By Roger Barnhart

While talking with volunteers at the information desk, in walks the sweetest elderly couple. Both were in their mid to late 80s. The wife is using a cane with one hand and holding onto her husband for support with the other. 

An early August day, outside temperatures were in the upper 90s. It was my first week working within a $40M health system as interim CEO and consultant. The facility offered a vast array of both general and specialized services. Without counting the licensed beds, one would never know it was not an urban health system, but rather a Critical Access Hospital.

by Roger Barnhart

The landscape within rural communities was very different in 1977 than it was 20 years later when Congress created the Critical Access Hospital (CAH) designation through the Balanced Budget Act of 1997. The intent was to reduce the financial vulnerability of rural hospitals and improve access to healthcare by keeping essential services in rural communities. In the 20+ years since, healthcare and the settings in which it is provided (and subsequent regulations) has continued to evolve.