Listed by publication date. You can also view these publications alphabetically.
- CAH Financial Indicators Report: Summary of Indicator Medians by State
Summarizes Critical Access Hospital (CAH) financial indicators for 2003, providing state and national medians for each indicator. The indicators are grouped by financial dimension: profitability, liquidity, capital structure, revenue, cost, and utilization. The number of CAHs included in the median calculations is also provided. Information about the definition and interpretation of the indicators can be found in the full report, Briefing Paper No. 7, Financial Indicators for Critical Access Hospitals. Report produced by the Flex Monitoring Project, funded by the Office of Rural Health Policy.
- Availability and Use of Capital by Critical Access Hospitals
Examines the experiences of Critical Access Hospitals (CAHs) in meeting their capital needs. It focuses specifically on their efforts to obtain capital, the capital sources tapped through these efforts, how CAHs have used the capital they have been able to obtain over the past few years, and assesses their current capital needs. Report produced by the Flex Monitoring Project, funded by the Office of Rural Health Policy.
- Rate of Return on Capital Investments at Small Rural Hospitals
Examines whether the aging of rural facilities, a major problem among rural hospitals, is due to a lower rate of return on capital investment at these hospitals. This paper also investigates whether membership in a hospital system improves access to capital and results in the updating of buildings and equipment. The study found that hospitals generally do no use system membership to overcome access to capital problems, most likely because investments are not readily available along this pathway. The study also found that hospitals generate 50 cents for every dollar invested in facility improvement. Although this is a way to generate revenue, the small hospitals will typically not be able to recover the costs spent in the improvement. These findings suggest that small hospitals, particularly the smallest and most rural hospitals, would need grants in order to adequately cover the costs of facility improvement.
- Rural Hospital Access to Capital: Issues and Recommendations
Identifies federal and state programs that have assisted or could assist rural hospitals in meeting their capital needs; assesses whether rural hospital borrowers have difficulty in meeting their capital needs under existing grant, loan, and mortgage insurance programs; and discusses potential options for improving access to capital for rural hospitals. Offers regulatory, programmatic, and policy recommendations to improve the HUD 242 Program and the USDA Community Facilities Program-two federal programs that have been able to assist some of the less creditworthy hospitals over the last three decades.
- Capital Needs of Small Rural Hospitals
Examines the capital situation of rural hospitals with fewer than 50 beds to determine the total cost of bringing each facility into compliance with current laws, as well as the facilities' cost of borrowing and ability to borrow. Key results include: 38 percent report having deficiencies that, by law, require renovation or remodeling; the median cost of correcting those deficiencies is $1,000,000; most hospitals will need to, and have the ability to, borrow funds to correct the deficiencies; and the hospitals that report being unable to obtain loans tend to be older, low-volume hospitals with operating losses. Study concludes that due to the poor financial condition of hospitals that lack the ability to borrow, a new federal loan program does not appear to be the answer to their capital needs. Rather, improving access to capital depends on improving hospital profitability. The authors offer three options. 1) Medicare policy could provide hospitals in regions with very few patients an adjustment that would allow low-volume hospitals to earn a profit on Medicare patients. 2) Medicare policy could be adjusted to allow Medicare to directly pay a portion of hospitals' charity care and bad debt burdens. 3) Policy makers could set up a technical assistance program operated at the state level to assist rural hospitals in improving their financial condition.