Rural Health Clinics

A "rural health clinic" means a facility which is engaged in furnishing primary health services to outpatients by physicians, physician assistants or nurse practitioners, including but not limited to health services related to family medicine, internal medicine, pediatrics, obstetrics, and gynecology and such services and supplies incident thereto. Such facility shall be located in an area that is not an urbanized area, as defined by the Bureau of the Census, in which there are insufficient numbers of needed health care practitioners, as determined by the secretary of the Louisiana Department of Health, and which has been determined to be a rural health clinic by the secretary of said department under 42 U.S.C. 1395aa(a).
La. R.S. 40:2197

 

Regulations

Licensure

Licensure Requirements

  • Initial License Application
  • Renewal Application
  • Services Actions
    • The information and forms in this packet are designed to assist providers in notifying Health Standards of service actions at Rural Health Clinics such as the following: 
      • Adding service
      • Removing service
      • Changing the space where service are provided
      • Altering and/or renaming rooms on the floor plan that is currently on file with this agency.
    • If any of these changes occur in a RHC that is licensed as an offsite campus of a hospital, a Hospital Change Packet will need to be submitted to the Hospital Program Manager assigned to the hospital. 
  • Changes in Hours of Operation
  • Payment Information: 

Certification Requirements

There are 3 ways that a Rural Health Clinic can be licensed and certified in Louisiana.

 An independently licensed RHC that is independently certified as a RHC
  1. This type will not be associated with a hospital.
  2. This type will have its own independent license, which is not linked with any other facility type.
  3. This type will submit a Rural Health Clinic license application to become a licensed RHC (not a hospital license application)
  4. This type will submit a CMS 855A to become a certified Rural Health Clinic and check off that it is enrolling as a “Rural Health Clinic”
An independently licensed RHC that is certified as an independent RHC but provider-based to the hospital
  1. This type will be associated with a hospital.
  2. This type will have its own independent license, which is not linked with any other facility type.
  3. This type will submit a Rural Health Clinic license application to become a licensed RHC (not a hospital license application)
  4. This type will submit a CMS 855A to become a certified Rural Health Clinic, check off that it is enrolling as a “Rural Health Clinic” (not a hospital), and indicate that it will be provider-based to the hospital.
  5. Please keep in mind that this type must be able to demonstrate compliance with provider-based requirements if asked by CMS
An RHC that is licensed as an outpatient department of the hospital, certified as an independent RHC but provider based to the hospital.
  1. Only Hospitals with fewer than 50 beds can be considered for this option.
  2. This type will have a HOSPITAL license with “RHC” included in the license number.  Please remember that this type must demonstrate that it is 100% owned by the hospital and can’t operate separately from the hospital.  Example: If the hospital is closed, the RHC will automatically close.
  3. This type will submit a Hospital license application to become a licensed offsite campus outpatient department of the hospital (not a Rural Health Clinic license application)
  4. This type will submit a CMS 855A to become a certified Rural Health Clinic, check off that it is enrolling as a “Rural Health Clinic” (not a hospital), and indicate that it will be provider-based to the hospital.  (Do not submit a CMS 855A to become a practice location of the hospital)
  5. Please keep in mind that this type must be able to demonstrate compliance with provider-based requirements if asked by CMSHSS-RH-01 Rural Health Clinic License Application

Change of Ownership Information

Additional Documents Required

  1. *License Application Emergency Preparedness Addendum form (Medicare Certified RHC)
  2. *Form CMS-1561A Health Insurance Benefit Agreement (Medicare Certified RHC)
  3. *Electronic verification from the Office of Civil Rights (OCR) of successful submission. (Medicare Certified RHC) Click here for the form
  4. OSFM inspection
  5. OPH inspection
  6. IRS Information Showing Legal Name & EIN

For all other Change of Ownership Information, please contact the HSS Ownership Group

Emergency Prepardness 

Helpful Links

Contact

Melissa Jacobs
[email protected]
225-342-6194

Accreditation Organizations

American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF)
5101 Washington St., Ste 2F
P.O. Box 9500
Gurnee, IL 60031
888-545-5222
The Compliance Team (TCT)
905 Sheble Lane, Ste 102
P.O. Box 160
Springhouse, PA 19477
215-654-9110

Surgeon General Evelyn Griffin, MD

Secretary Bruce D. Greenstein

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