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Rural Health Clinic (RHC) Standards Revisions

In response to the latest guidelines implemented by the Centers for Medicare & Medicaid Services (CMS), we have updated our RHC standards to align with new regulations and best practices. These revisions are not just procedural changes—they are integral to advancing the quality of care you provide and supporting your ongoing efforts for patient well-being.

Effective October 14, 2024, these revisions will be implemented. For a comprehensive overview of the changes, please download the updated standards manual by clicking the button below:

To assist in identifying the updates, please refer to the Change Report available for download below.

Overview of Key Revisions:

  • Nurse Practitioner Requirements (14-E-2)
    • New criteria for certification and educational standards, further verifying the qualifications, documentation, and readiness of your nursing staff.
  • Staffing Requirements (14-E-7)
    • Mandatory that at least one physician assistant or nurse practitioner must be an employee, reinforcing consistent and dependable patient care.
  • Availability of Patient Care Services (14-E-10)
    • Defined guidelines on the availability and presence of various healthcare professionals to provide comprehensive care during all clinic operating hours.
  • New Standards and Definitions
    • Updated standards, established clear guidelines, and precise definitions for roles such as certified nurse-midwives, clinical psychologists, clinical social workers, marriage and family therapists, mental health counselors, and secretaries.

Please review the Change Report in full for details.

At QUAD A, our commitment to excellence is unwavering: Patients First. Always. We are here to support you in upholding the highest standards of care so that every aspect of your practice reflects our shared dedication to patient safety and quality.

Remember your adherence to these guidelines is mandatory. If you have any questions about these standards or need further assistance, reach out to us at standards@quada.org. Together, we’ll navigate every step with clarity and confidence.


Since 1980, QUAD A (a non-profit, physician-founded and led global accreditation organization) has worked with thousands of healthcare facilities to standardize and improve the quality of healthcare they provide – believing that patient safety should always come first.