Critical Access Hospitals (CAHs) – Resources
Selected recent or important resources focusing on Critical Access Hospitals (CAHs).
CAH Quality Infrastructure Resources
Provides resources related to the Critical Access Hospital (CAH) Quality Infrastructure measure, which is part of the Flex Program's Medicare Beneficiary Quality Improvement Project (MBQIP) core measures. Covers CAH Quality Infrastructure measure specifications and detailed codebooks from 2023 to 2025.
Author(s): Megan Lahr, Madeleine Pick, Robert Barclay
Date: 09/2026
Sponsoring organization: Flex Monitoring Team
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Provides resources related to the Critical Access Hospital (CAH) Quality Infrastructure measure, which is part of the Flex Program's Medicare Beneficiary Quality Improvement Project (MBQIP) core measures. Covers CAH Quality Infrastructure measure specifications and detailed codebooks from 2023 to 2025.
Author(s): Megan Lahr, Madeleine Pick, Robert Barclay
Date: 09/2026
Sponsoring organization: Flex Monitoring Team
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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: 09/2026
Sponsoring organization: Flex Monitoring Team
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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: 09/2026
Sponsoring organization: Flex Monitoring Team
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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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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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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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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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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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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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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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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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U.S. map showing Critical Access Hospitals (CAHs). Updated quarterly.
Date: 07/2026
Sponsoring organization: Flex Monitoring Team
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Twenty-Five Years of Progress: Evidence-Based Strategies for Rural Hospital Replacement
Recording of a conference presentation exploring the financial and operational performance of Critical Access Hospitals (CAHs) before and after a facility replacement. Describes trends across successful replacement projects and profiles Rio Grande Hospital in Del Norte, Colorado. Includes a demonstration of the Stroudwater Capital Partners CAH Replacement Directory.
Additional links: Presentation Slides
Date: 06/2026
Sponsoring organization: Stroudwater Associates
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Recording of a conference presentation exploring the financial and operational performance of Critical Access Hospitals (CAHs) before and after a facility replacement. Describes trends across successful replacement projects and profiles Rio Grande Hospital in Del Norte, Colorado. Includes a demonstration of the Stroudwater Capital Partners CAH Replacement Directory.
Additional links: Presentation Slides
Date: 06/2026
Sponsoring organization: Stroudwater Associates
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