Critical Access Hospitals (CAHs) serve as vital healthcare providers in rural and underserved communities across the United States. These hospitals face unique challenges related to maintaining high-quality care while managing limited funding. Recent advances in artificial intelligence (AI) offer promising opportunities to improve care quality and support financial sustainability. This post explores the current state of CAHs from quality and funding perspectives and highlight

The Current State: Growing Complexity for Medical Staff Offices Medical Staff Offices (MSOs) in are under increasing pressure. Credentialing, privileging, and ongoing professional practice evaluation (OPPE) and focused professional practice evaluation (FPPE) are more complex, time-consuming, and scrutinized than ever before, yet staffing levels and tools have not kept pace. Joint Commission standards, CMS Conditions of Participation, and increasing legal exposure require MSO

The Current State: Financial Fragility in Rural Healthcare Critical Access Hospitals (CAHs) are facing one of the most financially precarious periods in modern healthcare history. Rising labor costs, persistent workforce shortages, inflationary pressure on supplies, and payer scrutiny have converged to strain already thin margins. According to the American Hospital Association, more than half of rural hospitals are operating at a loss , and closures continue to threaten acces

The Current State: Readmissions as a Persistent Rural Challenge Hospital readmissions remain one of the most visible indicators of fragmented care in the U.S. healthcare system. For Critical Access Hospitals (CAHs), readmissions are not simply a quality metric, they are a reflection of the structural challenges facing rural healthcare delivery. Patients served by CAHs are more likely to be older, have multiple chronic conditions, and face social barriers such as limited trans

The Current State: Length of Stay as a Silent Margin Killer Length of stay (LOS) has become one of the most influential, yet misunderstood, drivers of financial and operational performance in Critical Access Hospitals. While CAHs are reimbursed on a cost basis, inefficient LOS still erodes margins , limits access, and strains already stretched staff. National data from CMS shows that rural hospitals experience higher variability in LOS , often driven by discharge delays rath

The Current State: Why HAIs Remain a Defining Risk for CAHs Hospital-acquired infections (HAIs) continue to represent one of the most preventable , yet costly, threats to patient safety in the United States. For Critical Access Hospitals (CAHs), the stakes are even higher. With limited staffing, constrained budgets, and smaller patient volumes, even a single HAI event can disproportionately impact quality metrics, financial performance, and community trust. The Centers for Di

Access, quality, cost and reimbursement challenges abound for Critical Access Hospitals Smart AI designed by healthcare quality experts is ready for deployment and meet reimbursement rules creating a no downside risk decision for hospitals looking to improve quality. For Critical Access Hospitals (CAH), the status quo of business as usual is no longer sustainable. The confluence of changes with quality, cost, delivery and reimbursement merge to create a powerful current. With

Focusing on performance is the way forward in improving patient care. Measuring performance drives outcomes, yet too many hospitals still focus on months old data based on failures that cannot be changed. CMS made a major change to the Overall Hospital Quality Star Rating in the CY 2026 Outpatient Prospective Payment System (OPPS) Proposed Rule. The update directly elevates the Safety of Care measure group, preventing hospitals from attaining top-tier ratings if they underper

Conferences can be opportunities to share best practices and learn from top performers, but when they become the root of pathological adoption of new fads and buzz words, they do more harm than good in healthcare. Introduction In an industry tasked with preserving life and promoting well-being, one would expect healthcare organizations to be models of strategic discipline and operational focus. However, a troubling pattern continues to plague the upper echelons of healthcare

Care review performed in hospitals today by clinical analysts falls far short of addressing quality concerns. What got hospitals through the last decade won’t get them through the next. The complexity of inpatient care, the density of regulatory requirements, and the speed at which leaders must act have outgrown the traditional quality-review model built around a single clinical analyst reading a handful of charts each month. For executives responsible for finance, quality, a

Embracing Smart AI designed by healthcare quality insiders to solve quality problems is the best way forward to bend the quality curve. The Stalled Progress in Preventing Harm For more than two decades, American healthcare has struggled with preventing harm in hospitals. Since the Institute of Medicine’s landmark report To Err is Human (1999), we’ve seen numerous quality improvement initiatives. Hospitals have invested in safety protocols, reporting systems, performance meas

Small hospitals are often the heart of their communities. They provide essential care, frequently with fewer resources, tighter budgets, smaller staff, and less slack for error. Yet, they are expected to deliver the same standard of care as large tertiary centers. The tension is real: limited resources, growing regulatory and safety demands, rising costs, and zero tolerance for serious mistakes. In this blog, we’ll explore why quality assurance (QA) , can fundamentally improv

The ROI on investing in quality to prevent harm is well established but the stakes have grown. Hospitals and health systems face a simple truth: safer, higher-quality care ultimately saves money and reduces legal liability. Preventable patient harm costs billions each year, both in human suffering and economic loss. Yet, studies show that investing in quality improvement almost always yields a positive return. As Dr. Adam Schaffer of CRICO (Harvard’s malpractice insurer) obse

“Anesthetic safety begins long before the first drug flows—it starts with a thoughtful, systematic pre‑procedure assessment.”– American Society of Anesthesiologists (ASA) Guideline on Preanesthesia Evaluation, 2020 High-risk procedures, whether major surgery under general anesthesia or moderate sedation for endoscopy, carry inherent dangers. These include airway compromise, hemodynamic instability, aspiration, or peri-procedural myocardial infarction. To mitigate these risks,

In today’s complex healthcare environment, patients and families navigate a labyrinth of diagnoses, medications, procedures, and follow-up instructions. Without effective education and training tailored to each patient’s unique needs and abilities, the transition from hospital to home, or any next site of care, can quickly become perilous. The Joint Commission’s Standard PC.02.03.01: “The hospital provides patient education and training based on each patient’s needs and abili

Misunderstandings, incomplete explanations, or failure to confirm patient comprehension can create critical gaps that lead to medical errors, adverse events, and malpractice claims. The Joint Commission’s Standard PC.02.01.21—“The hospital effectively communicates with patients when providing care, treatment, and services”—highlights the necessity of clear, patient‑centered dialogue at every step of the healthcare journey. EvaluCare is a trusted partner to review medical care

As patients live longer with chronic diseases like Dementia and Alzheimer's, behavioral management will likely increase in the coming years. As the US population ages, hospitals are encountering a growing number of older adults presenting with cognitive impairments such as dementia and Alzheimer’s disease. These conditions can lead to a range of behavioral challenges, from agitation and wandering to aggression and paranoia, that make medical and surgical units particularly vu

The adaptation of Crew Resource Management (CRM) from aviation, and its healthcare‑specific iteration TeamSTEPPS, transformed how caregivers collaborate, maintain situational awareness, and deliver lifesaving interventions. By embedding structured communication tools, leadership principles, and shared mental models into daily routines, hospitals can dramatically reduce adverse events, from hospital‑acquired infections to surgical complications, and curb the potential for medi

By the end, you will see why PSOs are indispensable to a learning health system and how their confidential, non‑punitive approach unlocks candid insights that no other mechanism can replicate. EvaluCare is a resource to evaluate a hospitals culture of participation in PSOs and the adoption of practices that may prevent medical malpractice.

In this detailed exploration, we will trace the history of clinical registries, describe the variety of registries available to hospital services, illustrate how registry data uncover system issues (for example, linking acute kidney injury rates back to intraoperative practices), and explain why full engagement is essential for patient safety, academic advancement, and defense against malpractice risk. EvaluCare is a trusted partner to review quality registry data for medical