care testing devices will be required to report diagnostic test results as required by the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). The new rules also require hospitals, including Critical Access Hospitals, to provide COVID-19 cases and related data to the U.S. Department of Health and Human Services (HHS).

Read the full announcement here.

Prognosis for Rural Hospitals Worsens With Pandemic

Rural hospitals were already struggling before the coronavirus emerged. Now, the loss of revenue from patients who are afraid to come to the emergency room, postponing doctor’s appointments and delaying elective surgeries is adding to the pressure.

Read the full article here.

(Sarah Jane Tribble, 8/26)