Medicare has established Rural Emergency Hospitals (REHs) as a new Medicare provider type to address the growing concern over closures of rural hospitals.
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Who Can Convert to an REH
A facility is eligible to convert to an REH if it was a Critical Access Hospital (CAH) or rural hospital with not more than 50 beds as of December 27, 2020 (including a hospital that closed after December 27, 2020). REHs must provide emergency services and observation care and are prohibited by the statute from providing inpatient services.
Notification
Notify the MSDH Office of Licensure of the intent to convert to a REH on facility letterhead to HFLC-NLTC@msdh.ms.gov.
Required Documents
The following documents must be included with CMS Federal Enrollment application (CMS PECOS) and State Licensure application:
- EXHIBIT: Model Attestation
- EXHIBIT: Model REH Action Plan
- Copy of executed Transfer Agreement(s) with Level I and/or Level II Trauma Center as required by
42 CFR § 485.538 Condition of Participation: Agreement.
See the CMS document QSO-23-07-REH for details: - QSO-23-07-REH: Guidance for Rural Emergency Hospital Conversion CMS
Federal Application: How to Enroll
Prior to completing the licensure application, facilities should complete the CMS enrollment process to convert to a REH. See the following for enrollment steps:
- QSO-23-07-REH
- REH Medicare Provider Instructions
- MLN2259384: CMS Rural Emergency Hospital Enrollment
Complete CMS Enrollment through the CMS PECOS website:
- Visit the PECOS website
- REH Enrollment Instructions provide details on PECOS use.
REH Initial Survey
Eligible facilities that are existing CAHs and hospitals converting to an REH may attest to meeting the REH CoPs and will not require an automatic on-site initial survey as eligible facilities are expected to be in full compliance with the existing CAH and hospital requirements (as applicable) at the time of the request for conversion (See QSO-23-07-REH for full details).
License Application
After CMS has approved the conversion to a REH and the facility has received their new CMS REH provider number with effective date, complete this online license application:
Fees: There are no licensure fees to convert to a REH.
License Effective Date: Upon approval of the licensure application, the MSDH License Administrator will issue a REH License backdated to the effective CMS REH Certification date.
Certificate of Need (CON): CON approval is not required to convert to a REH. However, after receiving CMS Certification as an REH, your facility must contact the MSDH Office of Health Policy and Planning (CON) at (601) 576-7874 to request placing inpatient beds in abeyance (do not include acute beds allocated for a SNF Unit).
SNF Unit: Facilities considering adding SNF services in a Distinct Part Unit:
- Contact the CON Office for a Determination.
- Complete the CMS enrollment process: Contact the MSDH Long Term Care Division for additional information at 601‑364‑1110.
License Renewal
REH License year is January 1 – December 31.
- Renewal notices are sent in October.
- The annual renewal fee is $661.25.
Contact the MSDH License Administrator at (601) 364-2722 with any questions.
