Healthcare in rural areas has long been a daunting issue for administrators, politicians and especially for the citizens who depend on their local doctors and hospitals for medical care. A program that began in 1988 to address the needs of healthcare in Nevada’s rural communities is still feverishly working toward its goal of ensuring access to above-standard care for these residents.
Nevada Rural Hospital Partners (NRHP) has helped improve the reputation of rural hospitals, but most importantly, it has helped improve the care that local hospitals provide to residents who often have no other alternative for medical services. “The organization was built on belief that small and rural hospitals are stronger working together than standing alone,” said Robin Keith, president of NRHP. “In order to be viable, small and rural hospitals need five basic things: a supportive operating environment; adequate financial resources; quality human resources; an appropriate array of high-quality services and adequate facilities and technology.”
In the beginning, the program was called Nevada Rural Hospital Project and was funded by the Robert Wood Johnson Foundation as part of its Hospital-Based Rural Health Care Program. Though the name has changed, the goals remain the same: to improve the viability of rural hospitals, improve access to healthcare for rural residents; and improve the quality of health services in rural areas.
NRHP began as a voluntary consortium of 11 of Nevada’s small, rural and frontier hospitals, which already had a history of working together as part of the Nevada Hospital Association’s Rural Council. There are now 14 member hospitals. Members pay dues to NRHP and receive a number of services as benefits of membership, as well as participating in fee-for-service programs and grant-funded programs. The members are located in Elko, Battle Mountain, Winnemucca, Lovelock, Fallon, Incline Village, Carson City, Gardnerville, Yerington, Hawthorne, Boulder City, Caliente, Ely and Owyhee.
“Rural hospitals are important to local economies, and they certainly play a vital role in fostering economic development,” said Keith. NRHP hospitals employ about 2,200 people, and contribute about $100 million to Nevada’s economy.
Some of the accomplishments of NRHP since its inception include: funding grants for teleradiology and telemedicine; a distant-learning nursing program; revolving capital loan pool; a shared chief financial officer; technology upgrades; and a wide-area-network. Additionally, the program has supported the development of shared information technology programs that include: conversion of paper records and radiology images to digital records and images; hospital information systems integration; data disaster recovery; data security; and centralized applications (e-mail management, network server and Web site support).
Assistance has also been provided in staff training, standardization of hospital department policies and procedures, quality assurance management, managed care contract negotiation and review, administrator recruitment,, strategic planning, review of hospital operations, board development and financial management.
NRHP also serves as an advocate in regulatory and legislative issues dealing with Medicaid rates, patient safety, taxation, workforce development, tort reform, expansion of the CAH designation (Critical Access Hospital) to larger facilities, federal Medicare equity between rural and urban areas, and federal protection of rural markets.
“Viable hospitals are important because they deliver healthcare services and education, and they are anchors for other types of providers such as physicians, physical therapists and pharmacists,” Keith said. “NRHP is important because of the vast distances between facilities in Nevada and the fact that there are few options for getting treatment. Rural populations are generally older, sicker and poorer than urban populations, so this equals a greater need for services.”