Critical Access Hospital Information
Critical Access Hospitals (CAH)
A Critical Access Hospital applicant must:
- Be located outside a Metropolitan Statistical Area and
- Be located in a rural county or a rural area of an urban county
- Be 35 miles from another hospital, or be declared a "necessary provider of health care services"–based on criteria identified in the Wisconsin Rural Health Plan.
A Critical Access Hospital:
- Operates with a limit of 25 beds. If a swing-bed approval has been granted, all 25 beds can be used interchangeably for acute care or swing-bed services;
- Not exceed an average annual inpatient stay of 96-hour;
- Provide 24-hour emergency medical services;
- Make available 24-hour nursing services when patients are present in the facility; (staff may be on call if there are no patients);
- Be part of a rural health network, i.e., has entered into an agreement with a general hospital regarding, at a minimum, patient referral and transfer.
Critical Access Hospital applicants are encouraged to enter into arrangements–or agreements–with network or referral hospitals for:
- Development and use of communication systems, and where feasible, telemetry systems, electronic sharing of patient data, etc.;
- Provision of emergency and non-emergency transportation from or to CAHs;
- Staff training opportunities; and
- Credentialing and quality assurance assessments.
A Critical Access Hospital’s licensure status:
- Allows practices by physician assistants, nurse practitioners, or clinical nurse specialists with oversight by physicians who may be off-site; and
- Permits practice arrangements for part-time, off-site dietitians, pharmacists, laboratory technicians, medical or radiological technologists, and others.
For permanent rules that apply to the Critical Access Hospital Program, refer to Chapter HFS 124, subchapter VI. Federal criteria for participation in the Critical Access Hospital program are part the Balanced Budget Act of 1997, (Public Law 105-33), the Balanced Budget Refinement Act of 1999, (Public Law 106-113) and the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Public Law 108-173).