CMS Releases Proposed Conditions for Rural Emergency Hospital Designation

The goal for the proposed Rural Emergency Hospital rule is to establish Conditions of Participation to ensure the health and safety of patients who will receive these services.

By Mackenna Moralez


CMS released proposed conditions for hospitals looking to receive the rural emergency hospital designation. Rural Emergency Hospital (REH) is a new Medicare provider designation that aims to create an opportunity for small rural hospitals and critical access hospitals to offer more services and avoid potential closure. 

There are over 500 rural hospitals at immediate risk of closure due to financial losses and lack of financial reserves to sustain operations, according to a report by the Center for Healthcare Quality and Price Reform. Most states have at least one rural hospital at immediate risk of closure, and in 21 states, 25 percent or more of the rural hospitals are at risk.  

Most rural hospitals at risk of closing are in isolated rural communities. If closed, residents no longer would be able to receive emergency or inpatient care without having to travel great distances. In some cases, these facilities are the only place where residents can get laboratory tests or imaging studies done.  

Read Next: CMS Issues Guidance on Long-Term Care Compliance

The goal for the proposed REH rule is to establish conditions of participation (CoPs) to ensure the health and safety of patients who will receive these services in the most efficient manner possible while taking into consideration the access and quality of care needs of an REH’s patient population. 

According to a release by CMS, the proposed standards for REHs closely align with CAH CoPs in most cases, while taking into account the uniqueness of REHs and statutory requirements. In some instances, the proposed REH policies closely align to the current hospital and ambulatory surgical center standards, such as the polices for outpatient services’ requirements and life safety code, respectively. CMS is seeking input from the rural community on specific proposed REH standards, including the ability of an REH to provide low-risk childbirth-related labor and delivery services and whether CMS should require that an REH also provide outpatient surgical services if surgical labor and delivery intervention is necessary. Eligible rural emergency hospitals will receive payment for services provided on or after Jan. 1. 

The final rule for the REH CoPs is expected to be included in the CY 2023 OPPS/ASC final rule, anticipated this fall. 

Mackenna Moralez is the associate editor for Healthcare Facilities Today 



July 15, 2022


Topic Area: Maintenance and Operations


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