New RHC Application Process

New RHC Application Process

1. Ensure that the new RHC address is located in Health Professional Shortage Area (HPSA) by utilizing the HPSA Find tool.

2. Ensure that the RHC address is located outside of an urbanized area according to the 2010 Census Bureau data OR is outside of an urban area according to the 2020 Census Bureau data (see CMS Memorandum QSO-23-12-RHC for more on this interim guidance) by utilizing TIGERweb by the US Census Bureau. 

  • On the lefthand side of the screen, check the box next to "Urban Areas". Then, zoom in or search for the desired location.
  • To export or print, click on the print icon in the upper right. Choose the desired layout and file format, check the box next to "Print Legend" and click "Generate Map". 

3. Complete the RHC Application Packet and submit it to the Indiana Department of Health (IDOH) and Medicare:

4. Choose a surveying agency for your new RHC and complete the corresponding application and supporting documents:

  • Quad A
    • Application 
      • The 855A Approval Letter from Medicare is required to submit the application. The approval letter can be found on the clinic's Medicare status portal by click "View Approval". See example here.
      • RHCs will need to submit in the application a TIGERweb screenshot, signed Business Associate Agreement (BAA) between the RHC and Quad A, signed RHC Accreditation Agreement, and a 30-day staff schedule form (including one form for each mid-level provider).
    • Next Steps:
      • After submitting the application online, Quad A will process it within 10 business days. If there are no questions about the application, Quad A requests a 90-day window for the initial survey, during which they will come to the clinic unannounced to conduct the initial survey.
  • The Compliance Team (TCT)
    • Application
    • HR Files Tool
    • Next Steps:
      • After submitting the application and HR Files Tool, TCT will conduct a series of live advisor calls with the clinic to review TCT standards and the survey process.
      • TCT will collect a Business Associate Agreement (BAA), CMS 29 form (linked under Step 2), HR File Tool, floor plan, CLIA certificate, and the 855A approval letter from Medicare (Click on "View Approval" in the Medicare status portal. See example here.).
      • TCT will send the clinic the Onsite Ready Form. On this form, the clinic chooses their ready date, including five (5) blackout dates, as needed.
      • TCT will come to the clinic unannounced to conduct the initial survey.
  • The Indiana Department of Health (IDOH) cannot conduct initial surveys.

5. Below is an overview of the new RHC application process for Indiana:


RHC Certification Resources

RHC Regulations:

For changes to your existing RHC program: