critical access hospitals;
redesignation
SB 1238 allows a health care institution that terminates its Critical Access Hospital (CAH) designation to return to the provisions of its original license. The bill specifically provides an exemption from the law that requires a facility with a license that needs to be modified to be compliant with current building codes if it does not exceed its previously approved licensed capacity.
In 1997, the Balanced Budget Act was passed creating the Medicare Rural Hospital Flexibility Program. The Medicare Critical Access Hospital Program is a component of this program designed to allow rural hospitals to devote more resources towards emergency services while continuing to maintain their Medicare certification and receive sufficient Medicare reimbursement. These hospitals qualify for cost-based reimbursement from Medicaid agencies (AHCCCS) that is more favorable than a typical Medicare payment.
In order for a hospital to qualify to become a CAH, it must be all of the following:
1. Have an acute care bed limit of 15 beds.
2. Have an additional swing bed limit of 10 beds.
3. Have an average length of stay less than or equal to 96 hours
4. Provide 24-hour emergency care.
5. Participate in a network including a tertiary facility and EMS organization.
6. Participate in Medicare reimbursement program.
7. Located more than 35 miles from another hospital or 15 miles from another hospital in mountainous areas.
According to the Rural Health Office at the University of Arizona, as of 3/28/02 there are four health care institutions designated as CAH that include Southeast Arizona Medical Center, Benson Hospital, Northern Cochise Community Hospital and Wickenburg Regional Medical Center. There are at least six other health care institutions currently seeking CAH designation.
The Department of Health Services is responsible for reviewing the architectural plans and specifications of health care institutions as a condition for state licensure. If an institution applies for a new license or modifies an existing license, section 36-421 requires that the facility must be compliant with current building codes and standards.
In the event that a health care institution can no longer sustain a CAH designation, it must convert back to its original license status prior to becoming a CAH. Since the law requires that a health care institution that modifies its license to be compliant with current building code, the conversion may result in costly upgrades to bring older facilities into compliance.
SB 1238 allows a health care institution that has terminated its CAH designation to return to its original license and maintain compliance with the building codes that were in effect at the time the licensed was first received. The health care institution must not exceed its original licensed capacity prior to its designation or the institution will have meet current building codes.
· Allows a health care institution that was licensed as a critical access hospital to be exempt from having to make any modifications when requesting an amended license provided the institution is all of the following:
- The institution has terminated its critical access designation
- The bed capacity of the institution does not exceed the capacity that was approved before the institution converted to a critical access hospital
- The institution complies with codes and standards that were in effect when it was originally licensed.
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45th
Legislature
Second
Regular Session 2 April 17, 2002
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