Flex Summits & CAH-QC Meetings
Each year, the FLEX Program hosts conferences and summits for the Critical Access Hospitals based on topics they have an interest in. All news about upcoming events can be found here, as well as links to past events.
The Quarterly CAH-QC Materials & Notes will be available from this page, although not recorded.
FL Flex Summit 2026
The Medicare Rural Hospital Flexibility (FLEX) Program Annual Summit was held on Wednesday, August 11, 2026, at the Betty Easley Conference Center in Tallahassee, FL, bringing together leadership from Florida's Critical Access Hospitals, Rural Health Networks, Local Health Councils and other stakeholders for a day of focused learning, collaboration, and shared problem-solving. The summit included topics spanning quality improvement, financial sustainability, operational resilience, workforce development, and regulatory preparedness.
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Welcome & Introduction - Kayleen Pafford, DOH & Michael Leffler, DOH
Overview of Flex Needs Assessment, Site Visits, and CAH-QC - Peter Cotterrell, NH & Amy Ward, AHS
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Recording, Presentation& Case Study
Session Overview: Improving HCAHPS response rates begins with understanding the complete survey process and the quality of the data that drives it. This session provides a behind-the-scenes look at the HCAHPS survey workflow from the perspective of a CAHPS vendor, helping participants better understand how patient data moves from the hospital to survey administration. Attendees will learn how key demographic and encounter data elements can significantly impact response rates, explore considerations for selecting survey approaches that best fit different patient populations, and review a real-world case study highlighting how a rural hospital successfully increased its HCAHPS response rates through targeted process improvements.
Learning Objectives: At the end of this presentation, participants will be able to:
Describe the HCAHPS survey workflow from a CAHPS vendor perspective and identify how data quality affects survey administration and response rates.
Evaluate the advantages and limitations of different HCAHPS survey modes for diverse patient populations and organizational goals.
Identify practical strategies to improve HCAHPS response rates by applying lessons learned from a rural hospital case study and optimizing patient data processes.
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Session Overview: Rural hospital leaders frequently manage multiple high-stakes responsibilities—including quality, risk management, compliance, education, workforce support, and performance improvement—while working with limited backup and fewer nearby peers. This session presents Alliant Management Services’ collaborative council model, a structured community-of-practice approach designed to build leadership capacity, reduce professional isolation, and accelerate the spread of practical solutions across rural hospitals.
Participants will learn how monthly councils combine focused education, peer exchange, shared tools and templates, and follow-up support to help local leaders adapt proven practices to their own organizations. The session illustrates how a concern, incident, audit finding, regulation, or near miss can move from shared learning to local action through resource sharing, local testing, and Plan-Do-Study-Act (PDSA) improvement methods. Case examples highlight a developing centralized quality dashboard and best-practice repository, sepsis-improvement work, and a ‘You Said, We Did’ approach for translating safety-culture feedback into visible action.
Attendees will leave with a practical framework for launching or strengthening a peer-learning network, spreading a useful tool or lesson learned, and supporting sustainable improvement in quality, safety, compliance, and workforce resilience.
Learning Objectives: At the end of this presentation, participants will be able to:
Describe how collaborative councils help rural hospital leaders build knowledge, capacity, and connection.
Identify the core elements of Alliant’s monthly council model: education, peer exchange, shared resources, and follow-up support.
Apply a simple approach for spreading a tool or lesson learned into local performance improvement.
Recognize how communities of practice can strengthen quality, safety, compliance, and workforce resilience.
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Session Overview: The telehealth policy landscape continues to evolve, creating both new opportunities and new compliance considerations for Critical Access Hospitals. This session provides an overview of the latest federal and state telehealth policy updates, including Medicare reimbursement, regulatory flexibilities, licensure, prescribing requirements, and emerging legislative developments. Participants will gain practical insights into how these changes impact rural hospitals and leave with strategies to help their organizations remain compliant while continuing to expand access to care through telehealth.
Learning Objectives: At the end of this presentation, participants will be able to:
Identify the most significant recent federal and state telehealth policy and regulatory changes affecting Critical Access Hospitals.
Evaluate how current reimbursement, licensure, and compliance requirements influence telehealth operations, financial sustainability, and patient access in rural communities.
Apply practical strategies to prepare their organizations for upcoming policy changes while maintaining compliant and sustainable telehealth services.
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Centers that coordinate the daily disposition of trauma patients and balance mass casualties and critical resources across the health care system.
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Recording, Presentation & White Paper
Session Overview: The presentation will discuss how operational planning supports the response and recovery efforts of the provider community and review the importance of strong community relationships between various organizations (i.e., small and large, public and private, government and non-government, etc.). The discussion will also highlight the lessons learned from past events and where there are opportunities for improvement.
Learning objectives: At the end of this presentation, participants will be able to:
Indicate at least three (3) actions rural hospitals must consider in preparing for an emergency event, like a hurricane’s landfall.
Articulate the interconnective nature of the health care system and how during a large scale, catastrophic event response challenges arise from gaps in operational planning, and how the health care provider community can best work together to ensure the continuity of safe, patient care.
Identify the challenges of effective recovery strategies after a major disaster.
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Florida and national trends in rural health policy and advocacy (FHA). Education and resource updates (FRHA)
Recording, Presentation (FHA), Presentation (FRHA)
FHA Session Overview: Will provide an overview of the Florida Hospital Association’s priorities and advocacy around rural hospitals. Will outline key outcomes from the 2026 Florida Legislative Session and preview likely 2027 legislative topics. Will review federal policies and legislation that could impact rural hospitals.
Learning objectives: At the end of this presentation, participants will be able to:
Gain an understanding of the role of the Florida Hospital Association and its current and future advocacy efforts.
Gain an understanding of key outcomes from the 2026 Florida Legislative Session.
Gain an understanding of current federal policies and legislation that could impact rural hospitals.
FRHA Session Overview: This presentation provides an overview of the Florida Rural Health Association (FRHA), highlighting its mission, organizational role, advocacy efforts, educational initiatives, and impact on rural healthcare across Florida. The presentation describes how FRHA serves as a statewide voice for rural health by supporting policy development, professional education, stakeholder collaboration, and recognition of healthcare professionals who serve rural communities. It also showcases key accomplishments such as Project ECHO programming, member engagement activities, partnerships with healthcare organizations, and upcoming opportunities for involvement, emphasizing FRHA's commitment to improving health outcomes for rural Floridians.
Learning objectives: At the end of this presentation, participants will be able to:
Describe the mission, vision, and statewide role of the Florida Rural Health Association in advancing rural healthcare in Florida.
Identify key FRHA programs and initiatives, including advocacy activities, educational offerings, and partnerships that support rural health professionals and communities.
Recognize opportunities to engage with FRHA through membership, professional development, advocacy participation, and rural health recognition programs.
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Recording, Presentation
Session Overview: Creating a culture of excellence doesn't begin with policies, surveys, or quality metrics. Culture begins with people. This session explores how Doctors Memorial Hospital, a Critical Access Hospital, shifted its focus from simply checking boxes to creating an organization-wide culture where every employee, regardless of role, contributes to an exceptional patient experience. Through practical examples and leadership insights, attendees will learn how small, intentional actions build trust, strengthen employee engagement, improve patient perception, and ultimately drive organizational success. Participants will leave inspired to foster a culture where excellence is not an initiative, but a daily choice.Learning Objectives: At the end of this presentation, participants will be able to:
Identify the key elements that create and sustain a culture of excellence across all departments within a Critical Access Hospital.
Recognize how leadership behaviors and employee engagement influence patient experience, organizational culture, and long-term success.
Discover practical strategies to encourage organization-wide ownership of excellence through everyday actions and intentional recognition.
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Closing remarks from the State Office of Rural Health (SORH). Kayleen Pafford, DOH
FY25/26 CAH-QC Meetings
As part of the FY25/26 Flex Program there has been a re-launch of the Critical Access Hospital Quality Collaborative (CAH-QC) as a forum for hospitals to share ideas and best practices as well as track the SMART goals they have set aligned to QI and F&O project that they are undertaking that are related to the Flex program. In order to facilitate collaboration, these sessions are not planned to be recorded.
March Quarterly Meeting (3.16.2026)
June Quarterly Meeting (6.15.2026)
Presentation, Discussion Notes
Hybrid HWR Project Plan, HCAHPS Project Plan
FY24/25 Annual Program Summit
The Medicare Rural Hospital Flexibility (FLEX) Program Annual Summit was held on Wednesday, August 20, 2025, at the Betty Easley Conference Center in Tallahassee, FL. The summit served as a forum for healthcare professionals to collaborate, innovate, and advance rural healthcare delivery.
2025 Agenda
Welcome - Michael Leffler, Bureau Chief
Session 1 - Rural Hospital Capital Improvement Program (RHCIP)
Recording
Lake Butler Capital Improvement Program - Presentation by Nicole Horne
AdventHealth Vertical Container Farming - Presentation by Becky McIntyre
Session 2 - Doctors’ Memorial Hospital: RHCIP Accomplishments
Recording
Doctors’ Memorial - Presentation by Lauren Faison-Clark
Session 3 - Safe Mobility for Life
Recording
Safe Mobility for Life - Presentation by Gail Holley and Megan Case
Additional Resources:
Safe Mobility for Life's Healthcare Provider Resources
CarFit
Click HERE to sign-up for updates from Safe Mobility for Life
Session 4 - Lake Butler Hospital: Let’s THRIVE Initiative for Seniors
Recording
Let’s THRIVE Initiative - Presentation by Demetrise Thomas
Session 5 - Grant Readiness: The Culture and Practices of Successful Grant Seeking Organizations
Recording
Grant Readiness - Presentation by Allison Wiman and Javier Betancourt
Session 6 - Hendry Regional Medical Center: THRIVE Employee Culture Program
Recording
THRIVE - Presentation by Dakota Red and David Theroux
Session 7 - Calhoun Liberty Hospital: New Facility Celebration
Recording
New Facility - Presentation by Emily Brown
Past Years’ Conference Links
FY23/24 Quality Improvement Summit
FY23/24 Flex Conference Schedule & Links:
Conference Day 1: August 14, 2024
Conference Day 2: August 15, 2024
FY22/23 Annual FLEX Conference
Conference Day 1:
Presentations: State of the State (FDOH), FHA, FRHA, SDOH and Z codes
Conference Day 2:
Presentations: Texas CAH Dashboard (TORCH), CAH Success Story (Inquiseek), Reducing Uncompensated Care (CF), (Telehealth (SETRC)
FY21/22 Annual FLEX Conference
FY20/21 Annual FLEX Conference
“What can I bill for?” A Discussion on Medicare and Medicaid Telehealth Billing for CAHs and RHCs
“A Free Federal Emergency Telehealth System”: National Emergency Tele-Critical Care Network (NETCCN)
When will we be back to normal? An Update to the Revenue Cycle Performance Under the Continuing PHE