Critical Access Hospitals (CAHs) – Resources

Rural Health Safety Net Under Renewed Pressure as Pandemic Fades
Examines financial and operational metrics for rural hospitals, comparing hospitals in states that did and did not expand Medicaid, as well as the discontinuation of obstetrics and chemotherapy services. Discusses how the Rural Emergency Hospital (REH) designation can provide a path forward for some rural facilities and explores seven characteristics that may have the greatest impact on a facility's consideration to convert to an REH.
Date: 02/2023
Type: Document
Sponsoring organization: Chartis Center for Rural Health
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Care Coordination and Community Partnerships for Cancer Care in Critical Access Hospitals
Presents findings from a survey of 135 Critical Access Hospitals (CAHs) regarding care coordination practices for patients with cancer. Describes the types of care coordination services provided by CAHs and the staff that provide these services. Discusses partnerships between CAHs and community organizations regarding cancer initiatives.
Author(s): Megan Lahr, Xiomara Santana, Nathan Bean, Helen Parsons, Ira Moscovice
Date: 01/2023
Type: Document
Sponsoring organization: Flex Monitoring Team
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Changes in Service Offerings Post-System Affiliation in Rural Hospitals
Explores the effects of joining or leaving a regional or national healthcare system on 62 service offerings at rural prospective payment system (PPS) hospitals and Critical Access Hospitals (CAHs) between 2008 through 2020. Compares services offered at hospitals that joined a system, left a system, were always in a system during the study period, and were never is a system during the study period.
Date: 01/2023
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Rural Hospitals Must Keep up with Innovation to Remain Viable
Describes changes to the healthcare market environment, including technology, telehealth, services offered by retailers and large corporations, and declining patient volume. Outlines priorities for Critical Access Hospitals to remain viable, including the transition to population-based payment. Details a transition framework to guide hospitals as they move to a population-based payment system and navigate a changing environment.
Date: 01/2023
Type: Document
Sponsoring organization: Stroudwater Associates
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Impacts of Critical Access Hospital Independence and System Ownership during the COVID-19 Pandemic
Summarizes findings from a survey of 155 Critical Access Hospital (CAH) executives regarding experiences and challenges responding to the COVID-19 pandemic. Examines the impact of healthcare system affiliation on the CAHs' response to COVID, including the advantages and disadvantages of system affiliation and independence.
Author(s): Madeleine Pick, Megan Lahr, Abigail Wenninger
Date: 01/2023
Type: Document
Sponsoring organization: Flex Monitoring Team
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Efforts by Critical Access Hospitals to Increase Health Equity Through Greater Engagement with Social Determinants of Health
Examines the ways Critical Access Hospitals (CAHs) engage in upstream social determinant of health (SDOH) efforts to improve community health. Analyzes CAH and non-CAH programs that utilize screening, in-house strategies, and external partnerships to address SDOH. Discusses the impacts of SDOH policy on CAHs in rural communities.
Author(s): Bethany Lemont, Neeraj Puro, Berkeley Franz, Cory E. Cronin
Citation: Journal of Rural Health, 39(4), 728-736
Date: 2023
Type: Document
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Characteristics of Rural Hospitals Eligible for Conversion to Rural Emergency Hospitals and Three Rural Hospitals Considering Conversion
Findings brief presenting updated data for Rural Emergency Hospital (REH)-eligible hospitals. Compares financial and operational measures of 3 rural hospitals that have expressed interest in REH conversion with those of all 1,787 REH-eligible hospitals. Also discusses what factors may determine the number of rural hospitals that convert to REH, including risk of permanent closure.
Author(s): George Pink, Susie Gurzenda, Kristie Thompson, Ann Howard
Date: 12/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Interpretation Services for Patients with Limited English Proficiency in Critical Access Hospitals
Discusses the importance of language interpretation services and guidelines for communication and language assistance in healthcare. Describes common themes that emerged through interviews with six Critical Access Hospitals (CAHs) located in areas with a high proportion of patients with limited English proficiency (LEP) regarding the provision of language translation services, and identifies best practices that CAHs can emulate.
Author(s): Madeleine Pick, Megan Lahr, Shehrose Charania
Date: 12/2022
Type: Document
Sponsoring organization: Flex Monitoring Team
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Rates of Limited English Proficiency in Counties with Critical Access Hospitals
Describes the rates of residents with limited English proficiency (LEP) in counties with at least one Critical Access Hospital. Summarizes research on the relationship between the availability of language interpreting services and better healthcare outcomes.
Author(s): Robert Barclay, Nathan Bean, Madeleine Pick, Megan Lahr
Date: 12/2022
Type: Document
Sponsoring organization: Flex Monitoring Team
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COVID-19 Response in System-Owned and Independent CAHs
Recording of a November 2022 webinar presenting findings from Critical Access Hospital (CAH) executives regarding experiences and challenges responding to the COVID-19 pandemic. Compares the experiences of system-affiliated and independent CAHs.
Additional links: Presentation Slides
Author(s): Madeleine Pick
Date: 11/2022
Type: Video/Multimedia
Sponsoring organization: Flex Monitoring Team
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