Last Modified: 5/1/2018 Location: FL, PR, USVI Business: Part A
Critical access hospitals (CAHs) eligibility overview
The following providers may be eligible to become CAHs:
• Currently-participating Medicare hospitals;
• Hospitals that ceased operations on or after November 29, 1989; or
• Health clinics or centers (as defined by the state) that previously operated as a hospital before being downsized to a health clinic or center.
A Medicare-participating hospital must meet the following criteria to be designated by the Centers for Medicare & Medicaid Services (CMS) as a CAH:
• Be located in a state that has established a state Medicare rural hospital flexibility program;
• Be designated by the state as a CAH;
• Be located in a rural area or an area that is treated as rural;
• Be located either more than 35-miles from the nearest hospital or CAH or more than 15 miles in areas with mountainous terrain or only secondary roads; or prior to January 1, 2006, were certified as a CAH based on state designation as a "necessary provider" of health care services to residents in the area;
• Maintain no more than 25 inpatient beds that can be used for either inpatient or swing-bed services;
• Maintain an annual average length of stay of 96 hours or less per patient for acute inpatient care (excluding swing-bed services and beds that are within distinct part units);
• Demonstrate compliance with the CAH conditions of participation (CoPs) found at 42 CFR (Code of Federal Regulations) Part 485 subpart F; and
• Furnish 24-hour emergency care services seven days a week;
A CAH may also be granted "swing-bed" approval to provide post-hospital skilled nursing facility-level care in its inpatient beds.
Please refer to the CMS website for additional information on CAHs .
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.