 The
Critical Access Hospital (CAH) Program was created by Congress in 1998.
It was established to help ameliorate the negative impact the Balanced
Budget Act had on the fragile healthcare delivery system. Congress utilized
the experience of the Montana Medical Assistance Facility (MAF) and the
seven state demonstration program, the Essential Access Community Hospital/Rural
Primary Care Hospital (EACH/RPCH) program. It is the intent of Congress
for this program to help stabilize the rural healthcare delivery system.
CAH Program Fact Sheet
These are the requirements for a hospital to participate in the program:
- Must be located in a rural area or be treated as rural under a special provision that allows qualified hospital providers in urban areas to be treated as rural for purposes of becoming a CAH;
- Must be or have been a licensed hospital in the past 10 years;
- Furnish 24-hour emergency care services, using either on-site or on-call staff;
- Have no more than 25 licensed beds. May utilize any combination of "swing" (long-term care) beds and acute beds up to the maximum of 25 beds;
- Have an average length of stay of 96 hours or less;
- Be located either more than 35 miles from the nearest hospital or CAH or more than 15 miles in areas with mountainous terrain or only secondlary roads OR be State certified by December 31, 2005 as a "necessary provider" of healthcare services to the residents in the area;
- Must have written agreements with larger hospital(s) for
appropriate transfer and communication about patients. The patient and
physician still determine which hospital is appropriate if the patient
cannot get the level of care needed in the rural community.
The Colorado Health and Hospital Association provides financial analysis
and support for the hospitals and works with Medicaid and insurance carriers
to increase the reimbursement to the CAH hospitals. The Colorado Rural
Health Center (Colorado's Office of Rural Health) houses the office of
the CAH Director, disperses technical assistance grants to the CAH communities,
and coordinates the statewide meetings and Advisory Committee meetings,
and is the recipient of the Flex grant..
The Colorado Department of Public Health and Environment facilitates
the conversion process (CAH is actually a licensing category), and works
with the hospitals to develop networks and strengthen their EMS systems.
The Colorado Foundation for Medical Care provides technical assistance
with quality improvement programs.
Medicare Learning Network (MLN) Critical Access Hospital Fact Sheet |
