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Critical Access Hospitals to Lose Rural Designation

The Centers for Medicare & Medicaid Services (CMS) recently released a list of critical access hospitals (CAHs) that lost their rural designation as of Oct. 1, 2014. These CAHs lost that designation because they are in counties that will now be classified as urban.

States with the largest number of hospitals losing rural status include Louisiana (11), Texas (10), North Carolina (8), Washington (8), Virginia (7), Nebraska (7), Minnesota (7), Georgia (6), Arizona (5), Florida (5), Hawaii (5), New York (5), Pennsylvania (5), South Carolina (5) and Tennessee (5).

CAHs in these counties may reapply for the rural designation by Sept. 30, 2016, using one of two methods. The first relies upon the Rural-Urban Commuting Area (RUCA) codes which classify U.S. census tracts using measures of urbanization, population density and daily commuting. The classification uses a 1-10 scoring system. If a CAH has a RUCA code of 4 or higher it is eligible to reapply. The second method is via either a state law or regulation that defines the hospital as rural. To apply under either channel, hospital CEOs should submit documentation to the CMS office in their region.

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