Limits...
Choosing to convert to critical access hospital status.

Dalton K, Slifkin R, Poley S, Fruhbeis M - Health Care Financ Rev (2003)

Bottom Line: Counties where CAHs are located are more sparsely populated, but do not have substantially different sociodemographic profiles than other rural counties.Converting hospitals' acute daily census averaged well below the statutory limit of 15, but over one-half reduced unused bed capacity to meet CAH size limitations.The average case-mix adjusted Medicare cost per case was 16-percent higher for CAH converters than for other small hospitals and their financial ratios were substantially worse, although many other operating characteristics were similar.

View Article: PubMed Central - PubMed

Affiliation: University of North Carolina at Chapel Hill, USA. kathleen_dalton@unc.edu

ABSTRACT
The authors profile facilities converting to critical access hospitals (CAHs) from 1998-2000, comparing characteristics of their communities, operations, and finances to those of other small rural providers. Counties where CAHs are located are more sparsely populated, but do not have substantially different sociodemographic profiles than other rural counties. Converting hospitals' acute daily census averaged well below the statutory limit of 15, but over one-half reduced unused bed capacity to meet CAH size limitations. The average case-mix adjusted Medicare cost per case was 16-percent higher for CAH converters than for other small hospitals and their financial ratios were substantially worse, although many other operating characteristics were similar.

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Distribution of Bed Capacity in Hospitals Converting to CAH Compared to Other Low-Volume Hospitals: Fiscal Year 1998
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Related In: Results  -  Collection


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f2-hcfr-25-1-115: Distribution of Bed Capacity in Hospitals Converting to CAH Compared to Other Low-Volume Hospitals: Fiscal Year 1998

Mentions: It is reasonable to assume that encouraging hospitals to reduce unneeded capacity was at least a secondary policy objective of the Flex Program. Based on reported capacity at the end of the FY 1998 period, the program has been successful in this regard (Figure 2). For the group of CAH converters in our sample that filed FY 1998 cost reports, 3,013 out of a total of 13,025 non-nursery beds will have been closed by the time each hospital received its designation as a CAH—a 23-percent reduction in their aggregate capacity. It is possible that some of the beds identified in the cost reports may have been licensed, but never open (even though cost report instructions request that hospitals report only the number of beds that are open and available for patient care, some hospitals may report licensed capacity instead). The effect that capacity reductions will have on CAHs' average costs will ultimately depend on how many of the empty beds had actually been staffed, and on the use to which the former inpatient space is put.


Choosing to convert to critical access hospital status.

Dalton K, Slifkin R, Poley S, Fruhbeis M - Health Care Financ Rev (2003)

Distribution of Bed Capacity in Hospitals Converting to CAH Compared to Other Low-Volume Hospitals: Fiscal Year 1998
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4194839&req=5

f2-hcfr-25-1-115: Distribution of Bed Capacity in Hospitals Converting to CAH Compared to Other Low-Volume Hospitals: Fiscal Year 1998
Mentions: It is reasonable to assume that encouraging hospitals to reduce unneeded capacity was at least a secondary policy objective of the Flex Program. Based on reported capacity at the end of the FY 1998 period, the program has been successful in this regard (Figure 2). For the group of CAH converters in our sample that filed FY 1998 cost reports, 3,013 out of a total of 13,025 non-nursery beds will have been closed by the time each hospital received its designation as a CAH—a 23-percent reduction in their aggregate capacity. It is possible that some of the beds identified in the cost reports may have been licensed, but never open (even though cost report instructions request that hospitals report only the number of beds that are open and available for patient care, some hospitals may report licensed capacity instead). The effect that capacity reductions will have on CAHs' average costs will ultimately depend on how many of the empty beds had actually been staffed, and on the use to which the former inpatient space is put.

Bottom Line: Counties where CAHs are located are more sparsely populated, but do not have substantially different sociodemographic profiles than other rural counties.Converting hospitals' acute daily census averaged well below the statutory limit of 15, but over one-half reduced unused bed capacity to meet CAH size limitations.The average case-mix adjusted Medicare cost per case was 16-percent higher for CAH converters than for other small hospitals and their financial ratios were substantially worse, although many other operating characteristics were similar.

View Article: PubMed Central - PubMed

Affiliation: University of North Carolina at Chapel Hill, USA. kathleen_dalton@unc.edu

ABSTRACT
The authors profile facilities converting to critical access hospitals (CAHs) from 1998-2000, comparing characteristics of their communities, operations, and finances to those of other small rural providers. Counties where CAHs are located are more sparsely populated, but do not have substantially different sociodemographic profiles than other rural counties. Converting hospitals' acute daily census averaged well below the statutory limit of 15, but over one-half reduced unused bed capacity to meet CAH size limitations. The average case-mix adjusted Medicare cost per case was 16-percent higher for CAH converters than for other small hospitals and their financial ratios were substantially worse, although many other operating characteristics were similar.

Show MeSH