How do Critical Access Hospitals perform on the Lown Index?

For years, experts have been sounding the alarms on the wellbeing of smaller, rural hospitals in America. Many face negative operating margins which were exacerbated by COVID, and have had to close entire units in order to keep their doors open. These hospitals typically serve populations that would otherwise be without easily accessible healthcare, meaning each closure has significant consequences for the wellbeing of its community. Many of these hospitals are classified as Critical Access Hospitals and according to our data, some of them are the most socially responsible hospitals in the country.

Critical Access Hospitals

In order to qualify for Medicare’s Critical Access Hospital designation, hospitals must have no more than 25 inpatient beds, be in a rural area at least 35 miles from the nearest hospital or 15 miles by secondary roads, and maintain 24-hour emergency care services 7 days a week. Without these hospitals, patients in these areas would struggle to receive care. The top 4 are amongst only 54 hospitals in the country to earn a spot on the Lown Index Honor Roll by scoring straight A’s.

When comparing Critical Access and acute care hospitals, some differences jump out. Critical Access Hospitals tend to struggle more on clinical outcomes and cost efficiency, but excel on patient satisfaction and pay equity. This may reflect the trends of fewer resources, lower CEO pay, and more personalized care that are common characteristics of small, rural hospitals. Critical Access Hospitals are not ranked on patient safety or avoiding overuse because of their extremely low patient volume.

MetricAcute care, average rank (n-2808)Critical Access, average rank (n=1118)
Clinical Outcomes1,5192,862
Patient satisfaction1,933675
Cost efficiency1,5112,829
Pay equity2,408844
Community benefit1,8471,999

Top 10 Critical Access Hospitals, Social Responsibility 2023

RankHospital (Location)
1Pioneers Medical Center (Meeker, CO)
2UT Health Quitman (Quitman, TX)
3Holy Rosary Healthcare (Miles City, MT)
4Grand River Medical Center (Rifle, CO)
5Community Hospital of Anaconda (Anaconda, MT)
6UPMC Cole (Coudersport, PA)
7Providence Mount Carmel Hospital (Colville, WA)
8Heber Valley Hospital (Heber City, UT)
9LincolnHealth – Miles Campus & Hospital (Damariscotta, ME)
10St. Croix Regional Medical Center (Saint Croix Falls, WI)

Learn more about the Index and see how your hospital performed by visiting our website.