RHC Certification and Conversion


The process to Become a Rural Health Clinic

The process to become a rural health clinic is long and will involve pulling together certain documents for various governmental entities which will review the submissions and approve them as we go along. The usual process takes between 6 months to a year to complete all five steps listed below.

  1. Preparation and submission of the 855As , State application, and deeming authority applications.

  2. Preparation for State Inspection including preparing RHC and Emergency Preparedness Policy and Procedure manuals

  3. Emergency Preparedness Training and Testing.

  4. Passing the RHC survey or responding to deficiencies in the survey.    

  5. Obtaining provider numbers for Medicare and Medicaid as well as rate setting.

Rural Health Clinic Information Resources

 We also would like to inform you of our educational resources including our Facebook Group, website, webinars, YouTube channel and seminars on RHCs. We highly recommend joining our Facebook Group as we use this to notify the 550 members about our free webinars and educational offerings by other consultants or the NARHC.

Preparing for the RHC State Inspection Webinar and Materials

On December 13, 2018 Healthcare Business Specialists presented a webinar on preparing for the state/AAAASF/TCT inspections to become a rural health clinic and re-inspections conducted by the state, AAAASF, and TCT. Here is the recording of the webinar and the PDF of the presentation:

RHC Survey Preparation Steps and Resources

As you prepare for the RHC inspection here are some resources to help you comply with the nine conditions of participation to become a rural health clinic. It is important to start acting as if you are a rural health clinic before the inspection. We have provided some resources for you to review and start working on before the Mock Inspection occurs. The Mock Inspection is designed to be educational and instructional and will elaborate on the processes and procedures that the State Inspectors, AAAASF, and The Compliance Team will expect to be in place by the time of the Certification inspection. Please click on the links below to view the documents:

Forms from HBS to help through the Certification Process

Healthcare Business Specialists works with physician practices to convert them into rural health clinics. Here are some of the documents and questionnaires we use to get information from our clients.

CMS RHC Training Modules

On August 22, 2017 CMS published RHC and FQHC Basic Training Online Course (RFBTOC) which is a series of training modules for RHC  inspectors or new RHCs. The course will take approximately 25 hours to complete.  Rural Health Clinics (RHC) are required to comply with the Federal requirements set forth in the Medicare Conditions for Certification/Conditions for Coverage in order to receive Medicare and/or Medicaid payment. The goal of an RHC survey complaint survey is to determine whether the RHC complies with its applicable Conditions of Participation at 42 CFR 491, Subpart A. The link to find the RHC survey training course is as follows:

Startup Tools



Enrollment Information

Rural Health Clinics Center - CMS


Medically underserved areas

Rural Health Clinics must be located in a medically underserved area. The following links take you to the HRSA website with the HPSA, MUA, and MUP listings:

Health Professional Shortage Area Database         

Medically Underserved Area/Medically Underserved Population (MUA/MUP) Database