Federal Tort Claims Act (FTCA) Health Center Program Site Visit Protocol


The Health Resources and Services Administration (HRSA) conducts Health Center Federal Tort Claims Act (FTCA) Program site visits to support its responsibility to ensure compliance with the FTCA deeming requirements found in 42 U.S.C. 233(h) and (q) with particular respect to credentialing and privileging, risk management, claims management, and quality improvement/quality assurance (QI/QA). These deeming requirements are also addressed within the annual FTCA Health Center Deeming Program Assistance Letter (PAL), the FTCA Health Center Policy Manual (PDF - 435 KB), and pertinent chapters of the Health Center Program Compliance Manual. HRSA may conduct FTCA site visits on a regularly scheduled basis, to provide information related to a deeming application, and/or as otherwise determined by HRSA to be needed or appropriate.

Factors that may prompt an FTCA site visit include, but are not limited to, the following:

  • Submission of an initial FTCA deeming application;
  • Documentation submitted on the FTCA deeming application that indicates possible non-compliance with deeming requirements;
  • A history of repeated conditions, or current conditions, placed by HRSA on the health center’s Health Center Program grant, as documented on the health center’s associated Notice(s) of Award;
  • The need for follow-up based on prior site visit findings or other identified issues; and/or
  • A history of medical malpractice claims.

FTCA site visits are distinct from Health Center Program Operational Site Visits (OSVs) under section 330 of the Public Health Service Act. FTCA site visits enable HRSA to objectively assess and verify the implementation of FTCA deeming requirements and provide technical assistance (TA) to health centers as needed and appropriate. In contrast, OSVs assess a health center’s compliance with Health Center Program requirements described in the Health Center Program Compliance Manual. Health centers that are currently FTCA deemed or applying for initial FTCA deeming may also be assessed during an OSV for compliance with FTCA Program credentialing and privileging, risk management, claims management, and quality improvement/quality assurance (QI/QA) deeming requirements.


To prepare for an FTCA site visit, HRSA encourages all health centers to review the following resources:

Pursuant to Executive Order 13891, the information in this website does not bind the public, except as authorized by law or as incorporated into a contract.

Date Last Reviewed:  October 2020