What a Rural Emergency Hospital does
Congress created REHs in the Consolidated Appropriations Act, 2021, as an option for small rural hospitals at risk of closing. Only Critical Access Hospitals and small rural hospitals with 50 or fewer beds that were enrolled in Medicare on December 27, 2020 can convert. Under CMS rules, an REH must:
- run an emergency department staffed 24 hours a day, 7 days a week;
- keep its annual average patient stay at 24 hours or less;
- have a transfer agreement with a Level I or Level II trauma center;
- provide no inpatient care, except in a separately licensed skilled nursing unit.
REHs can also offer observation care and outpatient services such as lab work, imaging, rehabilitation and behavioral health.
Oklahoma's Rural Emergency Hospitals
| Facility (CMS name) | Town | REH in Medicare since |
|---|---|---|
| Stillwater Medical - Perry | Perry | April 2023 |
| Stillwater Medical-Blackwell | Blackwell | July 2023 |
| Harper County Community Hospital | Buffalo | October 2023 |
| Elkview General Hospital | Hobart | July 2024 |
| Clinton Regional Hospital | Clinton | November 2025 |
| Memorial Hospital | Stilwell | March 2026 |
| Ascension St John Nowata | Nowata | July 2026 |
Source: CMS Provider of Services file, July 2026 quarter, active REH records in Oklahoma (it also lists 38 active Critical Access Hospitals). CMS's Hospital General Information data, updated October 2026, list the first six as Rural Emergency Hospitals and Nowata as a Critical Access Hospital, with 39 Critical Access Hospitals in all. Status can change, so confirm with the hospital.
If your local hospital is an REH
- Use it for emergencies. Call 911 or go to the REH for emergency care, as you would any ER.
- Know where you'd be transferred. Ask which hospital it sends patients to for admission, and check that hospital is in your plan's network if you have Medicare Advantage.
- Ask about outpatient services such as lab, imaging or therapy, which may save you a long drive.
Read more on rural hospitals and telehealth in Oklahoma and our disaster and rural care guide. To check networks in your county from the companies they work with, you can request a call from a licensed insurance agent.
Related questions
Telehealth in rural Oklahoma
Visits from home through 2027.
Medicare after a tornado
Plan rules in disasters.
Early refills in a disaster
Getting your medicines.
Sources
- CMS — Rural Emergency Hospitals
- CMS — Rural Emergency Hospitals fact sheet (September 2024)
- CMS — Provider of Services File, Hospital and Non-Hospital Facilities (July 2026)
More questions in this guide
- Can I get an early prescription refill before an ice storm or after a tornado?
- Does Medicare cover telehealth visits in rural Oklahoma?
- Does Medicare pay for a generator for my oxygen or medical equipment?
- Is there a Medicare Special Enrollment Period after a disaster in Oklahoma?
- What happens to my Medicare coverage after a tornado in Oklahoma?
Part of the guide: Tornadoes, Ice Storms and Your Medicare in Oklahoma · All questions
Frequently asked questions
What happens if I need to be admitted at a Rural Emergency Hospital?
REHs can't admit you as an inpatient. They must have a transfer agreement with a Level I or Level II trauma center, and they transfer patients who need a hospital stay. Medicare covers a medically necessary ambulance transfer, and Part A covers the inpatient stay at the receiving hospital.
Do I pay more at a Rural Emergency Hospital?
No. Medicare pays REHs 5% more than the standard outpatient rate, but CMS says your copayment is based on the standard rate, without that increase. Part B's deductible and coinsurance apply as at other hospital outpatient departments.
Does Medicare Advantage cover Rural Emergency Hospitals?
Medicare Advantage plans must cover all services Original Medicare covers, and emergency care is covered even out of network. For non-emergency outpatient care at an REH, check whether it's in your plan's network.
Medicare in your Oklahoma county
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