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Rural Health Information Hub

Critical Access Hospitals (CAHs) – Resources

Selected recent or important resources focusing on Critical Access Hospitals (CAHs).

Critical Access Hospital (CAH) Evaluation of Compliance with the Rural and Distance Requirements
Provides guidance regarding the evaluation of Critical Access Hospital (CAH) status and location requirements for current CAHs and initial CAH determinations. Covers the circumstances that trigger a CAH eligibility review, the evaluation of whether a proposed provider-based location will impact a CAH's status, and procedures for decennial reviews of existing CAHs.
Date: 08/2026
Sponsoring organization: Centers for Medicare & Medicaid Services
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CAH Quality Inventory & Assessment - State Flex Program Resources
Provides ancillary materials related to the 2025 Critical Access Hospital (CAH) Quality Inventory & Assessment (Assessment) for State Flex Programs (SFPs). Includes resources on the background and components of the Assessment for State Flex Programs, a template email that State Flex Programs can use to send to CAHs regarding the Assessment, and instructions for State Flex Programs detailing how to use the Assessment Data Tool for 2025 Assessment.
Author(s): Madeleine Pick, Robert Barclay, Megan Lahr
Date: 08/2026
Sponsoring organization: Flex Monitoring Team
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CAH Quality Inventory & Assessment Resources
Provides a list of resources for Critical Access Hospitals (CAHs) to use to complete the 2025 CAH Quality Inventory and Assessment (Assessment). Includes resources regarding the background and components of the Assessment and instructions for each question.
Author(s): Madeleine Pick, Robert Barclay, Megan Lahr
Date: 08/2026
Sponsoring organization: Flex Monitoring Team
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Rural Hospital Financial Performance: Tools for Data-Driven Decision Making
Webinar recording featuring speakers from the Office of the Assistant Secretary for Planning and Evaluation (ASPE) and the North Carolina Rural Health Research Center discussing two data-driven tools, the Rural Hospital Financial Performance Dashboard and the Hospital Financial Distress Index, that can provide valuable insights into the financial health of rural hospitals.
Additional links: Audio Recording, Webinar Slides
Date: 07/2026
Sponsoring organization: Rural Health Information Hub
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Small Rural Hospital and Clinic Finance 101
Provides introductory information on healthcare facility finances and payment for state Medicare Rural Hospital Flexibility (Flex) Program personnel, Critical Access Hospital (CAH) staff and board members, small rural prospective payment system (PPS) hospitals, and provider-based Rural Health Clinics (RHC).
Date: 07/2026
Sponsoring organization: National Rural Health Resource Center
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MBQIP Report Resources
Provides a list of resources for State Flex Programs (SFPs) and Critical Access Hospitals (CAHs) to support them in utilizing quarterly Medicare Beneficiary Quality Improvement Project (MBQIP) reports in quality improvement activities.
Date: 07/2026
Sponsoring organization: Flex Monitoring Team
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State Flex Program Staff Sustainability Guide and Toolkit
A guide for state Flex Programs to help recruit good Flex Program staff, train them successfully, retain staff longer, and plan an orderly process of finding and training new staff before the outgoing staff leave. Presents a Staff Sustainability Cycle, a process for improving the retention of high-performing Flex Program staff, and outlines specific strategies and practical tools for addressing each component of the cycle.
Date: 07/2026
Sponsoring organization: National Rural Health Resource Center
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Location of Critical Access Hospitals
U.S. map showing Critical Access Hospitals (CAHs). Updated quarterly.
Date: 07/2026
Sponsoring organization: Flex Monitoring Team
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Concordance Between Social Needs Screening and Availability of Associated Programs in US Hospitals
Examines the extent to which hospitals screen patients for social needs by analyzing data from the 2022 American Hospital Association (AHA) survey. Explores the alignment between hospitals that screen for social needs and the availability of programs to address those needs. Compares data on social needs screening and corresponding programs at hospitals by rural and urban location, Critical Access Hospital (CAH) status, region, ownership, and participation in accountable care organizations (ACOs).
Author(s): Khyathi Gadag, Keith Mueller, Whitney E. Zahnd
Date: 06/2026
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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'Good Stewards': Rural Healthcare Experts Discuss Governance Board Best Practices
Provides an overview of hospital and health center boards, with insights from rural CEOs and board members in Colorado, Missouri, North Dakota, and Oklahoma and experts from national organizations. Discusses board orientation and ongoing education, as well as ways to improve board governance.
Author(s): Allee Mead
Citation: Rural Monitor
Date: 06/2026
Sponsoring organization: Rural Health Information Hub
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Additional resources are available related to this guide. See the full list of resources by topic for: