Certain Medicare provider designations offer an opportunity for qualifying hospitals to receive enhanced reimbursement from the Medicare program. Often these specially designated facilities serve rural and isolated areas where access to care can be limited. Designations include Critical Access Hospital (CAH), Sole Community Hospital (SCH) and Medicare-Dependent Hospital (MDH).

Critical Access Hospital
Hospitals must meet the following criteria to be designated as CAHs: be located in a rural area; furnish 24-hour emergency care; have no more than 25 inpatient beds; have an average length of stay of 96 hours or less; and be located more than 35 miles from the nearest hospital or 15 miles in areas with mountainous terrain or secondary roads, or be state-certified as a “necessary provider.”

Sole Community Hospital
Hospitals are eligible to be classified as SCHs if it they are located more than 35 miles from other like hospitals. Hospitals also may be classified as SCHs if they are located in a rural area and meet certain specified conditions.

Medicare-Dependent Hospital
Certain rural hospitals with 100 beds or fewer, that had at least 60 percent of inpatient days or discharges during fiscal year (FY) 1987, or two of the three most recently audited cost reports, attributed to Medicare, are MDHs. These hospitals are paid for inpatient stays at the national standardized rate or, if higher; a blend including 50 percent of the hospital’s adjusted FY 1982 or 1987 costs.