We used three years of national survey data (2000, 2002, 2004) to examine the scope of services offered by Critical Access Hospitals (CAHs). We investigated how the services offered by CAHs have changed, the role of network affiliations in these changes, and the reasons administrators gave for reported service expansions. With three years of survey data, we also examined how services offered have changed over time.

Key Findings:

• Most CAHs offer a core of services including radiology, laboratory services, emergency rooms, swing beds, pharmacy, outpatient rehab, outpatient surgery, and specialty clinics.
• While this core has not changed significantly over the period of three surveys, many CAHs have added or expanded services not dependent on inpatient capacity.
• Of the 474 CAHs surveyed in 2004, at least 20% added or expanded radiology, specialty clinics, outpatient rehabilitation, and laboratory services, while others commonly added or expanded outpatient surgery and rural health clinics.
• Of the 540 CAHs surveyed during the three survey years, at least one quarter added or expanded radiology, specialty clinics, outpatient rehab and laboratory services.