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Critical Access Hospitals (CAHs) – Resources

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

Revisions and Deletions Related to the Standards Simplification Project: Critical Access Hospital (CAH) Accreditation Program
Outlines Joint Commission accreditation requirements for Critical Access Hospitals (CAHs) that are above and beyond the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation (CoPs) and will be combined, revised, or deleted effective August 27, 2023. Covers the information management; medication management; National Patient Safety Goals (NPSG); and provision of care, treatment, and services chapters, among others.
Date: 06/2023
Type: Document
Sponsoring organization: Joint Commission
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The Impact of COVID-19 on CAH Financial Indicators
Describes the impact of the COVID-19 pandemic on Critical Access Hospital (CAH) financial indicators. Compares summary statistics on CAH financial indicators across eight categories in the six years prior to the pandemic (April 2015 - March 2020) to the same metrics during the pandemic (April 2020 - March 2022).
Author(s): Laura McFadyen, George Pink, Susie Gurzenda, Kristie W. Thompson, Kristin L. Reiter
Date: 06/2023
Type: Document
Sponsoring organization: Flex Monitoring Team
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The Impact of COVID-19 Funding on Profitability of Critical Access Hospitals
Examines the impacts of COVID-19 Public Health Emergency (PHE) funding on Critical Access Hospitals (CAHs). Compares CAH operating margins in the six years prior to the pandemic (April 2015 - March 2020) to operating margins during the pandemic (April 2020 - March 2022). Offers estimates to what CAH profitability would have been if CAHs did not receive PHE funding.
Author(s): Laura McFadyen, George Pink, Susie Gurzenda, Kristie W. Thompson, Kristin L. Reiter
Date: 06/2023
Type: Document
Sponsoring organization: Flex Monitoring Team
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Critical Access Hospitals: Views on How Medicare Payment and Other Factors Affect Behavioral Health Services
Provides an overview of how Medicare payment policies for care provided by Critical Access Hospitals (CAHs). Explores how CAHs provide behavioral health services in their communities. Summarizes findings from interviews with officials from 10 CAHs, stakeholder organizations, the Centers for Medicare & Medicaid Services (CMS), and the Health Resources and Services Administration (HRSA) regarding how Medicare payment policies and other factors affect CAHs' ability to provide behavioral health services.
Additional links: Full Report
Date: 06/2023
Type: Document
Sponsoring organization: Government Accountability Office
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Efforts by Critical Access Hospitals to Increase Health Equity Through Greater Engagement with Social Determinants of Health
Examines the ways Critical Access Hospitals (CAHs) engage in upstream social determinant of health (SDOH) efforts to improve community health. Analyzes CAH and non-CAH programs that utilize screening, in-house strategies, and external partnerships to address SDOH. Discusses the impacts of SDOH policy on CAHs in rural communities.
Author(s): Bethany Lemont, Neeraj Puro, Berkeley Franz, Cory E. Cronin
Citation: Journal of Rural Health, 39(4), 728-736
Date: 06/2023
Type: Document
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How Community Investment Saved a Rural Health System
Profiles Mackinac Straits Health System, a Critical Access Hospital (CAH) serving Michigan's Upper Peninsula. Discusses how the health system used strategic planning and key partnerships to address key needs, recover financially, and move forward.
Date: 06/2023
Type: Audio
Sponsoring organization: American Hospital Association
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Rural Health Research Recap: Rural Hospital Closures: 2023 Update
Summarizes recent research from Rural Health Research Centers examining hospital closures. Features statistics including number of acute hospitals as of 2020 with breakdowns by type and location, rural hospital closures from 2005-2022 with breakdowns by isolated rural, small rural, and large rural location, and numbers of closures by year from 2005-2022 with breakdowns by complete or converted closures.
Author(s): Per Ostmo
Date: 06/2023
Type: Document
Sponsoring organization: Rural Health Research Gateway
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Interoperability among Hospitals Treating Populations That Have Been Marginalized
Examines how hospitals that serve more marginalized patients engage with interoperability. Compares the percentage of hospitals supporting interoperable exchange and participating in national networks by hospital characteristics, including Critical Access Hospital (CAH) designation and rural-urban status.
Author(s): Jordan Everson, Vaishali Patel, Andrew W. Bazemore, Robert L. Phillips
Citation: Health Services Research, 58(4), 853-864
Date: 05/2023
Type: Document
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How Regional Partnerships Bolster Rural Hospitals
Explores how Critical Access Hospitals (CAHs) and other rural providers partner to overcome challenges. Profiles six regional partnerships that address staffing, quality improvement, contracts with payers, value-based payment, and community development. Offers lessons learned that could inform policy changes to strengthen rural providers.
Author(s): Martha Hostetter, Sarah Klein
Date: 05/2023
Type: Document
Sponsoring organization: Commonwealth Fund
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Factors Associated with Lengths-of-Stay for Inpatients with Substance Use Disorders
Policy brief identifying factors associated with inpatient length-of-stay (LOS) for the treatment of substance use disorders (SUDs) and exploring whether there are systematic differences in LOS for rural and urban residents. Includes statistics on characteristics of stays for a primary SUD diagnosis in Kentucky, North Carolina, Vermont, and Washington in 2018, with breakdowns by Mental Health Professional Shortage Area and rural or urban location, and selected factors on LOS for an SUD diagnosis, with breakdowns by mental diagnoses, chronic conditions, and socio-demographic measures.
Author(s): Curt Mueller, Craig Holden, Shena Popat, Alana Knudson
Date: 04/2023
Type: Document
Sponsoring organization: Rural Health Equity Research Center
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Additional resources are available related to this guide. See the full list of resources by topic for:


Last Updated: 7/24/2023