CAHs

A Critical Access Hospital is a facility that satisfies the following criteria:

• Meets the Conditions of Participation found at 42 CFR Part 485 subpart F
• Is one of the following:
  • A Rural Public Hospital
  • A Hospital that closed within the previous 10 years
  • A Hospital that downsized into a Rural Health Clinic
• Is in a State with an established plan with CMS for the MRHFP (see below)
• Is either:
  • Located more than 35 miles from another Hospital/CAH (15 miles in mountainous/rural areas)
  • Certified in the State plan as being a necessary provider of healthcare services to area residents
• Has Emergency Care Services available 24 hours a day, 7 days a week
• Has no more than 15 beds for Acute Inpatient care
  • If a Swing-Bed Facility, allowed up to 25 beds for Acute/SNF-level care, provided no more than 15 are used at any one time for acute care.
• Maintains an annual ALOS (Average Length of Stay) of 96 Hours per Patient for Acute Care patients

Medicare Rural Hospital Flexibility Program (MRHFP)

Section 4201 of the Balanced Budget Act of 1997, Public Law 105-33, amended §1820 of the Social Security Act and created the MRHFP.

The program allows for the creation of Critical Access Hospitals and is designed to promote rural health planning, network development, and improve access to health services for rural residents of the State.

It is available in any State having rural facilities and which chooses to set up such a program and submits an acceptable State plan to CMS.