Critical Access Hospitals (CAHs) – Resources
Selected recent or important resources focusing on Critical Access Hospitals (CAHs).
Characteristics of Critical Access Hospitals with High Financial and Quality Metric Performance
Examines Critical Access Hospital (CAH) financial and quality performance utilizing Medicare Beneficiary Quality Improvement Project (MBQIP) data. Provides characteristics of CAHs and their respective measures according to 5 financial and 5 quality benchmarks.
Author(s): Lauren Wallace, George H Pink, Kristie Thompson, et al.
Date: 11/2025
Sponsoring organization: Flex Monitoring Team
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Examines Critical Access Hospital (CAH) financial and quality performance utilizing Medicare Beneficiary Quality Improvement Project (MBQIP) data. Provides characteristics of CAHs and their respective measures according to 5 financial and 5 quality benchmarks.
Author(s): Lauren Wallace, George H Pink, Kristie Thompson, et al.
Date: 11/2025
Sponsoring organization: Flex Monitoring Team
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Medicare Payment Basics: Critical Access Hospitals Payment System
Presents an overview of Medicare payments for Critical Access Hospitals (CAHs). Compares differences in Medicare payments for CAHs, Sole Community Hospitals, and Medicare-Dependent Hospitals.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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Presents an overview of Medicare payments for Critical Access Hospitals (CAHs). Compares differences in Medicare payments for CAHs, Sole Community Hospitals, and Medicare-Dependent Hospitals.
Date: 11/2025
Sponsoring organization: Medicare Payment Advisory Commission
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The Evolving Role of Critical Access Hospitals in Rural Physician Training
Research letter examining prevalence of Critical Access Hospital (CAH)-based training and comparing CAHs with other rural teaching hospitals to evaluate potential for expansion. Features statistics on characteristics of training programs in CAHs and other rural teaching hospitals.
Author(s): Lori Rodefeld, Mukesh Adhikari, Catherine (Kasia) Horger, John Boll, Emily M. Hawes
Citation: JAMA Health Forum, 6(10), e254742
Date: 10/2025
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Research letter examining prevalence of Critical Access Hospital (CAH)-based training and comparing CAHs with other rural teaching hospitals to evaluate potential for expansion. Features statistics on characteristics of training programs in CAHs and other rural teaching hospitals.
Author(s): Lori Rodefeld, Mukesh Adhikari, Catherine (Kasia) Horger, John Boll, Emily M. Hawes
Citation: JAMA Health Forum, 6(10), e254742
Date: 10/2025
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Critical Access Hospital: 2026 National Patient Safety Goals
Identifies National Patient Safety Goals for the Joint Commission's Critical Access Hospital Accreditation Program. Covers emergency management, infection prevention, pain management and safe prescribing practices, suicide prevention, workplace and patient safety, and more. Effective January 1, 2026.
Additional links: Simplified Version
Date: 09/2025
Sponsoring organization: Joint Commission
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Identifies National Patient Safety Goals for the Joint Commission's Critical Access Hospital Accreditation Program. Covers emergency management, infection prevention, pain management and safe prescribing practices, suicide prevention, workplace and patient safety, and more. Effective January 1, 2026.
Additional links: Simplified Version
Date: 09/2025
Sponsoring organization: Joint Commission
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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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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: 09/2025
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
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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: 09/2025
Sponsoring organization: Rural Quality Improvement Technical Assistance (RQITA) Resource Center
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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 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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Last Updated: 1/16/2026