This project will identify the capital needs of CAHs, their experiences in accessing local capital resources that add to facility flexibility in dealing with daily financial needs, and the role of inter-organizational relationships in accessing capital and improving fiscal flexibility. State and municipal efforts to meet capital needs and the role of key state stakeholders will also be identified. Additionally, this project will assess facility-specific trends related to the management of existing debt and acquisition of new debt as indicators of post-conversion performance. Data on state-level capital activities will be collected through a quarterly e-mail survey of State Flex Coordinators, the TASC list serve, and telephone contacts with Flex Coordinators in key states. Medicare Cost Report data will be analyzed to examine changes in hospital financial condition and related capital behavior. Through the survey of CAH administrators, project staff will identify CAH capital needs and catalog CAH community experiences in obtaining or maintaining non-revenue support that leads to greater financial flexibility in managing day-to-day operational costs.

Publications

• The Availability and Use of Capital by Critical Access Hospitals
  University of Minnesota Rural Health Research Center
  Date: 03/2005
  This paper examines the experiences of critical access hospitals (CAHs) in meeting their capital needs. It focuses on their efforts to obtain capital, the capital sources tapped through these efforts and how CAHs have used the capital they have been able to obtain over the last few years and assesses their current capital needs.