Author Archives: Erin Mahn

President Obama signed into law H.R. 4067

President Obama signed into law H.R. 4067, which will extend to all of calendar year 2014 the enforcement moratorium on the outpatient therapeutic services “direct supervision” policy for Critical Access Hospitals (CAHs) and rural prospective payment system hospitals with 100 or fewer beds.

H.R. 4067 was introduced by Senator Jerry Moran (R-KS) and Congresswoman Jenkins (R-KS) and passed both the House and Senate. The National Rural Hospital applauds the leadership of Sen. Moran and Rep. Jenkins for this important bill for CAHs and small rural hospitals.

Documentary “Remote Area Medical” to Screen in Washington with Special Appearance by NRHA CEO Alan Morgan

The National Rural Health Association invites you to the screening of the documentary Remote Area Medical. The film will screen at West End Cinema on December 5th at 7 p.m. and is the Washington premiere. Alan Morgan, NRHA CEO, will be a special guest and he will provide a lively discussion after the film.

Praised as “bittersweet…poignant. Those stories aren’t unlike a country ballad, and are arranged with a sensitivity to detail and the lives behind them, though not without interludes of rough humor by The Wall Street Journal, Jeff Reichert and Farihah Zaman’s documentary follows a three-day clinic held at the Bristol Motor Speedway in Tennessee and shows what it means when rural America does not have the access it needs to sufficient healthcare.

“This film is a glimpse into the lives of everyday rural Americans who struggle to access care,” Alan Morgan, CEO of the National Rural Health Association said. “Rural Americans, on average, are poorer, sicker and older than their urban counterparts. Remote Area Medical is a compelling story of those desperate for medical care.”

Filmmaker Jeff Reichert will also be appearing for a Q&A. The film won the Founders Prize for Best Documentary at the 2013 Traverse City Film Festival.

Film screening and discussion of Remote Area Medical will be held at the West End Cinema in Washington, DC at 7 p.m. on December 5. The film is open to the public; for tickets visit To view the trailer, visit:

NRHA is thankful for rural victories

As Thanksgiving is around the corner, the National Rural Health Association is thankful for the many rural victories we have had to celebrate National Rural Health Day. National Rural Health Day has grown and is being recognized on Capitol Hill like never before.  Several significant speeches were given on both the House and Senate Floor.  Additionally, with the passage of the Senate Resolution and the direct supervision bill, this National Rural Health Day is our most successful to date.

Here are a few highlights of last Thursday:

S. Res. 588 (formerly S. Res. 26.) passes in the Senate.  On the evening of National Rural Health Day, Senators Moran (R-KS) and Klobuchar (D-MN) pushed to pass a resolution detailing the importance of rural hospitals and rural providers to patients and the rural economy.  Additionally, it outlines how important it is to provide fair reimbursement to those rural providers.  NRHA is thankful for Senators Moran and Klobuchar, as well as the other 17 original cosponsors.

Congress extends direct supervision enforcement moratorium. HR 4067, introduced by Congresswoman Jenkins (R-KS) passed both the House and Senate and now awaits the President’s signature.  It is anticipated that the President will sign.  The bill will extend to all of calendar year 2014 the enforcement moratorium on the outpatient therapeutic services “direct supervision” policy for critical access hospitals and rural prospective payment system hospitals with 100 or fewer beds.

NRHA and AHA send joint letter to Congress commemorating Rural Health Day. NRHA and the American Hospital Association teamed together to send a letter to the House Rural Health Coalition and the Senate Rural Health Caucus outlining the importance of Rural Health Day.  This event, we believe, exemplifies a new commitment on behalf of each association to work together toward to betterment of all rural hospitals.

NRHA is thankful for our rural champions and our NRHA members who support rural health care. But our work is not over yet. During December and the next year, NRHA will continue its efforts to protect the rural health safety net. NRHA asks you to continue the fight the 26th Annual Rural Health Policy Institute Feb. 3-5 in Washington, D.C. Click here to register today.

Senate passes rural health care resolution

Last night on National Rural Health Day, Senate Resolution 588 passed the Senate. The resolution, introduced by Senators Jerry Moran (R-KS) and Amy Klobuchar (D-MN), recognizes that access to hospitals and other health care providers for patients in rural areas of the United States is essential to the survival and success of communities in the United States.

Rural Americans face unique challenges in accessing health care. Per capita, they are sicker, older and frailer than their urban counterparts. The rural elderly are more likely to have chronic conditions such as arthritis, hypertension, diabetes and heart disease. They are also likely to be required to travel a greater distance when seeking care than urban counterparts.

The resolution states that “the closure of a hospital in a rural community often results in severe economic decline in the community and the departure of physicians, nurses, pharmacists, and other health providers from the community, and forces patients to travel long distances for care or to delay receiving care, leading to decreased health outcomes, higher costs, and added burden to patients.”

The National Rural Health Association applauds Sens. Moran and Klobuchar for recognizing the needs, challenges, and opportunities for rural health care facilities are also vastly different from those faced by their urban counterparts. Higher percentages of Medicare beneficiaries, recruitment challenges, workforce issues, and unique budgetary challenges are all examples of areas where rural facilities differ from their suburban and urban counterparts.

NRHA also thanks the 17 original cosponsors:

Senators Baldwin (D-WI); Boozman (R-AR); Cochran (R-MS); Crapo (R-ID); Donnelly (D-IN); Durbin (D-IL); Enzi (R-WY); Franken (D-MN); Grassley (R-IA); Heitkamp (D-ND); Heller (R-NV); Hirono (D-HI); Hoeven (R-ND);  Johnson (D-SD); Tester (D-MT); Thune (R-SD); and Wicker (R-MS).

Sen. Grassley and Rep. Smith celebrate National Rural Health Day

The National Rural Health Association applauds Senator Chuck Grassley (R-Iowa) and Representative Adrian Smith (R-NE) for being stalwart champions for rural America.

Rep. Smith delivered a statement on the floor of the U.S. House of Representatives recognizing National Rural Health Day. The video of the remarks is here.

Sen. Grassley took the U.S. Senate floor today to deliver a statement on the importance of rural health care and to recognize rural health care providers:

“Approximately 62 million Americans live in rural areas, and they depend on an ever shrinking number of healthcare providers.  Rural providers play an important role in improving the health of their communities and supporting local economies.  I want to thank our rural providers—individuals, hospitals and clinics for all that they do.

Rural providers support a population that makes invaluable contributions to this country through food production, manufacturing and other vital industries.  Yet, more people in rural areas are living below the poverty line than their urban counterparts.  Rural hospitals are struggling to continue providing care due to declining payments, many exacerbated by the Affordable Care Act. The past few years have been marked by increasing rural hospital closures, with 27 hospitals shutting their doors in the last two years.  The trend is concerning and deserves attention as many more facilities and communities are at risk right now.

Once a hospital is gone, the devastating impact on the community cannot be undone.  The economic impact is unmistakable. The typical critical access hospital creates over 140 jobs in primary employment and $6.8 million in local wages while serving a population of over 14,000.”

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Senators urge President Obama to protect Critical Access Hospitals

Senator Tammy Baldwin (D-WI) and 26 other senators wrote a bipartisan letter to President Obama urging him to exclude the Critical Access Hospital (CAH) reimbursement cuts and the 10-mile exclusion proposal from his Fiscal Year 2016 Budget request.

Obama’s Fiscal Year 2015 budget proposed reducing Medicare reimbursements for CAHs and removing the CAH designation for hospitals located within 10 miles of another hospital.

“Rural Hospitals have experienced significant Medicare reimbursement cuts that have strained critical resources. CAH facilities already face unique challenges, such as remote geographic location, workforce shortages, and limited resources, as they continue to provide 24 hour access to care for isolated rural communities,” the letter says. “Since the beginning of 2013, 24 rural hospitals have closed; this is double the pace of the previous 20 months. Proposals to reduce payments to CAHs will only serve to exacerbate the current problem and cause further care shortages in these isolated areas.”

The National Rural Health Association applauds Senator Baldwin and the other cosigners. NRHA urges members of Congress to stand up and protect the rural health care safety net.

NRHA honors rural veterans

This Veterans Day, we remember and honor those rural veterans who have served our nation. Rural Americans have always been committed to serving their country – more than a quarter of the country’s veterans live in rural communities and a disproportionate number of those serving in the military hail from rural communities.

A diverse group of rural veterans represent rural America. The percent of women veterans residing in rural areas has more than doubled between 1992 and 2011, rising from 3 percent to 7 percent and rural minority veterans have increased from 6 percent to 10 percent.

Veterans are often pillars and leaders in their rural communities. They have committed their lives to protecting and serving the country. The National Rural Health Association applauds their service.

NRHA has consistently been a staunch advocate for expanding access to care for rural veterans, including improving availability of providers, care delivery mechanisms and provider understanding of the special needs of rural veterans. NRHA urges members of Congress to stand up for rural veterans and protect their access to care in their rural communities.

President Obama signs the Improving Medicare Post-Acute Care Transformation Act of 2014 into law

President Obama signed into law the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). This legislation improves post-acute care for Medicare beneficiaries, and standardizes data for quality, payment and discharge planning for post-acute care providers, including nursing homes and home health agencies.

The bipartisan legislation was introduced by Ways and Means Committee Chairman Dave Camp (R-MI) and Ranking Member Sander Levin (D-MI).

More information on the IMPACT Act can be found here.

Members of Congress head home for August recess

Members of Congress are back home for their five-week district work period. The National Rural Health Association encourages rural health leaders across the country to visit the district offices, attend town halls and invite members of Congress to tour rural facilities.

The rural health care safety net is in jeopardy.  More rural hospitals have closed in the last year than over the past decade and they are continuing to face more challenges with Medicare reductions, failure to expand state Medicaid, and regulatory changes imposed by CMS.

Rural hospitals are critical to rural American and provide great value to the rural patient, rural community and taxpayer. Urge your members of Congress to stand up for rural and protect the rural health safety net.

NRHA has outlined concerns with the Affordable Care Act, sequestration and the attacks on rural hospitals here.

VA bill passes Senate and House, heads to White House

On Thursday, the Senate approved 91-3 a compromise bill to overhaul the Department of Veterans Affairs. The House passed the bill Wednesday and it will now go to President Barack Obama for his signature.

The legislation allows veterans who experience long wait times or live far from VA facilities to receive non-VA care. The bill also allows the VA to hire new doctors and nurses.

Continue monitoring NRHA’s blog for the latest VA news. For more information on the health needs of rural veterans, please view NRHA’s recent policy paper:  Rural Veterans: A Special Concern for Rural Health Advocates