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What is a Rural Health Clinic?
RURAL HEALTH CLINICS ACT - PL 95-210: AN OVERVIEW
The purpose of the Rural Health Clinics program is to encourage and stabilize the provision of out-patient primary care in underserved rural areas through the use of physicians, physician assistants (PAs) , nurse practitioners (NPs) and certified nurse midwives (CNMs). The following is an overview of the major requirements clinics must meet in order to become certified as a Rural Health Clinic.
1. Location - Rural Health Clinics must be located in communities that are both "rural" and "underserved". For purposes of the Rural Health Clinics Act, the following definitions apply to these terms:
- Rural Areas - Census Bureau designation as "Non-urbanized"
- Shortage Area - a federally designated Health Professional Shortage Area, a federally designated Mediically Underserved Area or an Area designation by the state's Governor as underserved.
2. Physical Plant
- May be permanent or mobile
- Has a preventive maintenance program
- Has non-medical emergency procedures
3. Staffing
- One or more physicians
- One or more PAs, NPs or CNMs
- PA, NP or CNM must on-site and available to see patients 50% of the time the clinic open for patients.
4. Provision of Services
Each Rural Health Clinic must be capable of delivering out-patient primary care services. The Clinic must maintain written patient care policies:
- Developed by a physician, physician assistant or nurse practitioner, and one health practitioner who is not a member of the clinic staff
- Describes the services provided directly by the clinic's staff or through arrangement
- Provide guidelines for medical management of health problems; and,
- Provide for annual review of the policies
Direct Services (must be provided by clinic staff)
- Provide diagnostic and therapeutic services commonly furnished in a physician's office
- Basic laboratory services (6 tests)
- Chemical examinations of urine
- Hemoglobin or Hematocrit
- Blood sugar
- Examination of stool specimens for occult blood
- Pregnancy test
- Primary culturing for transmittal
Emergency Services
- First response to common life-threatening injuries and acute illnesses
- Has available drugs used commonly in life-saving procedures
Services Provided through Arrangement (may be provided by individuals other than clinic staff)
- In-patient hospital care
- Specialized physician services
- Specialized diagnostic and laboratory services
- Interpreter for foreign language if indicated
- Interpreter for deaf and devices to assist communication with blind
5. Patient Health Records
- Record System Guided by Written Policies and Procedures
- Designated Professional Staff Member Responsible for Maintaining Records
- Records must include the following information
- Identification data
- Physicians orders
- Physical exam findings
- Consultative findings
- Social data
- Diagnostic and laboratory reports
- Consent forms
- Medical history
- Health status assessment
- Signatures of the physician or other health care professionals
Protection of Record Information Policies
- Maintenance of confidentiality, safeguards against loss, destruction or unauthorized use
- Written policies and procedures govern use and removal and release of information
- Written patient consent is required for release
CMS Link to Document regarding Swing Bed Billing
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