405.2417—Visiting nurse services: Determination of shortage of agencies.
A shortage of home health agencies exists if the Secretary determines that the rural health clinic:
(a)
Is located in a county, parish, or similar geographic area in which there is no participating home health agency or adequate home health services are not available to patients of the rural health clinic;
(b)
Has (or expects to have) patients whose permanent residences are not within the area serviced by a participating home health agency; or
(c)
Has (or expects to have) patients whose permanent residences are not within a reasonable traveling distance, based on climate and terrain, of a participating home health agency.