Which hospitals are considered rural?
Rural is defined as: all geographic areas 10 or more miles from the centroid of a population center of 40,000 or more. For a complete definition, visit What is Rural?
A Rural Hospital is characterized by one of the following:
- Type A Rural Hospitals : Remote with fewer than 50 beds, and more than 30 miles from the nearest hospital
- Type B Rural Hospitals : Rural with fewer than 50 beds, and 30 miles or less from the nearest hospital
- Type C Rural Hospitals : Rural with 50 or more beds
- Rural Referral Hospital : Federally designated as a rural referral center
Hospital Grant Programs Administered by ORH
Small Rural Hospital Improvement (SHIP)
The Office of Rural Health Policy's (ORHP) Small Rural Hospital Improvement (SHIP) grant program provides funding to small rural hospitals to help them do the following:
- Quality Improvement including Medicare Beneficiary Quality Improvement Project (MBQIP) implementation and reporting for CAHs.
- Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)
- International Statistical Classification of Diseases and Related Health Problems (ICD-10) activities
To be eligible for these grants, a hospital (defined as a non-federal, short-term, general acute care facility) must be:
- Small: 49 beds or less, as reported on the hospital's most recently filed Medicare Cost Report
- Rural: Located outside a Metropolitan Statistical Area (MSA); or located in a rural census tract of a MSA as determined under the Goldsmith Modification or the Rural Urban Commuting Areas (RUCA), and
- All designated Critical Access Hospitals (CAHs) are eligible, as well as hospitals with fewer than 50 beds located in an area designated by any State law or regulation as a rural area or as a rural hospital. There is no requirement for matching funds with this program.
Medicare Rural Hospital Flexibility (Flex)
The Medicare Rural Hospital Flexibility (Flex) Program, established by the Balanced Budget Act of 1997 (Public Law 105-33), is available to all 50 states. Its intent is to allow rural communities to preserve access to primary care and emergency health care services, provide health care services that meet community needs, and help assure the financial viability of small, rural hospitals.
The Flex Program enables certain rural hospitals to be classified as Critical Access Hospitals. A Critical Access Hospital (CAH) is able to improve its financial stability through enhanced Medicare reimbursement and reduced operating costs. The Flex grant program provides funding to each State Office of Rural Health for them to provide support to CAHs in three key areas:
- Quality Improvement
- Operational and Financial Improvement
- Health System Development and Community Engagement, including integrating EMS in regional and local systems of care
For more information on Oregon’s rural hospitals or the grant programs administered by ORH, please contact Maeve McClellan, Hospital Technical Assistance Specialist, | firstname.lastname@example.org | 503-494-4450 | toll-free 866-674-4376.