acute care hospital vs critical access

[Abwillingham]

The CMS classifies hospitals as either an “acute care hospital”, a “critical access hospital”, or a “children's” hospital.
Can a hospital not be two of these things? Or all three?

 

[MBSC]

Acute care hospitals and children's hospitals are special types of acute care hospitals. The classifications are used to identify the differences in reimbursement (payment) methods for each classification.

 

[Abwillingham]

Thanks but that does not really answer my question.
I am developing a website to help the general public understand this stuff but first I have to understand it myself.
Are all ACH also children's hospitals?
Are all children's hospitals also ACH?
Are all (or any) CAH also ACH?
It seems a hospital can be a combination of these three things but the CMS only applies one label to each hospital.

 

[MBSC]

The link at the bottom of this post may provide the clarification you need. Each hospital is assigned a six-digit CMS Certification Number (CCN) formally called an OSCAR number. The first two digits represent the state the hospital is located in. The next two digits represent the type of facility. The last two digits are unique to each facility.

As described in section 2779A1 (PDF page 430), if the last 4 digits of the CCN are in the 1300-1399 range, then the facility has met the criteria and been certified as a Critical Access Hospital (CAH). CAHs provide acute care services but have also met other criteria outlined earlier in the document. Children's hospitals provide acute care services but have also met additional criteria. The 0001-0879 short-term hospital certification is what most people know as acute care hospitals and is the most basic certification for hospitals. Acute care is actually a type of service performed by a hospital and many of the hospital certification classifications offer acute care services.

The different designations are required because reimbursement varies by the type of certification.

As described in section 2779C of the document, a hospital with one type of certification can have "units" or "wings" with another type of certification. For example, short-term hospital 420058 can have a psychiatric unit with certification number 42S058 where the third digit (letter S) represents that a different reimbursement method is to be applied to those claims.

Let me know if you have any other questions.

CMS Certification Numbers: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/som107c02.pdf