When a rural hospital closes, it takes away life-saving
services from expecting mothers in labor who don’t have time to drive long
distances to the nearest hospital. When a rural hospital closes, it takes away
life-saving services from farmers at their wits end about making loan payments
and are contemplating suicide.
When a rural hospital closes,
parents don’t have an emergency room to take their child to when he or she
accidentally breaks their arm playing outside. The existence of a rural
hospital contributes to economic growth and can sustain a community, but more
importantly, it provides life-saving care to families, farmers and expecting
moms.
With more rural hospitals closing
across the United States, something must be done. In 2015, policymakers, hospitals
and rural health care leaders came together and developed a solution to stop
these closures. The goal was to give rural hospitals another option to keep
their doors open – a lifeline. A large contributor to rural hospital closures
is the cost of maintaining inpatient units.
Right now, government regulations
require hospitals to have beds for people to stay for several days – but many
of these rural hospitals rarely have more than a bed or two filled. Patients
needing longer stays or requiring complex surgery are typically transferred to
higher acuity hospitals. While it may make sense for some hospitals to maintain
full inpatient units, it may not work for a rural hospital struggling to remain
open.
This is where the new and voluntary
Rural Emergency Hospital (REH) program comes in. This new program is a lifeline
to rural communities whose alternative is seeing their hospital close. REH
gives rural hospitals the option to right-size their health care infrastructure
while maintaining essential medical services for their communities, such as
emergency and outpatient services.
For patients who need to remain in
a hospital for a longer stay than 24 hours, REHs will work closely with a
network of hospitals to transfer the patient to a higher level of care. This
flexibility may seem like common sense, but government regulations have
prevented an REH from existing up until a Grassley law was passed in December
2020.
Recently, the Centers for Medicare
& Medicaid Services (CMS), tasked with establishing REH rules, issued their
final regulations allowing REHs to exist. Starting this month, rural hospitals
will now have the option to become an REH. As a policymaker and hospital
leader, we look forward to reviewing the final regulations and administrative
efforts that CMS will take in the coming months to further implement the law.
REH is the most significant reform
to sustaining access to rural health care services in decades. It also builds
on decades of my successful efforts to support the critical access hospital program,
reauthorize the Medicare-dependent hospital program, establish and reauthorize
the low volume hospital program and establish and reauthorize the rural
community hospital demonstration, to name a few. We look forward to continue
partnering to ensure the law works for rural hospitals and communities as
Congress intended.
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