Rural Hospitals (Flex Program)
“The Flex Program” refers to the Medicare Rural Hospital Flexibility Program, which was created by Congress in 1997. It allows small hospitals to be certified as Critical Access Hospitals (CAHs) and offers grants to States to help implement initiatives to strengthen the rural health care infrastructure. The grant program is administered by the Health Resources Service Administration’s Federal Office of Rural Health Policy. HRSA is a division of the U.S. Department of Health and Human Services.

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2019

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Improving Rural Systems of Care for Time Critical Diagnoses: A Review of State Flex Program Activities, John A. Gale MS and Karen B. Pearson

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Implementation of the Flex Program's Innovative Models Program Area: Final Evaluation Report, John Gale MS, Sara Kahn-Troster MPH, and Andrew Coburn PhD

2018

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Critical Access Hospitals' Community Benefit Activities: An Updated Review, John A. Gale MS, Zach T. Croll BA, Lauren Zoll MPH, and Andrew Coburn PhD

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Critical Access Hospitals' Community Health Needs Assessments and Implementation Plans: How do they Align?, John A. Gale MS, Zach T. Croll BA, Lauren Zoll MPH, and Andrew F. Coburn PhD

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An Interim Evaluation Report of the Innovative Projects Portfolio of the Flex Program, Sara Kahn-Troster MPH; John A. Gale MS; Anush Yousefian Hansen MS,MA; and Andrew F. Coburn PhD

2017

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After Closure: Options for Pursuing a High Performance Rural Health System, Andrew F. Coburn PhD

2016

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Comparing the Community Benefit Spending of Critical Access, Other Rural, and Urban Hospitals, John A. Gale MS, Zach T. Croll, Andrew F. Coburn PhD, and Jamar Croom MS

2015

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Critical Access Hospital-Relevant Measures for Health System Development and Population Health, John A. Gale MS, Andrew F. Coburn PhD, and Zach T. Croll

2014

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Turning around the struggling rural hospital: Shared responsibility and hard work, John A. Gale MS

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Collaborative Community Health Needs Assessments: Approaches and Benefits for Critical Access Hospitals, John A. Gale MS, Andrew F. Coburn PhD, and Helen E. Newton BA

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Community Paramedicine in Rural Areas: State and local findings and the role of the state Flex program, Karen B. Pearson MLIS, MA; John A. Gale MS; and George Shaler MPH

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The Evidence for Community Paramedicine in Rural Areas: State and local findings and the role of the state Flex program, Karen B. Pearson MLIS, MA; John A. Gale MS; and George Shaler MPH

2013

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Rural acute myocardial infarction survey (RAMIS), Nikiah Nudell BA, NRP; Tom Bouthillet NREMT-P; Don Rice MD; John A. Gale MS; and Gary Wingrove EMT-P

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Emergency Transfers of the Elderly from Nursing Facilities to Critical Access Hospitals: Opportunities for improving patient safety and quality, Karen B. Pearson MLIS, MA and Andrew F. Coburn PhD

2012

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Promoting a Culture of Safety: Use of the Hospital Survey On Patient Safety Culture in Critical Access Hospitals [Policy Brief], Andrew F. Coburn PhD; Zach T. Croll BA; and Karen B. Pearson MLIS, MA

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Promoting a Culture of Safety: Use of the Hospital Survey on Patient Safety Culture in Critical Access Hospitals [Briefing Paper], Zach T. Croll BA; Andrew F. Coburn PhD; and Karen B. Pearson MLIS, MA

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Community benefit activities of critical access hospitals, non-metropolitan hospitals and metropolitan hospitals, Zach T. Croll BA, John A. Gale MS, and Andrew F. Coburn PhD

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Why Do Some Critical Access Hospitals Close Their Skilled Nursing Facility Services While Others Retain Them? [Briefing Paper], John A. Gale MS; Zach T. Croll BA; Andrew F. Coburn PhD; and Walter R. Gregg MA, MPH

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Why Do Some Critical Access Hospitals Close Their Skilled Nursing Facility Services While Others Retain Them? [Policy Brief], John A. Gale MS; Zach T. Croll BA; Walter Gregg MA, MPH; and Andrew F. Coburn PhD

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Evidence-Based Falls Prevention in Critical Access Hospitals, Karen B. Pearson MLIS, MA and Andrew F. Coburn PhD

2011

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Improving Hospital Patient Safety Through Teamwork: The Use of TeamSTEPPS In Critical Access Hospitals, Andrew F. Coburn PhD and Zach T. Croll BA

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Developing regional STEMI systems of care: A review of the evidence and the role of the Flex program, John A. Gale MS

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Provision of long term care services by critical access hospitals: Are things changing?, Melanie Race MS, John A. Gale MS, and Andrew F. Coburn PhD

2010

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The Role of State Flex Programs in Supporting Quality Improvement in Critical Access Hospitals, Andrew F. Coburn PhD; John A. Gale MS; Mark Richards BA; and Anush Yousefian Hansen MS,MA

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Models For Quality Improvement In Critical Access Hospitals: The Role Of State Flex Programs, Andrew F. Coburn PhD; John A. Gale MS; Mark Richards BA; Anush Yousefian Hansen MS, MA; and Melanie Race MS

2009

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Policy Issues Affecting Maine’s Hospitals, John A. Gale MS and Jennifer D. Lenardson MHS

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A community benefit reporting toolkit for critical access hospitals, John A. Gale MS and Melanie Race MS

2007

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The Community Impact of Critical Access Hospitals, John A. Gale MS; Andrew F. Coburn PhD; Victoria Freeman DrPH; Walter R. Gregg MA, MPH; and Rebecca T. Slifkin PhD

2006

Rural Hospitals and Long-term Care: The Challenges of Diversification and Integration Strategies, Andrew F. Coburn PhD, Stephenie Loux MS, and Elise J. Bolda PhD

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Creating Progam Logic Models: A Toolkit for State Flex Programs, John A. Gale MS, Andrew F. Coburn PhD, and Stephanie Loux MS

2005

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Scope of services offered by Critical Access Hospitals: Results of the 2004 National CAH survey, David Hartley PhD, MHA and Stephenie L. Loux MS