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CMS Proposes Conditions of Participation for Rural Emergency Hospitals; Summary Available

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Last week, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule on conditions of participation (CoPs) for rural emergency hospitals (REHs), a provider type created by the Consolidated Appropriations Act of 2021. Under this provider type, critical access hospitals (CAHs) and certain rural hospitals could convert to an REH.  

In the proposed rule, CMS aligns many of the REH CoPs with existing CoPs for CAHs and acute care hospitals. Given the unique nature of REHs, CMS seeks comment on the following areas: 

  • The ability of an REH to provide low-risk childbirth-related labor and delivery services 
  • Whether CMS should require that an REH also provide outpatient surgical services in the event that surgical labor and delivery intervention is necessary  
  • Whether it is appropriate for an REH to allow a doctor of medicine or osteopathy, a physician assistant, a nurse practitioner, or a clinical nurse specialist — with training or experience in emergency medicine — to be on call and immediately available by telephone or radio and available on-site within specified time frames 

The rule also proposes changes to the CAH CoPs, which would alter the primary road and distance requirements and establish a patient’s right CoP. In addition, for CAHs that are part of a health system, the proposed rule allows for certain CoP requirements to be met if the system has a structure in place to satisfy the requirement and the CAH participates in that structure.   

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