Facilitate Conversion of Small Rural Hospitals to CAH status

In accordance with current statute, State Flex Programs are expected to facilitate appropriate conversion of small rural hospitals to critical access status. Flex programs must assist hospitals in evaluating the effects of conversion to critical access status.

CAH conversion requirements:

  • Be located in a State that has established a State rural health plan for the State Flex Program
  • 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
  • Demonstrate compliance with the CoPs found at 42 CFR Part 485 subpart F at the time of application for CAH status
  • Furnish 24-hour emergency care services 7 days a week, using either on-site or on-call staff
  • Provide no more than 25 inpatient beds that can be used for either inpatient or swing bed services; however, it may also operate a distinct part rehabilitation or psychiatric unit, each with up to 10 beds
  • Have an average annual length of stay of 96 hours or less per patient for acute care (excluding swing bed services and beds that are within distinct part units)
  • Be located either more than a 35-mile drive from the nearest hospital or CAH or a 15-mile drive in areas with mountainous terrain or only secondary roads OR certified as a CAH prior to January 1, 2006, based on State designation as a “necessary provider” of health care services to residents in the area.

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