This past week I was visiting with our Healdsburg District Hospital Program in Northern California. I really look forward to my visits at that program for a few reasons. One is that it is the epicenter of California wine country, two is that I really enjoy meeting up with the Medical Director Dan Rose, and three, I am always impressed at how well that small 25 bed hospital program is doing.Healsdburg is one of only thirty-one designated Critical Access Hospitals in CA. This identification is primarily based on the consideration of that hospital serving a "rural" community. Along with this designation comes the ability to be reimbursed by Medicare and Medicaid differently than other hospitals. This reimbursement matrix is based onCost-based reimbursement from Medicare, which has the potential to increase revenues. Another financial benefit is that capital improvement costs can be included in allowable costs for determining Medicare reimbursement. Understanding the nuances with Method II, or other aspects of CAH billing is really the key here. These two aspects, along with the common need found in the area of most CAH's, makes an outpatient Wound Care program a very good fit with Critical Access Hospitals in many cases.Now I did say, "many", not all. Here are the caveats; rural areas do make referrals slightly more difficult in some cases. An exceptional team led by a Physician Champion with an excellent reputation in the local community is paramount. A strong marketing and PR campaign is needed to raise awareness, and a careful development process to be certain that the billing and coding components are set up appropriately is vital.The addition of a wound center at a CAH makes a lot of sense if these issues, along with a host of others, are addressed first. Healdsburg is approaching it first full year of operation and has blown both the financial and clinical projections out of the water. It stands as a great example of how a Critical Access Hospital Wound Care Center can and should operate.Maybe wine isn't so bad for you after all.