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RMCHCS Pursues Critical Access Hospital Designation


Rehoboth McKinley Christian Health Care Services (RMCHCS) is pursuing conversion to a Critical Access Hospital (CAH). Under the CAH model, a hospital operates 25 or fewer inpatient beds and receives certain benefits, such as cost-based reimbursement for Medicare services. Once a hospital converts, CAH status must be maintained per location and other requirements.

Why the change?

Conversion to CAH supports RMCHCS' financial health. In addition, RMCHCS would be able to add skilled nursing services with a swing bed program. Skilled nursing services would help RMCHCS transition acute care patients to skilled care without leaving the community.

Are CAHs new?

Critical Access Hospitals are not new. In fact, among the 6,093 U.S. hospitals, about 1,360 are CAHs. Congress created CAH designation in 1997 to reduce the financial vulnerability of rural hospitals and improve access to healthcare by keeping essential services in rural communities.


There are several steps to take and RMCHCS is beginning the process to apply for CAH to the Centers for Medicare & Medicaid Services (CMS). It takes at least 8 months to receive determination from CMS.

What This Means

CAH status does not necessarily mean fewer services or reducing services. In fact, CAH is intended to provide the infrastructure needed to improve the hospital's strength and performance.

Our service offerings, even as we apply for CAH, depend on the availability of providers and/or funding. We are concurrently evaluating several services for sustainability as well as services the community needs, including some temporarily closed. If RMCHCS is approved for CAH status, our inpatient beds would move from 49 beds to 25 beds.

All services RMCHCS provides to the community will maintain or exceed high quality of care standards, consistent with our mission.

Read more about Critical Access Hospitals from the Rural Health Information Hub.