Hospital census continues to drive revenues under the current fee-for-service and cost-based payment systems in rural Prospective Payment System (PPS) hospitals and Critical Access Hospitals (CAHs). Rural hospitals, in particular, have experienced overall declining acute-care admissions and decreasing hospital revenues over the last several years. With the AHA’s 2019 Rural Report citing 136 rural hospital closures since 2010, the rising number of closures is disrupting access to medical care and services in rural communities and increasing area unemployment*. Staff competencies, provider availability, and ancillary services provided by each hospital often dictate the hospital’s ability to care for certain patient populations and level of acuity. However, most hospitals do not go through a formal process to define which patients can be appropriately cared for at their facility.