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Healthy Communities

Critical Access Hospitals

In 1997, Congress, through the Balanced Budget Act, authorized the creation of what is known as the Medicare Rural Hospital Flexibility (FLEX) Program. This program has led to the creation of what is being called the Critical Access Hospital (CAH). By establishing limited-service hospitals and rural health networks, these acute care facilities can provide outpatient, emergency, and limited inpatient services. The Department of Health has developed a Critical Access Hospital plan in consultation with the Arkansas Hospital Association. The plan was approved and funded by the Health Care Financing Administration, now known as the Centers for Medicare and Medicaid Services (CMS). There are currently 28 hospitals in the state that are designated as Critical Access Hospitals.

Each Critical Access Hospital is required by the plan:

To satisfy state requirements for designation as a CAH, the plan specifies that a hospital must first agree to meet all Federal requirements for designation. The hospital must submit an Application for Final Designation as a member of a rural health network along with other supporting documentation. The application must include a completed community needs assessment, local health services delivery plan, and a financial feasibility study with cost projections for at least a three-year period.

This program provides more opportunities for States and their rural communities to improve access to essential health care services, especially for communities that cannot support a fully operational facility. The CAH, recognized by CMS as a new type of provider, is eligible for enhanced reimbursement.


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Arkansas Department of Health
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