A critical access hospital is an organization certified to receive cost-based reimbursement from Medicare. The reimbursement that CAHs receive is intended to improve their financial performance and therefore, reduce hospital closures. Each hospital must review its own situation to determine if CAH status would be advantageous. CAHs are certified under a different set of Medicare Conditions of Participation (CoP) that are more flexible than the acute care hospital CoPs.
As of March 2011, there were 1,327 certified CAHs throughout the United States. To become a CAH, hospitals must be located in a rural area and must either be more than 35 miles away from another hospital or 15 miles from another hospital in mountainous terrain or areas with only secondary roads. As of January 2008, all CAHs, including necessary provider CAHs that create or acquire an off-campus provider-based facility, such as a clinic or a psychiatric or rehabilitation district part unit, must meet the CAH distance requirement of a 35-mile drive to the nearest hospital or CAH.