Nurse Corps
Loan Repayment Program
Fiscal Year 2024
Continuation Contract
Application and Program Guidance
September 2023
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Bureau of Health Workforce
5600 Fishers Lane
Rockville, Maryland 20857
For questions, call 1-800-221-9393 (TTY: 1-877-897-9910) Monday through Friday (except federal
holidays) 8:00 a.m. to 8:00 p.m. ET.
Authority: Section 846 of the Public Health Service Act, as amended (42 U.S.C. 297n).
Assistance Listings (AL/CFDA) Number: 93.908
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TABLE OF CONTENTS
Privacy Act Notification Statement ............................................................................................................ 5
Nurse Corps Loan Repayment Program Continuation Overview ................................................................ 6
KEY APPLICATION DATES ............................................................................................................................. 6
APPLICATION ELIGIBILITY REQUIREMENTS .................................................................................................. 8
UNDERSTANDING THE CONTRACT AND SERVICE OBLIGATION ................................................................. 12
PROGRAM COMPLIANCE ........................................................................................................................... 13
Application Information ........................................................................................................................... 18
APPLICATION DEADLINE ............................................................................................................................ 18
COMPLETING AN APPLICATION ................................................................................................................. 18
Additional Information ............................................................................................................................ 21
PAPERWORK REDUCTION ACT PUBLIC BURDEN STATEMENT ................................................................... 21
RESOURCES FOR APPLICANTS .................................................................................................................... 21
DEFINITIONS .............................................................................................................................................. 23
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EXECUTIVE SUMMARY
The Health Resources and Services Administration will accept applications for Nurse Corps Loan
Repayment Program Continuation Contracts. Current participants completing their second
year of service can receive an additional year of loan repayment assistance through the Nurse
Corps Loan Repayment Program. In exchange, participants must serve one additional year at
an approved critical shortage facility or approved school of nursing.
Eligible Applicants: Current Nurse Corps Loan Repayment Program
participants who are completing their second year
of service and are in good standing, including that
they have applied all of their previous loan
repayment award to their student loans.
Funding: An additional 25 percent of the approved original qualifying
educational loan balances. Awards are taxable.
Service Obligation: One-year full time at an eligible critical shortage
facility or school of nursing.
How to Apply:
Visit the Bureau of Health Workforce Customer Service Portal
Application Deadline:
NCLRP Initial Contract End Dates:
Application Cycle Start and End Dates:
October 1, 2023 – March 31, 2024
September 5, 2023 – October 19, 2023
April 1, 2024 – September 30, 2024
February 20, 2024 – April 4, 2024
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DEPARTMENT OF HEALTH & HUMAN SERVICES
Health R
esources and Services
Ad
ministration
Rockville, MD 20857
Bureau of Health Workforce
A Letter from Luis Padilla, MD
Dear Applicant,
The Health Resources and Services Administration’s Bureau of Health Workforce encourages
you to consider applying for a Nurse Corps Loan Repayment Program Continuation award.
Please review this Nurse Corps Loan Repayment Program Application and Program Guidance
for more information. As a part of our efforts to address the shortage of health professionals
nationwide, this program reduces the economic barriers to pursuing a nursing career in
underserved communities or academic nursing. You have already demonstrated a commitment
to working in health care facilities with a critical shortage of nurses or working as nurse
faculty to train the next generation of nurses. In exchange for your continued service, we will
help to reduce your remaining student debt.
As a former Health Resources and Services Administration award recipient, I understand how
busy you are. To that end, we have streamlined the application process to make it easier for you.
Thank you for taking the time to read this program’s Application and Program Guidance and for
your consideration in applying and continuing to serve.
Sincerely,
/Luis Padilla, MD/
Luis Padilla, MD
Associate Administrator for Health Workforce
Health Resources and Services Administration
U.S. Department of Health and Human Services
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Privacy Act Notification Statement
General
Information submitted to the Nurse Corps Loan Repayment Program is provided pursuant to the Privacy
Act of 1974 (Public Law 93-579), as amended, for individuals supplying information for inclusion in a
system of records.
Statutory Authority
Section 846 of the Public Health Service Act, (42 U.S.C. 297n), as amended.
Purposes and Uses
The purpose of the Nurse Corps Loan Repayment Program is to assist in the recruitment and
retention of professional registered nurses, including advanced practice registered nurses, dedicated
to working in health care facilities with a critical shortage of nurses or working as nurse faculty in
eligible schools of nursing by decreasing the economic barriers associated with pursuing careers at
such critical shortage facilities or in academic nursing. In return, participants commit to work at
eligible health care facilities with a critical shortage of nurses or serve as nurse faculty in eligible
schools of nursing. The information applicants provide is used to evaluate their eligibility,
qualifications, and suitability for the Nurse Corps Loan Repayment Program Continuation Contract. In
addition, information from other sources is considered (e.g., credit bureau reports and National
Practitioner Data Bank reports).
An individual’s contract, application, required supplemental forms, supporting documentation,
related correspondence, and data are maintained in a system of records to be used within the U.S.
Department of Health and Human Services to monitor Nurse Corps Loan Repayment Program-related
activities. The information may also be disclosed outside the U.S. Department of Health and Human
Services, as permitted by the Privacy Act and Freedom of Information Act, to the Congress, the
National Archives, the Government Accountability Office, and pursuant to a court order and various
routine uses as described in the System of Record Notice 09-15-0037.
The name of a Nurse Corps Loan Repayment Program participant and/or their discipline, specialty,
business address, business telephone number, and service obligation completion date may be
provided in response to requests made under the Freedom of Information Act.
Effects of Nondisclosure
Disclosure of the information sought is voluntary; however, if not submitted, except for the replies to
questions related to race/ethnicity, an application may be considered incomplete and therefore may
not be considered for funding under this announcement.
Non-Discrimination Policy Statement
In accordance with applicable federal laws and U.S. Department of Health and Human Services policy,
the Department does not discriminate on the basis of any non-merit factor, including race, color,
national origin, religion, sex, sexual orientation, gender identity, disability (physical or mental), age,
status as a parent, or genetic information.
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Nurse Corps Loan Repayment Program Continuation Overview
To assist in the recruitment and retention of professional registered nurses, including advanced
practice registered nurses, the Nurse Corps Loan Repayment Program provides awards to nurses in
exchange for a service commitment at a critical shortage facility or as nurse faculty serving at eligible
schools of nursing. The Nurse Corps Loan Repayment Program is administered by the Bureau of
Health Workforce in the Health Resources and Services Administration within the United States
Department of Health and Human Services.
The Nurse Corps Loan Repayment Program Continuation Contract extends the initial Nurse Corps
Loan Repayment Program obligation for one additional year of full-time service at an eligible critical
shortage facility or eligible school of nursing. It offers current Nurse Corps Loan Repayment
Program participants who have successfully completed their initial two-year contract the option to
reduce their approved original qualifying educational loan balances by an additional 25 percent by
providing a third year of service. All potential Nurse Corps Loan Repayment Program Continuation
Contract awards are subject to the availability of funds.
Funding Preferences
If sufficient funds are not appropriated to fully fund all eligible continuation applications, the Health
Resources and Services Administration will apply the statutory preference in the PHS Act Section
846(e) for qualified applicants with the greatest financial need based on their debt-to-salary ratio.
Application and Program Guidance
You (the applicant) are responsible for reading the Nurse Corps Loan Repayment Program Fiscal Year
2024 Application and Program Guidance (“Guidance”) in its entirety before proceeding with your
application. The Guidance explains in detail the obligations of individuals selected to participate in the
Nurse Corps Loan Repayment Program Continuation Contract. A complete understanding of the
commitment to serve at a critical shortage facility or eligible school of nursing, and the financial, legal, and
other consequences of failing to perform the commitment, is critical to successful completion of the
mandatory service obligation associated with a Nurse Corps Loan Repayment Program Continuation
Contract.
KEY APPLICATION DATES
•
Application Submission Dates:
NCLRP Initial Contract End Dates:
October 1, 2023 – March 31, 2024
April 1, 2024 – September 30, 2024
• Notification of Award: HRSA will notify all successful applicants of their award by September
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30, 2024. Award notifications will be sent on a rolling basis (depending upon the application
cycle start and end dates outlined above).
• Contract Start Date: The continuation contract takes effect on the day following the last day
of the participant’s initial two-year service obligation. It will be no later than September 30,
2024.
• Service Obligation Completion Date: One year after contract start date.
Once a participant receives a Continuation Contract for a particular service commitment, either as
a registered nurse or advanced practice registered nurse at a critical shortage facility or nurse
faculty at an eligible school of nursing, the individual cannot switch to the other type of service
commitment.
Refer to the Definitions provided in the Additional Information section of this Guidance for further
explanation of terms used throughout this document.
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APPLICATION ELIGIBILITY REQUIREMENTS
Eligibility Requirements
To be eligible for a Nurse Corps Loan Repayment Program Continuation Contract, an applicant must:
(1) Be a current Nurse Corps Loan Repayment Program participant serving full-time at an
eligible critical shortage facility or eligible school of nursing, as approved by the Nurse Corps
Loan Repayment Program under the initial two-year contract.
a. Applicants must review and verify their current service site’s name and address and
initiate an electronic Employment Verification Form. If the applicant’s authorized
point of contact is not listed, has changed, or is incorrect in the pre-populated
information regarding the applicant’s service site, the applicant may enter the correct
point of contact’s email address in the “Other point of contact email” section of the
application;
b. An appropriate official/point of contact at the approved critical shortage facility or
eligible school of nursing must complete the Employment Verification Form. The
point of contact may be the applicant’s immediate supervisor or an employer or
Nurse Corps Loan Repayment Program pre-existing authorized agent in the human
resources department at the service site; and
c. If the point of contact does not submit a completed Employment Verification Form,
or someone else besides the point of contact completes the Enrollment Verification
Form, we will consider the application incomplete, and the applicant will not be able
to submit the application.
d. An overdue In-Service Verification while serving under the initial two-year contract
may affect a participant’s eligibility for a Continuation Contract.
(2) Have a current, full, permanent, unencumbered, unrestricted license to practice as a
registered nurse or an advanced practice registered nurse in the state in which they are
employed, or they must be authorized to practice pursuant to the Enhanced Nursing
Licensure Compact. All Nurse Corps Loan Repayment Program participants must retain an
unrestricted registered nurse or advanced practice registered nurse license during the one-
year Nurse Corps Loan Repayment Program Continuation Contract service obligation period.
Puerto Rico applicants only: National Council Licensure Examination Exception: Nurses
practicing in Puerto Rico must have a current, full, permanent, unencumbered, unrestricted
license to practice as a registered nurse or an advanced practice registered nurse in the
territory of Puerto Rico and must upload a copy of their current unrestricted nursing license
and certificate with the application. Applicants from Puerto Rico are not required to pass the
National Council Licensure Examination exam unless they plan to work in one of the 50 states.
(3) Have applied all the Nurse Corps Loan Repayment Program payments received after
federal tax withholding under the initial two-year contract to reduce the original
qualifying educational loan balances;
a. Applicants must submit the most recent account statement for each loan showing the
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current balance with principal and interest, lender’s name, account number, and
applicant’s name (call or visit the lender’s website for additional information);
b. Applicants must submit a Disbursement Report that shows the approved educational
loans listed on the Participant Award Worksheet. Each loan must have its original
loan amount, the original loan date, type of loan, and the consolidation dates, if
applicable. For federal loans, the Aid Summary Report on the National Student Loan
Data System website can be provided instead of the Disbursement Report; and
c. Applicants must submit a Payment History Report detailing all payments made to
reduce the original qualifying educational loan balances.
(4) Have no current federal service obligation other than the Nurse Corps Loan
Repayment Program. The only exception is for members of a reserve component of
the Armed Forces or the National Guard:
a. Reservists should note the following: Military training or service performed by
reservists will not satisfy the Nurse Corps Loan Repayment Program obligation
unless otherwise indicated by Health Resources and Services Administration. If a
participant’s combined military training and service and/or other absences from the
critical shortage facility or school of nursing will exceed seven weeks (regardless of
how many days per week they serve) per service year, the participant should request
a suspension. We will stop payments during periods of active military duty/
suspension and will resume when the reservist returns to full-time service. We will
extend the service obligation end date by the length of the suspension to make up
for the break in service; and
b. If the approved critical shortage facility or school of nursing is unable to re-employ
the reservist after deployment, the individual should complete the Nurse Corps Loan
Repayment Program Continuation Contract at another approved critical shortage
facility or school of nursing. The participant must contact the Nurse Corps Loan
Repayment Program to request a transfer and receive approval in accordance with
the program’s transfer policy.
(5) Have a history of honoring prior legal obligations. The Nurse Corps Loan Repayment
Program will perform a hard inquiry
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with the credit bureaus prior to making the award
decision. Applicants who do not have a history of honoring prior legal obligations, as
evidenced by one or more of the following factors, will not be selected:
a. Default on any federal payment obligations, e.g., United States Department of Education
student loans, Health Education Assistance Loans, Nursing Student Loans, Federal
Housing Administration Loans, federal income tax liabilities, federally
guaranteed/insured loans (e.g., student or home mortgage loans) or any non-federal
payment obligations (e.g., court-ordered child support payments or state tax liabilities);
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According to the U.S. Consumer Financial Protection Bureau, these inquiries “are typically inquiries by lenders after you apply
for credit. These inquiries will impact your credit score because most credit scoring models look at how recently and how
frequently you apply for credit.” (Source: https://www.consumerfinance.gov/
).
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b. Write-offs/charge-offs of any federal or non-federal debts as uncollectible or waiver of
any federal service or payment obligation;
c. Default on a prior service obligation. Applicants who have defaulted on a prior service
obligation to the Federal Government, a state or local government, or other entity, unless
the obligation was subsequently satisfied; and
d. Judgment liens arising from federal debt.
(6) Failure/refusal to provide appropriate permission/consent for the Nurse Corps Loan Repayment
to access the participant’s credit report and failure/refusal to unfreeze a frozen credit report will
render an application incomplete and it will not be considered for an award under the program.
(7) Have met all program eligibility requirements listed in numbers one through six of this
section, be in full compliance with the existing Nurse Corps Loan Repayment Program service
obligation and agree to work full-time for the duration of the Continuation Contract at the
critical shortage facility or eligible school of nursing that the Nurse Corps Loan Repayment
Program approved for the initial two-year contract.
Eligible Nurse Corps Loan Repayment Sites
Nurse Corps Loan Repayment Program Participant Serving as Nurse Faculty
Nurse Corps Loan Repayment Program requires a participant who is a nurse faculty member to
provide full-time service by teaching pre-licensure students, including registered nurses or advance
practice registered nurses, at an eligible school of nursing. The Nurse Corps Loan Repayment
Program considers a school of nursing to be eligible if it is accredited by a national nursing
accrediting agency or by a state agency recognized by the United States Secretary of Education. The
Nurse Corps Loan Repayment Program considers institutions eligible if graduates are authorized to
sit for the National Council Licensure Examination. Review the list of agencies the United States
Secretary of Education recognizes for purposes of accrediting nurse education programs.
Nurse Corps Loan Repayment Program Participant Serving as a Registered Nurse or an Advanced
Practice Registered Nurse
A participant who is serving as a registered nurse or an advanced practice registered nurse is required
to provide full-time service at a critical shortage facility. The critical shortage facility must be in a
health care facility located in, designated as, or serving a primary medical care or mental health,
Health Professional Shortage Area. Examples of eligible health care facility types are listed below
and further explained in the Definitions section.
Eligible Health Care Facility Types
Participants working at the following types of facilities are eligible to apply for a Continuation Contract.
Further, participants can work at multiple sites under a single employer or within the same network under
dependent satellite facilities. Each critical shortage facility must meet all eligibility requirements. The
points of contact for each site will be responsible for completing the Employment Verification Form.
Participants are restricted from receiving service credit for work at other facilities outside of the network
of the single employer.
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Hospitals
• Disproportionate Share Hospital
• Private Hospital
• Public Hospital
• Small Rural Hospital
2
Community-Based Settings
• Ambulatory Surgical Center
• American Indian Health Facility
• Community Mental Health Center
3
• End Stage Renal Disease Dialysis Center
• Federally Qualified Health Center
• Free and Charitable Clinic
• Home Health Agency
• Hospice Program
• Native Hawaiian Health Center
• Nurse Managed Health Clinic/Center
• Outpatient Facility
• Residential Nursing Home
• Rural Health Clinic
• School Based Clinic
• State or Local Health Department
• Urgent Care Center
Requirements for School-Based Clinics
The Nurse Corps Loan Repayment Program requires a registered nurse or advanced practice
registered nurse to be employed full-time at least 32 hours per week throughout the year, including
those employed by an eligible school-based clinic. If the critical shortage facility is not open year-
round, the participant must transfer to an approved critical shortage facility during months the
school-based clinic is closed. Participants who work at school-based clinics that are not open year-
round will not receive service credit for any period they are not serving at an approved critical
shortage facility (refer to Eligible Health Care Facility Types section).
Telehealth
Participants will receive service credit when providing telehealth services in a manner consistent with
their service site’s telehealth policy.
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Critical Access Hospitals are eligible under the Small Rural Hospital category.
3
Community Behavioral Health Clinics are eligible under the Community Mental Health Center category.
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UNDERSTANDING THE CONTRACT AND SERVICE OBLIGATION
Service Obligation
The Nurse Corps Loan Repayment Program Continuation Contract award service obligation is for one
additional year.
Full-Time Service Obligation Requirements
Participants must provide full-time service for a period of one year. For this purpose, “full-time” at an
eligible critical shortage facility means at least 32 hours per week for a minimum of 45 weeks per
service year or at an eligible school of nursing, full-time as defined by the employer for a minimum of
9 months per service year as approved under the initial two-year contract. Nurse faculty must
provide full-time service as faculty for a full academic year beginning on the day following completion
of service under the initial two-year contract. Nurse Corps Loan Repayment Program participants
cannot complete the service obligation through part-time service.
Loan Repayment Assistance Award
In exchange for their continued service, participants will receive funds equal to 25 percent of their original
total qualifying educational loan balances that were approved at the time they entered the initial Nurse
Corps Loan Repayment Program Contract. Please refer to the Nurse Corps Loan Repayment Program
Application and Program Guidance in the year you were awarded for more information on qualifying
educational loans.
General Requirements for All Nurse Corps Loan Repayment Program Continuation Contract Participants
• To receive service credit during the one-year service obligation under the Nurse Corps Loan
Repayment Program Continuation Contract, all participants, including nurse faculty, must
retain a current, full, permanent, unencumbered, unrestricted license to practice as a
registered nurse, or an advanced practice registered nurse if applicable, in the state in which
they intend to practice, or be authorized to practice in that state pursuant to the Enhanced
Nursing Licensure Compact; or if working in a federal facility, retain a current, full,
permanent, unencumbered, unrestricted license as a registered nurse, or an advanced
practice registered nurse if applicable, in a state;
• Participants must continue to work for their Nurse Corps Loan Repayment Program
approved employer as a registered nurse, advanced practice registered nurse, or nurse
faculty member for the duration of the one-year contract to receive service credit under the
Nurse Corps Loan Repayment Program Continuation Contract;
• If a participant fails to commence full-time service on the effective date of the Continuation
Contract at the critical shortage facility or eligible school of nursing identified in the
continuation application, we may place the individual in default;
• Once a participant applies and receives a Continuation Contract for a particular service option
at a critical shortage facility or faculty at a school of nursing, the participant cannot switch to
the other type of service option (i.e., from health care professional to faculty or vice versa)
during the one-year service period.
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TAXES AND FINANCIAL INFORMATION
The Nurse Corps Loan Repayment Program payments are subject to federal taxes. The Nurse Corps
Loan Repayment Program will withhold federal income tax and Federal Insurance Contributions Act
tax (for Social Security and Medicare) from a participant’s award. We pay these taxes directly to the
Internal Revenue Service on the participant’s behalf. We report all Nurse Corps Loan Repayment
Program payments and federal taxes withheld to the participant and the Internal Revenue Service on
a Form W-2 after the end of the tax year. Loan repayment funds may also be subject to state and
local income taxes.
Participants who want additional funds withheld to cover the income tax on their awards should
indicate the amount to be deducted on an Employee’s Withholding Certificate (Form W-4).
Participants must complete and upload the Internal Revenue Service Form W-4, Employee's
Withholding Certificate. Participants should consult the Internal Revenue Service regarding any
additional tax obligations. All tax questions should be directed to a tax professional or the Internal
Revenue Service at https://www.irs.gov or through the TAX HELPLINE at 1- 800-829-1040. The
Internal Revenue Service Tax Withholding Estimator is available to perform a quick “paycheck
checkup.” The Nurse Corps Loan Repayment Program is unable to provide an individual with an
after-tax calculation or any tax advice or information.
Each January, participants will receive a W-2 Wage and Tax Statement for the taxable income
received under the Nurse Corps Loan Repayment Program during the prior tax year. Participants
may sign up to have their W-2 form posted in their Bureau of Health Workforce Customer Service
Portal account. W-2 forms are posted no later than January 30 of each year. If the W-2 form is not
available by that date, the participant should submit an inquiry via the Bureau of Health Workforce
Customer Service Portal. Participants may also choose to have their W-2 form mailed to the address
provided in the Bureau of Health Workforce Customer Service Portal. Participants must ensure their
name, mailing and email addresses, and banking information are up to date.
Under the Treasury Offset Program, the United States Treasury Department is authorized to offset the
Nurse Corps Loan Repayment Program payments for delinquent federal and state debts, including
delinquent child support. A participant’s Nurse Corps Loan Repayment Program payments may be
garnished to satisfy related debts.
PROGRAM COMPLIANCE
Worksite Absence
No more than seven weeks per service year under the contract may be spent away from the critical
shortage facility or eligible school of nursing (regardless of how many days per week the participant
serves). Any leave/absences totaling greater than seven weeks in a service year will extend the
contract end date. Participants who anticipate an absence from their site for more than seven weeks
must request a suspension of their service obligation (see the Suspension section).
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Service Verification
The Nurse Corps Loan Repayment Program requires that participants provide verification they are in
compliance with the service obligation. Participants must ensure that an authorized site point of contact
completes and submits an In-Service Verification form every six months during their year of service. The In-
Service Verification form must be submitted through the Bureau of Health Workforce Customer Service
Portal. An overdue In-Service Verification while serving under the initial two-year contract may affect a
participant’s eligibility for a Continuation Contract. By completing and signing the In-Service Verification,
the participant and the site point of contact are certifying the participant’s compliance with the full-time
service requirements during the identified period. For participants working at multiple sites, an In-Service
Verification for each site is required every six months. The In-Service Verification records the total number
of full-time workdays that a participant was absent, for any reason, from the critical shortage facility or
school of nursing during the reporting period. An In-Service Verification differs from the Employment
Verification Form that is submitted with the application; however, both forms must be completed by the
official point of contact and submitted via the Bureau of Health Workforce Customer Service Portal.
Participants and their service site point of contacts must complete and submit the In-Service
Verification within 30 days of notification that the service verification is due.
Professional Group/Group Practice In-Service Verification Requirements
All registered nurses and advanced practice registered nurses employed by a professional group
must have the In-Service Verification completed by the site point of contact at the critical
shortage facility where they are physically present and working, and not by an employee of the
Professional Group.
Ineligible Employment
Registered nurses and advanced practice registered nurses working for staffing or employment
agencies that hire out employees for temporary work do not meet the Nurse Corps Loan Repayment
Program Continuation Contract service requirements. Registered nurses and advanced practice
registered nurses working in temporary nursing positions, like PRN, per diem, and nurses employed by
travel nurse agencies, do not meet the service requirements for the Nurse Corps Loan Repayment
Program Continuation Contract.
Leaving an Approved Service Site Prior to Completion of Service Obligation
If a participant stops working at the approved critical shortage facility without prior written approval of
the Nurse Corps Loan Repayment Program, the individual may be placed in default of the Nurse Corps
Loan Repayment Program Continuation Contract. We will suspend all payments until a request to
resume service at an eligible critical shortage facility is received and approved. If a participant’s
employment is terminated for cause, they may be recommended for default.
Transfer Request to Another Approved Service Site
The Nurse Corps Loan Repayment Program expects that participants will fulfill their service obligation at
the critical shortage facility or eligible school
of nursing included in their application. However, we
understand that circumstances may arise that result in a participant’s need to leave the initial site and
complete the service obligation at another approved site. If a participant can no longer continue
working at the initial critical shortage facility or school of nursing, the participant must immediately
15
contact the Nurse Corps Loan Repayment Program through the Bureau of Health Workforce Customer
Service Portal or Customer Care Center.
A participant can request a transfer to another site via the Bureau of Health Workforce Customer
Service Portal by going to the Activities section, then to Change My Site Request. The request must
include the reason for the transfer and an initiation of an Employment Verification Form for the
prospective site to determine whether it is an eligible critical shortage facility or eligible school of
nursing. The prospective site must be an eligible critical shortage facility or school of nursing in the
same or higher funding preference tier as the one in which the individual’s Nurse Corps Loan
Repayment Program contract was awarded. See Selection Factors in the Fiscal Year 2023 Application
and Program Guidance. All transfers require prior written approval.
We will notify the participant via the Bureau of Health Workforce Customer Service Portal of the
decision regarding the transfer request. If approved, the participant can resume full-time service at the
approved transfer critical shortage facility or school of nursing.
Additional Transfer Requirements
If there is a 30-day or less break in service between the stop work date at the initial/former service
site and the start date at the approved transfer site, Nurse Corps Loan Repayment Program
payments will not be interrupted. However, if the participant fails to resume service within 30 days of
the stop work date at the initial/former critical shortage facility or school of nursing, the Nurse Corps
Loan Repayment Program will stop all payments. Once the participant begins full-time service at
another approved critical shortage facility or eligible school of nursing, we will extend the Nurse
Corps Loan Repayment Program service end date, and the Nurse Corps Loan Repayment Program
payments will resume.
Unemployment During the Nurse Corps Loan Repayment Program Service Obligation
Nurse Corps Loan Repayment Program participants who resign or are terminated from their initial
critical shortage facility or school of nursing must contact the Nurse Corps Loan Repayment Program
immediately through the Bureau of Health Workforce Customer Service Portal. Nurse Corps Loan
Repayment Program participants who are not working at an eligible critical shortage facility or school
of nursing will face an immediate suspension of monthly payments until they return to service at an
eligible critical shortage facility or school of nursing. The Nurse Corps Loan Repayment Program will
provide the participant a specific period of time to obtain an offer and accept a position at an
approved critical shortage facility or school of nursing. The Nurse Corps Loan Repayment Program may
grant an extension upon written request. The participant is responsible for obtaining employment at
an eligible critical shortage facility or school of nursing. The Nurse Corps Loan Repayment Program will
recommend for default participants who do not secure employment at an eligible critical shortage
facility or school of nursing within the allotted time.
Breaching the Nurse Corps Loan Repayment Program Continuation Contract
Participants are encouraged to immediately contact the Nurse Corps Loan Repayment Program if a
situation arises in which they are potentially unable to fulfill their service obligation. A participant
who enters a one-year Nurse Corps Loan Repayment Program Continuation Contract, but fails to
begin or complete the service obligation, is liable to repay all Nurse Corps Loan Repayment Program
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Continuation payments received. This includes the amounts withheld for federal taxes plus interest at
the maximum legal prevailing rate from the date of the breach of the Nurse Corps Loan Repayment
Program Continuation Contract. Breach of the contract may permanently disqualify an individual
from receiving future awards under the Nurse Corps Loan Repayment Program and other Health
Resources and Services Administration and federal programs.
Any debt owed to the Federal Government under the Nurse Corps Loan Repayment Program is due
within three years of the participant’s breach of the contract. The debt amount is subject to interest at
the maximum legal prevailing rate from the date of breach until paid in full. Other charges and
penalties for delinquent or past due debts may be assessed.
Suspensions and Waivers
The Secretary of the United States Department of Health and Human Services or the Secretary’s
designee may, under certain circumstances, suspend or waive the Nurse Corps Loan Repayment
Program Continuation Contract service or payment obligation. Participants must submit a written
request for a suspension or waiver through the Bureau of Health Workforce Customer Service Portal.
To process such a request, the Nurse Corps Loan Repayment Program requires additional supporting
documentation that demonstrates a compelling circumstance.
Suspension
Suspension is a mechanism that provides temporary relief to a Nurse Corps Loan Repayment Program
participant who has a short-term (not permanent) circumstance that temporarily makes compliance
with the service obligation impossible or would involve an extreme personal hardship to the
participant such that enforcement of the obligation would be unconscionable. Participants who
anticipate an absence from their site for more than seven weeks must request a suspension of their
service obligation. Periods of approved suspension will extend a participant’s Nurse Corps Loan
Repayment Program service obligation end date. Categories of service suspension include:
a. Medical or Personal Reasons - A suspension may be granted for up to one year if the
participant provides independent medical documentation of a physical or mental
health disability or personal circumstances such as a terminal or debilitating illness of
an immediate family member, which results in the participant’s temporary inability to
perform the Nurse Corps Loan Repayment Program obligation. Upon receipt of the
written suspension request, the Nurse Corps Loan Repayment Program will notify the
participant of the instructions for submitting further supporting documentation.
b. Maternity/Paternity/Adoption Leave - Maternity/paternity/adoption suspension will
be approved by the Nurse Corps Loan Repayment Program upon request if adequately
documented in the Bureau of Health Workforce Customer Service Portal. If
participants plan to be away from their approved service site for maternity/paternity/
adoption leave, participants are required to submit their suspension request through
the Bureau of Health Workforce Customer Service Portal before taking the leave. The
Nurse Corps Loan Repayment Program will allow participants to be away from their
service site within the timeframes established by either the Family Medical Leave Act
(up to 12 weeks) or for a longer period as permitted under state law where the
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participant resides, consistent with the leave policies of the employer. If participants
plan to take leave beyond the allowed maternity/paternity/adoption leave period,
participants are required to contact the Nurse Corps Loan Repayment Program for
guidance. Remember that a participant may be away from their Nurse Corps Loan
Repayment Program-approved service site for no more than seven weeks per service
year; therefore, after a suspension, a participant’s obligation end date will be
extended for each day of a Nurse Corps Loan Repayment Program-approved absence
over the allowable seven weeks.
c. Call to Active Duty in the Armed Forces - A participant who is also a military reservist
when called to active duty will be granted a suspension for up to one year, which may
be extended, beginning on the activation date described in the reservist’s call to
active-duty order. In addition to the written request for a suspension, a copy of the
order to active duty must be submitted to the Nurse Corps Loan Repayment Program.
Upon receipt of the written request, the suspension will be extended if the armed
forces entity continues the period of active duty. The period of active military duty
service will not be credited towards the Nurse Corps Loan Repayment Program service
obligation unless otherwise indicated by Health Resources and Services
Administration.
Waiver
A waiver is a mechanism that permanently relieves the participant of all or part of the Nurse Corps
Loan Repayment Program service obligation. We will only grant a waiver if the participant
demonstrates that compliance with the obligation is impossible or would involve extreme hardship to
the individual and enforcement of the agreement with respect to the individual would be
unconscionable. The request must be submitted in writing to the Nurse Corps Loan Repayment
Program and must specify the reason(s) the waiver is being sought. The Nurse Corps Loan Repayment
Program will contact the participant directly regarding the medical and financial documentation
necessary to process the waiver request. The Nurse Corps Loan Repayment Program does not
routinely grant waivers and requires a demonstration of compelling circumstances.
Cancellation of a Nurse Corps Loan Repayment Program Obligation
The Nurse Corps Loan Repayment Program will cancel a participant’s obligation in its entirety in the
unfortunate event of the participant’s death. No liability is transferred to the participant’s heirs.
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Application Information
APPLICATION DEADLINE
Applicants must submit the complete Nurse Corps Loan Repayment Program Continuation Contract
online application with all required supporting documents uploaded by the application deadline (see
Application Submission Dates). The Nurse Corps Loan Repayment Program will not accept
documentation by fax, email, or mail. Applicants must use the Bureau of Health Workforce Customer
Service Portal.
Multi-Page Documents: We strongly encourage applicants to upload all supporting documents in PDF
format to expedite processing of the application. It is the applicant’s responsibility to ensure that the
information uploaded is accurate and viewable; a PDF format allows applicants to view documents
prior to submission. When uploading documents to the online application, applicants must be sure
that the documents do not exceed 5MB, as the system restricts larger documents to maintain
storage. Multi-paged documents can be consolidated by scanning and saving into one document, and
then uploaded.
COMPLETING AN APPLICATION
The Nurse Corps Loan Repayment Program Continuation Contract application package consists of:
(1) An online application;
(2) Required supporting documentation; and
(3) Additional supporting documentation (if applicable).
Missing and Incomplete Documents
The Nurse Corps Loan Repayment Program will consider applications incomplete if they are missing
documents, have illegible documents or other incomplete application materials. Incomplete applications
will be deemed ineligible.
Online Application
Applicants must complete each of the sections listed below:
(1) Employment
(2) Employment Verification
(3) Loan Information
(4) Self-Certification
(5) Sign Contract
Required Supporting Documentation
Each document submitted must include the applicant’s first and last name. The applicant is responsible for
uploading the required supporting documents and submitting the application by the application due date
and time.
(1) Payment History - Applicants must account for all funds received under the initial two-year
contract by submitting a history of payments made to the lenders or holders for all approved
loans listed on the Payment Authorization Worksheet in your Bureau of Health Workforce
Customer Service Portal account. The history of payments must be equal to or greater than the
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actual funds received from the Nurse Corps Loan Repayment Program from the service
obligation start date to the date of the submission of the Continuation Contract application.
The payment history must include the lender’s/holder’s name and the applicant’s name and
account number. The applicant’s loan servicer or lender will typically provide a payment
history online. Applicants should call the lender or loan servicer if they are having difficulty
downloading the information from the lender’s website. Bank statements will not be
accepted.
(2) Account Statements - Applicants must submit a current account statement that shows the
principal and interest of their current loan balances. The account statement must include the
lender’s name, applicant’s name and account number, and the current balance with the
principal and interest.
(3) Disbursement Report - Applicants may submit a Disbursement Report that shows all the loans
that have been obtained. Each loan document must have the applicant’s name, the original
loan amount, original loan date, type of loan, and consolidation dates, if applicable.
(4) Employment Verification Form - Applicants are required to review and verify the name and
address of the current critical shortage facility or eligible school of nursing and initiate an
electronic Employment Verification Form. The Employment Verification Form must be
completed by an appropriate official or authorized site point of contact at the critical shortage
facility or school of nursing. The point of contact should be the applicant’s immediate
supervisor or an authorized agent of the human resources department at the service site. If
the point of contact does not submit a completed Employment Verification Form, or if it is not
completed by the appropriate official, the application will be considered incomplete, and the
applicant will not be able to submit the application.
Additional Supporting Documentation (if applicable)
Based on the applicant’s responses to the online application, additional clarifying documents may be
required for submission. Examples of additional documentation that may be required include: (1)
name changes since the initial contract was signed, which require the submission of a marriage
license, divorce decree, or official court document; and (2) documentation of a Call to Active Duty
obligation, which would be required to verify an existing active-duty service obligation for applicants
who are members of a reserve component of the armed forces, including the National Guard.
Application Submission
Applicants will receive a receipt of submission once the application has been successfully submitted
online. Applicants can verify that sections of the application are complete on the status page.
Applicants will not be able to edit submitted applications. If an applicant needs to edit an application
after submission but before the deadline (see Application Submission Dates), the applicant should
contact Nurse Corps Loan Repayment Program staff via the Bureau of Health Workforce Customer
Service Portal or the Customer Care Center 1-800-221-9393. Please allow 5 to 10 business days for
the Nurse Corps Loan Repayment Program to update your submitted documents.
We advise applicants to keep a copy of the complete application package for their records. The
information in the online application must match the submitted supporting documentation. After the
applicant submits the application, the individual will receive a notification stating, “Overall
application status is submitted” and an “Application ID number” for their reference.
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Application Review and Award Process
Once a participant has submitted a complete application (which includes a signed Continuation
Contract), we will review the application and supporting documentation to determine if the applicant
meets all the eligibility requirements for an award. If the Nurse Corps Loan Repayment Program
selects a participant for a Nurse Corps Loan Repayment Program Continuation award, the Secretary
of U.S. Department of Health and Human Services or designee will countersign the individual’s signed
contract. The Continuation Contract’s one-year service obligation begins the day following the last
day of the participant’s service obligation under the initial two-year contract.
The National Practitioner Data Bank will be queried as part of the application review process if
the employing critical shortage facility or school of nursing indicates on the Employment
Verification Form any of the following:
• A National Practitioner Data Bank report has never been obtained by the employing critical
shortage facility or school of nursing for the applicant;
• It has been more than 18 months since the National Practitioner Data Bank was
queried by the employing critical shortage facility or school of nursing, for the
applicant; or
• A National Practitioner Data Bank report regarding the applicant on file with the
employing critical shortage facility or school of nursing contains adverse
information.
An applicant may withdraw their application via the Bureau of Health Workforce Customer Service
Portal at any time prior to the Secretary or Secretary’s designee counter-signing the Nurse Corps Loan
Repayment Program Continuation Contract.
Withdrawal of Signed Contract
As part of your continuation application submission, you will sign the Continuation Contract. If an
individual selected for an award decides not to accept the Continuation Contract after signing it, the
individual should notify the Nurse Corps Loan Repayment Program immediately through the Bureau
of Health Workforce Customer Service Portal:
(1) If the Secretary or designee has not yet countersigned the contract, the individual will not
incur a service obligation or any penalty for terminating the contract.
(2) If the Secretary or designee has already signed the contract, the individual has a binding
contract to complete the service obligation. Withdrawing from the program after the start of
the Continuation Contract is not an option and may result in the participant being placed in
default. The Continuation Contract one-year service obligation begins the day following the
last day of the participant’s service obligation under the initial two-year contract.
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Additional Information
PAPERWORK REDUCTION ACT PUBLIC BURDEN STATEMENT
The purpose of this information collection is to obtain information through the Nurse Corps Loan
Repayment Program that is used to assess a Loan Repayment Program applicant’s eligibility and
qualifications for the Loan Repayment Program and to monitor a participant’s compliance with the
program’s service requirements. Clinicians interested in participating in the Nurse Corps Loan
Repayment Program must submit an application to the Nurse Corps. An agency may not conduct or
sponsor, and a person is not required to respond to, a collection of information unless it displays a
currently valid OMB control number. The OMB control number for this information collection is 0915-
0140 and it is valid until 02/28/2026. Public reporting burden for this collection of information is
estimated to average 0.68 hours per response, including the time for reviewing instructions,
searching existing data sources, and completing and reviewing the collection of information. Send
comments regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane,
Room 14N136B, Rockville, Maryland, 20857.
RESOURCES FOR APPLICANTS
Customer Care Center
Any individual with questions about the Nurse Corps Loan Repayment Program may contact the
Customer Care Center Monday through Friday (except federal holidays), 8:00 am to 8:00 pm ET.
• 1-800-221-9393 (TTY – 1-877-897-9910)
Bureau of Health Workforce Customer Service Portal
The Bureau of Health Workforce Customer Service Portal is a web-based system that allows Nurse
Corps Loan Repayment Program Continuation Contract participants to make inquiries, requests (e.g.,
transfers, suspensions and waivers) and to access the six-month In-Service Verification and
Employment Verification forms.
Health Workforce Connector
The Health Workforce Connector contains a searchable database for all Nurse Corps Loan Repayment
Program approved service sites, including those with current job openings. Participants should
contact the Nurse Corps Loan Repayment Program if they are interested in transferring to a site listed
on the Health Workforce Connector to determine its eligibility.
Health Professional Shortage Area Find
All Nurse Corps Loan Repayment Program participants must serve in a federally designated primary
care or mental Health Professional Shortage Area. The websites below allow applicants to find
shortage areas by address. You cannot use P.O. Box addresses.
• Health Professional Shortage Area Find
• Shortage Areas by Address
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Nurse Corps Loan Repayment Program Social Media
• Nurse Corps Loan Repayment Program Facebook Page
• Nurse Corps Loan Repayment Program LinkedIn Page
NOTE: The announcements and information the Nurse Corps Loan Repayment Program posts on
social media sites are informal and unofficial communications. Official program policies and
requirements are set forth in this Application and Program Guidance, the applicable contract, on the
Nurse Corps Loan Repayment Program website, and through other communications provided to the
participant via the Bureau of Health Workforce Customer Service Portal.
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DEFINITIONS
Ambulatory Surgical Center - An entity that operates exclusively for the purpose of furnishing
surgical services to patients who do not require hospitalization and for which the expected duration
of services does not exceed 24 hours following admission.
American Indian Health Facilities - A health care facility (whether operated directly by the Indian
Health Service; or by a tribe or tribal organization contracting with the Indian Health Service
pursuant to the Indian Self-Determination and Education Assistance Act, codified at 25 U.S.C. 450 et
seq., or by an urban Indian organization receiving funds under Subchapter IV of the Indian Health
Care Improvement Act, codified at 25 U.S.C. 1651 et seq.), which provides clinical treatment services
to eligible American Indians and Alaska Natives on an outpatient basis. Visit: Find Health Care |
Indian Health Service (IHS) for more information.
Community Mental Health Center - Behavioral and mental health facilities must be located in
or serve in a Health Professional Shortage Area and must offer comprehensive primary
behavioral health services to all residents of the defined Health Professional Shortage Area.
The site must offer comprehensive primary behavioral health care services including, but not
limited to:
Core Comprehensive Behavioral Health Service Elements:
1) Screening and assessment
2) Treatment plans
3) Care coordination
Non-Core Behavioral Health Service Elements:
1) Diagnosis
2) Therapeutic services (including psychiatric medication prescribing
and management, chronic disease management, and substance use
disorder treatment)
3) Crisis/emergency services (including 24-hour crisis call access)
4) Consultative services
5) Case management
Continuation Contract - A Continuation Contract is an optional written contract pursuant to Section
846(a) of the Public Health Service Act, as amended, under which: (1) the participant agrees to
engage in a period of continuous full-time service for a third consecutive year as a registered nurse
or advanced practice registered nurse at an eligible critical shortage facility or nurse faculty in an
accredited eligible school of nursing after completion of their initial two-year service obligation
under their initial two-year contract, and (2) the Secretary agrees to repay, in consideration of such
service, 25 percent of their original total qualifying educational loan balances that were approved at
the time they entered into the initial Nurse Corps Loan Repayment Program Contract.
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Default of Service Obligation - Failure to begin or complete a contractual service commitment.
Disproportionate Share Hospital - A hospital that has a disproportionately large share of low-income
patients and receives an augmented payment from the state under Medicaid or a payment adjustment
from Medicare. Hospital-based outpatient clinics are included under this definition. Visit: Disproportionate
Share Hospital for more information.
End Stage Renal Disease Dialysis Centers - An end state renal disease facility is an entity that
provides outpatient maintenance dialysis services, or home dialysis training and support services, or
both. End stage renal disease facilities are described under section 1881 of the Social Security Act
and 42 CFR 413.174 as being either hospital-based or independent facilities.
Federally Qualified Health Center – Federally Qualified Health Centers include: (1) private
nonprofit entities or public agencies that receive a grant under section 330 of the Public Health
Service Act or funding from such a grant under a contract with the recipient of such a grant and
meets the requirements to receive such a grant; (2) entities designated as “Look-Alikes” by the
Secretary of the U.S. Department of Health and Human Services (or designee) as meeting the
requirements for receiving a grant under section 330 of the Public Health Service Act; and (3)
outpatient health programs or facilities operated by a tribe or tribal organization under the
Indian Self-Determination Act or by an urban Indian organization receiving funds under Title V of
the Indian Health Care Improvement Act. Federally Qualified Health Centers include Community
Health Centers, Migrant Health Centers, Health Care for the Homeless Health Centers, and
Public Housing Primary Care Health Centers.
Free and Charitable Clinics - Free and Charitable Clinics are safety-net health care organizations that
utilize a volunteer/staff model to provide a range of medical, dental, pharmacy, vision and/or
behavioral health services to economically disadvantaged individuals. Such clinics are 501(c)(3) tax-
exempt organizations or operate as a program component or affiliate of a 501(c)(3) organization.
Note: free clinic volunteer staff are not eligible for Nurse Corps Loan Repayment Program
Continuation awards. Entities that otherwise meet the above definition, but charge a
nominal/sliding fee to patients, may still be considered Free and Charitable Clinics provided that
essential services are delivered regardless of the patient's ability to pay. Free and Charitable Clinics
restrict eligibility for their services to individuals who are uninsured, underinsured, and/or have
limited or no access to primary, specialty, or prescription health care.
Health Workforce Connector - A searchable database of open job opportunities and information on
approved sites.
Home Health Agency - An agency or organization, certified under section 1861(o) of the Social
Security Act, which is primarily engaged in providing skilled nursing care and other therapeutic
services at a patient’s home. Visit: Home Health Agency Center for more information.
Hospice Program - An agency or organization, certified under section 1861(dd)(2) of the Social
Security Act, which provides 24-hour care and treatment services (as needed) to terminally ill
individuals and bereavement counseling for their immediate family members. Care is provided in
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individuals’ homes, on an outpatient basis, and on a short-term inpatient basis, directly or under
arrangements made by the agency or organization. Visit: Hospice Center for more information.
Initial Two-year Contract - A written contract pursuant to Section 846(a) of the PHS Act, as
amended, under which: (1) the participant agrees to engage in a period of continuous full-time
service for two consecutive years as a registered nurse or advanced practice registered nurse at an
eligible critical shortage facility or as nurse faculty in an accredited eligible school of nursing, and (2)
the Secretary agrees to repay, in consideration of such service, a percentage of the amount which is
outstanding on the participant's qualifying educational loans on the effective date of the initial two-
year contract.
In-Service Verification - The Nurse Corps Loan Repayment Program verifies every six months that
participants are in compliance with the service obligation. By completing and signing the In-Service
Verification, the participant and the point of contact are certifying the participant’s compliance with
the full-time service requirements during the identified period. For participants working at multiple
sites, we require an In-Service Verification from each site every six months. The In-Service
Verification records the total number of full-time workdays that a participant was absent, for any
reason, from the critical shortage facility or school of nursing during the reporting period.
Multiple Sites - Applicants may work at multiple sites under a single employer or within the same
network under dependent satellite facilities. Each critical shortage facility must meet all eligibility
requirements.
Native Hawaiian Health Center - An entity (1) which is organized under the laws of the state of
Hawaii; (2) which provides or arranges for health care services through practitioners licensed by the
state of Hawaii, where licensure requirements are applicable; (3) which is a public or private
nonprofit entity; and (4) in which Native Hawaiian health practitioners significantly participate in the
planning, management, monitoring, and evaluation of health services. For more information, see the
Native Hawaiian Health Care Act of 1992, as amended.
Nurse-Managed Health Clinic/Center - An entity which is a nurse-practice arrangement, managed by
advanced practice nurses, which provides primary care or wellness services to underserved or
vulnerable populations and that is associated with a school, college, university or department of
nursing, Federally Qualified Health Center, or independent health or social services agency. These
clinics must serve the general public.
Outpatient Facility – Outpatient facilities provide healthcare services to private, group and specialty
practices that are open to the public.
Participant Award Worksheet – A detailed payment disbursement report reflecting all the
participant’s eligible loans that qualify for repayment under the Nurse Corps Loan Repayment
Program Continuation award. Nurse Corps Loan Repayment Program Continuation award monthly
payments can only be applied to the loans listed on the Participant Award Worksheet.
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Point of Contact – An official at a critical shortage facility or eligible school of nursing who is the
applicant’s immediate supervisor or an authorized agent of the human resources department at the
service site. The site point of contact must verify (1) the participant’s total work hours and (2) work
status, during the service obligation. The Point of Contact must be active and registered in the Bureau
of Heath Workforce Customer Service Portal.
Private Hospital - Hospitals or affiliated outpatient clinics in a state that are private entities and are
primarily engaged in providing the following care, by or under the supervision of physicians, to
inpatients: (1) diagnostic and therapeutic services for medical diagnosis, treatment, and care of
injured, disabled, or sick persons; or (2) rehabilitation of injured, disabled, or sick persons. Hospital-
based outpatient clinics are included under this definition.
Public Hospital - Any hospital or hospital-based outpatient clinic that is owned by a government
(federal, state, or local), receives government funding, and is primarily engaged in providing the
following care, by or under the supervision of physicians, to inpatients: (a) diagnostic and therapeutic
services for medical diagnosis, treatment, and care of injured, disabled, or sick persons; or (b)
rehabilitation of injured, disabled, or sick persons. United States Department of Veterans Affairs
hospitals and military treatment facility hospitals are also included under this definition. State
psychiatric hospitals must use facility Health Professional Shortage Areas to determine site
eligibility—population and geographic Health Professional Shortage Areas cannot be used.
Residential Nursing Home - An institution that is primarily engaged in providing, on a regular basis,
health-related care and service to individuals who because of their mental or physical condition
require care and service (above the level of room and board) that can be made available to them only
through institutional facilities. This category includes a “skilled nursing facility,” which is an institution
(or distinct part of an institution) certified under section 1819(a) of the Social Security Act, that is
primarily engaged in providing skilled nursing care and related services to residents requiring medical,
rehabilitation, or nursing care and is not primarily for the care and treatment of mental diseases;
transitional facilities; assisted living; and group homes.
Rural Health Clinic - An entity that the Centers for Medicare & Medicaid Services has certified as a
rural health clinic under section 1861(aa)(2) of the Social Security Act. A rural health clinic provides
outpatient services to a non-urban area with an insufficient number of health care practitioners.
School-Based Clinic - A health clinic that is located in or near a school facility of a school district or
board or of an Indian tribe or tribal organization.
Small Rural Hospital - A non-federal, short-term general acute care hospital that is located in a rural
area (as defined for purposes of section 1886(d)(2)(D) of the Social Security Act) and has less than 50
beds. Critical Access Hospitals are included as eligible within this Critical Shortage Facility.
State or Local Health Department - The state, county, parish, or district entity that is responsible for
providing healthcare services, which include health promotion, disease prevention, and intervention
services, in clinics or other health care facilities that are funded and operated by the state or local
Public Health, Health, or Human Services Departments.
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Telehealth - The use of electronic information and telecommunications technologies to support and
promote long-distance clinical health care, patient and professional health-related education, public
health, and health administration. Technologies include videoconferencing, the internet, store-and-
forward imaging, streaming media, and terrestrial and wireless communications.
Transfer - Upon a written request and written approval, participants may transfer to another eligible
critical shortage facility or school of nursing that falls in the same funding preference tier that the
individual was initially awarded in, or higher.
Urgent Care Center - Urgent care centers provide acute episodic care on a walk-in basis to assist
patients with an illness or injury that does not appear to be limb or life-threatening and is either
beyond the scope or availability of the typical primary care practice. Urgent care centers primarily
treat injuries or illnesses requiring immediate care but not serious enough to require an emergency
room visit.
For additional definitions, refer to the Guidance corresponding to the year of your initial two-year
Nurse Corps Loan Repayment Program Contract.