HHS Report Recommendations Put Small Rural Hospitals at Risk

Sep 9, 2013

Credit raconline.org

The United States Department of Health and Human Services issued a report with recommendations that, if acted upon, could put hundreds of small, rural hospitals in jeopardy according to an article by the Kansas Health Institute.

There are 1,300 hospitals designated as “critical access” in the United States.  Critical Access Hospital designation was created by Congress in 1997 with the intention of providing rural populations reasonable access to healthcare.  

The hospitals were:

·        To be 35 miles apart, with exceptions made for difficult terrain 

·        Limited in size to 25 or less acute care or swing beds

·        To provide emergency services 24/7

·        To have an annual average length of stay of less than 96 hours 

In meeting this criteria, Medicare payments would be based on the cost of providing service.  In some states, favorable Medicaid payments were also given.  This payment systems helps hospitals provide service despite the small number of patients treated.

States were given the latitude, until Jan. 1, 2006, to designate hospitals that did not meet the distance requirement, but were “necessary providers.”  However, if the inspector’s recommendation to reinstate the distance requirement is implemented, 849 of the designated hospitals would be eliminated from the payment system.  Inspectors estimate this would result in a taxpayers savings of $268 million a year. 

Those calculations are challenged by the National Rural Health Association.  Brock Slabach, senior vice president for member services at the National Rural Health Association, said,  "They didn't use very sophisticated mapping techniques. It could be over or under we don't know. But I would say any hospital on the list that doesn't meet the (original) criteria should consider themselves vulnerable."

Kansas has 83 Critical Access Hospitals, Colorado- 29, Oklahoma- 34, and Texas- 80. 

To see if the hospital in your area is a CAH, click here.