Press Release

Statement on JAMA Report on Critical Access Hospitals

Rich Umbdenstock
President and CEO
American Hospital Association

July 5, 2011

Today's report does a disservice to critical access hospitals (CAHs) and paints an incomplete picture of the care they provide every day.  They are vital to their communities, operating in remote geographic locations with relatively small numbers of health professionals. 

The established protocol of CAHs is to transfer patients who may benefit from more aggressive treatment and who are clinically stable enough for transport to larger hospitals that provide some of the more advanced services cited in the report. Patients who are transferred from the CAH to a larger hospital, however, do not count in the performance information used in the study, thus creating a distorted picture of CAHs' overall quality.

The authors of this study imply that quality can only be good if these small, multiservice hospitals also have an intensive care unit, a cardiac catheterization service and other facilities that would be rarely used in that setting.  The reality is that CAHs are dedicated to providing safe, effective care to the communities they serve and work tirelessly to ensure patients get the right care at the right time.  To effectively transition patients to the right level of care, CAHs work with patients and their loved ones while taking into account weather and many other logistical challenges.  If not for CAHs, many patients would face long distances to get the care they need or simply go without access in critical situations.

About the AHA

The AHA is a not-for-profit association of health care provider organizations and individuals that are committed to the health improvement of their communities. The AHA is the national advocate for its members, which include nearly 5,000 hospitals, health care systems, networks, other providers of care and 43,000 individual members. Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends. For more information, visit the AHA website at

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