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Rural Health Information Hub

Critical Access Hospitals (CAHs) – Resources

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

History of the Swing Bed: A Look Through the Rural Rearview Mirror
Reviews the history of the swing bed program, which helps rural hospitals serve patients and the community through provision of post-acute care. Shares insights from experts who describe early implementation and key program elements that have contributed to the program's success.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 08/2021
Sponsoring organization: Rural Health Information Hub
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Understanding the Rural Swing Bed: More than Just a Reimbursement Policy
Provides an overview of the swing bed program and its role as a patient-centric post-acute care solution that helps rural hospitals serve their communities. Discusses the impact of the program, reimbursement, quality measures, and more.
Author(s): Kay Miller Temple
Citation: Rural Monitor
Date: 08/2021
Sponsoring organization: Rural Health Information Hub
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Mid-Level Leaders and the Transition to Value Video Series
A 6-part video series on healthcare leadership for mid-level Critical Access Hospital (CAH) leaders. Provides information and strategies on leading a team through the shift to value-based payment with training modules on strategic and systems thinking, collaborative and change leadership, healthcare finance, and talent development.
Additional links: Action Plan, Discussion Questions and Recommended Activities, Resource Guide
Date: 05/2021
Sponsoring organizations: National Rural Health Resource Center, Technical Assistance and Services Center
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Evaluation of the Use of CAH Cohorts for Quality Improvement Activities
Describes how State Flex Programs (SFPs) use cohorts of Critical Access Hospitals (CAHs) in quality improvement initiatives. Discusses the benefits and challenges of CAH cohorts, how SFPs are evaluating the impact of these initiatives, and opportunities to enhance the use of cohorts in Flex Program activities. Includes findings from interviews with six SFPs.
Author(s): John Gale, Celia Jewell, Sara Kahn-Troster, Nathan First
Date: 03/2021
Sponsoring organization: Flex Monitoring Team
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CAH Partnerships During the COVID-19 Pandemic
Presents findings from a survey of Critical Access Hospitals (CAHs) in eight states on how they partnered with communities and public health agencies in response to the COVID-19 pandemic. Discusses the type of support CAHs received from their State Flex Program (SFP).
Author(s): Madeleine Pick, Megan Lahr, Keelia Silvis, Ira Moscovice
Date: 03/2021
Sponsoring organization: Flex Monitoring Team
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Monitoring State Flex Program Financial and Operational Improvement Activities
Presents the results of a qualitative evaluation of State Flex Program interventions implemented under Program Area 2: Financial and Operational Improvement (FOI). Describes the type of projects proposed by a subset of 14 State Flex Programs, key themes, and challenges faced to monitoring and documenting these interventions on financial and operational performance. Includes an inventory of all 45 State Flex Program FOI initiatives.
Author(s): John Gale, Sara Kahn-Troster, Zachariah Croll, Nathan First
Date: 03/2021
Sponsoring organization: Flex Monitoring Team
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Critical Access Hospital Requirements: CMS Emergency Preparedness Final Rule
Provides a reference source for Critical Access Hospital (CAH) requirements related to the final rule from the Centers for Medicare & Medicaid Services (CMS), "Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers." Includes excerpts from the final rule as well as related CMS interpretive guidelines for CAHs. Addresses the development of an emergency plan, related policies and procedures, communications, training, and more.
Date: 03/2021
Sponsoring organization: Administration for Strategic Preparedness and Response
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Opioid and Substance Use Strategies for Critical Access Hospitals
Recording of a February 26, 2021, webinar discussing the role of Critical Access Hospitals (CAHs) in addressing opioid and substance use disorders (O/SUDs) in local systems of care. Provides a framework to support CAH opioid and substance use initiatives. Highlights examples of O/SUD activities taken by CAHs and offers lessons learned.
Additional links: Presentation Slides
Date: 02/2021
Sponsoring organization: Flex Monitoring Team
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Alternatives to Hospital Closure: Findings from a National Survey of CAH Executives
Discusses factors leading to rural hospital closures and alternatives to closure to maintain access to healthcare in rural areas and/or Critical Access Hospital (CAH) viability. Presents data from a survey of 227 CAH CEOs and other management staff, discussing their responses to a list of alternatives to hospital closure, including Rural Health Clinic (RHC) certification, conversion to emergency or urgent care services, Federally Qualified Health Center (FQHC) certification, and other alternatives.
Author(s): Sharita Thomas, Kristie Thompson, Kathleen Knocke, George Pink
Date: 02/2021
Sponsoring organization: North Carolina Rural Health Research Program
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Discharge Instructions, Readmission, and Mortality
Analyzes discharge, readmission, payment, and mortality data in hospitals by patient-physician communication and health condition. Includes interactive data visualizations comparing metro and nonmetro differences at the county level. Offers a video tutorial for interacting with the data.
Sponsoring organization: National Rural Health Resource Center
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Last Updated: 4/1/2025