Rural Hospital Flexibility Program (Flex)

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 Flex program was established by the Balanced Budget Act of 1997.

Since 1999, the Nevada State Office of Rural Health (SORH) has overseen the Nevada Flex Program, including the process for Critical Access Hospitals (CAH) designation and the requirements for CAH participation in Flex-funded technical assistance in Nevada. Over the past two decades, the SORH has received $8.1 million dollars to support CAHs in Flex program activities.

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.

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

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

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