Legislation Gives Bed Flexibility to Critical Access Hospitals

The American Hospital Association has sent a letter to U.S. Rep. Greg Walden (R-Ore.) applauding his introduction of legislation to give more bed flexibility to critical access hospitals.


The American Hospital Association has sent a letter to U.S. Rep. Greg Walden (R-Ore.) applauding his introduction of legislation to give more bed flexibility to critical access hospitals.

Passage of the bill, H.R. 3444 and referred to the House Ways & Means Committee, is necessary to prevent CAHs from having to divert or transfer patients because they have hit their cap of 25 beds per day, according to the AHA. Here is text of the association’s Nov. 6 letter to Walden:

“On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, and our 43,000 individual members, the American Hospital Association is pleased to support the Critical Access Flexibility Act (H.R. 3444). This legislation would allow critical access hospitals to have much needed flexibility that would help them adjust with their communities’ daily ebb and flow of patient care.

“Under the current requirements for a CAH, a hospital can have up to 25 patient beds per day. Unfortunately, hospitals cannot always anticipate the patient count and find that turning patients away is unavoidable. H.R. 3444’s additional flexible option would allow for CAHs to accommodate daily and seasonal fluctuations. For example, one day a hospital bed count may be at 10 and the next at 30. A hospital in this instance would not need to turn away patients or interrupt continuity of care. This legislation would allow current CAHs the option to have an average annual daily census of 20 throughout the year.

“Many current CAHs have average censuses well under 25 beds but have seasonal or daily fluctuations that could drive their daily census above 25. When this happens, they are required to divert patients to another hospital. High volumes of obstetric patients often force hospitals to transfer other patients already admitted to the hospital at the expense of the Medicare program due to EMTALA restrictions on diverting a patient that is in labor. This bill will address these problems and provide increased flexibility to better accommodate patients’ needs.

“Again, we applaud your efforts and are pleased to support H.R. 3444. We look forward to working with you and your colleagues to achieve passage of this bill.”

Text of the legislation is available here.

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