PA small rural hospital program ranks No. 1 nationally for quality excellence

UNIVERSITY PARK, Pa. — The Pennsylvania Medicare Rural Hospital Flexibility Program received the 2025 Medicare Beneficiary Quality Improvement Project Certificate of Excellence Award in recognition of outstanding critical access hospital (CAH) state quality reporting and performance. The Pennsylvania program was ranked No. 1 nationally for the second consecutive year. Pennsylvania is one of only two states to have received this recognition two years in a row.

Lannette Fetzer, quality improvement coordinator; Sandee Kyler, rural health systems manager and deputy director; and Lisa Davis, director and outreach associate professor health policy and administration at the Pennsylvania Office of Rural Health (PORH), accepted the award on behalf of the state’s critical access hospitals.

The Pennsylvania Office of Rural Health provides expertise in the areas of rural health, agricultural health and safety, and community and economic development. PORH is administratively housed in the Department of Health Policy and Administration in the College of Health and Human Development at Penn State.

The award was presented on July 17 at the annual Medicare Rural Hospital Flexibility Program Reverse Site Visit in Washington, D.C., and was given by the Federal Office of Rural Health Policy (FORHP) in the U.S. Department of Health and Human Services’ Health Resources and Services Administration.

The program is a quality improvement activity under the Medicare Rural Hospital Flexibility grant program of FORHP. The goal of the program is to improve the quality of care provided in CAHs by increasing quality data reporting by CAHs and then driving quality improvement activities based on the data. The program is a voluntary reporting system that includes quality and satisfaction measures from the Centers for Medicare and Medicaid Services Hospital Compare plus a CAH-specific, Emergency Department Transfer Communication measure set. Pennsylvania was one of the first four states to have 100% CAH participation in the grant program.

In addition to Pennsylvania, Alabama, Hawaii, Iowa, Massachusetts, Nevada, New Hampshire, South Dakota, Virginia, West Virginia and Wisconsin were also recognized in the top 10 nationally.

“Pennsylvania is fortunate to have 17 CAHs dedicated to delivering high-quality care in rural communities. Their unwavering commitment to excellence is evident in the compassionate, patient-centered services they provide every day. It is truly a privilege to work alongside these hospitals as they continue to set a standard for outstanding rural health care,” said Fetzer.

During the meeting, Fetzer and Kyler were invited to present “Connecting the Dots: Enhancing Care Coordination in Rural Health Systems” to a national audience of CAH state-based technical assistance experts. The presentation highlighted the importance of care coordination, use of a logic model, and the financial implications for hospitals. The session received a standing ovation, reflecting the value and relevance of their insights to rural health leaders across the country.

“At the heart of every quality improvement effort are people who genuinely care — about their patients, their neighbors, and the health of their communities,” Kyler said. “Our critical access hospitals don’t just provide health care — they are woven into the fabric of rural life. This recognition honors their deep-rooted commitment to doing what’s right, every day, for the people they serve.”

The Medicare Rural Hospital Flexibility Program was established through the Balanced Budget Act of 1997, the Balanced Budget Refinement Act, the Benefits Improvement and Protection Act, and the Medicare Modernization Act. This program improves access to preventive and emergency health care services for rural populations. Providing federal grant funding to eligible states, the program requires states to address rural health network development and directs significant effort into designating CAHs, which are small hospitals (25-beds or less) in rural counties that serve high Medicare, Medicaid, low income and uninsured populations. Pennsylvania has 17 CAHs.

PORH was formed in 1991 as a joint partnership between the federal government, the Commonwealth of Pennsylvania and Penn State. The office is one of 50 state offices of rural health in the nation funded under a program administered by FORHP and is charged with being a source of coordination, technical assistance, and networking; partnership development; and assisting in the recruitment and retention of health care providers.