The Centers for Medicare and Medicaid Services has approved Adventist Health Columbia Gorge’s application to become a designated Critical Access Hospital.  The Joint Commission, which accredits hospitals, has accepted the application and will survey the hospital and its hospital-based clinics to finalize the transition to a Critical Access Hospital.  Adventist Health Columbia Gorge administrator Jayme Thompson says it’s a huge step forward toward final approval.  In order to finalize the new status, accreditation surveyors from The Joint Commission will perform an on-site evaluation of Adventist Health Columbia Gorge’s compliance with specific Critical Access conditions.  The survey focuses on patient safety, quality of care, and structural requirements and includes in-person observation, staff interviews, and record reviews.  A Critical Access Hospital is a special designation by the Centers for Medicare & Medicaid Services for small, rural hospitals to receive cost-based reimbursement from the federal government.