Boulder City (Nev.) Hospital will transition from a critical access hospital to a rural emergency hospital effective May 1, according to regulatory filings and public notices.
In a notice filed under the federal Worker Adjustment and Retraining Notification Act, the hospital said it will permanently discontinue its acute inpatient care units as part of the conversion. The move will result in a permanent layoff affecting 71 employees across multiple departments.
Effective May 1, the hospital will cease accepting inpatient admissions. Patients requiring overnight hospitalization beyond a 24-hour observation stay will be stabilized and transferred to area hospitals under existing transfer agreements.
Service lines that will no longer accept patients include inpatient care services — including the medical-surgical unit and transitional rehabilitation unit — as well as geriatric psychiatry.
Emergency services will continue to operate 24/7, along with observation and outpatient services.
Hospital leaders cited financial instability, low patient volumes and reimbursement gaps as key factors in the decision. In public notices, Boulder City Hospital said the transition is intended to preserve essential emergency and outpatient care while eliminating the high fixed costs associated with maintaining inpatient beds.
Under the rural emergency hospital designation, facilities do not provide acute inpatient services but may offer emergency and observation care, provided the annual per-patient average length of stay does not exceed 24 hours.
The designation was established by Congress through the Consolidated Appropriations Act of 2021 and implemented by CMS in 2023. Rural emergency hospitals receive a fixed monthly Medicare facility payment and are reimbursed at the standard outpatient prospective payment rate plus an additional 5% for covered outpatient services.
Since 2023, at least 43 hospitals across 18 states have converted to rural emergency facilities.
Boulder City Hospital said its conversion remains subject to state licensing and federal certification requirements.
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