Critical Access Hospitals (CAHs) – Resources

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
Type: Document
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
Type: Document
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
Type: Video/Multimedia
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
Type: Document
Sponsoring organization: Flex Monitoring Team
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The Effect of Medicare Payment Standardization Methods on the Perceived Cost of Post-Acute Swing Bed Care in Critical Access Hospitals
Discusses the different payment systems the Centers for Medicare and Medicaid Services (CMS) uses to reimburse for post-acute care in Critical Access Hospitals (CAHs), prospective payment system (IPPS) hospitals, and skilled nursing facilities (SNFs). Describes how the payment standardization methods may influence post-acute care discharge patterns and access to care for rural residents. Examines the effects of these payment methods on the perceived cost of CAH swing bed care as it relates to the Medicare Spending per Beneficiary performance measure.
Author(s): Tyler Malone, Denise Kirk, Kristin Reiter
Date: 03/2021
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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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
Type: Document
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
Type: Document
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
Type: Document
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
Type: Video/Multimedia
Sponsoring organization: Flex Monitoring Team
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Critical Access Hospital in Oregon Uses Advisory Council and Trainings to Improve Cultural Competency
Features St. Charles Madras, a Critical Access Hospital in Oregon. Highlights how it improved care for American Indian and Latino patients by creating a Patient Family Advisory Council, implementing cultural competency trainings, and installing new artwork representing its community.
Author(s): Allee Mead
Citation: Rural Monitor
Date: 02/2021
Type: Document
Sponsoring organization: Rural Health Information Hub
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