What are the requirements for relocating an existing CAH under the Necessary Provider replacement rules?
CAHs that have been granted Necessary Provider status and want to rebuild in a new location that does not meet the distance requirements of the 35-mile rule will be treated in the same manner as if they were building a replacement facility at the previous location. The new CAH facility will have to continue to meet the same criteria that led to its original state designation, serve at least 75% of the same service area, offer 75% of the same services, and utilize at least 75% of the same staff in its new location. See the September 7, 2007 letter from CMS to State Survey Agency Directors titled Critical Access Hospitals (CAHs): Distance from Other Providers and Relocation of CAHs with a Necessary Provider Designation for more detailed information.
CAHs that have been granted Necessary Provider status and want to rebuild in a new location that does not meet the distance requirements of the 35-mile rule will be treated in the same manner as if they were building a replacement facility at the previous location. The new CAH facility will have to continue to meet the same criteria that led to its original state designation, serve at least 75% of the same service area, offer 75% of the same services, and utilize at least 75% of the same staff in its new location. See the September 7, 2007 letter from CMS to State Survey Agency Directors titled Critical Access Hospitals (CAHs): Distance from Other Providers and Relocation of CAHs with a Necessary Provider Designation for more detailed information. Additional requirements may exist due to the state’s rules regarding Necessary Provider designation. For more information, contact your State Rural Hospital Flexibility Program Contact.
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