Each state was asked to respond to the following question:
In each of the following program areas, please list up to three top Flex activities in your state for FY2016, and include information on how you measure this/these activities. Also, if applicable, please include information on past work for this/these activities if your current work is building upon it.
The following responses relate to Program Area: Support for Designation of Critical Access Hospitals (CAHs).
The Alabama Flex Program is currently working with one hospital that is looking into converting to CAH status.View Alabama's State Flex Profile >
AzFlex continues to assess the interest of eligible hospitals for CAH designation. Two hospitals are currently eligible for CAH designation in Arizona. AzFlex is providing technical assistance to one eligible hospital interested in exploring CAH designation. Another Indian Health Services (IHS) hospital is in the process of being built and will be eligible for CAH designation based on size and location to other hospitals.View Arizona's State Flex Profile >
One of the original intents of the Flex Program was for states to assist eligible rural hospitals convert to CAH status to safeguard access to care in vulnerable rural areas. While these activities have decreased over the years as most eligible hospitals have already converted, there is still periodic need for these assessments and assistance. CRHC has provided recent assistance in this area. Four facilities are in the process of completing feasibility analyses with the intent to convert from prospective payment system (PPS) hospitals to CAH within the year. CRHC continues to keep resources pertaining to the CAH Conversion process up-to-date and will offer assistance to any hospital inquiring about its options.View Colorado's State Flex Profile >
ICAHN did not request funding for designation assistance; however, ICAHN provides ongoing support to small hospitals as needed to convert to CAH status. Right now, two small rural hospitals are still seeking CAH designation but have yet to be approved after two years in review.View Illinois's State Flex Profile >
The Flex Program will provide technical assistance to rural communities or hospitals seeking CAH status or conversion to CAH status.View Missouri's State Flex Profile >
New Mexico has two new hospitals interested in CAH designation and OPCRH will assist these hospitals in the process.View New Mexico's State Flex Profile >
Assistance provided by the Oklahoma Office of Rural Health for CAH conversion is on an as-needed basis. Staff will provide documentation and data when requested by a hospital that is considering the CAH designation to see if location, payer mix, etc. meet the criteria to be eligible for conversion. Oklahoma has recently had two new CAH conversions.View Oklahoma's State Flex Profile >
Pennsylvania has had a renewed interest in hospitals seeking CAH designation. Since December 2014, three hospitals have converted to CAH designation, with the most recent occurring in November 2016. None of these hospitals were originally considered in 2001 for designation since all were over 50 beds. Two of the hospitals were approved with the secondary road waiver while one used the mountainous terrain waiver. The use of GIS technology assisted in identifying the necessary terrain necessary to meet the Centers for Medicare & Medicaid Services (CMS) regulations.View Pennsylvania's State Flex Profile >
South Carolina provides activities that support appropriate conversion of small rural hospitals to CAH status. This is done by monitoring the state of all rural hospitals to determine the likelihood of conversion or closure as well as providing technical assistance as requested to communities seeking to convert to CAH status, decertify from CAH status or relocate/reopen/convert to other types of facilities. Success is measured by the status of rural hospitals reviewed semi-annually and at-risk facilities documented, and the number of technical assistance requests received.View South Carolina's State Flex Profile >
If requested, the Texas Flex Program will provide technical assistance through conference calls and site visits, if necessary. Financial support for the feasibility study for CAH status conversion will also be provided.View Texas's State Flex Profile >
The Flex Program previously assisted a rural hospital in developing CAH policies and procedures through a qualified vendor. This rural hospital converted to CAH on July 1, 2016. Additionally, the program is working with a second hospital who intends to convert to CAH status beginning January 2017.View Utah's State Flex Profile >
Virginia has one newly designated CAH as of May 2016. The State Flex Coordinator continues to provide support and technical assistance to another previously closed SHIP-eligible hospital that is completing the CAH Designation Application process.View Virginia's State Flex Profile >