What is a Rural Health Clinic?

30-Minute Podcast "Overview of the RHC Program - A Snapshot in Time" (1/18/19) 

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 outpatient 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 Medically 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;
      • 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 tests
        • 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