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Oregon bill would let some rural hospitals convert to federal 'rural emergency hospital' model
Summary
House Bill 4047 would direct the Oregon Health Authority to adopt a state licensing option so eligible rural hospitals can convert to the federal Rural Emergency Hospital (REH) model, preserving emergency and outpatient services while eliminating inpatient beds as a tool to prevent closures.
House Bill 4047 would direct the Oregon Health Authority to adopt rules that allow eligible rural hospitals to convert to the federal Rural Emergency Hospital (REH) designation, supporters told the House Committee on Health Care.
"House Bill 4047 directs the Oregon Health Authority to establish a new hospital licensing option in Oregon, the Rural Emergency Hospital or REH," Representative Ed Deal said in testimony supporting the measure.
The REH model, created by Congress in 2021, lets certain small hospitals drop inpatient beds while continuing 24-hour emergency services, observation care and essential outpatient services. Proponents said the designation preserves access in communities that can no longer sustain traditional inpatient operations and makes those facilities eligible for federal outpatient reimbursement and a monthly facility payment.
"REHs do not operate inpatient beds... they are still required to provide 24 hour emergency services, observation care and other essential outpatient services," Deal said. Travis Mavison of the Hospital Association of Oregon told the committee the state must establish the licensing framework for Oregon facilities to participate under federal law.
Committee members asked whether converting to an REH would be permanent and what services patients might lose. Witnesses clarified the conversion is reversible and that inpatient services, primarily beds, would be suspended while emergency and outpatient services remain. The CMS eligibility rules limit conversion to existing hospitals; the bill does not authorize new emergency-only hospitals.
Supporters urged the committee to approve a mechanism now so the option exists if rural hospitals later require it. No witnesses opposed the bill during the hearing; the committee closed the public hearing and indicated the matter would move forward.
Next steps: the bill will proceed through committee consideration and any rulemaking required if enacted. The committee did not make a final vote in the hearing.
