Comment on DOD-2008-HA-0007-0001

As the CEO of Grays Harbor County Public Hospital District #1, I would like to endorse the changes proposed. However, I would like to see the regulation eliminate the clause that limits payment to charges. Providing care in rural communities that often have a very depressed economy is financially challenging and often exceeds the cost of providing the same care at larger facilities. Critical access hospitals play a very important and necessary role within the communities they serve, often filling a large gap in healthcare services. The proposed changes will help to ensure the continued survival of rural hospitals like ours.