Conversion to a Rural Emergency Hospital (REH)

This page has been automatically translated from English. MSDH has not reviewed this translation and is not responsible for any inaccuracies.

Medicare has established Rural Emergency Hospitals (REHs) as a new Medicare provider type to address the growing concern over closures of rural hospitals.

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Who Can Convert to an REH

A facility is eligible to convert to an REH if it was a Critical Access Hospital (CAH) or rural hospital with not more than 50 beds as of December 27, 2020 (including a hospital that closed after December 27, 2020). REHs must provide emergency services and observation care and are prohibited by the statute from providing inpatient services.


Notify the MSDH Office of Licensure of the intent to convert to a REH on facility letterhead to

Required Documents

The following documents must be included with CMS Federal Enrollment application (CMS PECOS) and State Licensure application:

Federal Application: How to Enroll

Prior to completing the licensure application, facilities should complete the CMS enrollment process to convert to a REH. See the following for enrollment steps:

Complete CMS Enrollment through the CMS PECOS website:

REH Initial Survey

Eligible facilities that are existing CAHs and hospitals converting to an REH may attest to meeting the REH CoPs and will not require an automatic on-site initial survey as eligible facilities are expected to be in full compliance with the existing CAH and hospital requirements (as applicable) at the time of the request for conversion (See QSO-23-07-REH for full details).

License Application

After CMS has approved the conversion to a REH and the facility has received their new CMS REH provider number with effective date, complete this online license application:

Fees: There are no licensure fees to convert to a REH.

License Effective Date: Upon approval of the licensure application, the MSDH License Administrator will issue a REH License backdated to the effective CMS REH Certification date.

Certificate of Need (CON): CON approval is not required to convert to a REH. However, after receiving CMS Certification as an REH, your facility must contact the MSDH Office of Health Policy and Planning (CON) at (601) 576-7874 to request placing inpatient beds in abeyance (do not include acute beds allocated for a SNF Unit).

SNF Unit: Facilities considering adding SNF services in a Distinct Part Unit: 

  1. Contact the CON Office for a Determination.
  2. Complete the CMS enrollment process: Contact the MSDH Long Term Care Division for additional information at 601-364-1110.

License Renewal

REH License year is January 1 – December 31. 

  • Renewal notices are sent in October.
  • The annual renewal fee is $661.25.

Contact the MSDH License Administrator at (601) 364-2722 with any questions.

Last reviewed on Mar 18, 2024 request edits

Related resources

Mississippi State Department of Health 570 East Woodrow Wilson Dr Jackson, MS 39216 866‑HLTHY4U Contact and information

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