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Critical Access Hospitals (CAHs) – Resources

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

CAH Participation in Flex Financial and Operational Improvement Activities, 2015–2018
Examines patterns of Critical Access Hospital (CAH) participation in activities funded by the Medicare Rural Hospital Flexibility (Flex) Program. Looks at CAHs' participation in financial and operational improvement activities, with information by various hospital characteristics including risk of financial distress.
Author(s): Kathleen Knocke, Kristin Reiter, George H. Pink
Date: 10/2019
Type: Document
Sponsoring organization: Flex Monitoring Team
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Antibiotic Stewardship Implementation: Suggested Strategies from High Performing Critical Access Hospitals
Describes antibiotic stewardship (AS) best practices identified through focus groups of 34 high performing Critical Access Hospitals across 25 states. Provides an overview of focus group findings on the seven core elements of hospital AS and identifies recurring themes.
Date: 09/2019
Type: Document
Sponsoring organization: Stratis Health
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Small Rural Hospital Transition (SRHT) Project Guide: A Rural Hospital Guide to Improving Care Management: 2019 Update
A guide for rural hospital leadership that identifies best practices in care management. Addresses care management roles and staffing needs and covers utilization review and discharge planning. Helps identify opportunities for process improvement. Also discusses competencies needed to transition to a value-based reimbursement environment focused on population health.
Date: 08/2019
Type: Document
Sponsoring organizations: National Rural Health Resource Center, Stroudwater Associates
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A Flexible Solution: How Critical Access Hospitals Reshaped Rural Health
Brief video overview describing how the Balanced Budget Act of 1997 created the Critical Access Hospital designation to reduce rural hospital closures. Discusses the role of the Senate Finance Committee and Federal Office of Rural Health Policy in developing the related policies, the transition of rural hospitals to critical access status, and the creation and impact of the Medicare Rural Hospital Flexibility Program (Flex Program).
Date: 07/2019
Type: Video/Multimedia
Sponsoring organization: Rural Health Information Hub
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Characteristics of Communities Served by Critical Access Hospitals at High Risk of Financial Distress in 2019
Compares differences in communities for those served by Critical Access Hospitals (CAHs) who are at greater financial risk versus communities with CAHs at low or medium risk for financial distress. Addresses differences in demographics, unemployment rates, high school graduation rates, and health status, including tobacco use and obesity.
Author(s): Sharita R. Thomas, George H. Pink, Kristin L. Reiter
Date: 05/2019
Type: Document
Sponsoring organization: Flex Monitoring Team
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Quality Improvement Implementation Guide and Toolkit for Critical Access Hospitals
A guide for Critical Access Hospitals to help them navigate the Medicare Beneficiary Quality Improvement Project (MBQIP) and find ways to support quality improvement in their facilities. Includes ways to organize quality improvement programs, what to focus on, federal program examples, and info-graphics.
Date: 01/2019
Type: Document
Sponsoring organization: Stratis Health
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Together We Can Be Bully Free: CAH and Law Enforcement Address Peer Victimization through School-Based Program
Highlights an anti-bullying program developed by Union General Hospital, a Critical Access Hospital (CAH) in Union Parish, Louisiana. Describes how the hospital and local law enforcement collaborate to teach elementary, middle, and high school students about the negative effects bullying and how to model positive social behavior.
Author(s): Jenn Lukens
Citation: Rural Monitor
Date: 07/2018
Type: Document
Sponsoring organization: Rural Health Information Hub
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Critical Access Hospital Replacement Process: The Manual
Describes the facility replacement process, including the phases, actions, and involved parties that are needed. Offers guidance on the facility replacement process, including assessing the Critical Access Hospital's physical and financial situation, gaining community support, identifying and obtaining financing, working with lenders and Federal enhancement programs, and completing the design and construction process.
Date: 10/2010
Type: Document
Sponsoring organization: U.S. Department of Health and Human Services
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Critical Access Hospital Replacement Process: The Roadmap
Provides a visual overview of the entire facility replacement process. Divided into four phases including Planning, Design and Financing, Endorsement, and Construction. Each phase is further described by events, actions, duration, costs/fees, and involved parties.
Date: 10/2010
Type: Document
Sponsoring organization: Federal Office of Rural Health Policy
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Public Law 105-33: Balanced Budget Act of 1997
Includes the entire text of Public Law 105-33, commonly known as the Balanced Budget Act of 1997. The legislation created the Critical Access Hospital designation and outlines details of the program, including eligibility and operational regulations.
Date: 08/1997
Type: Document
Sponsoring organization: U.S. Congress
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Last Updated: 10/4/2023