Critical Access Hospitals (CAHs) – Resources

Implementation of Antibiotic Stewardship Activities in Critical Access Hospitals
Recording of a November 18, 2020, webinar that covers the implementation of antibiotic stewardship (AS) activities. Discusses the 2019 National Healthcare Safety Network Survey results and examines challenges Critical Access Hospitals (CAH) face reporting and implementing AS measures. Provides practical suggestions for improving AS activities in CAHs. Transcript available in the video description.
Date: 11/2020
Type: Video/Multimedia
Sponsoring organizations: Centers for Disease Control and Prevention, Federal Office of Rural Health Policy
view details

Visionary Board Leadership and the Transition to Value Video Series
A 6-part video series on healthcare leadership for Critical Access Hospital (CAH) board members. Details best practices for CAH leadership through training modules that include hospital board interviews, discussion questions, and example activities to use in the development of long-term visioning plans.
Date: 07/2020
Type: Video/Multimedia
Sponsoring organizations: National Rural Health Resource Center, Technical Assistance and Services Center
view details

Engaging Critical Access Hospitals in Addressing Rural Substance Use
Provides a framework for Critical Access Hospitals (CAHs) to identify and address substance use needs in their communities. Includes examples of rural CAH substance use prevention, treatment, and recovery strategies.
Author(s): John Gale, Sara Kahn-Troster, Zachariah Croll, Nathan First
Date: 06/2020
Type: Document
Sponsoring organization: Flex Monitoring Team
view details

Estimated Reduction in CAH Profitability from Loss of Cost-Based Reimbursement for Swing Beds
Examines the impact of proposed legislation recommending changes to swing bed reimbursements for Critical Access Hospitals (CAHs) from cost-based to the Skilled Nursing Facility Prospective Payment System (SNF PPS). Estimates CAH profitability using reimbursement formulas from Medicare cost reports and discusses the characteristics of CAHs most affected by a change in swing bed reimbursement.
Author(s): Drake M. Broussard, Kristin L. Reiter
Date: 05/2020
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
view details

CAHMPAS Financial Data Revisions
Provides an overview of new and revised financial indicators included in the Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS) tool. Discusses the revised indicator framework and provides benchmarks and percentiles for all indicators for 2017 and 2018.
Author(s): Savannah Stallings, Ann Howard, George Pink, Kristin Reiter
Date: 05/2020
Type: Document
Sponsoring organization: Flex Monitoring Team
view details

Best Practices from 14 CAH Executives Operating in Challenging Environments
Summarizes findings from interviews with Critical Access Hospital (CAH) chief executive officers about daily operations, forecasting, and community health outcomes. Identifies best practices of leaders of CAHs with low financial risk despite operating in challenging environments.
Author(s): Shartia R. Thomas, Kristin Reiter, George H. Pink
Date: 04/2020
Type: Document
Sponsoring organization: Flex Monitoring Team
view details

Rural Hospital Participation in Medicare Accountable Care Organizations
Report explores the rates of rural hospital participation in Medicare Shared Savings Program (SSP) Accountable Care Organizations (ACOs). Details some of the factors that correspond to participation and compares rates by region and by rural status.
Date: 04/2020
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
view details

Impact of CAH Participation in Flex Financial and Operations Improvement Activities on Hospital Financial Indicators
Explores the association between Critical Access Hospitals' (CAH) participation in financial and operational improvement activities between 2015 and 2018 with improved financial indicators. Compares CAH financial indicators and other variables including Rural Health Clinic operation, ownership type, and census region, by the number of years of participation in CAH improvement activities.
Author(s): Kathleen Knocke, Kristin Reiter, George H. Pink
Date: 04/2020
Type: Document
Sponsoring organization: Flex Monitoring Team
view details

Geographic Variation in the 2018 Profitability of Urban and Rural Hospitals
Compares the profitability of Critical Access Hospitals, other rural hospitals, and urban hospitals in 2018 by census region, census division, and state. Examines the reasons for geographic variation in the profitability of urban and rural hospitals.
Additional links: 2016‐18 Profitability of Urban and Rural Hospitals by Medicare Payment Classification, Rural Hospitals with Long‐Term Unprofitability, Understanding the Broader Context of Rural Hospitals and Profitability
Author(s): Andrew W. Maxwell, Ann Howard, George H. Pink
Date: 04/2020
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
view details

CAH Medicaid Payer Mix in Expansion vs. Non-Expansion States
Examines the change in median Medicaid payer mix among Critical Access Hospitals between 2013 and 2018 and compares the change across states that adopted Medicaid expansion and those that did not.
Author(s): Savannah Stallings, George Pink, Kristin Reiter
Date: 04/2020
Type: Document
Sponsoring organization: Flex Monitoring Team
view details