Religious Nonmedical Health Care Institutions

This page provides basic information about being certified as a Medicare and/or Medicaid Religious Nonmedical Health Care Institution (RNHCI) provider and includes links to applicable laws, regulations, and compliance information.

The RNHCI provider is responsible for meeting both Conditions of Coverage and Conditions of Participation to qualify as a Medicare provider and that portion of the Conditions of Coverage that define an RNHCI and the Conditions of Participation to qualify as a Medicaid provider.

The Boston Regional Office has the primary responsibility for the approval and certification process to ensure and verify that the RNHCI conforms to specific Conditions of Coverage and all of the Conditions of Participation.  To qualify as a Medicare or Medicaid RNHCI an institution must meet all ten of the following requirements: 

• Is described in subsection (c)(3) of §501 of the Internal Revenue Code of 1986 and is exempt from taxes under subsection 501(a);
• Is lawfully operated under all applicable Federal, State, and local laws and regulations;
• Furnishes only nonmedical nursing items and services to beneficiaries who choose to rely solely upon a religious method of healing, and for whom the acceptance of medical services would be inconsistent with their religious beliefs.  (NOTE: Religious components of the healing are not covered);
• Furnishes nonmedical items and services exclusively through nonmedical nursing personnel who are experienced in caring for the physical needs of nonmedical patients.  For example, caring for the physical needs such as assistance with activities of daily living; assistance in moving, positioning, and ambulation; nutritional needs; and comfort and support measures;
• Furnishes nonmedical items and services to inpatients on a 24-hour basis;
• Does not furnish, on the basis of religious beliefs, through its personnel or otherwise, medical items and services (including any medical screening, examination, diagnosis, prognosis, treatment, or the administration of drugs) for its patients;
• Is not owned by, under common ownership with, or has an ownership interest of 5 percent or more in, a provider of medical treatment or services and is not affiliated with a provider of medical treatment or services or with an individual who has an ownership interest of 5 percent or more in a provider of medical treatment or services (permissible affiliations are described in §403.739(c));
• Has in effect a utilization review plan that meets the requirements of §403.720(a)(8);
• Provides information CMS may require to implement §1821of the Act, including information relating to quality of care and coverage determinations; and
• Meets other requirements CMS finds necessary in the interest of the health and safety of the patients who receive services in the institution.