Chapter 21, “Federal Tort Claims Act (FTCA) Deeming Requirements” of the Health Resources and Services Administration (HRSA) Health Center Compliance Manual (Compliance Manual Chapter 21) outlines the compliance expectations for review of the FTCA section during an Operational Site Visit.  The review is conducted by the Clinical Consultant, utilizing the HRSA Health Center Program Site Visit Protocol (SVP) (Site Visit Protocol FTCA), and is only completed for health centers that are currently FTCA deemed.  

With the transition to and implementation of Virtual Operational Site Visits (VOSVs), many health centers are questioning how the FTCA section of the review is conducted and what HRSA’s expectations are regarding compliance.  Although the methodology and logistics for conducting OSVs for some sections of the review have changed, the expectations regarding compliance have not.  The health center is expected to upload the required documents to the Citrix ShareFile platform and utilize the GoToMeeting platform link provided by the Clinical Consultant to participate in the review.   

As with onsite OSVs, the FTCA portion of the review does not factor into compliance, although the final report does include responses and comments provided by the Clinical Consultant.  FTCA utilizes the results of the site visit report as a screening mechanism to support deeming decisions and identify opportunities for additional technical assistance.  Unresolved conditions related to Chapter 5, “Clinical Staffing” (Compliance Manual Chapter 5) and Chapter 10, “Quality Improvement/Assurance” (Compliance Manual Chapter 10) of the HRSA Compliance Manual have the ability to impact FTCA deeming, if they are not resolved at the time HRSA makes annual deeming decisions.  

To prepare for this section of the review, health centers should do the following:

• Identify the staff members who will participate in the interview.  Some examples include those individuals involved with the Quality Improvement Program, Risk Management Program and Claims Management.
• Review all the documentation required for this section and ensure what is written on paper is reflective of current practice.  The Clinical Consultant will verify this during the interview. 
• Prepare in advance.  There are three questions in the FTCA Section of the SVP that require a narrative response and must include examples.  This narrative is entered into the report by the Clinical Consultant.  The health center should prepare responses in advance, knowing the Clinical Consultant has a character limit of 1000 characters, including spaces, within the reporting template.

Health centers should follow the guidance outlined in Chapter 21 of the HRSA Health Center Compliance Manual.  Additionally, health centers can conduct a self-evaluation of compliance with all the requirements for this chapter by answering the questions in the “Federal Tort Claims Act Deeming Requirements” section of the HRSA Site Visit Protocol.