The Wyoming Flex Program has two goals
- To provide training and support to Critical Access Hospitals (CAH) as they seek to improve services.
- To support hospitals seeking a CAH designation.
Applications for the Flex Program Scholarship are open
Who can apply?
- Wyoming Flex Program scholarship funds are available to support anyone working at a Wyoming Critical Access Hospital that reports Medicare Beneficiary Quality Improvement Project (MBQIP) Measures.
- Flex scholarships are also available for all rural Wyoming Emergency Medical Services (EMS) personnel—they do not have to be attached to a CAH.
- Funds are reimbursed to the CAH or independent EMS personnel upon receipt of all documentation. The full process can be found here.
- For information on scholarships or MBQIP please contact the Flex Program Manager – Gail.VanBuren@wyo.gov
What can scholarships be used for?
Training scholarships must advance one of the Flex program goals: quality, finances, operations, population health, or EMS improvement.
Approval Process
All scholarships need to be submitted by the organization’s point of contact. The funds will be approved based on availability and how closely they fit the Flex Program goals. Scholarships cannot be used for hands-on training with patients. They will be processed once a week on Mondays.
Application Link
Another source of training funds: Workforce Services Training Fund
Who can apply?
- Wyoming Flex Program scholarship funds are available to support anyone working at a Wyoming Critical Access Hospital that reports Medicare Beneficiary Quality Improvement Project (MBQIP) Measures.
- Flex scholarships are also available for all rural Wyoming Emergency Medical Services (EMS) personnel—they do not have to be attached to a CAH.
- Funds are reimbursed to the CAH or independent EMS personnel upon receipt of all documentation. The full process can be found here.
- For information on scholarships or MBQIP please contact the Flex Program Manager – Gail.VanBuren@wyo.gov
What can scholarships be used for?
Training scholarships must advance one of the Flex program goals: quality, finances, operations, population health, or EMS improvement.
Approval Process
All scholarships need to be submitted by the organization’s point of contact. The funds will be approved based on availability and how closely they fit the Flex Program goals. Scholarships cannot be used for hands-on training with patients. They will be processed once a week on Mondays.
Application Link
Another source of training funds: Workforce Services Training Fund
Critical Access Hospital (CAH) Designation Requirements
- The standard location of a CAH is more than a 35-mile drive on primary roads (or, in the case of mountainous terrain or areas with only secondary roads available, a 15-mile drive) from another hospital.
- CAHs maintain no more than 25 inpatient beds, which may be used for either inpatient or swing-bed services.
- CAHs provide acute inpatient care for a period that does not exceed 96 hours per patient on an annual average.
- Additional information regarding CAH designation can be found in the Code of Federal Regulations (CFR).
- Wyoming Healthcare Licensing and Surveys information and application can be found here.
- Begin the CAH designation process by contacting the Office of Rural Health at wyo.ruralhealth@wyo.gov
Quality Resources
MBQIP 101 Training – October 28, 2026 @ 10:00 am MT
- The Wyoming Flex Program will host MBQIP 101 for all Wyoming CAHs and staff who are new to MBQIP and/or who need a refresher on MBQIP measures and reporting. All CAH team members are invited to participate.
- Register in advance for this training
QI Roundtable: HCAHPS Improvement – November 19, 2026 @ 10:00 am MT
- The WY QI Roundtable, hosted by the Wyoming Flex Program, will focus on HCAHPS improvement, including highlights from the FY25 HCAHPS cohort, data on the new HCAHPS measures, and best practices for CAHs using email, mail, and telephone surveys. All CAHs are encouraged to have staff participation.
- Register in advance for this meeting
Upcoming MBQIP Submission Deadlines!
DUE: November 2, 2026
DUE: November 2, 2026
Other Resources
- Flex Program Fundamentals
- Improving Quality with Rural Hospitals and Clinics
- View All MBQIP Deadlines
- MBQIP Navigator – This guide helps MBQIP participants understand and navigate the MBQIP core measure reporting process.
Financial & Operational Resources
Stroudwater’s 3rd Annual Swing Bed Bootcamp – November 17, 2026 @ 9 am MT
Registration is now open for Stroudwater’s 3rd Annual Swing Bed Bootcamp, a no-cost virtual event for Critical Access Hospitals and eligible PPS hospitals.
Each year, our team works with hospitals at different stages of their swing bed journey. Some are trying to identify more appropriate patients and grow the census. Others are working through admission workflows, documentation, length of stay, reimbursement, or survey readiness. Even well-established programs are asking how to connect these pieces in a more consistent, high-performing service line.
This year’s Bootcamp is built around that full patient and program journey.
During the two-hour session, we’ll move from patient identification through program performance, including:
- Identifying the right patients for swing beds
- Building efficient referral, screening, and admission processes
- Strengthening documentation, compliance, and survey readiness
- Delivering coordinated interdisciplinary care and managing length of stay
- Improving discharge planning, referral development, and program growth
- Understanding financial impact and the measures that define program success
Rural Emergency Hospital (REH) Designation
The Rural Emergency Hospital (REH) is a new Medicare provider type created to address the growing concern over rural hospital closures. The Rural Emergency Hospital (REH) Technical Assistance Center offers education concerning the new REH designation, including eligibility (does an organization meet the REH requirements), assessment (assess the benefits and downsides of conversion, including financial and operational analysis), assistance with the application process, assistance with implementing operational and staffing changes, and post-conversion support.
REH Resources
Ken Harmon (kh@rhrco.org) is the technical assistance coordinator for Wyoming.
Final Rules Published for Medicare – Updates from Noridian
Timeframe for Prior Authorization Decisions
- CMS changed the review timeframe that a Medicare Administrative Contractor (MAC) has for prior authorization decisions. This timeframe has changed from 10 business days to seven business days. Expedited requests will remain unchanged.
- You can view the Noridian Medicare Portal Eligibility & MBI Lookup Tool webinar on the Webinars on Demand Feature for Jurisdiction E and Jurisdiction F.
Other Information
Outpatient Antibiotic Stewardship Across Critical Access Hospital Networks – November 18, 2026 @ Noon MT
Discover how critical access hospitals and their affiliated outpatient networks can strengthen outpatient antibiotic stewardship
and improve antibiotic use. This virtual webinar will explore updates to CDC’s Core Elements of Outpatient Antibiotic Stewardship and share practical strategies and real-world examples for putting the updated guidance into action.
Who should attend
- Antimicrobial stewardship program leaders
- Infection preventionists at CAHs
- Quality improvement staff
- Laboratory and pharmacy personnel involved in antibiotic stewardship
- CAH administrators and providers
The Infection Control Finding Putting Critical Access Hospitals at Highest Risk – October 27, 2026 @ Noon MT
National Rural Health Association
Survey findings are revealing recurring infection control breakdowns in Critical Access Hospitals and Rural Health Clinics, with some carrying the potential for condition-level deficiencies, adverse accreditation decisions, and Immediate Threat to Health and Safety findings. From failures in standard precautions and disinfection to high-risk sterilization practices, understanding where organizations are most vulnerable is the first step toward preventing those findings.
- Attendees will learn how to:
- Evaluate common infection control opportunities identified during survey.
- Recognize high-risk practices involving standard precautions, disinfection, sterilization, and implementation of infection control activities.
- Strengthen collaboration between leadership and infection prevention teams to support effective implementation of policies, processes, and procedures.
- Apply leadership support, resources, staff competency, and performance improvement strategies to strengthen infection prevention efforts.
Looking Ahead Rural Health Educational Series
National Rural Health Association (NRHA)
Register below for the sessions most relevant to you and your organization. All sessions begin at Noon MT.
NOVEMBER 11 From $74.6M in Denied Charges to Action →
NOVEMBER 12 The Potential Impact of AI in Rural Healthcare →
NOVEMBER 19 $100M in Additional CAH Reimbursement →
DECEMBER 3 Rethinking the Rural Hospital Model →
DECEMBER 4 Building an AI Training Strategy →
This project is/was supported by the Health Resources and Service Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U2WRH33330-01-00 Medicare Rural Hospital Flexibility (Flex) Program and 0% financed with nongovernmental sources. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements to be inferred by HRSA, HHS, or the U.S. Government.