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CMS Updates the CAH Manual

October 12th, 2016

CMS updated the Critical Access Hospitals (CAH) on July 31, making the manual now 270 pages long. CMS had just rewritten a third of it on April 7. This included sections on pharmacy, nursing, dietary, infection control, contracted services, and rehab. This was the biggest revisions since the inception of the CAH program. These changes can be reviewed by clicking on the manual under Appendix W.

CMS issued a 24-page transmittal on July 31 discussing the changes. It revises four tag numbers: 160, 162, 165, and 168, all concerning the loss of rural status for some CAHs because of the adoption of the latest Office of Management and Budget metropolitan statistical area delineations.

Now CMS makes some additional revisions to clarify existing guidance related to requirements concerning CAH location requirements relative to other CAHs or hospitals. Changes were also made to the State Operations Manual under chapter two on the certification process. For example, any new hospital that wants to be certified as a CAH will be assessed first to make sure they meet the CAH criteria. This includes determining compliance with the location and distance requirements. All CAHs, including necessary provider CAHs, must be located in a rural area which is outside a Metropolitan Statistical Area.

The revised CAH manual can be accessed here, under Appendix W.