Abortion Or Reproductive Health Centers
Any health care facility operated substantially for the purpose of performing abortions. Such a facility must be a free-standing unit and not part of a hospital or other facility licensed for other purposes by the State Board of Health.
Ambulatory Surgical Centers
Any health care facility with the primary purpose of providing medically necessary or elective surgical care. Excluded from this definition are the offices of private physicians and dentists, including those organized as professional corporations, professional associations, partnerships, or sole proprietorships.
Assisted Living Facilities
An individual, individuals, corporation, partnership, limited partnership, limited liability company or any other entity that provides, or offers to provide, residence and personal care to three or more individuals who are in need of assistance with activities of daily living.
Exceptions: Refer to Rules for Assisted Living Facilities
Specialty Care Assisted Living Facility
A facility that meets the definition of Assisted Living Facility but which is specially licensed and staffed to permit it to care for residents with a degree of cognitive impairment that would ordinarily make them ineligible for admission or continued stay in an assisted living facility.
Cerebral Palsy Centers
A building or place maintained for the care of patients suffering from that group of neuromuscular disorders in which there is impairment or loss of muscular control due to an abnormality of the brain. Included are institutions that provide dormitory facilities and which offer custodial care or an educational program, but this does not include day schools or clinics where the patients attend during the day and return to their homes at night.
Community Mental Health Centers
The Office of Mental Illness Community Programs serves as a liaison between the DMH/MR and community mental health providers in an effort to enhance treatment for consumers. The office works to ensure that quality standards are implemented and maintained throughout the community provider network. This office is responsible for:
- Planning and implementing new programs designed to further enhance treatment and quality of life.
- Working with community providers to maintain quality standards in existing services.
- Improving the community continuum of care available to adults with serious mental illness and children and adolescents with severe emotional disturbance with particular emphasis on services that divert admissions to and enhance discharges from state hospitals and other more restrictive treatment settings.
- Planning and coordinating services with other state agencies, advocacy organizations, state and local providers, insurers, and other interested parties.
Visit the Department of Mental Health to learn how to become a provider.
End Stage Renal Disease Treatment and Transplant Centers
Facilities that are intended to treat persons suffering permanent and irreversible kidney failure, who require dialysis on a regular maintenance basis, or who may be suitable candidates for kidney transplantation. The facilities that are classified under these Rules as "End Stage Renal Disease Treatment and Transplant Centers" are further defined in these Rules as Renal Dialysis Centers, Renal Dialysis Facilities and Renal Transplantation Centers.
Federally Qualified Health Centers
Provides preventive primary health services when furnished by or under the direct supervision of a physician, nurse practitioner, physician assistant, certified nurse midwife, clinical psychologist, or clinical social worker.
The Federally Qualified Health Center (FQHC) benefit under Medicare was added effective October 1, 1991, when Section 1861(aa) of the Social Security Act was amended by Section 4161 of the Omnibus Budget Reconciliation Act of 1990. FQHCs are "safety net" providers such as community health centers, public housing centers, outpatient health programs funded by the Indian Health Service, and programs serving migrants and the homeless. The main purpose of the FQHC Program is to enhance the provision of primary care services in underserved urban and rural communities.
Medicare pays FQHCs an all-inclusive per visit amount based on reasonable costs with the exception of all therapeutic services provided by clinical social workers and clinical psychologists, which are subject to the outpatient psychiatric services limitation. This limit does not apply to diagnostic services. Medicare also pays Rural Health Clinics (RHC) on the same basis.
Designation - An entity may qualify as an FQHC if it is:
- Receiving a grant under Section 330 of the Public Health Service (PHS) Act;
- Receiving funding from such grant under a contract with the recipient of a grant and meets the requirements to receive a grant under Section 330 of the PHS Act;
- Determined by the Secretary of the Department of Health and Human Services to meet the requirements for receiving such a grant (look-alike) based on the recommendation of the Health Resources and Services Administration; or
- An outpatient health program or facility operated by a tribe or tribal organization under the Indian Self-Determination Act or by an urban Indian organization receiving funds under Title V of the Indian Health Care Improvement Act as of October 1, 1991.
FQHCs also provide preventive primary health services when furnished by or under the direct supervision of a physician, nurse practitioner, physician assistant, certified nurse midwife, clinical psychologist, or clinical social worker.
Home Health Agencies
A program which provides skilled nursing services and at least one of the following other therapeutic services: physical therapy, speech language pathology, or occupational therapy, medical social services, or home health aide services in a place of residence used as a patient's home. The HHA must provide at least one of these services (i.e., skilled nursing, physical therapy, speech language pathology, occupational therapy, medical social services, or home health aide services) directly and in its entirety by employees of the HHA. The other therapeutic service and any additional services may be provided either directly or under arrangement. HHAs are not required to be licensed by the Alabama State Board of Health but may apply for certification in Medicare and Medicaid programs.
A coordinated program of home, outpatient, and inpatient care and services including the coordination of the services listed below to hospice patients, and families, through a medically directed interdisciplinary team, under the Code of Alabama, 1975, in order to meet the physical, psychological, social, spiritual, and other special needs that are experienced during the final stages of illness, dying, and bereavement:
- Nursing care by or under the supervision of a registered nurse.
- Medical social services by a social worker under the direction of a physician.
- Services of an aide.
- Medical supplies including drugs and biologicals, and the use of medical appliances.
- Physician's services.
- Short-term inpatient care, including both palliative and respite care and procedures.
- Counseling for hospice patients and hospice patients' families.
- Services of volunteers under the direction of the provider of the hospice care program.
- Bereavement services for hospice patients' families.
A health institution planned, organized, and maintained for offering to the public, generally, facilities and beds for use in the diagnosis and/or treatment of illness, disease, injury, deformity, abnormality or pregnancy, when the institution offers such care or service for not less than twenty-four consecutive hours in any week to two or more individuals not related by blood or marriage to the owner and/or chief executive officer/administrator. In addition, the hospital may provide for the education of patients, medical and health personnel, as well as conduct research programs to promote progress and efficiency in clinical and administrative medicine.
Independent Clinical Laboratory
Any laboratory which operates primarily independent of other health care facilities that are licensed by the Alabama State Board of Health, or hospital laboratories that receive and perform reference work from sources outside of the hospital, and performs diagnostic and medical laboratory procedures upon referral.
Independent Physiological Laboratory
Any facility or unit, mobile or otherwise, that provides diagnostic physiological services for humans, for example, pulmonary function tests, spirometer, EKG, Holter monitor, EEG, transtelephonic pacemaker analysis, oximetry, diagnostic hearing tests, echo-ultrasound, diagnostic ultra sound, doppler studies, and non-invasive peripheral vascular studies. Facilities that provide ionizing radiation or magnetic resonance imaging only are excluded from this definition. Private physician offices performing diagnostic physiological services exclusively for their patients are excluded from this definition.
A business entity that is engaged in providing housing, meals and care to sick or disabled individuals who require, on a daily basis or more frequently, medical care, nursing care, or rehabilitation services. This definition shall not include any business, operation, or facility that is exempt from licensure pursuant to Alabama law, nor shall it include any business, operation, or facility that is (1) licensed by the Alabama State Board of Health as another kind of facility, and (2) functioning within the scope of applicable law and administrative rules.
Portable X-Ray Suppliers
A mobile service that provides diagnostic x-ray tests (including tests furnished in a place of residence used as the patient's home) under the supervision of a physician.
Psychiatric Residential Treatment Facilities (PRTF)
A psychiatric hospital enrolled as a Medicaid provider or a psychiatric residential treatment facility (RTF) which is accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the Commission on Accreditation of Rehabilitation Facilities (CARF), the Council on Accreditation of Services for Families and Children (COA), or by another accrediting organization with comparable standards that is recognized by the State, that meets pertinent regulations and provides a range of comprehensive services to treat the psychiatric condition of residents under the age of 21 on an inpatient basis under the direction of a physician. The purpose of such comprehensive services is to improve the resident's condition or prevent further regression so that the services will no longer be needed.
A business entity offering and providing outpatient assistance in the rehabilitation of disabled persons by providing two or more services that must be performed by or under the supervision of a physical therapist, occupational therapist or speech pathologist.
Rural Health Clinics
A clinic that is located in a rural area designated as a shortage area and is not a rehabilitation agency or a facility primarily for the care and treatment of mental diseases. The Rural Health Clinic program is intended to increase primary care services for Medicaid and Medicare patients in rural communities. RHCs can be public, private, or non-profit. The main advantage of RHC status is enhanced reimbursement rates for providing Medicaid and Medicare services in rural areas. RHCs must be located in rural, underserved areas ad must use one or more physician assistants or nurse practitioners.
Sleep Disorder Facilities
A free-standing outpatient medical facility that evaluates and treats patients with sleep disorders.
Page last updated: November 26, 2019