Critical Access Hospital Resources
Determining whether CAH conversion is advisable is both a hospital and community decision. A financial feasibility assessment is the first step in making an informed decision; additional considerations are community need and administrative effect on hospital operations. State Flex Programs spend considerable resources on conversion activities including communication and technical assistance, building coalitions, and troubleshooting.
Tools
CAH Fact Sheet
This document, from the Centers for Medicare and Medicaid Services
(CMS), provides further clarification on the implementation of the
Medicare Modernization Act of 2003 guidelines for the Critical Access
Hospital Program.
CAH Physician
Survey
This is an example of a survey of physicians at CAHS. The document is
from the Michigan Center for Rural Health.
CAH Program; Decision
Flowchart
This flowchart, prepared by the Washington State Department of Health, Office of
Rural Health, is a visual description of the decision making process for CAH
designation.
CAH Program Technical Assistance
Grants Fact Sheet
The document, prepared by the Colorado Rural Health Center, gives information
about the process of applying for CAH grants in Colorado and can be adapted for
use by any state.
CAH Status Report
This Microsoft Excel template was developed by the Center for Rural Health,
School of Medicine, University of North Dakota. It is used to track the progress
of hospitals that are working on CAH certification so that status can be seen at
a glance, from a single page.
CAH Talking Points for
Physicians
This document, prepared by the Illinois Department of Public Health, Center for
rural Health, lists benefits, requirements, and expectations of critical access
hospitals.
Checklist for
Medicare Critical Access Hospital (CAH) Certification Survey
The checklist, from the Nevada Center for Education and Health, is
designed for use by hospital administrators and staff to ensure that
they are prepared for the initial survey their hospital will undergo
as part of the CAH application process.
CMS Critical Access Hospital (CAH) Claims
This Special Edition article was issued based on instructions from CMS.
Providers submitting claims to Medicare fiscal intermediaries for CAH
anesthesia and ambulance services are effected by this change.
Communication Toolkit
(Not a U.S. Government Web Site)
The Communication Toolkit, developed by the Nebraska Hospital Association, will
assist hospitals in discussions about the critical access hospital program with
employees, trustees, the community and the media. Note: You will have to modify
to fit new CAH guidelines.
Conducting
Hospital Employee Feedback Surveys - Training Module
Developed by Linda Powell of Mountain States Group, this
module a list of those tools and examples for employee feedback surveys
as well as other tools that you can download in their original format so
you can edit and use what you need. Simply click on the file you want to
download.
Current Status of CAH
Components
This document from the Michigan Center for Rural Health is an example
of a grid that could be used to track data and services of CAHs.
Financial Impact of CAH Conversion on Rural Hospitals in
Nebraska: A Report to the Nebraska CAH Steering Committee
This report from the Nebraska Center for Rural Health Research
discusses how converting to CAH status has improved financial
viability of rural hospitals in Nebraska.
Fitch Report on CAH Hospitals
An overview of strengths, risks, benefits, and requirements of critical
access hosptials. This report also includes information on profiles of
Fitch-Rated CAHs.
Improving Access to Primary Care
This policy, developed by the New Hampshire Department of Health, Bureau of
Rural Health and Primary Care, addresses improvement of access to primary care
and for the low-income uninsured, a requirement for CAH designation in New
Hampshire.
"Let's Talk CAH"
This document, prepared by Pat Schou at the Illinois Department
of Health, Center for Rural Health, is a three-page summary of
the CAH program with some helpful Q & A.
Midlevel Practioners
in the ED
This study from the Minnesota Office of Rural Health and Primary Care
looks into various aspects of using Midlevel Practioners in the
Emergency Department's of Critical Access Hospitals verses Non-
Critical Access Hospitals.
"Necessary Provider"
Definitions
This document is a compilation of State's criteria for designation as a
necessary provider that shows how each state has addressed local considerations
or unique requirements.
Sample Network
Agreement
This agreement, developed by the Nebraska Hospital Association, covers patient
referrals and transfers, transportation, communication systems, credentialing
and quality assurance.
Strategic
Planning Module
Developed by Linda Powell of Mountain States Group, the
Strategic Planning Module contains a list of those tools and examples as
well as other tools that you can download in their original format so
you can edit and use what you need. Simply click on the file you want to
download.
Swing Bed Policy and Procedures
This document, developed by the Illinois Department of Public Health, Center
for Rural Health, lists the policies and procedures that are suggested for the
Swing Bed facility in a CAH.
Trends
Over Time in the Provision of Skilled Nursing Care in Critical Access
Hospitals
Focusing on critical access hospitals and cost-based reimbursement, this study
observes trends in the delivery of skilled nursing facility services in swing
beds and hospital-based units during a period of drastic changes in Medicare
payments for post-acute care.
Survey Tools
-
CAH Survey
Preparation Guidelines
This list of questions was developed by the Illinois Department of Public Health, Center for Rural Health, to prepare for a survey in the areas of case management and utilization review. -
CAH Self Survey
This document was created by Alaska's Health Facilities Licensing & Certification. It is a self-survey guide for evaluating compliance for §485.618 through §485.645 of certification to CAH. -
Checklist
for Medicare CAH Certification Survey
This comprehensive checklist, developed by the Center for Education and Health Services Outreach, University of Nevada, is used by hospital administrators and staff to ensure that the facility is prepared for the certification visit as part of the CAH application process. -
Survey Documents
This document, developed by the Illinois Department of Public Health, Center for Rural Health, lists the documents that will be requested during a site visit, including policies and procedures. -
These survey documents were developed by the Nebraska Hospital Association:
-
Guide to Survey Preparation
-
Survey Document Checklist
-
Survey
Checklist for Written policies, Procedures, and Agreements -
Re-Survey Preparation
-
Guide to Survey Preparation
- The following survey documents were develped by the Illinois Department of Public Health, Center for Rural Health:
Resources
2006 Rural
Hospital Replacement Facility Study
This study was completed by the RED CAPITAL GROUP and Stroudwater
Associates to analyze performance data to determine volume, efficiency,
and profitability, of replacement facilities.
American
Hospital Association
(Not a U.S. Government Web Site)
This site contains legislative and regulatory updates pertaining to Critical
Access Hospitals, a CAH FAQ page, and many other resources helpful for the
critical acces hospital program.
CAH
Financial Indicators Report: Summary of Indicator Medians by State
This Briefing Paper presents state and national median values of the
twenty financial indicators included in the 'CAH Financial Indicators
Report'. These indicators were specifically designed to capture the
financial performance of CAHs.
CAH Planning,
Design, and Construction Guide
Two alternative prototype designs for 25 and 15 bed
Critical Access Hospitals to provide guiding principals to assist the
hospitals in development of a replacement facility.
Critical Access Hospital Frequently Asked Questions
This link to the Rural Assistance Center's website has a list of
Frequently Asked Questions related to Critical Access Hospitals.
Critical
Access Hospital Year 2 Hospital Compare Participation and Quality Measure Results (April 2007)
This report examines the second year participation and
quality measure results for CAHs in the CMS Hospital Compare public
reporting database for hospital quality measures.
Flex Monitoring Team
(Not a U.S. Government Web Site)
This site contains "Findings from the Field," which documents experiences from
State and CAH perspectives on various initiatives within the Flex Program.