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Rural Health Information Hub

Rural Emergency Hospitals (REHs) – Resources

Selected recent or important resources focusing on Rural Emergency Hospitals (REHs).

Rural Emergency Hospital Conversion and Technical Assistance Webinar
Recording of a November 2, 2023, webinar discussing the Rural Emergency Hospital (REH) program. Provides an overview of the REH designation, policy and regulatory requirements, and REH Technical Assistance Center (TAC) services. Presentation slides include links to resources and templates. Transcript available in the video description.
Date: 11/2023
Sponsoring organization: Rural Health Redesign Center
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CY 2024 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS 1786-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 2024. Summarizes provisions regarding changes to the community mental health centers (CMHC) Conditions of Participation (CoPs); payment for intensive outpatient program (IOP) services; payment methodology for Indian Health Service (IHS) and tribal facilities that convert to Rural Emergency Hospital (REH) status; the Hospital Outpatient Quality Reporting (OQR), Ambulatory Surgical Center Quality Reporting (ASCQR), and Rural Emergency Hospital Quality Reporting (REHQR) Programs; and more.
Date: 11/2023
Sponsoring organization: Centers for Medicare and Medicaid Services
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Early Learnings From the Rural Health Redesign Center and its Rural Emergency Hospital Technical Assistance Center
Provides a brief overview of the Rural Emergency Hospital (REH) designation and the Rural Health Redesign Center's Rural Emergency Hospital Technical Assistance Center (REH-TAC). Describes the characteristics of Critical Access Hospitals (CAHs) and rural prospective payment system (PPS) hospitals that have explored REH conversion and have sought technical assistance from REH-TAC. Includes data on net patient revenue, operating income, margins, annualized 340B revenue, and more, by hospital type. Highlights common concerns raised by hospitals exploring REH conversion.
Date: 10/2023
Sponsoring organization: Rural Health Redesign Center
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Rural Emergency Hospitals: Legislative and Regulatory Considerations for States
Provides an overview of the Rural Emergency Hospital designation, including licensure and federal requirements for the designation that states must consider before pursuing legislation for REH licensure. Presents a table comparing how 14 states addressed these considerations. Offers legislation to assist states that want to pursue the model.
Additional links: Guide to Legislative and Regulatory Considerations for States
Author(s): Vicki Veltri, Rebekah Falkner
Date: 08/2023
Sponsoring organization: National Academy for State Health Policy
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The Benefits and Challenges of Converting to a Rural Emergency Hospital
Podcast episode with Anson General Hospital's Chief Executive Office and Chief Nursing Officer regarding the hospital's transition to a Rural Emergency Hospital. Discusses changes to services offered, financial and operational impacts of the conversion, and what the local patient population thinks about the transition.
Date: 06/2023
Sponsoring organization: American Hospital Association
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Rural Hospitals and the New Rural Emergency Hospital Designation
An episode of the Exploring Rural Health podcast featuring Janice Walters, Chief Operating Officer for the Rural Health Redesign Center, home of the Rural Emergency Hospital Technical Assistance Center. Offers an overview of Medicare's Rural Emergency Hospital (REH) designation, which became available on January 1, 2023.
Date: 05/2023
Sponsoring organization: Rural Health Information Hub
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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
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
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.
Date: 03/2023
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
Sponsoring organization: Chartis Center for Rural Health
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Additional resources are available related to this guide. See the full list of resources by topic for:


Last Updated: 2/10/2025