Child Site Eligibility: Registration Requirements and Common Pitfalls

Child Site Registration Fundamentals

Child sites are off-site outpatient facilities registered under a parent covered entity's 340B program. Proper registration requires meeting specific eligibility criteria, maintaining required documentation, and ensuring ongoing compliance with program requirements.

Eligibility Criteria

• Listed on the parent entity's most recent audited cost report
• Reimbursable under the parent entity's arrangement
• Integral part of the covered entity (not independent)
• Provides healthcare services consistent with parent entity's scope
• Maintains appropriate provider relationships and oversight
• Located within reasonable geographic proximity (for some entity types)

Common Registration Pitfalls

Many covered entities face child site registration rejections due to inadequate documentation, unclear reimbursement relationships, or insufficient integration with the parent entity. HRSA scrutinizes child site applications carefully—preparation and documentation are essential for approval.

Documentation Requirements

• Cost report listing with clear identification
• Reimbursement arrangement documentation
• Organizational charts showing integration
• Provider credentialing and oversight evidence
• Lease agreements or facility ownership documentation
• Policies demonstrating operational integration

Ongoing Compliance

Child site eligibility is not a one-time determination. Covered entities must maintain ongoing compliance, update registrations when operations change, and conduct regular self-assessments. Changes in reimbursement arrangements, organizational structure, or service scope may affect eligibility. CareBridge's Readiness & Risk Review service helps organizations validate child site eligibility before registration.