{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/32.1-122.07.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/32.1-122.07.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/32.1-122.07.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/32.1-122.07.html"}],"law_id":84079,"edition_id":1,"section_id":84079,"structure_id":15045,"section_number":"32.1-122.07","catch_line":"(Effective July 1, 2028) Authority of Commissioner for certain health planning activities; rural health plan; designation as a rural hospital","history":"1989, cc. 617, 633; 2000, c. 903; 2002, c. 83; 2006, c. 378; 2025, cc. 114, 135.","full_text":"A\n\nThe Commissioner, with the approval of the Board, is authorized to make application for federal funding and to receive and expend such funds in accordance with state and federal regulations.B\n\nThe Commissioner shall administer section 1122 of the United States Social Security Act if the Commonwealth has made an agreement with the United States Secretary of Health and Human Services pursuant to such section.C\n\nIn compliance with the provisions of the Balanced Budget Act of 1997, P.L. 105-33, and any amendments to such provisions, the Commissioner shall submit to the appropriate regional administrator of the Centers for Medicare & Medicaid Services (CMS) an application to establish a Medicare Rural Hospital Flexibility Program in Virginia.D\n\nThe Commissioner shall develop and the Board of Health shall approve a rural health care plan for the Commonwealth to be included with the application to establish a Medicare Rural Hospital Flexibility Program. In cooperation and consultation with the Virginia Hospital and Health Care Association, the Medical Society of Virginia, representatives of rural hospitals, and experts within the Department of Health on rural health programs, the plan shall be developed and revised as necessary or as required by the provisions of the Balanced Budget Act of 1997, P.L. 105-33, and any amendments to such provisions. In the development of the plan, the Commissioner may also seek the assistance of the regional health planning agencies. The plan shall verify that the Commonwealth is in the process of designating facilities located in Virginia as critical access hospitals, shall note that the Commonwealth wishes to certify facilities as “necessary providers” of health care in rural areas, and shall describe the process, methodology, and eligibility criteria to be used for such designations or certifications. Virginia’s rural health care plan shall reflect local needs and resources and shall, at minimum, include, but need not be limited to, a mechanism for creating one or more rural health networks, ways to encourage rural health service regionalization, and initiatives to improve access to health services, including hospital services, for rural Virginians.E\n\nNotwithstanding any provisions of this chapter or the Board’s regulations to the contrary, the Commissioner shall, in the rural health care plan, (i) use as minimum standards for critical access hospitals, the certification regulations for critical access hospitals promulgated by the Centers for Medicare & Medicaid Services (CMS) pursuant to Title XVIII of the Social Security Act, as amended; and (ii) authorize critical access hospitals to utilize a maximum of ten beds among their inpatient hospital beds as swing beds for the furnishing of services of the type which, if furnished by a nursing home or certified nursing facility, would constitute skilled care services without complying with nursing home licensure requirements or retaining the services of a licensed nursing home administrator. Such hospital shall include, within its plan of care, assurances for the overall well-being of patients occupying such beds.F\n\nNothing herein or set forth in Virginia’s rural health care plan shall prohibit any hospital designated as a critical access hospital from leasing the unused portion of its facilities to other health care organizations or reorganizing its corporate structure to facilitate the continuation of the nursing home beds that were licensed to such hospital prior to the designation as a critical access hospital. The health care services delivered by such other health care organizations shall not be construed as part of the critical access hospital’s services or license to operate.G\n\nAny medical care facility licensed as a hospital shall be considered a rural hospital on and after September 30, 2004, pursuant to 42 U.S.C. § 1395ww(d)(8)(E)(ii)(II), if (i) the hospital is located in an area defined as rural by federal statute or regulation; (ii) the Board of Health defines, in regulation, the area in which the hospital is located as a rural health area or the hospital as a rural hospital; or (iii) the hospital was designated, prior to October 1, 2004, as a Medicare-dependent small rural health hospital, as defined in 42 U.S.C. § 1395ww(d)(5)(G)(iv).","order_by":null,"text":{"0":{"id":301298,"text":"The Commissioner, with the approval of the Board, is authorized to make application for federal funding and to receive and expend such funds in accordance with state and federal regulations.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":301299,"text":"The Commissioner shall administer section 1122 of the United States Social Security Act if the Commonwealth has made an agreement with the United States Secretary of Health and Human Services pursuant to such section.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"C"},"2":{"id":301300,"text":"In compliance with the provisions of the Balanced Budget Act of 1997, P.L. 105-33, and any amendments to such provisions, the Commissioner shall submit to the appropriate regional administrator of the Centers for Medicare & Medicaid Services (CMS) an application to establish a Medicare Rural Hospital Flexibility Program in Virginia.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"D"},"3":{"id":301301,"text":"The Commissioner shall develop and the Board of Health shall approve a rural health care plan for the Commonwealth to be included with the application to establish a Medicare Rural Hospital Flexibility Program. In cooperation and consultation with the Virginia Hospital and Health Care Association, the Medical Society of Virginia, representatives of rural hospitals, and experts within the Department of Health on rural health programs, the plan shall be developed and revised as necessary or as required by the provisions of the Balanced Budget Act of 1997, P.L. 105-33, and any amendments to such provisions. In the development of the plan, the Commissioner may also seek the assistance of the regional health planning agencies. The plan shall verify that the Commonwealth is in the process of designating facilities located in Virginia as critical access hospitals, shall note that the Commonwealth wishes to certify facilities as “necessary providers” of health care in rural areas, and shall describe the process, methodology, and eligibility criteria to be used for such designations or certifications. Virginia’s rural health care plan shall reflect local needs and resources and shall, at minimum, include, but need not be limited to, a mechanism for creating one or more rural health networks, ways to encourage rural health service regionalization, and initiatives to improve access to health services, including hospital services, for rural Virginians.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C","next_prefix":"E"},"4":{"id":301302,"text":"Notwithstanding any provisions of this chapter or the Board’s regulations to the contrary, the Commissioner shall, in the rural health care plan, (i) use as minimum standards for critical access hospitals, the certification regulations for critical access hospitals promulgated by the Centers for Medicare & Medicaid Services (CMS) pursuant to Title XVIII of the Social Security Act, as amended; and (ii) authorize critical access hospitals to utilize a maximum of ten beds among their inpatient hospital beds as swing beds for the furnishing of services of the type which, if furnished by a nursing home or certified nursing facility, would constitute skilled care services without complying with nursing home licensure requirements or retaining the services of a licensed nursing home administrator. Such hospital shall include, within its plan of care, assurances for the overall well-being of patients occupying such beds.","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D","next_prefix":"F"},"5":{"id":301303,"text":"Nothing herein or set forth in Virginia’s rural health care plan shall prohibit any hospital designated as a critical access hospital from leasing the unused portion of its facilities to other health care organizations or reorganizing its corporate structure to facilitate the continuation of the nursing home beds that were licensed to such hospital prior to the designation as a critical access hospital. The health care services delivered by such other health care organizations shall not be construed as part of the critical access hospital’s services or license to operate.","type":"section","prefixes":["F"],"prefix":"F","entire_prefix":"F","prefix_anchor":"F","level":1,"prior_prefix":"E","next_prefix":"G"},"6":{"id":301304,"text":"Any medical care facility licensed as a hospital shall be considered a rural hospital on and after September 30, 2004, pursuant to 42 U.S.C. § 1395ww(d)(8)(E)(ii)(II), if (i) the hospital is located in an area defined as rural by federal statute or regulation; (ii) the Board of Health defines, in regulation, the area in which the hospital is located as a rural health area or the hospital as a rural hospital; or (iii) the hospital was designated, prior to October 1, 2004, as a Medicare-dependent small rural health hospital, as defined in 42 U.S.C. § 1395ww(d)(5)(G)(iv).","type":"section","prefixes":["G"],"prefix":"G","entire_prefix":"G","prefix_anchor":"G","level":1,"prior_prefix":"F"}},"ancestry":[{"id":15045,"edition_id":1,"name":"Health Planning and Resources Development","identifier":"4.1","label":"article","depth":3,"order_by":1,"parent_id":13670,"metadata":{},"date_created":"2026-06-26 03:51:44","date_modified":"2026-06-26 03:51:44","permalink":{"id":202707,"object_type":"structure","relational_id":15045,"identifier":"4.1","token":"32.1\/4\/4.1","url":"\/32.1\/4\/4.1\/","edition_id":1,"permalink":0,"preferred":1}},{"id":13670,"edition_id":1,"name":"Health Care Planning","identifier":"4","label":"chapter","depth":2,"order_by":1,"parent_id":12727,"metadata":{},"date_created":"2026-06-26 03:45:31","date_modified":"2026-06-26 03:45:31","permalink":{"id":202389,"object_type":"structure","relational_id":13670,"identifier":"4","token":"32.1\/4","url":"\/32.1\/4\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12727,"edition_id":1,"name":"Health","identifier":"32.1","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:50","date_modified":"2026-06-26 03:43:50","permalink":{"id":201099,"object_type":"structure","relational_id":12727,"identifier":"32.1","token":"32.1","url":"\/32.1\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":78217,"structure_id":15045,"section_number":"32.1-122.01","catch_line":"Definitions","url":"\/32.1-122.01\/","token":"32.1\/4\/4.1\/32.1-122.01","metadata":false},{"id":57359,"structure_id":15045,"section_number":"32.1-122.02","catch_line":"Repealed","url":"\/32.1-122.02\/","token":"32.1\/4\/4.1\/32.1-122.02","metadata":false},{"id":62918,"structure_id":15045,"section_number":"32.1-122.03","catch_line":"State Health Plan","url":"\/32.1-122.03\/","token":"32.1\/4\/4.1\/32.1-122.03","metadata":false},{"id":76872,"structure_id":15045,"section_number":"32.1-122.03:1","catch_line":"Statewide Telehealth Plan","url":"\/32.1-122.03_1\/","token":"32.1\/4\/4.1\/32.1-122.03_1","metadata":false},{"id":76966,"structure_id":15045,"section_number":"32.1-122.04","catch_line":"Responsibilities of the Department","url":"\/32.1-122.04\/","token":"32.1\/4\/4.1\/32.1-122.04","metadata":false},{"id":62584,"structure_id":15045,"section_number":"32.1-122.05","catch_line":"Regional health planning agencies; boards; duties and responsibilities","url":"\/32.1-122.05\/","token":"32.1\/4\/4.1\/32.1-122.05","metadata":false},{"id":62988,"structure_id":15045,"section_number":"32.1-122.06","catch_line":"Funds for regional health planning","url":"\/32.1-122.06\/","token":"32.1\/4\/4.1\/32.1-122.06","metadata":false},{"id":84079,"structure_id":15045,"section_number":"32.1-122.07","catch_line":"(Effective July 1, 2028) Authority of Commissioner for certain health planning activities; rural health plan; designation as a rural hospital","url":"\/32.1-122.07\/","token":"32.1\/4\/4.1\/32.1-122.07","metadata":false},{"id":81811,"structure_id":15045,"section_number":"32.1-122.08","catch_line":"Continuation of regulations","url":"\/32.1-122.08\/","token":"32.1\/4\/4.1\/32.1-122.08","metadata":false}],"previous_section":{"id":62988,"structure_id":15045,"section_number":"32.1-122.06","catch_line":"Funds for regional health planning","url":"\/32.1-122.06\/","token":"32.1\/4\/4.1\/32.1-122.06","metadata":false},"next_section":{"id":81811,"structure_id":15045,"section_number":"32.1-122.08","catch_line":"Continuation of regulations","url":"\/32.1-122.08\/","token":"32.1\/4\/4.1\/32.1-122.08","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/32.1-122.07\/","history_text":"

This law was first created in 1989. The record of its establishment is cataloged in chapters 617 and 633 of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. Unfortunately, the 1989 \u201cActs\u201d aren\u2019t available online. It has been modified 4 times. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. Those modifications are as follows: in 2000, chapter 903<\/a>; in 2002, chapter 83<\/a>; in 2006, chapter 378<\/a>; in 2025, chapters 114<\/a> and 135<\/a>.<\/p>","references":[{"id":58917,"section_number":"32.1-125.3","catch_line":"Bed capacity and licensure in hospitals designated as critical access hospitals; designation as rural hospital","order_by":null,"url":"\/32.1-125.3\/"}],"refers_to":false,"permalink":{"id":202737,"object_type":"law","relational_id":84079,"identifier":"32.1-122.07","token":"32.1\/4\/4.1\/32.1-122.07","url":"\/32.1-122.07\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/32.1-122.07\/","token":"32.1\/4\/4.1\/32.1-122.07","dublin_core":{"Title":"(Effective July 1, 2028) Authority of Commissioner for certain health planning activities; rural health plan; designation as a rural hospital","Type":"Text","Format":"text\/html","Identifier":"\u00a7 32.1-122.07","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> The Commissioner<\/span>, with the approval of the Board<\/span>, is authorized to make application for federal funding and to receive and expend such funds in accordance with state and federal regulations. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> The Commissioner<\/span> shall administer section 1122 of the United States Social Security Act if the Commonwealth has made an agreement with the United States Secretary<\/span> of Health and Human Services pursuant to such section. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> In compliance with the provisions of the Balanced Budget Act of 1997, P.L. 105-33, and any amendments to such provisions, the Commissioner<\/span> shall submit to the appropriate regional administrator of the Centers for Medicare & Medicaid Services (CMS) an application to establish a Medicare Rural Hospital Flexibility Program in Virginia. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> The Commissioner<\/span> shall develop and the Board<\/span> of Health shall approve a rural health care plan for the Commonwealth to be included with the application to establish a Medicare Rural Hospital Flexibility Program. In cooperation and consultation with the Virginia Hospital and Health Care Association, the Medical Society of Virginia, representatives of rural hospitals, and experts within the Department<\/span> of Health on rural health programs, the plan shall be developed and revised as necessary or as required by the provisions of the Balanced Budget Act of 1997, P.L. 105-33, and any amendments to such provisions. In the development of the plan, the Commissioner<\/span> may also seek the assistance of the regional health planning agencies. The plan shall verify that the Commonwealth is in the process of designating facilities located in Virginia as critical access hospitals, shall note that the Commonwealth wishes to certify facilities as “necessary providers<\/span>” of health care in rural areas, and shall describe the process, methodology, and eligibility criteria to be used for such designations or certifications. Virginia’s rural health care plan shall reflect local needs and resources and shall, at minimum, include, but need not be limited to, a mechanism for creating one or more rural health networks, ways to encourage rural health service regionalization, and initiatives to improve access to health services, including hospital services, for rural Virginians. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> Notwithstanding any provisions of this chapter or the Board<\/span>’s regulations to the contrary, the Commissioner<\/span> shall, in the rural health care plan, (i) use as minimum standards for critical access hospitals, the certification regulations for critical access hospitals promulgated by the Centers for Medicare & Medicaid Services (CMS) pursuant to Title XVIII of the Social Security Act, as amended; and (ii) authorize critical access hospitals to utilize a maximum of ten beds among their inpatient hospital beds as swing beds for the furnishing of services of the type which, if furnished by a nursing home or certified nursing facility, would constitute skilled care services without complying with nursing home licensure requirements or retaining the services of a licensed nursing home administrator. Such hospital shall include, within its plan of care, assurances for the overall well-being of patients occupying such beds. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

F.<\/span> Nothing herein or set forth in Virginia’s rural health care plan shall prohibit any hospital designated as a critical access hospital from leasing the unused portion of its facilities to other health care organizations or reorganizing its corporate structure to facilitate the continuation of the nursing home beds that were licensed to such hospital prior to the designation as a critical access hospital. The health care services delivered by such other health care organizations shall not be construed as part of the critical access hospital’s services or license to operate. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

G.<\/span> Any medical care facility<\/span> licensed as a hospital shall be considered a rural hospital on and after September 30, 2004, pursuant to 42 U.S.C. § 1395ww(d)(8)(E)(ii)(II), if (i) the hospital is located in an area defined as rural by federal statute<\/span> or regulation; (ii) the Board<\/span> of Health defines, in regulation, the area in which the hospital is located as a rural health area or the hospital as a rural hospital; or (iii) the hospital was designated, prior to October 1, 2004, as a Medicare-dependent small rural health hospital, as defined in 42 U.S.C. § 1395ww(d)(5)(G)(iv). <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\n(EFFECTIVE JULY 1, 2028) AUTHORITY OF COMMISSIONER FOR CERTAIN HEALTH PLANNING\nACTIVITIES; RURAL HEALTH PLAN; DESIGNATION AS A RURAL HOSPITAL (\u00a7 32.1-122.07)\n\nA. The Commissioner, with the approval of the Board, is authorized to make\napplication for federal funding and to receive and expend such funds in\naccordance with state and federal regulations.\n\nB. The Commissioner shall administer section 1122 of the United States Social\nSecurity Act if the Commonwealth has made an agreement with the United States\nSecretary of Health and Human Services pursuant to such section.\n\nC. In compliance with the provisions of the Balanced Budget Act of 1997, P.L.\n105-33, and any amendments to such provisions, the Commissioner shall submit to\nthe appropriate regional administrator of the Centers for Medicare &\nMedicaid Services (CMS) an application to establish a Medicare Rural Hospital\nFlexibility Program in Virginia.\n\nD. The Commissioner shall develop and the Board of Health shall approve a rural\nhealth care plan for the Commonwealth to be included with the application to\nestablish a Medicare Rural Hospital Flexibility Program. In cooperation and\nconsultation with the Virginia Hospital and Health Care Association, the Medical\nSociety of Virginia, representatives of rural hospitals, and experts within the\nDepartment of Health on rural health programs, the plan shall be developed and\nrevised as necessary or as required by the provisions of the Balanced Budget Act\nof 1997, P.L. 105-33, and any amendments to such provisions. In the development\nof the plan, the Commissioner may also seek the assistance of the regional\nhealth planning agencies. The plan shall verify that the Commonwealth is in the\nprocess of designating facilities located in Virginia as critical access\nhospitals, shall note that the Commonwealth wishes to certify facilities as\n“necessary providers” of health care in rural areas, and shall\ndescribe the process, methodology, and eligibility criteria to be used for such\ndesignations or certifications. Virginia’s rural health care plan shall\nreflect local needs and resources and shall, at minimum, include, but need not\nbe limited to, a mechanism for creating one or more rural health networks, ways\nto encourage rural health service regionalization, and initiatives to improve\naccess to health services, including hospital services, for rural Virginians.\n\nE. Notwithstanding any provisions of this chapter or the Board’s\nregulations to the contrary, the Commissioner shall, in the rural health care\nplan, (i) use as minimum standards for critical access hospitals, the\ncertification regulations for critical access hospitals promulgated by the\nCenters for Medicare & Medicaid Services (CMS) pursuant to Title XVIII of\nthe Social Security Act, as amended; and (ii) authorize critical access\nhospitals to utilize a maximum of ten beds among their inpatient hospital beds\nas swing beds for the furnishing of services of the type which, if furnished by\na nursing home or certified nursing facility, would constitute skilled care\nservices without complying with nursing home licensure requirements or retaining\nthe services of a licensed nursing home administrator. Such hospital shall\ninclude, within its plan of care, assurances for the overall well-being of\npatients occupying such beds.\n\nF. Nothing herein or set forth in Virginia’s rural health care plan shall\nprohibit any hospital designated as a critical access hospital from leasing the\nunused portion of its facilities to other health care organizations or\nreorganizing its corporate structure to facilitate the continuation of the\nnursing home beds that were licensed to such hospital prior to the designation\nas a critical access hospital. The health care services delivered by such other\nhealth care organizations shall not be construed as part of the critical access\nhospital’s services or license to operate.\n\nG. Any medical care facility licensed as a hospital shall be considered a rural\nhospital on and after September 30, 2004, pursuant to 42 U.S.C. §\n1395ww(d)(8)(E)(ii)(II), if (i) the hospital is located in an area defined as\nrural by federal statute or regulation; (ii) the Board of Health defines, in\nregulation, the area in which the hospital is located as a rural health area or\nthe hospital as a rural hospital; or (iii) the hospital was designated, prior to\nOctober 1, 2004, as a Medicare-dependent small rural health hospital, as defined\nin 42 U.S.C. § 1395ww(d)(5)(G)(iv).\n\nHISTORY: 1989, cc. 617, 633; 2000, c. 903; 2002, c. 83; 2006, c. 378; 2025, cc.\n114, 135.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}