Abstract
Strengthening the economic viability of Critical Access Hospitals (CAHs) to maintain access to appropriate healthcare services of high quality in rural areas is a major goal of the Medicare Rural Hospital Flexibility Program. As our nation’s rural hospitals continue to age, with many institutions (especially smaller facilities that typically converted to CAH status) over forty years old and in need of immediate renovation or replacement, access to capital has become critical. Without sufficient capital resources, hospitals face considerable challenges in keeping pace with depreciation, as well as remaining current with health code requirements, advances in medical technology, and changing population needs. This report describes current CAH capital needs and their experiences obtaining the capital critical for remaining compliant with fire and life safety codes and essential for maintaining effective and efficient operations.