Critical Access Hospital

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Critical Access Hospital (CAH) is a designation given to eligible rural hospitals by the United States' Centers for Medicare and Medicaid Services (CMS). This program aims to reduce the financial vulnerability of rural hospitals and improve access to healthcare by keeping essential services in rural communities.

History[edit | edit source]

The Critical Access Hospital program was established by the Balanced Budget Act of 1997. This act was passed by the United States Congress to control the increasing costs of healthcare. The CAH program was a response to a series of rural hospital closures in the 1980s and early 1990s.

Eligibility[edit | edit source]

To be designated as a CAH, a hospital must meet the following criteria:

  • Be located in a state that has established a State Rural Health Plan.
  • Be more than a 35-mile drive from any other hospital or CAH (in mountainous terrain or areas with only secondary roads available, the mileage criterion is 15 miles).
  • Have 25 or fewer acute care inpatient beds.
  • Provide 24/7 emergency care services.
  • Have an average annual length of stay of 96 hours or less for acute care patients.

Benefits[edit | edit source]

The benefits of being designated as a CAH include cost-based reimbursement from Medicare, which is generally higher than standard Medicare payments, and flexibility in staffing and services, which allows the hospital to tailor its services to meet the needs of its community.

Challenges[edit | edit source]

Despite the benefits, CAHs face several challenges, including a limited volume of patients, difficulty in recruiting and retaining healthcare professionals, and the need to provide a wide range of services despite limited resources.

See also[edit | edit source]


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