Grassley, Gardner Introduce Bill to Give Rural Hospitals New Option to Stay Open, Maintain Emergency Rooms for Residents

WASHINGTON – Sen. Chuck Grassley of Iowa and Sen. Cory Gardner of Colorado today introduced legislation to help rural hospitals stay open while meeting the needs of rural residents for emergency room care and outpatient services.  
“A tractor accident or a heart attack is dangerous under the best of circumstances, but it’s a lot more dangerous for someone who’s far away from an emergency room,” Grassley said. “When a rural hospital closes, its emergency room closes with it. This proposal will fill a pressing need, help keep hospital doors open, and offer hospital services where and when people need them most.”

“Rural communities deserve the same access to emergency services as their urban counterparts,” said Gardner. “Following a traumatic injury, patients have a small window of time to reach services before their conditions begin to deteriorate severely. The REACH Act will expand access to emergency healthcare, and help keep life-saving medical facilities open in underserved areas that need them most.”

The senators noted that 60 percent of trauma deaths in the United States occur in rural areas, where only 15 percent of the population is represented.  The pace of rural hospital closures is accelerating, and many other hospitals that haven’t closed are struggling to keep their doors open.
Under Medicare, many rural hospitals are designated as Critical Access Hospitals, meaning they have to maintain a certain amount of inpatient beds as well as an emergency room. Many hospitals struggle to attract enough inpatients to keep their Critical Access Hospital status. When they close their doors, it often means a community loses its emergency services.  Studies show that proximity to an emergency room often means the difference between life and death.    
The Grassley-Gardner bill, the Rural Emergency Acute Care Hospital (REACH) Act, S. 1648, would create a new Rural Emergency Hospital classification under Medicare. The hospital would have an emergency room and outpatient services. It would not have the inpatient beds that many hospitals are struggling to maintain. For example, a patient in a rural hospital with kidney disease might go to his community hospital for dialysis as an outpatient service.  He would go to a separate major hospital for specialized care such as a kidney operation.  He would go to his community hospital for emergency care for an acute episode, when time is of the essence.

The bill wouldn’t force any new requirements on hospitals. It simply would offer them a new option. The hospitals would have to maintain some protocols in exchange for removing inpatient services, such as being able to rapidly move a patient to a larger hospital elsewhere that offers more services.

A white paper on the issues behind the bill is available here. A summary is available here. Grassley’s floor statement on the introduction is available here.