Nevada Flex Program

Nevada State Office of Rural Health

Mount Grant General Hospital

The Medicare Rural Hospital Flexibility Program (Flex), administered by the federal Office of Rural Health Policy (ORHP), provides grants to states to assist rural hospitals and communities. The program was created as a result of the Balanced Budget Act of 1997 and provides funding to states for the designation of Critical Access Hospitals (CAHs) and the provision of technical assistance to CAHs.

Since 1999, the Nevada State Office of Rural Health has overseen the Nevada Flex Program, including the process for CAH designation and the requirements for CAH participation in Flex-funded technical assistance in Nevada. These requirements are described in "Critical Access Hospital Designation in Nevada" (January 2015).


To increase access to quality inpatient services, clinic and outpatient services, skilled nursing and long-term care services, and pre-hospital and emergency medical services for the 300,000 residents of rural and frontier Nevada.


To increase access to health care services for all residents of rural and frontier Nevada by improving the economic viability of health care providers and expanding the continuum of health services through the provision of technical assistance and support.

Over the past two decades, the Nevada State Office of Rural Health has received $8.1 million dollars in grant to support Critical Access Hospitals and Flex program activities in rural and frontier communities in Nevada. To date, the Nevada Flex Program's principal subcontractor, Nevada Rural Hospital Partners, has received $3.3 million in funding through the Flex grant.

During the current fiscal year beginning September 1, 2018 (FY 18), the Nevada Flex Program will utilize $469,924 in Flex-grant funding to implement proven and innovative technical assistance to support:

  • Rural hospital quality improvement and patient safety, including facilitation of a statewide rural hospital quality improvement network and quality reporting among the state's 13 CAHs;
  • Rural hospital financial, operational, and performance improvement, including facilitation of a statewide rural hospital performance improvement network among Nevada's 13 CAHs and CAH participation in revenue cycle management activities;
  • Rural population health management and emergency medical services integration, including the production and dissemination of the Nevada Rural and Frontier Health Data Book and oversight of the online Nevada Instant Atlas; and
  • Integration of innovative health care models in rural hospitals, including CAH participation in Project ECHO Nevada clinics.

Thirteen Critical Access Hospitals in Nevada currently receive support and technical assistance from the Nevada Flex Program:

  • Banner Churchill Community Hospital (Fallon)
  • Battle Mountain General Hospital
  • Boulder City Hospital
  • Carson Valley Medical Center (Gardnerville)
  • Desert View Hospital (Pahrump)
  • Grover C. Dils Medical Center (Caliente)
  • Humboldt General Hospital (Winnemucca)
  • Incline Village Community Hospital
  • Mesa View Regional Hospital (Mesquite)
  • Mount Grant General Hospital (Hawthorne)
  • Pershing General Hospital (Lovelock)
  • South Lyon Medical Center (Yerington)
  • William Bee Ririe Hospital (Ely)

For additional information on the Nevada Flex Program, CAH designation in Nevada, and current Flex grant-supported activities in Nevada, please contact Program Coordinator, Laima Etchegoyhen, MPH at