What is a Critical Access Hospital?

Released: 02/28/18

By Lynn Luloff, Chief Financial Officer, Winneshiek Medical Center

In the 1980’s and 1990’s, many rural hospitals closed across the nation. To provide support for rural participating Medicare hospitals, the federal government created a hospital designation called Critical Access Hospitals. Winneshiek Medical Center became a Critical Access Hospital in 2005, and has been named a Top 100 Critical Access Hospital in the nation by iVantange for the past five years. But what exactly does this title mean and why is it important?

Critical Access Hospital (CAH) is a designation that provides financial benefits to hospitals in rural areas by improving Medicare reimbursement rates. As a CAH, Winneshiek Medical Center gets reimbursed at a higher rate from Medicare than if we were not under that status. CAHs may also qualify for a variety of capital funding opportunities, such as grants and loans.

What are the requirements to be a Critical Access Hospital? The facility must:

  • Be located in a rural area
  • Have 25 or less inpatient (includes acute and obstetric) beds that may also be used for swing bed services (skilled care)
  • Provide 24-hour emergency care services 7 days a week
  • Maintain an annual average length of stay for acute patients of 96 hours or less (patients needing longer-term acute care are transferred to an acute care hospital)
  • Be the only CAH within a 35-mile radius (facilities granted CAH status prior to 2006 – like WMC – are exempt from this criterion.)

WMC has agreements in place for patient referrals and transfers. For services not provided at WMC, emergency and non-emergency patient transportation is available to larger acute care hospitals such as Saint Marys in Rochester, Mayo Clinic Health System Franciscan Healthcare and Gundersen Health System in La Crosse, University of Iowa in Iowa City, and others. CAHs must also have arrangements with respect to quality assurance and Winneshiek Medical Center chooses to meet rigorous quality requirements to maintain accreditation by The Joint Commission.

Whether or not a hospital decides to pursue Critical Access Hospital status is based on the health care needs and expectations of the citizens they serve. For Winneshiek Medical Center, CAH designation makes sense and allows us to continue to provide quality services as the region’s most trusted partner for health care.

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