ball grind equipment

Online message

Freestanding Dialysis Facility Quality Incentive Program ...

09/11/2019  Analytical approach: Using a unique facility identifier, we linked Medicare freestanding dialysis facility data from 2015 with US Renal Disease System patient-level data. Kaplan-Meier product limit estimator was used to describe the survival of study participants. Cox proportional hazards regression was used to assess the multivariable association between facility performance scores and 09/11/2019  Analytical approach: Using a unique facility identifier, we linked Medicare freestanding dialysis facility data from 2015 with US Renal Disease System patient-level data. Kaplan-Meier product limit estimator was used to describe the survival of study participants. Cox proportional hazards regression was used to assess the multivariable association between facility performance scores and

Association between Freestanding Dialysis Facility Size ...

Methods: Our cross-sectional analysis compared QIP scores across levels of facility size for 5,193 freestanding dialysis facilities that received QIP scores in 2015. We used Medicare facility data including Dialysis Facility Compare, Performance Scores, Facility-Level Impact, and Area Health Resource and United States Renal Data System files for the payment year 2015. We measured the facility size using the number of dialysis stations per dialysis facilityMethods: Our cross-sectional analysis compared QIP scores across levels of facility size for 5,193 freestanding dialysis facilities that received QIP scores in 2015. We used Medicare facility data including Dialysis Facility Compare, Performance Scores, Facility-Level Impact, and Area Health Resource and United States Renal Data System files for the payment year 2015. We measured the facility size using the number of dialysis stations per dialysis facility

Freestanding Dialysis Facility Quality Incentive Program ...

01/11/2019  Using a unique facility identifier, we linked Medicare freestanding dialysis facility data from 2015 with US Renal Disease System patient-level data. Kaplan-Meier product limit estimator was used to describe the survival of study participants. Cox proportional hazards regression was used to assess the multivariable association between facility performance scores and patient survival.01/11/2019  Using a unique facility identifier, we linked Medicare freestanding dialysis facility data from 2015 with US Renal Disease System patient-level data. Kaplan-Meier product limit estimator was used to describe the survival of study participants. Cox proportional hazards regression was used to assess the multivariable association between facility performance scores and patient survival.

Freestanding Dialysis Facility Quality Incentive Program ...

Freestanding Dialysis Facility Quality Incentive Program Scores and Mortality Among Incident Dialysis Patients in the United States Fozia Ajmal, Janice C. Probst, John M. Brooks, James W. Hardin, Zaina Qureshi, and Tazeen H. Jafar Rationale Objective: The Centers for Medicare Medicaid Services introduced the QualityFreestanding Dialysis Facility Quality Incentive Program Scores and Mortality Among Incident Dialysis Patients in the United States Fozia Ajmal, Janice C. Probst, John M. Brooks, James W. Hardin, Zaina Qureshi, and Tazeen H. Jafar Rationale Objective: The Centers for Medicare Medicaid Services introduced the Quality

Association between Freestanding Dialysis Facility Size ...

Association between Freestanding Dialysis Facility Size and Medicare Quality Incentive Program Performance Scores. Ajmal F(1), Probst J(2), Brooks J(2), Hardin J(3), Qureshi Z(2). Author information: (1)Department of Health Services Policy and Management, Columbia, South Carolina, USA, [email protected] (2)Department of Health Services Policy and Management, Columbia, South Association between Freestanding Dialysis Facility Size and Medicare Quality Incentive Program Performance Scores. Ajmal F(1), Probst J(2), Brooks J(2), Hardin J(3), Qureshi Z(2). Author information: (1)Department of Health Services Policy and Management, Columbia, South Carolina, USA, [email protected] (2)Department of Health Services Policy and Management, Columbia, South

Provision of Home Dialysis by Freestanding Renal Dialysis ...

This article applies standard neoclassical economic ideas about firm behavior to freestanding renal dialysis facilities. A facility is assumed to decide whether to provide a modality, based on its self-interest. The primary objective of most, and the sole objective of many, facilities is profit maximization. However, facilities are constrained by several considerations in their efforts to increase profits. First, This article applies standard neoclassical economic ideas about firm behavior to freestanding renal dialysis facilities. A facility is assumed to decide whether to provide a modality, based on its self-interest. The primary objective of most, and the sole objective of many, facilities is profit maximization. However, facilities are constrained by several considerations in their efforts to increase profits. First,

Sec. 10.30.02.04. Freestanding Dialysis Facilities ...

30/10/2002  The freestanding dialysis facility shall have sufficient social service and dietetic staffing by licensed and trained professionals available to meet the needs of the dialysis patients. G. Psychiatric services may be obtained by referral to a licensed psychiatrist.30/10/2002  The freestanding dialysis facility shall have sufficient social service and dietetic staffing by licensed and trained professionals available to meet the needs of the dialysis patients. G. Psychiatric services may be obtained by referral to a licensed psychiatrist.

Billing Instructions for Freestanding Dialysis Facility ...

services rendered at free-standing dialysis facilities must be received within six (6) months of the date of service on the claim. If a claim is received within the 6 month limit but rejected, resubmission will be accepted within 60 days of the date of rejection or within 6 months of the date of service, services rendered at free-standing dialysis facilities must be received within six (6) months of the date of service on the claim. If a claim is received within the 6 month limit but rejected, resubmission will be accepted within 60 days of the date of rejection or within 6 months of the date of service,

BILLING INSTRUCTIONS FOR FREESTANDING DIALYSIS FACILITY ...

Free-standing dialysis facilities will bill on a UB04. Services that are to be billed on the UB04 are dialysis services furnished on an outpatient basis and provided by a freestanding dialysis facility. These services include chronic hemodialysis, chronic peritoneal dialysis, self-dialysis, home dialysis and home dialysis training andFree-standing dialysis facilities will bill on a UB04. Services that are to be billed on the UB04 are dialysis services furnished on an outpatient basis and provided by a freestanding dialysis facility. These services include chronic hemodialysis, chronic peritoneal dialysis, self-dialysis, home dialysis and home dialysis training and

State Operations Manual - CMS

Dialysis facility means an entity that provides outpatient maintenance dialysis services, or home dialysis training and support services, or both. A dialysis facility may be an independent or hospital-based unit (as described in §413.174(b) and (c) of this chapter) that includes a self-care dialysis unit that furnishes only self-dialysis services. Discharge means the termination of patient ...Dialysis facility means an entity that provides outpatient maintenance dialysis services, or home dialysis training and support services, or both. A dialysis facility may be an independent or hospital-based unit (as described in §413.174(b) and (c) of this chapter) that includes a self-care dialysis unit that furnishes only self-dialysis services. Discharge means the termination of patient ...

Freestanding Dialysis Facility definition - Law Insider

Define Freestanding Dialysis Facility. means a facility which is primarily engaged in providing dialysis treatment, maintenance, or training to patients on an Outpatient or home care basis.Define Freestanding Dialysis Facility. means a facility which is primarily engaged in providing dialysis treatment, maintenance, or training to patients on an Outpatient or home care basis.

Freestanding Dialysis Facility Qu... preview related ...

Freestanding Dialysis Facility Quality Incentive Program Scores and Mortality Among Incident Dialysis Patients in the United States. Ajmal F; Probst J; Brooks J; et al. See more; American Journal of Kidney Diseases (2020) 75(2) 177-186. DOI: 10.1053/j.ajkd.2019.07.023. 3 Citations. Citations of this article . 27 Readers. Mendeley users who have this article in their library. Add to library ...Freestanding Dialysis Facility Quality Incentive Program Scores and Mortality Among Incident Dialysis Patients in the United States. Ajmal F; Probst J; Brooks J; et al. See more; American Journal of Kidney Diseases (2020) 75(2) 177-186. DOI: 10.1053/j.ajkd.2019.07.023. 3 Citations. Citations of this article . 27 Readers. Mendeley users who have this article in their library. Add to library ...

Sec. 10.30.02.04. Freestanding Dialysis Facilities ...

30/10/2002  The freestanding dialysis facility shall have sufficient social service and dietetic staffing by licensed and trained professionals available to meet the needs of the dialysis patients. G. Psychiatric services may be obtained by referral to a licensed psychiatrist.30/10/2002  The freestanding dialysis facility shall have sufficient social service and dietetic staffing by licensed and trained professionals available to meet the needs of the dialysis patients. G. Psychiatric services may be obtained by referral to a licensed psychiatrist.

Freestanding Dialysis Facility Quality Incentive Program ...

Freestanding Dialysis Facility Quality Incentive Program Scores and Mortality Among Incident Dialysis Patients in the United States. American Journal of Kidney Diseases ( IF 6.618) Pub Date : 2019-11-01, DOI: 10.1053/j.ajkd.2019.07.023Freestanding Dialysis Facility Quality Incentive Program Scores and Mortality Among Incident Dialysis Patients in the United States. American Journal of Kidney Diseases ( IF 6.618) Pub Date : 2019-11-01, DOI: 10.1053/j.ajkd.2019.07.023

Freestanding Dialysis Facility Quality Incentive Program ...

The Centers for Medicare Medicaid Services introduced the Quality Incentive Program (QIP) along with the bundled payment reform to improve the qualiThe Centers for Medicare Medicaid Services introduced the Quality Incentive Program (QIP) along with the bundled payment reform to improve the quali

Association of Freestanding Dialysis Facility Size ...

Association of freestanding dialysis facility size, Quality Incentive Program scores and patient survival by Fozia Ajmal Bachelor of Medicine and Bachelor of Surgery Dow University of Health Sciences, 1998 Master of Business Administration College of Business Management, 2006 Master of Science University of London, 2010 Submitted in Partial Fulfillment of the Requirements For the Degree of ...Association of freestanding dialysis facility size, Quality Incentive Program scores and patient survival by Fozia Ajmal Bachelor of Medicine and Bachelor of Surgery Dow University of Health Sciences, 1998 Master of Business Administration College of Business Management, 2006 Master of Science University of London, 2010 Submitted in Partial Fulfillment of the Requirements For the Degree of ...

Provision of Home Dialysis by Freestanding Renal Dialysis ...

Each dialysis facility is required to submit annually an ESRD Statistical Cost Report, which contains costs, broken down by category, for example, drugs, supplies, and salaries. Most important for this article, however, these data contain the number of dialysis and training sessions for home hemodialysis. A number of researchers have utilized the information in these reports, for example, Held ...Each dialysis facility is required to submit annually an ESRD Statistical Cost Report, which contains costs, broken down by category, for example, drugs, supplies, and salaries. Most important for this article, however, these data contain the number of dialysis and training sessions for home hemodialysis. A number of researchers have utilized the information in these reports, for example, Held ...

"Association of Freestanding Dialysis Facility Size ...

07/11/2017  We measured facility size by number dialysis stations. Given a non-linear relationship between QIP sores and dialysis stations, we categorized stations into three categories including small (≤10), medium (11- 25) and large (>25). We used a multivariable generalized linear model to determine the association between QIP scores and facility size.07/11/2017  We measured facility size by number dialysis stations. Given a non-linear relationship between QIP sores and dialysis stations, we categorized stations into three categories including small (≤10), medium (11- 25) and large (>25). We used a multivariable generalized linear model to determine the association between QIP scores and facility size.

State Operations Manual - CMS

Dialysis facility means an entity that provides outpatient maintenance dialysis services, or home dialysis training and support services, or both. A dialysis facility may be an independent or hospital-based unit (as described in §413.174(b) and (c) of this chapter) that includes a self-care dialysis unit that furnishes only self-dialysis services. Discharge means the termination of patient ...Dialysis facility means an entity that provides outpatient maintenance dialysis services, or home dialysis training and support services, or both. A dialysis facility may be an independent or hospital-based unit (as described in §413.174(b) and (c) of this chapter) that includes a self-care dialysis unit that furnishes only self-dialysis services. Discharge means the termination of patient ...

Title 10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE Subtitle ...

12/05/2007  Chapter 04 Freestanding Kidney Dialysis Centers Authority: Health-General Article, §19-3B-01 et seq., Annotated Code of Maryland .01 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) "Center administrator" means an individual appointed by the governing body who is responsible for the center's daily operation and the duties set forth in ...12/05/2007  Chapter 04 Freestanding Kidney Dialysis Centers Authority: Health-General Article, §19-3B-01 et seq., Annotated Code of Maryland .01 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) "Center administrator" means an individual appointed by the governing body who is responsible for the center's daily operation and the duties set forth in ...

Freestanding Dialysis Facility Qu... preview related ...

Freestanding Dialysis Facility Quality Incentive Program Scores and Mortality Among Incident Dialysis Patients in the United States. Ajmal F; Probst J; Brooks J; et al. See more; American Journal of Kidney Diseases (2020) 75(2) 177-186. DOI: 10.1053/j.ajkd.2019.07.023. 3 Citations. Citations of this article . 27 Readers. Mendeley users who have this article in their library. Add to library ...Freestanding Dialysis Facility Quality Incentive Program Scores and Mortality Among Incident Dialysis Patients in the United States. Ajmal F; Probst J; Brooks J; et al. See more; American Journal of Kidney Diseases (2020) 75(2) 177-186. DOI: 10.1053/j.ajkd.2019.07.023. 3 Citations. Citations of this article . 27 Readers. Mendeley users who have this article in their library. Add to library ...

Sec. 10.30.02.04. Freestanding Dialysis Facilities ...

30/10/2002  The freestanding dialysis facility shall have sufficient social service and dietetic staffing by licensed and trained professionals available to meet the needs of the dialysis patients. G. Psychiatric services may be obtained by referral to a licensed psychiatrist.30/10/2002  The freestanding dialysis facility shall have sufficient social service and dietetic staffing by licensed and trained professionals available to meet the needs of the dialysis patients. G. Psychiatric services may be obtained by referral to a licensed psychiatrist.

Freestanding Dialysis Facility Quality Incentive Program ...

The Centers for Medicare Medicaid Services introduced the Quality Incentive Program (QIP) along with the bundled payment reform to improve the qualiThe Centers for Medicare Medicaid Services introduced the Quality Incentive Program (QIP) along with the bundled payment reform to improve the quali

Freestanding Dialysis Facility Quality Incentive Program ...

Freestanding Dialysis Facility Quality Incentive Program Scores and Mortality Among Incident Dialysis Patients in the United States. American Journal of Kidney Diseases ( IF 6.618) Pub Date : 2019-11-01, DOI: 10.1053/j.ajkd.2019.07.023Freestanding Dialysis Facility Quality Incentive Program Scores and Mortality Among Incident Dialysis Patients in the United States. American Journal of Kidney Diseases ( IF 6.618) Pub Date : 2019-11-01, DOI: 10.1053/j.ajkd.2019.07.023

"Association of Freestanding Dialysis Facility Size ...

07/11/2017  We measured facility size by number dialysis stations. Given a non-linear relationship between QIP sores and dialysis stations, we categorized stations into three categories including small (≤10), medium (11- 25) and large (>25). We used a multivariable generalized linear model to determine the association between QIP scores and facility size.07/11/2017  We measured facility size by number dialysis stations. Given a non-linear relationship between QIP sores and dialysis stations, we categorized stations into three categories including small (≤10), medium (11- 25) and large (>25). We used a multivariable generalized linear model to determine the association between QIP scores and facility size.

Dialysis Facility Program Overview

Have you ever wondered how your freestanding dialysis facility compares to the large dialysis chains (your competitor) in terms of business operations? Where is your profit coming from? Are your margins in jeopardy due to managed care companies discounting your fee schedules? Let HDS provide a program overview to identify areas where improvement will help your financial or clinical outcomes ...Have you ever wondered how your freestanding dialysis facility compares to the large dialysis chains (your competitor) in terms of business operations? Where is your profit coming from? Are your margins in jeopardy due to managed care companies discounting your fee schedules? Let HDS provide a program overview to identify areas where improvement will help your financial or clinical outcomes ...

The State of Outpatient Dialysis Access Centers ...

The freestanding outpatient facility has evolved into a mainstay of dialysis access care and has been shown to provide consistently reliable and efficient care. Initial concerns with safety and quality have been largely quieted and dispelled. Challenges regarding the growth and survival of these centers are now largely focused around public policy, regulations, and the erosion of reimbursement ...The freestanding outpatient facility has evolved into a mainstay of dialysis access care and has been shown to provide consistently reliable and efficient care. Initial concerns with safety and quality have been largely quieted and dispelled. Challenges regarding the growth and survival of these centers are now largely focused around public policy, regulations, and the erosion of reimbursement ...

Facility size and mortality in hospital‐based and ...

ABSTRACT Aim Existing studies on the association between haemodialysis facility size/volume and patient survival are mostly limited to freestanding dialysis units in the United States. This study i...ABSTRACT Aim Existing studies on the association between haemodialysis facility size/volume and patient survival are mostly limited to freestanding dialysis units in the United States. This study i...

State Operations Manual - CMS

Dialysis facility means an entity that provides outpatient maintenance dialysis services, or home dialysis training and support services, or both. A dialysis facility may be an independent or hospital-based unit (as described in §413.174(b) and (c) of this chapter) that includes a self-care dialysis unit that furnishes only self-dialysis services. Discharge means the termination of patient ...Dialysis facility means an entity that provides outpatient maintenance dialysis services, or home dialysis training and support services, or both. A dialysis facility may be an independent or hospital-based unit (as described in §413.174(b) and (c) of this chapter) that includes a self-care dialysis unit that furnishes only self-dialysis services. Discharge means the termination of patient ...

Title 10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE Subtitle ...

12/05/2007  Chapter 04 Freestanding Kidney Dialysis Centers Authority: Health-General Article, §19-3B-01 et seq., Annotated Code of Maryland .01 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) "Center administrator" means an individual appointed by the governing body who is responsible for the center's daily operation and the duties set forth in ...12/05/2007  Chapter 04 Freestanding Kidney Dialysis Centers Authority: Health-General Article, §19-3B-01 et seq., Annotated Code of Maryland .01 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) "Center administrator" means an individual appointed by the governing body who is responsible for the center's daily operation and the duties set forth in ...

Sec. 10.30.02.04. Freestanding Dialysis Facilities ...

30/10/2002  (1) The director of a freestanding dialysis facility shall be a nephrologist or a physician with at least 1 year of... (2) Each freestanding dialysis facility shall have at least one additional nephrologist or physician trained in dialysis...30/10/2002  (1) The director of a freestanding dialysis facility shall be a nephrologist or a physician with at least 1 year of... (2) Each freestanding dialysis facility shall have at least one additional nephrologist or physician trained in dialysis...

Freestanding Dialysis Facility Qu... preview related ...

Freestanding Dialysis Facility Quality Incentive Program Scores and Mortality Among Incident Dialysis Patients in the United States. Ajmal F; Probst J; Brooks J; et al. See more; American Journal of Kidney Diseases (2020) 75(2) 177-186. DOI: 10.1053/j.ajkd.2019.07.023. 3 Citations. Citations of this article . 27 Readers. Mendeley users who have this article in their library. Add to library ...Freestanding Dialysis Facility Quality Incentive Program Scores and Mortality Among Incident Dialysis Patients in the United States. Ajmal F; Probst J; Brooks J; et al. See more; American Journal of Kidney Diseases (2020) 75(2) 177-186. DOI: 10.1053/j.ajkd.2019.07.023. 3 Citations. Citations of this article . 27 Readers. Mendeley users who have this article in their library. Add to library ...

Dialysis Facility Program Overview

Have you ever wondered how your freestanding dialysis facility compares to the large dialysis chains (your competitor) in terms of business operations? Where is your profit coming from? Are your margins in jeopardy due to managed care companies discounting your fee schedules? Let HDS provide a program overview to identify areas where improvement will help your financial or clinical outcomes ...Have you ever wondered how your freestanding dialysis facility compares to the large dialysis chains (your competitor) in terms of business operations? Where is your profit coming from? Are your margins in jeopardy due to managed care companies discounting your fee schedules? Let HDS provide a program overview to identify areas where improvement will help your financial or clinical outcomes ...

Facility size and mortality in hospital‐based and ...

ABSTRACT Aim Existing studies on the association between haemodialysis facility size/volume and patient survival are mostly limited to freestanding dialysis units in the United States. This study i...ABSTRACT Aim Existing studies on the association between haemodialysis facility size/volume and patient survival are mostly limited to freestanding dialysis units in the United States. This study i...

State Operations Manual - CMS

Dialysis facility means an entity that provides outpatient maintenance dialysis services, or home dialysis training and support services, or both. A dialysis facility may be an independent or hospital-based unit (as described in §413.174(b) and (c) of this chapter) that includes a self-care dialysis unit that furnishes only self-dialysis services. Discharge means the termination of patient ...Dialysis facility means an entity that provides outpatient maintenance dialysis services, or home dialysis training and support services, or both. A dialysis facility may be an independent or hospital-based unit (as described in §413.174(b) and (c) of this chapter) that includes a self-care dialysis unit that furnishes only self-dialysis services. Discharge means the termination of patient ...

Institutional credentialing and recredentialing requirements

Freestanding Dialysis Facility • License: Dialysis facility : Freestanding Radiation Oncology Center • License: Clinic or Physician • Accreditation (one of the following): o American College of Radiology (ACR) o American College of Radiation Oncology (ACRO) o The Joint Commission (TJC) • Registration – Radiation Control Inspection Letter • Medical Director – current, valid, and ...Freestanding Dialysis Facility • License: Dialysis facility : Freestanding Radiation Oncology Center • License: Clinic or Physician • Accreditation (one of the following): o American College of Radiology (ACR) o American College of Radiation Oncology (ACRO) o The Joint Commission (TJC) • Registration – Radiation Control Inspection Letter • Medical Director – current, valid, and ...

Leading the Dialysis Unit: Role of the Medical Director ...

01/11/2018  The dialysis facility governing body meets regularly to discuss the clinical care parameters and also the fiscal health of the dialysis unit including any staffing needs or staff performance concerns. This gives medical directors a role in the administrative and business operations of the dialysis unit, which is beyond the scope of the other nephrologists caring for patients in the facility ...01/11/2018  The dialysis facility governing body meets regularly to discuss the clinical care parameters and also the fiscal health of the dialysis unit including any staffing needs or staff performance concerns. This gives medical directors a role in the administrative and business operations of the dialysis unit, which is beyond the scope of the other nephrologists caring for patients in the facility ...

Healthcare Development – AMD Global

Freestanding ERs; Dialysis Centers; Imaging Suites; Wound Care; Investments. Healthcare Real Estate; Equity Positions; Equipment Financing; Actively-Managed Investments; Industry Environment; Management Services. Revenue Cycle Management. Physician/Professional Billing (1500) Hospital/Facility (UB-04) RCM; Customized EHR/EMR; Full-Service ...Freestanding ERs; Dialysis Centers; Imaging Suites; Wound Care; Investments. Healthcare Real Estate; Equity Positions; Equipment Financing; Actively-Managed Investments; Industry Environment; Management Services. Revenue Cycle Management. Physician/Professional Billing (1500) Hospital/Facility (UB-04) RCM; Customized EHR/EMR; Full-Service ...

DOH ADMINISTRATIVE ORDER NO. 2012 – 0001 - NEW

Hospital based – a dialysis facility that operates within a hospital. 2. Non hospital based – a dialysis facility that operates outside of the hospital premises or on its own. 2. STANDARDS Every HDC shall be organized to provide safe, quality, effective and efficient HD services. a. PERSONNEL Every HDC shall have an adequate number of qualified, trained and competent staff to ensure ...Hospital based – a dialysis facility that operates within a hospital. 2. Non hospital based – a dialysis facility that operates outside of the hospital premises or on its own. 2. STANDARDS Every HDC shall be organized to provide safe, quality, effective and efficient HD services. a. PERSONNEL Every HDC shall have an adequate number of qualified, trained and competent staff to ensure ...

Place of Service Codes – CMS POS Code 2021 List in

01/11/2019  Place of Service 51 – Inpatient Psychiatric Facility Description: ... POS 65 reported when a facility other than a hospital, which delivers dialysis services, maintenance, and/or training to patients or caregivers on an ambulatory or home-care basis. 66-70: Unassigned: N/A: 71: Public Health Clinic : POS 71 is stated on the claim form when a certified facility which is situated in a rural ...01/11/2019  Place of Service 51 – Inpatient Psychiatric Facility Description: ... POS 65 reported when a facility other than a hospital, which delivers dialysis services, maintenance, and/or training to patients or caregivers on an ambulatory or home-care basis. 66-70: Unassigned: N/A: 71: Public Health Clinic : POS 71 is stated on the claim form when a certified facility which is situated in a rural ...