Skip to main content
Rural Health Information Hub

Critical Access Hospitals (CAHs) – Resources

Selected recent or important resources focusing on Critical Access Hospitals (CAHs).

State Requirements for Demographic Data Reporting upon Hospital Discharge: An Overview for State Flex Programs
Summarizes results of an environmental scan of state-level policies regarding current state requirements regarding hospitals' collection and reporting of demographic data among 37 of the 45 states participating in the Medicare Rural Hospital Flexibility (Flex) Program. Describes requirements for sex, gender, and sexual orientation data; race, ethnicity, and language data; and other data and reporting, as well as variations in how categories are defined across states. Discusses challenges Critical Access Hospitals (CAHs) may face in meeting state requirements.
Author(s): Madeleine Pick, Carson Crane, Megan Lahr
Date: 05/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
view details
Rural Health Care: Supporting Lives and Improving Communities
Presents the U.S. Senate Committee on Finance May 16, 2024, hearing on rural healthcare. Discusses the financial vulnerability of rural hospitals, the rural healthcare workforce and graduate medical education (GME), access to maternal healthcare, health information technology and telehealth, and more. Features testimony from the Chartis Center for Rural Health; Grande Ronde Hospital, a Critical Access Hospital in Oregon; the Wisconsin Collaborative for Rural Graduate Medical Education; and the Rural Policy Research Institute.
Additional links: Jeremy P. Davis, Grande Ronde Hospital - Testimony, Keith J. Mueller, Rural Policy Research Institute - Testimony, Lori Rodefeld, Wisconsin Collaborative for Rural Graduate Medical Education - Testimony, Michael Topchik, Chartis Center for Rural Health - Testimony
Date: 05/2024
Type: Video/Multimedia
Sponsoring organization: Senate Committee on Finance
view details
Differences in Measurement of Operating Margin: An Update
Describes how differences in measurement of operating margin for hospitals can affect the reported values. Compares the operating margins of urban and rural prospective payment system hospitals and Critical Access Hospitals (CAHs) across three definitions of operating margin using Medicare Cost Report data from April 2021 through March 2022. Describes situations in which each operating margin would be the most appropriate to calculate. Updates a 2008 study from the Flex Monitoring Team.
Author(s): Jessie Ma, Susie Gurzenda, Kristin Reiter, George Pink
Date: 05/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
view details
National Health Service Corps Site Reference Guide
Provides clarification for National Health Service Corps (NHSC) sites regarding eligibility requirements, qualification factors, compliance, roles and responsibilities, and other factors for becoming an NHSC approved site. Acts as a supplemental resource to the information provided in the online NHSC Site Application.
Date: 05/2024
Type: Document
Sponsoring organization: Health Resources and Services Administration
view details
Quality Improvement Workbook
Outlines seven steps of the quality improvement process. Offers interactive worksheets to help Critical Access Hospitals develop and support quality improvement goals and projects.
Date: 04/2024
Type: Document
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
view details
Using the Updated Financial Distress Index to Describe Relative Risk of Hospital Financial Distress
Describes the relative risk of rural hospitals and selected urban hospitals experiencing financial distress in 2023. Provides an overview of an updated Financial Distress Index (FDI), which incorporates variables reflecting changes to operational environments since the publication of the 2017 FDI to predict and analyze financial distress and risk of rural hospital closure. Presents data on the characteristics of hospitals by relative risk of financial distress in 2023 and the number of hospitals in each state across in category of relative risk of financial distress.
Author(s): Tyler Malone, George Pink, Kristie Thompson, Mark Holmes
Date: 04/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
view details
2023 National CAH Quality Inventory & Assessment National Report
Presents a high-level summary of key data points from the October-December 2023 National Critical Access Hospital (CAH) Quality Inventory and Assessment. Includes data on CAH system affiliation; median average daily census and emergency department volume; hospital inpatient, behavioral health and specialty care, and outpatient and other service lines; and CAH quality payment model participation.
Author(s): Megan Lahr, Robert Barclay, Madeleine Pick
Date: 04/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
view details
CAH Financial Indicators Report: Summary of Indicator Medians by State
Presents state and national median values of 29 financial indicators included in the Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS). Provides an overview of each measurement and reports median values by state. Indicators represent seven areas of financial performance: profitability, liquidity, capital structure, revenue, cost, utilization, and other.
Date: 04/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
view details
Health Care Coalitions: A Resource to Support Critical Access Hospital Emergency Preparedness Planning
Describes unique challenges Critical Access Hospitals (CAHs) face regarding emergency preparedness planning. Presents findings from interviews with leaders from eight statewide or regional healthcare coalitions (HCCs) regarding strategies and resources HCCs provide to support the CAH emergency preparedness planning process.Outlines the functions and roles of HCCs by the four Administration for Strategic Preparedness and Response (ASPR) capability goals.
Author(s): John Gale, Karen Pearson, Rebecca Stearns
Date: 04/2024
Type: Document
Sponsoring organization: Flex Monitoring Team
view details
MBQIP 2025 Measure Core Set Information Guide
Provides an overview of the 2025 Core Measure Set adopted by the Federal Office of Rural Health Policy (FORHP) for use in the Medicare Beneficiary Quality Improvement Project (MBQIP). Offers descriptions, rationales, data elements, data availability, resources, and more for each new and continuing measure.
Date: 04/2024
Type: Document
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
view details

Additional resources are available related to this guide. See the full list of resources by topic for:


Last Updated: 6/20/2024