Critical Access Hospital Recognition Nomination Form

Nominations will be accepted through Friday, February 11, 2022.

Do you know of a critical access hospital (CAH) that has implemented an innovative approach to health equity? If so, please consider nominating them for Critical Access Hospital Recognition, an initiative of the Technical Assistance and Service Center (TASC), a program of the National Rural Health Resource Center (The Center), and the Federal Office of Rural Health Policy (FORHP). 

The Critical Access Hospital Recognition initiative aims to capture best practices and recognize the innovative work done in CAHs across the country.  It is also an opportunity for state Flex Coordinators to highlight the support state Flex Programs provide to CAHs. 

NOMINATION CRITERIA: 
CAH health equity initiatives must meet the following requirements: 

  • The activities are supported by the state Flex program
  • Has a well-developed evaluation plan 
  • Able to share 2-5 qualitative and/or quantitative outcomes 

SCORING CRITERIA: 
Thorough descriptions of the following are required: 

  • An innovative approach to health equity implemented to improve population health/and or access to care (0-3 Points)
  • Describe how addressing health equity to improve rural population health or access to services was identified as a need  (0-2 Points)
  • Provide 2-5 qualitative and/or quantitative outcomes explaining how the initiative is successfully meeting community needs and improving population health and/or access to care (0-5 Points)
  • How the state Flex Program supported the CAH in their implementation efforts (0-2 points) 

Based on the scoring criteria listed above, chosen CAHs will each receive a Certificate of Recognition.  They will also be profiled in TASC’s electronic newsletter, Rural Route, the TASC website, and The Center’s social media platforms.  Please visit TASC’s website to see past CAH Recognition Awardee Spotlights. Further information will be provided and requested once the scoring has concluded.

For questions, please contact Matt Bancroft at mbancroft@ruralcenter.org

CAH Nominee
Hospital Administrator
Flex Coordinator
Justification
Supporting documentation may be emailed to Angie LaFlamme at alaflamme@ruralcenter.org.
(0-3 points)
(0-2 points)
(0-5 points)
(0-2 points)
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This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,560,000 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.