Do You Qualify As A Critical Access Hospital? Understanding The CAH Designationhe

  • Healthcare Management
  • medical management - Rural Hospitals
  • August 21, 2023

Understanding the requirements, benefits, and responsibilities of a CAH designation can help hospitals maintain critical access status.

CAH Designations Explained

Critical access hospitals (CAHs) are an essential component of the US healthcare system. The small, rural hospitals provide vital medical services to communities that may not otherwise have access to healthcare. However, not all rural hospitals qualify as CAHs automatically. Understanding the designation and requirements is crucial for both hospitals and patients.


The importance of CAHs

Critical access hospitals provide a critical safety net for rural communities, ensuring residents receive access to healthcare services when needed. Designated CAHs play a role in the overall health of rural communities by providing preventive care and health education services. CAHs also play a role in supporting the local economy. These hospitals become major employers in rural areas by providing jobs for healthcare professionals, support staff, and other workers.

Meeting the qualifications

The hospital must have no more than 25 beds and must be located more than 35 miles from another hospital or be considered the only hospital within a service area to receive a CAH designation. A critical access hospital must provide 24/7 emergency services and inpatient care and must be a participating provider in the Medicare and Medicaid programs. Hospitals must also maintain an average length of stay of less than 96 hours for acute care patients.

What are the benefits?

If a hospital meets the CAH criteria, the facility can receive cost-based reimbursement from Medicare and Medicaid. This money is designed to help offset the higher costs of providing care in rural areas. Critical access hospitals also get access to the Flex program’s grants, technical assistance, and educational resources in exchange for meeting certain performance standards. The Flex program is intended to help CAHs improve performance in areas such as patient satisfaction, clinical quality, and efficiency.

Improvement in quality of care

Being designated as a CAH is not just about receiving financial benefits. The designation also comes with specific responsibilities. CAHs must have a Quality Assessment Performance Improvement (QAPI) program and participate in the Hospital Value-Based Purchasing program. The program ties a portion of the hospital’s reimbursement to the quality of patient care.

Losing CAH designation

A hospital can lose the CAH designation if the hospital no longer meets the established criteria. For example, if a hospital expands the bed count to more than 25 beds, the hospital will lose CAH status and the associated benefits. CAHs should regularly review operations and make necessary changes to ensure hospitals continue to meet the criteria.

Overcoming rural hospital challenges

A critical access hospital designation is an important distinction for rural hospitals, providing financial benefits that help hospitals provide vital healthcare services to the community while holding hospitals accountable for the quality of care. Patients should know whether the hospital is a CAH, as the designation can affect the services and reimbursement for the provided care.

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