“Chapter 8 – Continuity of Care and Hospital Admitting” of the Health Resources and Services Administration (HRSA) Compliance Manual focuses on ensuring continuity of care for health center patients who are receiving Emergency Room (ER) or inpatient services.  This is an “either or” requirement whereby the health center providers must have admitting privileges, or the health center must have formal written arrangements with providers or entities that address health center patient admissions. In addition, the health center must have procedures in place for tracking of ER visits and hospital admissions.

To demonstrate compliance with the patient sample requirement for this chapter, the health center must provide a sample of five to ten patient records for patients who were hospitalized or had ER visits within the past 12 months.  Samples must reflect the full circle of care, from admission and follow-up through closure.  Prepare samples in a manner that demonstrates the following:

• The receipt of medical information related to the ER or hospital visit.  Examples include discharge instructions, laboratory, radiology, or other results.
• Any follow-up actions taken by the health center, based on the information received.  Examples include a telephone call to the patient or a hospital follow-up visit.

It is important to remember that if patient samples are uploaded into the Citrix ShareFile system, all Personally Identifiable Information (PII) must be redacted.  If samples are shown via GoToMeeting using screenshots or live navigation, redaction of PII is not necessary. 

Health centers should follow the guidance outlined in “Chapter Eight – Continuity of Care and Hospital Admitting” of the HRSA Health Center Compliance Manual (Chapter 8: Continuity of Care and Hospital Admitting) for requirements related to continuity of care.  Additionally, health centers should utilize the Sample Review Resource Guide (Sampling Review Resource Guide) to obtain guidance with the sampling process.