Certify a Comprehensive Outpatient Rehabilitation Facility

Purpose: A facility should contact the Acute and Home Care Licensure and Certification Section within three months prior to being operational for an application packet. The information should be completed and returned to the section. The facility must have seen patients and be in operation before an initial survey can be scheduled. The initial survey will be scheduled within three weeks of receiving notice of the fiscal intermediary's approval. If the facility has deficiencies during the initial survey, then the effective date of participation will be the date the section receives an acceptable plan of correction signed by the facility. All information is forwarded to the Atlanta Centers for Medicare and Medicaid Services Regional Office for approval. The regional office is responsible for assigning the provider number and notifying the fiscal intermediary.

If the proposed Comprehensive Outpatient Rehabilitation Facility projects are to have medical diagnostic equipment in excess of $500,000, it may be a "diagnostic center" in accordance with G.S. 131E-176(7a) and would have to get a certificate of need.

Contacts: For questions regarding any part of this process, please contact the appropriate sections of the N.C. Division of Health Service Regulation.

Acute and Home Care Licensure and Certification Section 919-855-4620
Certificate of Need Section 919-855-3873

Procedures:

  1. Obtain a certificate of need, if necessary: Certificate of Need Section
    1. If proposing to develop a comprehensive outpatient rehabilitation facility, the applicant first contacts the Certificate of Need Section to obtain a determination of whether the proposal requires a certificate of need.
    2. The Certificate of Need section makes its determination based on the proposed capital expenditure for the project. A copy of the determination is sent to the Acute and Home Care Licensure and Certification Section.
  2. Obtain Medicare/Medicaid certification: Acute and Home Care Licensure and Certification Section
    1. The applicant requests an application packet from the section three months prior to operation.
    2. The applicant completes the required information and returns it to the section.
    3. The Medicare application (CMS Form 855) is forwarded by the provider to the fiscal intermediary for approval. An initial survey will be scheduled with approval of the application by the fiscal intermediary.
    4. The section schedules the survey within three weeks of the approval by the fiscal intermediary and after patients are being seen.
    5. If the facility has deficiencies during the initial survey, then the effective date for participation will be the date that the section receives an acceptable plan of correction signed by the facility.
    6. The section forwards all information to the Atlanta Centers for Medicare & Medicaid Services (CMS) Regional Office for approval.
    7. The regional office assigns the CMS Certification Number (CCN) and notifies the fiscal intermediary.