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Rural Emergency Hospitals – Resources

Selected recent or important resources focusing on Rural Emergency Hospitals.

Big Changes with the New Rural Emergency Hospital Model
Podcast episode providing an overview of the Rural Emergency Hospital designation. Discusses the role of the Rural Emergency Hospital Technical Assistance Center and the types of support it provides.
Date: 04/2023
Type: Audio
Sponsoring organization: American Hospital Association
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Rural Emergency Hospital Requirements: CMS Emergency Preparedness Final Rule
Provides a reference source for Rural Emergency Hospital (REH) 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 REH Conditions of Participation regarding emergency preparedness, as well as CMS interpretive guidelines for 17 other provider types. Covers the development of an emergency plan, related policies and procedures, communications, training, and more.
Date: 03/2023
Type: Document
Sponsoring organization: Administration for Strategic Preparedness and Response
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Orientation to Rural Emergency Hospital Conversion and Technical Assistance, Additional Guidance
Recording of a March 1, 2023, webinar discussing the Rural Emergency Hospital (REH) program. Provides an overview of January 2023 guidance from the Centers for Medicare & Medicaid Services, including REH action plans, transfer agreements, self-attestation to Conditions of Participation, the REH application process, and the rural status distance exception. Transcript available in the video description.
Additional links: Presentation Slides
Date: 03/2023
Type: Video/Multimedia
Sponsoring organizations: Mathematica, Rural Health Redesign Center
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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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Guidance for Rural Emergency Hospital Provisions, Conversion Process and Conditions of Participation
Provides guidance regarding the enrollment and conversion processes for facilities interested in participating in the Medicare and Medicaid programs as a Rural Emergency Hospital (REH). Covers eligibility, enrollment, conversion action plans, action plans, and attestation. Includes answers to frequently asked questions about the REH program and State Operations Manual Appendix O - Survey Protocol, Regulations and Interpretive Guidelines for Rural Emergency Hospitals.
Date: 01/2023
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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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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Clarity for Rural Emergency Hospitals and Changes for Critical Access Hospitals: CMS Finalizes Conditions of Participation and Payment and Enrollment Policies But Pauses Stark Law Flexibilities
Provides an overview of the Rural Emergency Hospitals (REHs) provisions of the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule. Discusses REH reimbursement, Conditions of Participation (CoPs), enrollment provisions, and Stark Law regulatory modifications to accommodate REHs. Highlights changes to the definition of "primary roads" related to Critical Access Hospital (CAH) CoPs.
Author(s): Emily Jane Cook, Caroline Reignley, Amber Arnold, Sandra M. DiVarco
Date: 11/2022
Type: Document
Sponsoring organization: McDermott Will & Emery
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Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Acquisition; Rural Emergency Hospitals: Payment Policies, Conditions of Participation, Provider Enrollment, Physician Self-Referral; New Service Category for Hospital Outpatient Department Prior Authorization Process; Overall Hospital Quality Star Rating; COVID-19
Establishes the Rural Emergency Hospital (REH) provider type. Outlines REH payment policy, Conditions of Participation (CoPs), quality measures, and enrollment policy. Outlines changes to the Critical Access Hospitals (CAH) CoPs regarding location and distance requirements, patient's rights requirements, and flexibilities for CAHs that are part of a larger health system. Among other things, this rule also revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2023 and finalizes provisions included in the COVID-19 interim final rules.
Additional links: Fact Sheet
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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CY 2023 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1772-FC) Rural Emergency Hospitals — New Medicare Provider Type
Provides an overview of Rural Emergency Hospitals, a Medicare provider type established by the Consolidated Appropriations Act, 2021. Details key policies outlined in the Calendar Year 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule, including payment policies, conditions of participation, REH provider enrollment, and exceptions to the physician self-referral law.
Date: 11/2022
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Key Considerations for a Rural Hospital Assessing Conversion to Rural Emergency Hospital
Offers a conceptual framework of key considerations for rural hospitals contemplating conversion to a rural emergency hospital (REH). Covers financial feasibility, workforce, community impact, partnerships, and regulatory considerations.
Author(s): Kristin Reiter, TJ Grant, Susie Gurzenda, et al.
Date: 10/2022
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Last Updated: 5/3/2024