HI 00401.250 Rural Health Clinic (RHC) Defined

Citations:

Social Security Act—Sec. 1861(aa)

Regulations No. 5—Secs. 405.2401-405.2430

A rural health clinic is a facility which:

A. is engaged primarily in furnishing to out-patients, services described in HI 00401.255 ;

B. in the case of a facility which is not a physician-directed clinic, has an arrangement (consistent with the provisions of State and local law relative to the practice, performance and delivery of health services) with one or more physicians (see HI 00401.295 ). Provision must be made for the periodic review by physicians of covered services furnished by physician assistants and nurse practitioners, their supervision and guidance, the preparation by physicians of necessary medical orders for care and treatment of clinic patients, and the availability of physicians for necessary referral of, and consulation for, patients, for advice and assistance in the management of medical emergencies, and, in the case of a physician directed clinic, has one or more of its staff physicians perform the activities accomplished through such an arrangement;

C. maintains clinical records on all patients;

D. has arrangements with one or more hospitals, having agreements in effect under section 1866 of the Act for the referral and administration of patients requiring inpatient services or such diagnostic or other specialized services as are not available at the clinic;

E. has written policies, developed with the advice of (and with provision for review of such policies from time to time by) a group of professional personnel, including one or more physicians and one or more physician assistants or nurse practitioners, to govern the services described in HI 00401.255 ;

F. has a physician, physician assistant, or nurse practitioner responsible for the execution of policies described in E. and relating to the provision of the clinic's services;

G. directly provides routine diagnostic services, including clinical laboratory services, as prescribed in regulations and has prompt access to additional diagnostic services from facilities meeting requirements under title XVIII;

H. in compliance with State and Federal law, has available for administering to clinic patients at least such drugs and biologicals as are determined by the Secretary to be necessary for the treatment of emergency cases and has appropriate procedures or arrangements for storing, administering and dispensing drugs and biologicals;

I. has appropriate procedures for review of utilization of clinic services to the extent that the Secretary determines to be necessary and feasible; and

J. meets such other requirements as the Secretary may find necessary in the interest of health and safety of the individuals who are furnished services by the clinic.

For POMS purposes, the term rural health clinic includes only a facility which is located in an area which is not an urbanized area and that is designated by the Secretary as a shortage area, that is, having a shortage of health manpower or personal health services.