General Information

Critical Access Hospital Designation

Legislation enacted as part of the Balanced Budget Act (BBA) of 1997 authorized states to establish State Medicare Rural Hospital Flexibility Programs (Flex Program), under which certain facilities participating in Medicare can become Critical Access Hospitals (CAH). The following providers may be eligible to become CAHs:

  • Have 25 or fewer acute care inpatient beds
  • Be located more than 35 miles from another hospital
  • Maintain an annual average length of stay of 96 hours or less for acute care patients
  • Provide 24/7 emergency care services

Unlike facilities such as Medicare Dependent Hospitals or Sole Community Hospitals, CAHs represent a separate provider type with their own Medicare Conditions of Participation as well as a separate payment method.

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