Critical Access Hospitals (CAHs) – Resources
Selected recent or important resources focusing on Critical Access Hospitals (CAHs).
Sustaining Rural Labor & Delivery Programs: Strategies for Financial Analyses and Considerations for Maintaining Services
A guide for Critical Access Hospital and other rural hospital executives to use when assessing the financial viability of their Labor & Delivery programs. Outlines three strategies that may bring a Labor & Delivery program closer to sustainability and prevent unnecessary closure of services in rural areas.
Author(s): Eric Shell, Dahlia McGrath, Jeff Sommer, et al.
Date: 09/2025
Sponsoring organization: Flex Monitoring Team
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A guide for Critical Access Hospital and other rural hospital executives to use when assessing the financial viability of their Labor & Delivery programs. Outlines three strategies that may bring a Labor & Delivery program closer to sustainability and prevent unnecessary closure of services in rural areas.
Author(s): Eric Shell, Dahlia McGrath, Jeff Sommer, et al.
Date: 09/2025
Sponsoring organization: Flex Monitoring Team
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Rural Resource: Availability of Obstetric Simulation Training by State
Explores the availability of simulation training and continuing medical education (CME)/distance learning opportunities for both rural hospitals with obstetric units and those without obstetric units. Presents findings of an environmental scan of national, regional, and state-level obstetric training resources. Offers recommendations for ways State Flex Programs and Critical Access Hospitals can use this resource to identify applicable simulation trainings.
Author(s): Madeleine Pick, Hamdi Abas, Megan Lahr
Date: 09/2025
Sponsoring organization: Flex Monitoring Team
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Explores the availability of simulation training and continuing medical education (CME)/distance learning opportunities for both rural hospitals with obstetric units and those without obstetric units. Presents findings of an environmental scan of national, regional, and state-level obstetric training resources. Offers recommendations for ways State Flex Programs and Critical Access Hospitals can use this resource to identify applicable simulation trainings.
Author(s): Madeleine Pick, Hamdi Abas, Megan Lahr
Date: 09/2025
Sponsoring organization: Flex Monitoring Team
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An Evaluation of State Flex Program Initiatives to Support Critical Access Hospital-Based Rural Health Clinics
Describes the 16 State Flex Program (SFP) Critical Access Hospital (CAH)-based Rural Health Clinic (RHC) initiatives for the 2023-2024 funding year. Explores the various strategies SFPs have employed to assist CAH-based RHCs by highlighting common activities, challenges, and successes observed across their programs. Summarizes interviews with seven SFPs identifying common themes and notable variations in how they engage with CAH-based RHCs.
Author(s): Bridget Harr, Rebecca Stearns, John Gale
Date: 09/2025
Sponsoring organization: Flex Monitoring Team
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Describes the 16 State Flex Program (SFP) Critical Access Hospital (CAH)-based Rural Health Clinic (RHC) initiatives for the 2023-2024 funding year. Explores the various strategies SFPs have employed to assist CAH-based RHCs by highlighting common activities, challenges, and successes observed across their programs. Summarizes interviews with seven SFPs identifying common themes and notable variations in how they engage with CAH-based RHCs.
Author(s): Bridget Harr, Rebecca Stearns, John Gale
Date: 09/2025
Sponsoring organization: Flex Monitoring Team
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Skill Mix Versus Flexibility: Decoding Nurse Staffing Impacts on Critical Access Hospitals
Presents a study on the skill mix and flexibility of nurse staffing on the financial stability, care quality, and efficacy of Critical Access Hospitals (CAHs) in Pennsylvania from 2000 to 2023. Correlates skill mix and flexibility with hospital outcomes and controls for hospital-specific, socioeconomic, and demographic factors.
Author(s): Dinesh R Pai, Esmaeil Bahalkeh
Citation: Journal of Rural Health, 41(3), e70075
Date: 08/2025
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Presents a study on the skill mix and flexibility of nurse staffing on the financial stability, care quality, and efficacy of Critical Access Hospitals (CAHs) in Pennsylvania from 2000 to 2023. Correlates skill mix and flexibility with hospital outcomes and controls for hospital-specific, socioeconomic, and demographic factors.
Author(s): Dinesh R Pai, Esmaeil Bahalkeh
Citation: Journal of Rural Health, 41(3), e70075
Date: 08/2025
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CAH Quality Inventory & Assessment - State Flex Program Resources
Provides ancillary materials related to the 2025 Critical Access Hospital (CAH) Quality Inventory & Assessment (Assessment) for State Flex Programs (SFPs). Includes resources on the background and components of the Assessment for State Flex Programs, a template email that State Flex Programs can use to send to CAHs regarding the Assessment, and instructions for State Flex Programs detailing how to use the Assessment Data Tool for 2024 Assessment.
Author(s): Megan Lahr, Robert Barclay, Madeleine Pick
Date: 08/2025
Sponsoring organization: Flex Monitoring Team
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Provides ancillary materials related to the 2025 Critical Access Hospital (CAH) Quality Inventory & Assessment (Assessment) for State Flex Programs (SFPs). Includes resources on the background and components of the Assessment for State Flex Programs, a template email that State Flex Programs can use to send to CAHs regarding the Assessment, and instructions for State Flex Programs detailing how to use the Assessment Data Tool for 2024 Assessment.
Author(s): Megan Lahr, Robert Barclay, Madeleine Pick
Date: 08/2025
Sponsoring organization: Flex Monitoring Team
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CAH Quality Inventory & Assessment Resources
Provides a list of resources for Critical Access Hospitals (CAHs) to use to complete the 2025 CAH Quality Inventory and Assessment (Assessment). Includes resources regarding the background and components of the Assessment and instructions for each question.
Author(s): Megan Lahr, Robert Barclay, Madeleine Pick
Date: 08/2025
Sponsoring organization: Flex Monitoring Team
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Provides a list of resources for Critical Access Hospitals (CAHs) to use to complete the 2025 CAH Quality Inventory and Assessment (Assessment). Includes resources regarding the background and components of the Assessment and instructions for each question.
Author(s): Megan Lahr, Robert Barclay, Madeleine Pick
Date: 08/2025
Sponsoring organization: Flex Monitoring Team
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HCAHPS Toolkit for Critical Access Hospitals
Designed to assist Critical Access Hospitals (CAHs) in reporting and utilizing Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data. Provides a detailed description of HCAHPS as a Medicare Beneficiary Quality Improvement Project (MBQIP) core measure, strategies for improving HCAHPS survey response rates, and answers to common HCAHPS questions. Offers recommendations for utilizing HCAHPS data reports from vendors and the Flex Monitoring Team (FMT) and improving HCAHPS scores.
Date: 08/2025
Sponsoring organization: Flex Monitoring Team
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Designed to assist Critical Access Hospitals (CAHs) in reporting and utilizing Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data. Provides a detailed description of HCAHPS as a Medicare Beneficiary Quality Improvement Project (MBQIP) core measure, strategies for improving HCAHPS survey response rates, and answers to common HCAHPS questions. Offers recommendations for utilizing HCAHPS data reports from vendors and the Flex Monitoring Team (FMT) and improving HCAHPS scores.
Date: 08/2025
Sponsoring organization: Flex Monitoring Team
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AHEAD CMS-Designed Medicare FFS Hospital Global Budget Calculator Tool for Critical Access Hospital
Provides an overview and demonstration of the CMS-Designed Medicare Fee-for-Service Hospital Global Budget (HGB) Calculator Tool for Critical Access Hospitals, which aims to support eligible CAHs in understanding the key elements of the AHEAD Medicare Fee-for-Service (FFS) HGB methodology. Discusses key differences in the hospital global budget construction and methodology for critical access hospitals and fee-for-service hospitals.
Additional links: AHEAD Model CMS-Designed Medicare FFS Critical Access Hospital Global Budget Calculator Tool, AHEAD Model: CMS-Designed Medicare Hospital Global Budget Critical Access Hospital Calculator Tool At-A-Glance
Date: 07/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Provides an overview and demonstration of the CMS-Designed Medicare Fee-for-Service Hospital Global Budget (HGB) Calculator Tool for Critical Access Hospitals, which aims to support eligible CAHs in understanding the key elements of the AHEAD Medicare Fee-for-Service (FFS) HGB methodology. Discusses key differences in the hospital global budget construction and methodology for critical access hospitals and fee-for-service hospitals.
Additional links: AHEAD Model CMS-Designed Medicare FFS Critical Access Hospital Global Budget Calculator Tool, AHEAD Model: CMS-Designed Medicare Hospital Global Budget Critical Access Hospital Calculator Tool At-A-Glance
Date: 07/2025
Sponsoring organization: Centers for Medicare and Medicaid Services
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Prepublication Requirements: Obstetrical Services Requirements
Outlines new and revised Joint Commission standards and Elements of Performance (EPs) for Critical Access Hospitals to align with Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoPs) regarding obstetric care.
Date: 07/2025
Sponsoring organization: Joint Commission
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Outlines new and revised Joint Commission standards and Elements of Performance (EPs) for Critical Access Hospitals to align with Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoPs) regarding obstetric care.
Date: 07/2025
Sponsoring organization: Joint Commission
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Critical Access Hospital and Hospital Requirements Streamlined to Reduce Burden
Outlines streamlined Joint Commission requirements for accreditation and Elements of Performance (EPs) for hospitals and Critical Access Hospitals (CAHs). Includes links to survey process guides, disposition reports, and crosswalk and crosswalk compare reports for each deemed program's Conditions of Participation and the equivalent Joint Commission EPs.
Date: 07/2025
Sponsoring organization: Joint Commission
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Outlines streamlined Joint Commission requirements for accreditation and Elements of Performance (EPs) for hospitals and Critical Access Hospitals (CAHs). Includes links to survey process guides, disposition reports, and crosswalk and crosswalk compare reports for each deemed program's Conditions of Participation and the equivalent Joint Commission EPs.
Date: 07/2025
Sponsoring organization: Joint Commission
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Last Updated: 9/15/2025