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Medicare Conditions of Participation
Certification of Certain Health Facilities

6.) Certification of Certain Health Facilities

        a.) Rural health clinics and FQHCS

A rural health clinic (RHC) and federally qualified health center (FQHC) must comply with the following requirements in order to be certified for participation in Medicare:144

  • A RHC must be located in a rural area that is designated in a shortage area.145 A FQHC must be located in a rural or urban area that is designated as either a shortage area or an area that has a medically underserved population. Both the RHC and the FQHC may be permanent or mobile units.
  • A RHC or FQHC must comply with requirements relating to construction, maintenance, and emergency procedures.146
  • A RHC or FQHC must maintain a clinical record system. For each patient receiving health care services, the clinic or center must maintain a record in a manner that protects patient confidentiality.147
  • A clinic or center must have an annual evaluation of its total program that reviews the utilization of its services, clinical records, and health care policies.148



  • 144. 42 C.F.R. § 491.3
  • 145. 42 C.F.R. § 491.5
  • 146. 42 C.F.R. § 491.6
  • 147. 42 C.F.R. § 491.10
  • 148. 42 C.F.R. § 491.11