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Critical Access Hospitals

Rural hospitals considering the pros and cons of conversion to critical access hospital status may benefit from a road map which depicts a potential series of events and milestones that they may encounter.


CAH Conversion Road Map - Potential Key Events and Milestones

1. Assessing future community health needs and unique roles for the facility, especially regarding emergency, inpatient, outpatient, and residential programs and CAH requirements

2. Identifying potential support hospital (SH) network partners.

3. Assessing the financial viability of needed services both as an independent organization and a network affiliate - forecasting utilization levels, individual and shared costs, revenue and profit/loss:

4. Identifying the anticipated programmatic impact on existing and needed programs:

5. Selecting the most responsive viable option: Ultimately the corporate board is the final decision maker, yet, in reality it should be a tripartite decision: made by the board/community, administration, medical staff.

6. Determining support needs.

7. Identifying potential SH partners:

8. Selecting SH partner(s)

9. Negotiating and executing network affiliation agreements

10. Developing and submitting state required forms and applications - CON if applicable.

11. Obtaining state approval

12. Implementing CAH conversion:

13. Preparing for federal and state site survey.

14. Completing site survey.

15. Obtaining approval to operate.

16. Initiating operation as a CAH.

17. Obtaining rates from state and federal government.


Modified from a Report on Rural Primary Care Hospital Conversion completed by

HMS Associates for the New York State Health Department Office of Rural Health, 1998.


Organizations interested in information on CAH conversion experiences should complete the following form and send to HMS Associates.

Your Name:          
City, State, Zip:   
Contact Person:       
Comments please:    


HMS AssociatesSuite B, Box 3742280 Millersport HighwayGetzville, NY 14068
Tel. (716) 688 - 8448Fax (716) 688 - 0395Toll Free (877) 889-6519


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