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Rural Hospitals – Resources

Selected recent or important resources focusing on Rural Hospitals.

Effects of Rural Hospital Closures on Nurse Staffing Levels and Health Care Utilization at Nearby Hospitals
Analyzes healthcare utilization and nurse staffing levels when nearby rural hospitals close. Utilizes 2014-2019 American Hospital Association Survey data to examine vocational nurse/licensed practical nurse (LPN), registered nurse (RN), and advanced practice nurse (APN) staffing levels as well as inpatient and outpatient surgical operations and emergency department (ED) visits within 4 years of a hospital closure.
Author(s): Jing Dong, Siying Liu, Asefeh Faraz Covelli, Guido Cataife
Citation: Health Economics, 33(12), 2687-2707
Date: 12/2024
Type: Document
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The Potential for Hospital System Integration to Improve the Financial Outlook of Rural Hospitals in the United States
Provides an overview of the current financial status of rural hospitals and their risk of closure, as defined by days of cash on hand and total margins. Discusses the impact of rural hospital closures on local communities, including on health outcomes, demographics, and the economy. Explores the extent to which affiliating with, merging with, or being acquired by a larger hospital system can impact the financial position of rural hospitals.
Author(s): Al Dobson, Michael Beins, Patrick McMahon, et al.
Date: 11/2024
Type: Document
Sponsoring organizations: Coalition to Strengthen America's Healthcare, Dobson DaVanzo & Associates
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CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1809-FC)
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments for hospital outpatient and Ambulatory Surgical Center (ASC) services for calendar year 2025. Summarizes provisions regarding changes to Intensive Outpatient Program (IOP) and partial hospital program rate setting; incorporating an add-on payment to the Medicare outpatient hospital all-inclusive rate (AIR) for certain high-cost drugs for people with Medicare who receive care at Indian Health Service (IHS) or tribal hospitals; updates to the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; a new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) for obstetrical services; Medicaid and CHIP continuous eligibility; Medicaid clinic services "four walls" exceptions; and more.
Date: 11/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Understanding the Impact of Medical Debt in Rural Communities: Perspectives from Rural Hospital Administrators
Presents findings from key informant interviews with rural hospital administrators across seven states regarding the impact of medical debt on hospitals and patients in rural communities. Describes themes related to causes and consequences of medical debt across three domains: hospital, patient/community, and policy.
Author(s): Mariana Tuttle, Ingrid Jacobson, Katie Rydberg, Carrie Henning-Smith
Date: 11/2024
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Separate Payment for Essential Medicines – New Biweekly Interim Payments for the Inpatient Prospective Payment System
Provides an overview of payment adjustments to small, independent hospitals for establishing and maintaining access to buffer stocks of essential medicines for cost report periods beginning on or after October 1, 2024.
Date: 10/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Characteristics of Patients Hospitalized in Rural and Urban ICUs From 2010 to 2019
Examines the characteristics of fee-for-service Medicare patients who received intensive care in rural. Compares patient characteristics to those who received intensive care in urban hospitals, and the change in patient characteristics between 2010 and 2019. Presents data by patient age, sex, race and ethnicity, mean area deprivation index rank, primary diagnosis, and more.
Author(s): Emily A. Harlan, Muhammad Ghous, Ira S. Moscovice, Thomas S. Valley
Citation: Critical Care Medicine, 52(10), 1577-1586
Date: 10/2024
Type: Document
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Interfacility Transfer of Children With Time-Sensitive Surgical Conditions, 2002-2017
Explores changes in the number of interfacility transfers and travel distance for children with four time-sensitive surgical conditions across nine states between 2002 and 2017. Examines whether the changes in transfers and travel distance varied by patients' urban or rural residence.
Author(s): Kyle J. Van Arendonk, Elisabeth T. Tracy, Jonathan S. Ellison, et al.
Citation: JAMA Network Open, 7(10), e2440251
Date: 10/2024
Type: Document
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Hospital Differences in Adult Inpatient Stays with Healthcare-Associated Infections, 2019 and 2021
Examines the rate of adult inpatient hospital stays involving five healthcare-associated infections (HAI) in 2019 and 2021. Presents data from an analysis of 2019 and 2021 State Inpatient Databases (SID) from public, non-federal acute-care hospitals across 38 states by hospital characteristics, including ownership, rural or urban location, safety-net designation, and Critical Access Hospital designation.
Author(s): Melissa A. Miller, Leyi Lin, David P. Calfee, Amy Gehrke, Alex Bohl
Date: 10/2024
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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News Media Coverage of Rural Hospital Closures and the Causes
Reports findings from attributed causes of rural hospital closures through analysis of news media reports. Features statistics on attributed causes for closures, from a sample of 137 closures between 2010-2022.
Author(s): Harini Somanchi, Julie Perry, Kristie Thompson, George Pink
Date: 10/2024
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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An Updated Model of Rural Hospital Financial Distress
Discusses a potential model to predict financial distress in rural hospitals, including negative cash flow margin, negative equity, or closure of facility. Tests 2,311 rural hospitals from 2013 to 2019 with the model and discusses its potential to predict financial distress and create accurate assessments.
Author(s): Tyler L. Malone, George H. Pink, George M. Holmes
Citation: Journal of Rural Health
Date: 10/2024
Type: Document
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Last Updated: 11/22/2024