Annually RHCs are required to conduct a program evaluation of the RHC program. This evaluation typically includes a review of active and closed medical records, a review, update, and approval of policy and procedures and protocols, a mock inspection of the clinic, a review of the volume and activity of the clinic and other procedures depending on the needs of the RHC. The goals and objectives of the annual evaluation process are to fulfill the obligation outlined in the Current Federal Register (42 CFR 491.11) and (Appendix G) Interpretative Guidelines of rural health clinic regulations related to program evaluation. The purpose of the evaluation is to determine whether:
1. the utilization of services was appropriate;
2. the established policies were followed; and
3. any changes are needed.
An evaluation of a clinic's total operation including the overall organization, administration, policies and procedures covering personnel, fiscal and patient care areas must be done at least annually. This evaluation may be done by the clinic, the group of professional personnel required under 42 CFR 491.9(b)(2), or through arrangement with other appropriate professionals.
The annual evaluation once complete must be reviewed and approved by the Medical Director, NP/PA/CNM of the clinic, and a community member or someone not on the payroll of the clinic and maintained at the clinic for review by state inspectors or deeming authorities. We conduct a number of these annual evaluations each year for our clients through fee-based engagements (Click here for our brochure). If you would rather conduct the annual evaluation internally we have provided a couple of documents that will help with the process including a template for the report and a mock inspection report.
We hope these templates are helpful. If you do feel the need for us to come onsite to assist with the annual evaluation, please email Mark Lynn at firstname.lastname@example.org or call or text at 423.243.6185.