State Office of Rural Health

Rural Emergency Hospitals (REHs) are a new provider type established by the Consolidated Appropriations Act, 2021 to address the growing concern over closures of rural hospitals. The REH designation provides an opportunity for Critical Access Hospitals (CAHs) and certain rural hospitals (50 beds or less) to avert potential closure and continue to provide essential services for the communities they serve. Conversion to an REH allows for the provision of emergency services, observation care, and additional medical and health outpatient services, if elected by the REH, that do not exceed an annual per patient average of 24 hours. This new provider type, effective January 1, 2023 will promote equity in health care for those living in rural communities by facilitating access to needed services.


Technical Assistance:

National TA Center (launches 9/30/22)

As of September 2022, the Rural Health Redesign Center has been working in cooperation with the Health Resources and Services Administration (HRSA), and the Centers for Medicare and Medicaid Services (CMS) to provide technical assistance to rural hospitals across the nation interested in assessing the feasibility of the new Rural Emergency Hospital provider designation.

For more information, click here.


State Flex Program

 In addition to the funding to establish a national REH TA Center, the Federal Office of Rural Health Policy (FORHP) also received additional funding for each state to provide outreach and education to hospitals that may be interested in converting to this new provider type.

For more information, please visit: Virginia Flex Program



CMS- REHs Proposed Rule Making Fact Sheet

  • REH: Payment Policies
  • Conditions of Participation to Ensure Quality Care
  • REH Provider Enrollment
  • REH Physician Self-Referral Law Update
  • Next Steps


National Academy for State Health Policy