“Critical Access Hospitals” are limited service hospitals designed to provide essential services to rural communities. The Balanced Budget Act of 1997 established the Medicare Rural Hospital Flexibility Program (RHFP) which provided grants to States for designation of hospitals as Critical Access Hospitals or CAH. Because of relaxed staffing requirements and cost-based reimbursement for Medicare and Montana Medicaid patients, converting a struggling rural hospital to a CAH can allow the community to stabilize and maintain local health care access. A current listing on Montana CAHs is available by clicking here.
Key criteria for designation of CAHs include:
- located more than 35 road miles or, in the case of a facility located in mountainous terrain or where only secondary roads exist, more than 15 road miles from a hospital or another critical access hospital; or be certified by the State as a necessary provider of health care services to residents in the area (in Montana, this includes all hospitals located in a frontier county or a non-IHS hospital located within the boundaries of an Indian Reservation)
- provide 24-hour emergency care that is necessary for ensuring access to emergency care services in the area served by the facility.
- has no more than 15 acute care inpatient beds or in the case of a facility with swing beds, 25 acute care inpatient beds, of which no more than 15 are used for acute care at any one time.
- provide inpatient care for a period not exceeding 96 hours, as determined on an average, annual basis for each patient.
- operates a quality assessment and performance improvement program and follows appropriate procedures for review of utilization of services.
Besides designation of CAHs, the RHFP addresses four major goals:
- Creation and maintenance of a State Rural Health Plan.
- Development and implementation of Rural Health Networks.
- Improvement and integration of Emergency Medical Services.
- Ability to address Quality of Care issues.