Frequently Asked Questions about
CRITICAL ACCESS HOSPITALS
I. Understanding the New Designation
What is a Critical Access Hospital (CAH)?
A Critical Access Hospital (CAH) is a special designation from the Centers for Medicare & Medicaid Services (CMS) for small, rural hospitals. This status is designed to help hospitals like WGH remain financially stable so they can continue to provide essential healthcare services. The designation allows for better Medicare and Medicaid reimbursement based on the cost of care.
How do you meet the criteria to become a Critical Access Hospital?
CMS allows rural community hospitals to apply if they meet certain criteria, including distance from other hospitals and a limit of 25 inpatient beds (plus 10 Behavioral Health and 15 Observation beds). The designation does not restrict outpatient services or volume in any way.
Why did WGH apply for this status?
To secure essential healthcare services for the community. Over the past three years, WGH has experienced impactful losses despite efforts to grow and reduce expenses. CAH status provides cost-based reimbursement which stabilizes our financials and allows us to remain an independent hospital.
II. Impact on Patient Care & Services
How does this designation affect the care I will receive?
The designation will not negatively impact the quality or availability of care. It is about financial stability, not a reduction in services. We will continue to offer 24/7 emergency services, a full range of inpatient and outpatient services, and specialty care such as general surgery, orthopedics, and urology.
Does this mean the hospital is "downsizing" its staff or beds?
No. We are not decreasing the number of staff or beds currently used to meet the community's needs.
What services will stay at WGH?
WGH remains a full-service hospital. We will continue to provide:
24/7 Emergency Services
Inpatient Specialty Care: General Surgery, Orthopedics and Sports Medicine, Gastrointestinal (GI), and Urology.
Full Outpatient Services: Including RehabWorks (PT, OT, Speech, Cardiac/Pulmonology Rehab), Cancer Care Center (Hematology/Oncology and Radiation Oncology), Diagnostic Imaging, Lab, Pathology, Wound Care, Same Day Surgery, and Walk-In Care.
Warren Medical Group (WMG): Care delivered at WMG offices is not restricted by this change and includes Family Medicine and Pediatrics, Women’s Health, Orthopedics, Urology, Eye Care and General Surgery.
III. Maternity & Labor and Delivery (L&D)
Is the L&D unit closing because of the Critical Access status?
No. These are two separate, unrelated situations. The CAH designation has been pursued for 12 months as a way to stabilize hospital finances. The discontinuation of inpatient Labor and Delivery is a safety-driven decision caused by a national shortage of OB/GYN physicians and the sudden unavailability of a provider.
Will Women’s Health and GYN services still be available at WGH?
Yes. Women’s Care and GYN remains a core specialty at WGH. We will continue to provide prenatal care, postpartum support, and gynecological wellness exams close to home.
IV. Costs and the Local Economy
Will this change how much I pay for healthcare?
For most patients, there will be no noticeable change to out-of-pocket costs. This status primarily changes how the federal government reimburses the hospital. Your insurance benefits, deductibles, and plan structure will not change.
How does this help the Warren community and local economy?
By ensuring WGH remains financially strong, we preserve hundreds of local jobs and ensure Warren County doesn't become a "healthcare desert." As a large employer, our stability contributes directly to the economic well-being of the region. A strong local hospital also helps other area businesses with their own recruitment efforts.
Why Am I getting a bill for an old visit?
Our hospital's status changed, and Medicare is retroactively adjusting how they pay those dates effective January 14.
Did My insurance change?
No, your Medicare coverage is the same, but the method they use to pay us has updated.
Will my out of pocket be higher?
It might be slightly different. CAH billing is based on costs, so your 20% coinsurance might reflect those updated costs.
Can I set up a payment plan?
Our hospital's status changed, and Medicare is retroactively adjusting how they pay those dates effective January 14.