Critical Access Hospitals (CAHs) – Resources
Selected recent or important resources focusing on Critical Access Hospitals (CAHs).
EHR Capabilities and Interoperability in Critical Access Hospitals
Explores the electronic health record (EHR) and interoperable health information exchange capabilities among Critical Access Hospitals (CAHs) in 2019. Analyzes 2019 American Hospital Association Information Technology Supplement (AHAIT) survey data, which includes data from nearly 700 CAHs. Compares EHR capabilities and the use of electronic methods for four interoperability domains by CAH status and system affiliation. Discusses how to support CAHs in advancing information sharing and using comprehensive EHRs.
Author(s): Madeleine Pick, Alyssa Furukawa, Megan Lahr, Dori Cross
Date: 01/2024
Sponsoring organization: Flex Monitoring Team
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Explores the electronic health record (EHR) and interoperable health information exchange capabilities among Critical Access Hospitals (CAHs) in 2019. Analyzes 2019 American Hospital Association Information Technology Supplement (AHAIT) survey data, which includes data from nearly 700 CAHs. Compares EHR capabilities and the use of electronic methods for four interoperability domains by CAH status and system affiliation. Discusses how to support CAHs in advancing information sharing and using comprehensive EHRs.
Author(s): Madeleine Pick, Alyssa Furukawa, Megan Lahr, Dori Cross
Date: 01/2024
Sponsoring organization: Flex Monitoring Team
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Critical Access Hospital-Local Health Department Partnerships to Address Rural Community Needs
Explores Critical Access Hospital (CAH) involvement in collaborative community health networks that include local public health departments (LHDs), other healthcare organizations, social service agencies, and other community organizations. Uses survey data from the American Hospital Association (AHA) to describe the collaborative partnerships CAHs are engaged in, the organizations with which they partner, and the activities these partnerships undertake. Presents findings from qualitative interviews with four pairs of CAH and LHD leaders regarding challenges and lessons learned from these local-level collaborations. Identifies three areas of activity - community health needs assessments, emergency preparedness planning, and emergent public health crises - that provide an opportunity to encourage collaboration between CAHs and LHDs and address priority needs.
Author(s): Zachariah Croll, Celia Jewell, John Gale
Date: 01/2024
Sponsoring organization: Flex Monitoring Team
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Explores Critical Access Hospital (CAH) involvement in collaborative community health networks that include local public health departments (LHDs), other healthcare organizations, social service agencies, and other community organizations. Uses survey data from the American Hospital Association (AHA) to describe the collaborative partnerships CAHs are engaged in, the organizations with which they partner, and the activities these partnerships undertake. Presents findings from qualitative interviews with four pairs of CAH and LHD leaders regarding challenges and lessons learned from these local-level collaborations. Identifies three areas of activity - community health needs assessments, emergency preparedness planning, and emergent public health crises - that provide an opportunity to encourage collaboration between CAHs and LHDs and address priority needs.
Author(s): Zachariah Croll, Celia Jewell, John Gale
Date: 01/2024
Sponsoring organization: Flex Monitoring Team
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2022 National and State Healthcare-Associated Infections Progress Report
Examines progress on reducing healthcare-associated infection rates for 6 types of infections in Acute Care Hospitals, Critical Access Hospitals, Inpatient Rehabilitation Facilities, and Long-term Acute Care Hospitals. Compares observed versus expected infection rates using 2015 baseline data. Includes national and state data tables on infection-specific standardized infection ratios (SIRs) and standardized utilization ratios (SURs) for each facility type.
Date: 11/2023
Sponsoring organization: Centers for Disease Control and Prevention
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Examines progress on reducing healthcare-associated infection rates for 6 types of infections in Acute Care Hospitals, Critical Access Hospitals, Inpatient Rehabilitation Facilities, and Long-term Acute Care Hospitals. Compares observed versus expected infection rates using 2015 baseline data. Includes national and state data tables on infection-specific standardized infection ratios (SIRs) and standardized utilization ratios (SURs) for each facility type.
Date: 11/2023
Sponsoring organization: Centers for Disease Control and Prevention
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A Comparison of Non-Operating Revenue between Rural and Urban Hospitals
Compares the relative percentage and composition of non-operating revenue (NOR) among Critical Access Hospitals (CAHs), rural Prospective Payment System (R-PPS) hospitals, and urban Prospective Payment System (U-PPS) hospitals from 2011-2019. Describes how hospitals can use NOR to offset negative operating incomes. Presents data on the composition of NOR by hospital type and ownership.
Author(s): Ariana Pitcher, Ruoyu Zhang, Susie Gurzenda, George Pink, Kristin L. Reiter
Date: 11/2023
Sponsoring organization: Flex Monitoring Team
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Compares the relative percentage and composition of non-operating revenue (NOR) among Critical Access Hospitals (CAHs), rural Prospective Payment System (R-PPS) hospitals, and urban Prospective Payment System (U-PPS) hospitals from 2011-2019. Describes how hospitals can use NOR to offset negative operating incomes. Presents data on the composition of NOR by hospital type and ownership.
Author(s): Ariana Pitcher, Ruoyu Zhang, Susie Gurzenda, George Pink, Kristin L. Reiter
Date: 11/2023
Sponsoring organization: Flex Monitoring Team
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Performance Management/Program Evaluation Guide: Medicare Rural Hospital Flexibility (Flex) Program
Offers guidance to state Flex program coordinators to incorporate performance management and evaluation into Flex program operations as required by the Flex Program Cooperative Agreement. Supports the state's capacity for assessing program activities, making improvements, and establishing if activities are effective. Defines key terms and concepts, discusses reporting requirements, demonstrates a performance year work plan, covers data collection, and provides examples of goals and measures to be included in the evaluation plan.
Additional links: Flex Program Glossary of Evaluation Terms, Quick List: Flex Program Evaluation Resources
Date: 10/2023
Sponsoring organization: National Rural Health Resource Center
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Offers guidance to state Flex program coordinators to incorporate performance management and evaluation into Flex program operations as required by the Flex Program Cooperative Agreement. Supports the state's capacity for assessing program activities, making improvements, and establishing if activities are effective. Defines key terms and concepts, discusses reporting requirements, demonstrates a performance year work plan, covers data collection, and provides examples of goals and measures to be included in the evaluation plan.
Additional links: Flex Program Glossary of Evaluation Terms, Quick List: Flex Program Evaluation Resources
Date: 10/2023
Sponsoring organization: National Rural Health Resource Center
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MBQIP Quality Measures National Annual Report - 2022
Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2022. Presents data on the four Medicare Beneficiary Quality Improvement Project (MBQIP) domains: patient safety/inpatient, outpatient, patient engagement, and care transitions.
Author(s): Megan Lahr, Alyssa Furukawa, Madeleine Pick, Robert Barclay
Date: 10/2023
Sponsoring organization: Flex Monitoring Team
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Summarizes quality measure reporting rates and performance among Critical Access Hospitals (CAHs) in 2022. Presents data on the four Medicare Beneficiary Quality Improvement Project (MBQIP) domains: patient safety/inpatient, outpatient, patient engagement, and care transitions.
Author(s): Megan Lahr, Alyssa Furukawa, Madeleine Pick, Robert Barclay
Date: 10/2023
Sponsoring organization: Flex Monitoring Team
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Provision of Hospice Services by Critical Access Hospitals: Strengths and Challenges
Describes the characteristics of Critical Access Hospitals (CAHs) that report providing hospice services by analyzing data from the 2021 American Hospital Association (AHA) annual survey. Presents findings from qualitative interviews with seven CAHs who report providing hospice care, including how CAHs provide hospice services, the advantages CAHs may have when providing end-of-life care, and what CAH-specific barriers exist in providing such care.
Author(s): Robert Barclay, Megan Lahr, Hannah MacDougall, Abigail Wenninger
Date: 10/2023
Sponsoring organization: Flex Monitoring Team
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Describes the characteristics of Critical Access Hospitals (CAHs) that report providing hospice services by analyzing data from the 2021 American Hospital Association (AHA) annual survey. Presents findings from qualitative interviews with seven CAHs who report providing hospice care, including how CAHs provide hospice services, the advantages CAHs may have when providing end-of-life care, and what CAH-specific barriers exist in providing such care.
Author(s): Robert Barclay, Megan Lahr, Hannah MacDougall, Abigail Wenninger
Date: 10/2023
Sponsoring organization: Flex Monitoring Team
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Year Three Evaluation Report: Evaluation of the EMS Supplemental Funding Grants
Provides an overview of the eight Flex Program Emergency Medical Services (EMS) Supplemental funding grant recipients, including a summary of the project goals, partners, and outcome measures. Details each grantee's project accomplishments, lessons learned, and sustainability strategies.
Author(s): John Gale, Karen Pearson
Date: 09/2023
Sponsoring organization: Flex Monitoring Team
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Provides an overview of the eight Flex Program Emergency Medical Services (EMS) Supplemental funding grant recipients, including a summary of the project goals, partners, and outcome measures. Details each grantee's project accomplishments, lessons learned, and sustainability strategies.
Author(s): John Gale, Karen Pearson
Date: 09/2023
Sponsoring organization: Flex Monitoring Team
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Quality Time: Sharing PIE – Improving Swing Bed Quality
Podcast episode discussing how two Critical Access Hospital (CAH) quality improvement leaders in Mississippi and Nevada used proactive approaches to improve their swing bed programs. Describes efforts in reducing healthcare-associated infections with pneumonia and improving the documentation and coordination of swing bed patients.
Date: 09/2023
Sponsoring organization: Stratis Health
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Podcast episode discussing how two Critical Access Hospital (CAH) quality improvement leaders in Mississippi and Nevada used proactive approaches to improve their swing bed programs. Describes efforts in reducing healthcare-associated infections with pneumonia and improving the documentation and coordination of swing bed patients.
Date: 09/2023
Sponsoring organization: Stratis Health
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Medicare Beneficiary Quality Improvement Project (MBQIP) Quality Reporting Guide
Offers Flex Coordinators, Critical Access Hospital staff, and others who are working with the Medicare Beneficiary Quality Improvement Project (MBQIP) information to better understand the measure reporting process. Discusses how to register for the reporting site, which measures are to be reported, and how to submit data for each measure. Groups measures by how and where the data is to be reported.
Date: 08/2023
Sponsoring organization: Stratis Health
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Offers Flex Coordinators, Critical Access Hospital staff, and others who are working with the Medicare Beneficiary Quality Improvement Project (MBQIP) information to better understand the measure reporting process. Discusses how to register for the reporting site, which measures are to be reported, and how to submit data for each measure. Groups measures by how and where the data is to be reported.
Date: 08/2023
Sponsoring organization: Stratis Health
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Last Updated: 2/18/2025