Texas has listed $223 million of rural grants as approved. Only $87 million has a signed contract, and the state says no grant counts as awarded until a contract is signed.
A new study looked at 14 rural Texas hospitals that closed between 2007 and 2018. Deaths from four emergencies rose more in the counties that lost them, and the counties touching those, than in other Texas counties with no closure nearby. Only 3 of the 14 closed hospitals were Critical Access Hospitals.
On September 18, CMS told surveyors how to check a critical access hospital's emergency protocols. They will pull emergency records, ask staff to walk through a protocol, and treat missing personnel as noncompliance.
The first round of this money has to be committed by October 30. Salary is the one cost that cannot be carried into next year. And across seven federal documents, staffing never comes up once.
Texas Medicaid payments to hospitals stopped for seventeen days in September. None of the news reports said whether critical access hospitals were among the ones that lost money. The state rules say they were.
New CMS guidance sets out how it will check whether a hospital still qualifies as Critical Access. Read it closely and the memo says a hospital gets two years to fix an eligibility problem, while the manual text attached to it says one.
A new Senate bill would make it easier for a rural emergency hospital to start admitting patients again. The news is covering it as a money story. It is really a staffing story, because admitted patients mean a licensed nurse on the floor every night.