Criteria for a critical access hospital (CAH)
(1) The hospital is in a state that has established a State Medicare Rural Hospital Flexibility Program.
(2) The hospital has been designated by the state as a CAH.
(3) It is one of the following:
(3a) a rural public hospital participating in Medicare
(3b) a participating hospital that ceased operation on or before 11/29/1989
(3c) a health clinic or health center
(4) The hospital is located in a rural area or an area considered to be rural.
(5) It is one of the following
(5a) > 35 miles from another hospital
(5b) > 15 miles from another hospital AND accessible only by secondary roads
(5c) > 15 miles from another hospital AND in mountainous terrain
(5d) designated necessary provider of health services to residents in the area prior to January 1, 2006.
(6) It has <= 25 inpatient beds that can be used for either inpatient or swing bed services.
(7) It has an average annual length of stay <= 96 hours for inpatient services.
(8) It complies with the CAH conditions of participation.
(9) It maintains emergency care services 24 hours a day, 7 days a week.
Additional rules apply if the CAH is involved in hospice, skilled nursing, rehabilitation, substance abuse or psychiatric services.
