Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0050 - Rural Health, Office of
Chapter 3 - DESIGNATION OF CRITICAL ACCESS HOSPITAL
Section 3-6 - Criteria

Universal Citation: WY Code of Rules 3-6

Current through September 21, 2024

(a) Critical Access Hospital Requirements.

(i) Each Critical Access Hospital shall comply with criteria set forth in Social Security Act Section 1820. [ 42 U.S.C. 1395i-4] (c). This document is available at the website http://www.ssa.gov/OP_Home/ssact/title18/1820.htm.

(ii) Key Criteria for designation include:
(A) A facility shall be currently participating Medicare hospital, a hospital that ceased operation on or after November 29, 1989, or a health care clinic or health center that ceased operation as a hospital before being downsized to a health clinic or health center.

(B) A facility located more than 35-mile drive from any other hospital (or, in the case of mountainous terrain or in areas with only secondary roads available, a 15-mile drive) or Critical Access Hospital unless designated by the Department of Health, prior to January 1, 2006 to be a necessary provider.

(C) The facility makes available 24-hour emergency medical services that the State determines are necessary for ensuring access to emergency care services in each area served by a Critical Access Hospital (consistent with the Wyoming Trauma Plan).

(D) The facility provides not more than twenty five (25) acute care inpatient beds or in the case of a Critical Access Hospital with a swing bed agreement, swing beds.

(E) The facility provides inpatient care for a period that does not exceed, as determined on an annual, average basis, ninety-six (96) hours per patient, unless a longer period is required because:
(I) Transfer to a hospital is precluded because of inclement weather or other emergency conditions, or;

(II) A peer review organization or equivalent entity, upon request, waives the 96-hour restriction on a case-by-case basis;

(F) The facility meets such staffing requirements as would apply to a hospital located in a rural area, except that:
(I) The facility need not meet hospital standards relating to the number of hours during a day, or days during a week, in which it must be open and fully staffed, except as required to make available emergency medical care services as described above and must have nursing services available on a 24-hour basis, but need not otherwise staff the facility except when an inpatient is present;

(G) The facility may provide the services of a dietitian, pharmacist, laboratory technician, medical technologist, and/or radiological technologist on a part-time, off site basis; and

(H) The inpatient care described may be provided by a Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist subject to the oversight of a physician who need not be present in the facility.

(I) Documentation of agreements for the following services with one or more hospitals for;
(I) Patient referral and transfer;

(II) Development and use of communications systems including telemetry systems and systems for electronic sharing of patient data;

(III) Provision of emergency and non-emergency transportation; and

(IV) Documentation of agreement with respect to credentialing and quality assurance with one or more hospitals or a peer review organization or equivalent entity.

(b) Necessary Provider Requirements.

The following criteria will be used to certify a facility as being a necessary provider of health care services to residents in an area. The facility will be designated as a necessary provider of health care services if it meets two (2) of the following criteria:

(i) The facility is located in an area that meets the criteria for designation as a Health Professional Shortage Area (HPSA)as defined by 42 Code of Federal Regulations, Chapter 1, Part 5, or Medically Underserved Area (MUA) as defined by Public Law 99-280, Federal Register, October 15,1976, Pages 45718-45723.

(ii) The facility has been designated a Sole Community Provider as defined by the Department of Health's Rural Health Care Plan.

(iii) The facility was licensed by the State as a hospital and has been closed for no more than ten (10) years.

(iv) The board has determined that the ongoing operation of the facility is in danger of financial insolvency and has passed a board resolution allowing the facility to apply for a Critical Access Hospital designation. This does not apply to closed facilities.

(v) The Director, Department of Health, must designate the facility as a Critical Access Hospital before state licensure or federal (Medicare) certification can be pursued.

Disclaimer: These regulations may not be the most recent version. Wyoming may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.