How to Start a Rural Health Clinic

One of the more common questions that we have each year is “how do you start a rural health clinic in Mississippi?”  The answer is in several parts:

Step 1

The first step is to determine if your site is eligible. Contact the Mississippi State Department of Heath, Office of Rural Health Clinic Licensure to find out if your site qualifies for RHC status. The site must be in a U.S. Census non-urbanized area, and in a health professional shortage or underserved area designated within the last four years. The Office or Rural Health and Primary Care can also assist with this.

Step 2

The second step is to evaluate the financial feasibility of RHC status based on estimated (for new clinics) or actual (for existing clinics) data on payer mix – Medicare, Medicaid, other. Existing practices that do not have an NP, PA or CNM on staff must consider whether the cost of hiring one will be offset by increased revenue.

Step 3

The third step in the certification process is filing an RHC application and a CMS provider enrollment form. Contact the Office of Rural Health Clinic Licensure for an RHC application packet. The CMS 855A Medicare Enrollment Application – Institutional Providers form is available on the CMS web site.

You will be notified whether you are eligible for the RHC program after your application has been processed. If eligible, the next step is the RHC Certification inspection. When you are ready for inspection and in compliance with RHC requirements, you may either notify the Office of Rural Health Clinic Licensure for an inspector to come, or you may partner with a third party entity such as The Compliance Team (see our sponsor directory). The survey will be conducted, and if you pass, you will be eligible for step 4.

Step 4

The last step of the certification process is the RHC Cost Report. Once a clinic has received its Medicare Provider Letter from CMS, the clinic files a projected cost report to have its Medicare Rate determined. It is important to get expert advice from someone familiar with the CMS-222 Schedule M Cost Report. Accuracy can have significant financial impact on a year-end cost report.
For more detailed information about becoming an RHC, visit the Rural Assistance HUB – Starting a Rural Health Clinic