,i  #aacth ,,congress  #ast ,session    
,h4 ,r4 #cddd  ,,in ,,the ,,house ,,of  
,,representatives  ,october #cj1        
#bjac,mr4 ,walden 7for himself and ,mr4 
,kind7 introduced the following bill2   
which was referred to the ,committee on 
,ways and ,means  ,a ,,bill  ,to amend  
title ,,xviii of the ,social ,security  
,act to provide flexibility in the      
manner in which beds are counted for    
purposes of determining whether a       
hospital may be designated as a critical
 access hospital under the ,medicare    
program4  #a4 ,short title ,this ,act   
may be cited as the ,critical ,access   
,hospital ,flexibility ,act of #bjac4   
#b4 ,flexibility in the manner in which 
beds are counted for purposes of        
determining whether a hospital may be   
designated as a critical access hospital
 under the ,medicare program  7a7 ,in   
general ,section #ahbj7;c77#b7 of the   
,social ,security ,act 7#db ,u4,s4,c4   
#acie;i-#d7;c77#b77 is amended-- 7#a7 in
 subparagraph 7,b77iii71 by inserting   

subject to subparagraph 7,f71 before    
provides not more2 and  7#b7 by adding  
at the end the following3  7,f7         
,alternative bed number determination   
7i7 #bj-;bed alternative ,in the case of
 a facility that was designated as a    
critical access hospital before the date
 of the enactment of the ,critical      
,access ,hospital ,flexibility ,act of  
#bjac1 such facility may satisfy the    
requirement under subparagraph 7,b77iii7
 by providing inpatient care for a      
period that does not exceed1 as         
determined on an annual1 average basis1 
#if hours per patient and by-- 7,i7     
providing not more than #be acute care  
inpatient beds 7meeting the standards   
established by the ,secretary under such
 subparagraph72 or  7,,ii7 providing not
 more than #bj acute care inpatient beds
 7as determined on an annual1 average   
basis and meeting any applicable        
standards established by the ,secretary 
under such subparagraph which do not    
conflict with this subclause74  7ii7    

,occupied beds only ,in determining the 
number of beds for purposes of clause   
7i7 and subparagraph 7,b77iii71 only    
beds that are occupied shall be counted4
  4  7b7 ,effective date ,the amendments
 made by this section take effect on    
,january #a1 #bjad4