Challenges Of Rural Hospitals


Rural hospitals are key to the healthcare system. However, these facilities often face financial stressors of serving smaller, lower-income communities. The critical access hospital (CAH) designation is a program designed to help rural hospitals stay open. The program improves access to healthcare for communities that commonly face barriers to healthcare access.

Improving Accessibility to Healthcare with Critical Access Hospitals

Critical access qualifications

Hospitals currently participating in Medicare services may be eligible for the CAH designation. To qualify for CAH designation, hospitals must:

  • Have 25 or fewer acute care inpatient beds
  • Be at least 35 miles away from the next nearest hospital
  • Provide 24/7 emergency care services
  • Have an annual average length of stay of less than 96 hours for acute care patients

Challenges of rural hospitals

The CAH designation was designed to help rural hospitals stay open and improve access to care. Rural hospitals often face financial stressors that healthcare facilities in more urban areas do not. For example, rural hospitals often do not have an adequate variation in payer mix that would ensure coverage of costs. Additionally, the size of the service area can prove difficult for offering the lucrative services that bring in cash.

Advantages of CAH

Keeping rural hospitals open is essential. Many of these facilities offer healthcare services to communities that do not have adequate access to healthcare. Additionally, rural hospitals are often the main supplier of jobs in rural communities. Keeping these facilities open is essential in attracting more businesses and industries to rural areas. The CAH designation can benefit not just the rural hospital but also the rural community.

Emergency services are key

To become a CAH, hospitals must provide 24/7 emergency services. Providers must be on-site, or on-call and available to be on-site within 30 minutes at all times. Adequate emergency staffing is key to rural healthcare access and to the success of a rural hospital.

The only access to healthcare

For many people in rural communities, the hospital is the only access to healthcare. These communities need hospitals to stay open. Critical access hospital designation can be a solution to improving access to healthcare in some vulnerable communities.