To be automatically notified of Critical Access Hospital happenings and other Rural Health information, sign-up for the ORH list serve at https://lists.health.wyo.gov/wws/lists/wdh/orh.
Wyoming Critical Access Hospital Network website: http://wcahn.org
CMS Fact Sheet on Critical Access Hospitals
List of Wyoming Critical Access Hospitals
Critical Access Hospitals Federal Certification Information
2008 Flex Eval
CMS Swing bed factsheet
Map of Wyoming Critical Access Hospitals
About Critical Access Hospitals
Critical Access Hospital (CAH) designation is a core component of the Medicare Rural Hospital Flexibility (Flex) Program. The intent of designating hospitals as “critical access” is to:
· Preserve access to primary care and emergency services,
· Provide health care services that meet community needs,
· Help assure the financial viability of the hospital through improved reimbursement and different operating requirements
A CAH is a small, rural, acute care facility that provides outpatient, emergency, and limited inpatient services. The primary benefit of designation as a CAH is exemption from the prospective payment system, and receiving cost-based reimbursement for services based on 101 percent of the CAH’s reasonable costs. Additional benefits include: the ability to claim capital improvement and equipment costs in the Medicare cost report, eligibility for CAH specific grants and network participation, and flexibility with staffing and hospital programs (state-specific).
Eligibility depends on geographic, population and facility characteristics. In addition, individual states have the option of designating a facility as a “necessary provider” in place of some of the geographic requirements. The necessary provider provision is due to sunset on January 1, 2006.
· A licensed, acute care hospital.
· Have up to 25 beds with any combination of acute or swing (semi-skilled beds for patients meeting certain criteria). Observation beds are included in the 25-bed count.
· Provide inpatient care for no more than a 96-hour average length of stay.
· Must provide 24-hour emergency care, but is not required to meet all the staffing and service requirements that apply to full service hospitals (e.g. some ancillary and support services may be provided on a part-time, off-site basis).
· May have up to two 10-bed distinct part units (DPU) for rehabilitation or psychiatric services (but only one of each) that do not count against the 25-bed limit. DPUs are paid under the prospective payment system.
Geographic and population criteria
· Located in a rural area.
· More than a 35-mile drive, or 15 miles in mountainous terrain or areas with only secondary roads, from another hospital or CAH.
· Located outside of a Metropolitan Statistical Area (MSA) and not classified as “urban” for Medicare standardized payment or by the Medicare Geographic Review Board; located in a rural urban community area (RUCA), in an MSA, or be designated by the state as a necessary provider of health care services to residents in the area.
Overview of Flex
The Rural Hospital Flexibility (Flex) Program is a Federal initiative that provides funding to State Governments to strengthen rural health. It:
- Allows small hospitals the flexibility to reconfigure operations and be licensed as Critical Access Hospital (CAHs).
- Offers cost-based reimbursement for Medicare acute inpatient and outpatient services.
- Encourages the development of rural-centric health networks.
- Offers grants to States to help implement a CAH program in the context of broader initiatives to strengthen the rural health care infrastructure.
The Flex grant program helps stabilize rural hospitals and improves access to health services in rural communities. Grants are awarded to States for: Development and implementation of Rural Health Plans with broad collaboration; stabilizing rural hospitals by helping them consider, plan for, and obtain designation as "Critical Access Hospitals" (CAH); supporting CAHs, other providers and communities as they develop networks of care; helping improve and integrate emergency medical services; and improving the quality of care in rural communities. To date, over 1,200 hospitals have converted to Critical Access status.