101 STAT. 1330-50
PUBLIC LAW 100-203—DEC. 22, 1987
42 USC 1395WW
(A) IN GENERAL.—The Secretary of Health and Human Services shall provide for a study of the criteria used for the classification of hospitals as rural referral centers under section 1886(d)(5)(C)(i) of the Social Security Act. The study shall include an examination of— (i) the extent that hospitals classified as rural referral centers receive more or less than their actual costs of providing inpatient hospital services, and (ii) the appropriateness of providing for payment for such centers at a rate other than the rate for a hospital located in an other urban area. (B) REPORT.—The Secretary shall report to Congress, by not later than March 1, 1989, on the study conducted under subparagraph (A) and on recommendations for the criteria that should be applied under section 1886(d)(5)(C)(i) of the Social Security Act for the classification of hospitals as rural referral centers for cost reporting periods beginning on or after October 1, 1989.
(e) G R A N T PROGRAM FOR RURAL HEALTH C A R E TRANSITION.—
(1) The Administrator of the Health Care Financing Adminisf tration, in consultation with the Assistant Secretary for Health (or a designee), shall establish a program of grants to assist eligible small rural hospitals and their communities in the planning and implementation of projects to modify the type and extent of services such hospitals provide in order to adjust for one or more of the following factors: (A) Changes in clinical practice patterns.
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(B) Changes in service populations. (C) Declining demand for acute-care inpatient hospital ,,^.., capacity. (D) Declining ability to provide appropriate staffing for inpatient hospitals. (E) Increasing demand for ambulatory and emergency services. (F) Increasing demand for appropriate integration of community health services. (G) The need for adequate access (including appropriate transportation) to emergency care and inpatient care in areas in which a significant number of underutilized hospital beds are being eliminated. (H) The Administrator shall submit a final report on the program to the Congress not later than 180 days after all projects receiving a grant under the program are completed. ,^ Each demonstration project under this subsection shall demonstrate methods of strengthening the financial and managerial capability of the hospital involved to provide necessary services. Such methods may include programs of cooperation with other health care providers, of diversification in services furnished (including the provision of home health services), of physician recruitment, and of improved management systems. (2) For purposes of this subsection, the term "eligible small J, rural hospital" * means any non-Federal, short-term general ® acute care hospital that— • • Copy read " 'eligible small rural hospital' ".