MPCA CHC - RHC

"Assuring access to quality healthcare for all Montanans."

The Difference Between RHCs and CHCs

WHAT IS THE DIFFERENCE BETWEEN A COMMUNITY HEALTH CENTER AND A RURAL HEALTH CLINIC?

For a detailed comparison of the difference between Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs), please read this document (pdf).

WHAT TO LOOK FOR	Community Health Center	Rural Health Clinic	WHAT IT MEANS
1. Is the facility required to devote all its revenue to providing health care to people in its community?	YES	NO	CHCs must be either not-for-profit or public. RHCs may be either for-profit or not-for-profit.
2. Is the facility governed by a Board of Directors whose members are patients at the facility?	YES	NO	At least 51% of a CHC's Board of Directors must be composed of members who are patients at the center. RHCs are not required to have a Board of Directors.
3. Does the facility provide services for everyone regardless of age?	YES	NO	CHCs must provide care for all ages. RHCs may be limited to a specific type of primary care practice (OB-GYN, pediatrics, etc)
4. Is the facility required to provide a full range of primary care and preventive services?	YES	NO	CHCs must provide primary health care, maternity & pre-natal care, preventive care for infants, children & adults, some emergency care, Mental Health/SA, dental and pharmaceutical services. RHCs have no minimum service requirements
5. Is the facility required to provide emergency medical services after normal business hours?	YES	NO	CHCs are required to provide emergency care on a 24 hour basis. RHCs have no requirement for after-hour emergency care.
6. Is the facility required to serve anyone regardless of ability to pay?	YES	NO	CHCs are required to serve all residents of their service area with charges on a sliding fee scale based upon ability to pay. RHCs are not required to provide services to low-income patients or to provide sliding fee reductions to charges. If a RHC employs a NHSC provider, those services must be provided on a sliding fee scale.
7. Is the facility required to maintain an ongoing Quality Assurance Program?	YES	NO	CHCs are required to have an ongoing quality assurance program that identifies and takes actions necessary to correct problems. RHCs have no specific requirements for quality assurance plans.
8. Is the facility located in an area that is currently designated as a Medically Underserved Area (MUA) or as a Health Professional Shortages Area (HPSA)?	YES	NO	CHCs must be located in a rural or urban area where communities experience barriers to receiving health care (MUAs and HPSAs). RHCs may retain their status even if their service areas are no longer designated as rural or as shortage areas.
9. Is the facility required to be open for evening and/or weekend hours for the convenience of working families?	YES	NO	CHCs are required to be open at least 32 hours per week; emergency coverage after normal business hours is also required. RHCs have no minimum hours or emergency coverage requirements.
10. Is the facility required to submit regular financial reports, including independent annual audits?	YES	NO	CHCs are required to submit an annual independent audit as well as regular financial reports. RHCs must submit an annual audit but have no specific financial reporting requirements.
11. Federal Tort Claim Act ( FTCA)	YES	NO	CHC's - Eligible RHC's - Not eligible
12. Federal Drug Pricing	YES	NO	CHC' s - Optional RHC's - Not required
13. Transportation	YES	NO	CHC's - Required through the site or through arrangement RHC's - Not Required
14. Case Management	YES	NO	CHC's - Required on site or through arrangement RHC's - Not required
15. Hospital admitting privileges	YES	NO	CHC's - Required RHC's - No, but can be provide through arrangement
16. Annual redesignation/recertification	YES	YES	CHC's - Statement of compliance with criteria or grant review ( for a PHS funded site) RHC's - Extensive on-site survey
17. Agency responsible for recertification	YES	YES	CHC's - PHS Regional Office/BPHC/CMS Automatic for 329/330/340 RHC's - State licensing agency and CMS
18. Prospective Payment System (PPS) for Medicaid Covered Services	YES	YES	CHC's - Effective January 1, 2001 RHC's - Effective January 1, 2001

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Montana Primary Care Association
1805 Euclid Avenue
Helena, MT 59601
Phone: (406) 442-2750
Fax: (406) 449-2460