To extend the nonenforcement instruction for the Medicare direct supervision requirement for therapeutic hospital outpatient services insofar as it applies to critical access hospitals and rural hospitals, to require a study of the impact on critical access hospitals and rural hospitals of a failure to extend such instruction, and for other purposes.

Directs the Secretary of Health and Human Services (HHS), during a specified extension period, to extend the therapy supervision nonenforcement instruction (the enforcement instruction on supervision requirements for outpatient therapeutic services in critical access and small rural hospitals, as extended for calendar year 2013 by the Centers for Medicare & Medicaid Services).

Directs the Secretary to study the impact (including the economic impact and the impact upon hospital staffing needs, if any) on critical access hospitals and small rural hospitals of not extending the therapy supervision nonenforcement instruction.