Critical access hospital

Critical Access Hospital is a designation given to certain rural hospitals by the Centers for Medicare and Medicaid Services (CMS). This designation was created by Congress in the 1997 Balanced Budget Act in response to a string of hospital closures in the 1980s and early 1990s. The goal of the Critical Access Hospital program is to reduce the financial vulnerability of rural hospitals and improve access to healthcare by keeping essential services in rural communities.

Eligibility

To be designated as a Critical Access Hospital, a hospital must:

• Be located in a state that has established a State Rural Health Plan
• Be located more than a 35-mile drive from any other hospital or Critical Access Hospital; or be located more than a 15-mile drive from any other hospital or Critical Access Hospital in areas with mountainous terrain or only secondary roads
• Furnish 24-hour emergency care services 7 days a week
• Have an average length of stay (ALOS) for its patients of 96 hours or less for acute care
• Provide no more than 25 inpatient beds that can be used for either inpatient or outpatient care
• Be located in a rural area or be treated as rural under a special provision of the law

Benefits

The benefits of being designated as a Critical Access Hospital include cost-based reimbursement for Medicare patients, instead of standard fixed reimbursement rates. This can result in higher Medicare payments to the hospital.

Challenges

Despite the benefits, Critical Access Hospitals face several challenges. These include a limited capacity, a lack of specialty services, and difficulties in recruiting and retaining medical staff.

See also

• Rural health
• Medicare
• Medicaid
• Healthcare in the United States

References

Critical access hospital Resources
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