Open Accessibility Menu

Valley Health Page Memorial Hospital Preserves Critical Access Hospital Designation

Valley Health Page Memorial Hospital (PMH) has been notified by the Centers for Medicare & Medicaid Services (CMS) that its designation as a Critical Access Hospital (CAH) remains intact. The federal government’s decision to maintain the hospital’s CAH status ends a six month process undertaken by Valley Health System and PMH to document and defend the continued legitimacy of its 2005 designation.

“We are extremely pleased that CMS reviewed our case objectively and rescinded its termination of Page Memorial Hospital’s Critical Access designation,” said Valley Health President and CEO Mark H. Merrill. “We understand the need for scrutiny and legitimacy and find it positive that our experience will help CMS clarify the review process for its field representatives nationwide.”

PMH has been a Critical Access Hospital since October 1, 2005. The CMS designation provides a cost of care reimbursement differential to smaller hospitals in medically underserved rural communities and with less financial income opportunities. Without this advantage, these hospitals would be hard pressed to remain open, leaving rural communities without lifesaving services as acutely ill patients face delays in care and adverse outcomes due to travel.

On August 24, 2015 Page Memorial Hospital was notified by the Federal Office of Rural Health Policy that its Critical Access Hospital designation would be terminated no later than August 24, 2016. The letter stated that the hospital no longer meets the mileage or mountainous terrain requirements to participate in the CAH program.

In PMH’s request for reconsideration to CMS, it demonstrated that the hospital was not, in fact, originally certified based on distance or mountainous terrain, but was designated a “necessary provider” of health services as it met all five CMS standards for this classification:

  1. Hospital is located in a nonmetropolitan county that is a federally designed Medically Underserved Area (MUA) or Health Professional Shortage Area (HPSA);
  2. Hospital is located in a county where the percentage of poverty exceeds the state average percentage as specified in the most recent U.S. census of population;
  3. The percentage of the hospital’s revenue from Medicare exceeds the state average for Medicare reimbursement;
  4. Hospital is located in a county where the percentage of the population age 65 and older is greater than the state average as specified in the most recent U.S. census estimate of population and age; and
  5. Hospital is located in a county whose most recent three-year unemployment rate average exceeds the same three-year average rate for the state.

“These same criteria hold true in Page County today,” said Page Memorial Hospital President N. Travis Clark. (See table below.) “While this process wasn’t a distraction we welcomed, it has strengthened our connections with state and national agencies, rural health and hospital associations, and a variety of elected officials from Luray to Washington, D.C. I’d like to thank them, as well as many community members, for their enthusiastic support. We look forward to continuing to serve the community for decades to come.”


  • % of Population > 65
    • 19.4%
    • 13.4%
  • % Living in Poverty
    • 15.1%
    • 11.3%
  • Unemployment Rate
    • 6.7%
    • 5.0%
  • Elder Suicide Rate
    • 43.9 per 100,000**
    • 15.6 per 100,000
  • Heart Disease Deaths
    • 193 per 100,000
    • 161 per 100,000
  • Diabetes Prevalence
    • 11%
    • 8.7%

** Highest rate in Virginia

“We are extremely grateful for the cooperation and support we received from Secretary Hazel and others in the Governor’s Office and the bipartisan support from our elected leaders, including Senators Mark Warner and Tim Kaine, Congressman Bob Goodlatte and Congresswoman Barbara Comstock,” Merrill concluded. “Their willingness to advocate on our behalf on this matter is gratifying. Our elected leaders recognized the importance of PMH’s CAH designation for access to care and the economic impact PMH has in its community. Our elected leaders are to be commended for such favorable support.”