NRHP is pleased to provide this “toolkit” of resources for Critical Access Hospitals in Nevada to consider when exploring a conversion to a Critical Access Hospital.

Latest News:

On June 15th, 2023, Nevada became one of the first 15 states to recognize the new Rural Emergency Hospital (REH) model in state law, with the passage of Assembly Bill AB277. Now, the Nevada Board of Health is required to promulgate regulations regarding the licensure of REHs in Nevada. More information on regulations soon!

You can find a full list of REH legislation by state here: Rural Emergency Hospitals (

Or read more about AB277 here: Bill to adopt new Medicare designation could prevent rural hospital closures – The Nevada Independent

Rural Emergency Hospital Technical Assistance Center:

In September 2022, the Rural Health Redesign Center was awarded as the national technical assistance provider by HRSA. Please visit their website here: Rural Emergency Hospital | Rural Health Redesign Center (

Eligible hospitals can apply for technical assistance with the RHRC via this form: Initial request for Technical Assistance (

What is a Rural Emergency Hospital?

  • Created as a new Medicare provider in the Consolidated Appropriations Act of 2021
  • Must have been a Critical Access Hospital or Small Rural Hospital with fewer than 50 beds on 12/27/2020
  • Must enroll in Medicare
  • Must have a transfer agreement in effect with a Level I or Level II Trauma Center
  • Must provide:
    • a staffed Emergency Department 24 hours a day, 7 days a week
  • Must be licensed by their state
  • Must meet the Conditions of Participation (below)
  • Can provide:
    • Distinct-part Long Term Care
    • Distinct-part Rehabilitation
    • Distinct-part Psychiatric Care
  • Cannot provide:
    • Any acute care inpatient hospital services

Conditions of Participation (42 CFR Part 485 Subpart E)

For more information from the Centers for Medicare & Medicaid Services, please visit their Rural Emergency Hospitals webpage here: Rural Emergency Hospitals | CMS

Enrolling in Medicare:

To enroll, visit the Medicare Administrative Contractor (MAC) website here: Rural Emergency Hospital (REH) – JE Part A – Noridian (

Medicare Program Integrity Manual – Rural Emergency Hospitals

Medicare Enrollment Guide for Institutional Providers: Medicare Enrollment Guide for Institutional Providers | CMS

Enrolling in Nevada Medicaid:

-Check back here for more information soon!


DataGen analyzed the estimated impact of a hospital’s transition to an REH provider status. For the full analysis or questions about the new provider type, reach out to DataGen here.

Model Legislation/Considerations for Regulations:

The National Academy for State Health Policy has developed the following page: with links to their “Model Rural Emergency Hospital Act” for state legislatures and regulatory bodies to consider.

This webpage is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $495,108 with 50% financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit