reglab/statecodes huggingface dataset:
2023 Vermont Statutes › Title 18 - Health › Chapter 43 - Licensing of Hospitals › § 1906. Revocation of license; hearing

§ 1906. Revocation of license; hearing
The licensing agency, after notice and opportunity for hearing to the applicant or licensee, is authorized to deny, suspend, or revoke a license in any case in which it finds that there has been a substantial failure to comply with the requirements established under this chapter. Such notice shall be served by registered mail or by personal service setting forth the reasons for the proposed action and fixing a date not less than 60 days from the date of such mailing or service, at which the applicant or licensee shall be given opportunity for a hearing. After such hearing, or upon default of the applicant or licensee, the licensing agency shall file its findings of fact and conclusions of law. A copy of such findings and decision shall be sent by registered mail or served personally upon the applicant or licensee. The procedure governing hearings authorized by this section shall be in accordance with the usual and customary rules provided for such hearings.
2023 Vermont Statutes › Title 18 - Health › Chapter 43 - Licensing of Hospitals › § 1907. Appeal

§ 1907. Appeal
Any applicant or licensee, or the State acting through the Attorney General, aggrieved by the decision of the licensing agency after a hearing, may, within 30 days after entry of the decision as provided in section 1906 of this title, appeal to the Superior Court wherein the appellant is located. The court may affirm, modify, or reverse the decision of the licensing agency and either the applicant or licensee or licensing agency or State may appeal to the Supreme Court for such further review as is provided by law. Pending final disposition of the matter, the status quo of the applicant or licensee shall be preserved, except as the court otherwise orders in the public interest. (Amended 1971, No. 185 (Adj. Sess.), § 185, eff. March 29, 1972; 1973, No. 193 (Adj. Sess.), § 3, eff. April 9, 1974.)
2023 Vermont Statutes › Title 18 - Health › Chapter 43 - Licensing of Hospitals › § 1908. Rules; exceptions

§ 1908. Rules; exceptions
(a) The licensing agency shall adopt and enforce rules and standards with respect to the different types of hospitals to be licensed under this chapter as may be designed to further the accomplishment of the purposes set forth in this chapter; such rules and standards shall be modified, amended, or rescinded from time to time by the licensing agency as may be in the public interest.
(b) No such rules and standards shall be adopted or enforced that would have the effect of denying a license to a hospital solely by reason of the school or system of practice employed or permitted to be employed by physicians therein, provided that such school or system of practice is recognized by the laws of the State. Provided, however, that no rule or requirement shall be made under this chapter for any hospital conducted for those who rely upon treatment by spiritual means or prayer in accordance with the creed or tenets of any recognized church or religious denomination, except as to the sanitary and safe condition of the premises, cleanliness of operation, and its physical equipment. (Amended 2015, No. 23, § 106; 2023, No. 6, § 131, eff. July 1, 2023.)
2023 Vermont Statutes › Title 18 - Health › Chapter 43 - Licensing of Hospitals › § 1909. Inspections

§ 1909. Inspections
The licensing agency shall make or cause to be made such inspections and investigations as it deems necessary. If the licensing agency finds a violation as the result of an inspection or investigation, the licensing agency shall post a report on the licensing agency’s website summarizing the violation and any corrective action required. (Amended 2019, No. 55, § 2.)
2023 Vermont Statutes › Title 18 - Health › Chapter 43 - Licensing of Hospitals › § 1910. Records

§ 1910. Records
(a) Information received by the licensing agency through filed reports, inspection, or as otherwise authorized by law shall:
(1) not be disclosed publicly in a manner that identifies or may lead to the identification of one or more individuals or hospitals;
(2) be exempt from public inspection and copying under the Public Records Act; and
(3) be kept confidential except as it relates to a proceeding regarding licensure of a hospital.
(b) The provisions of subsection (a) of this section shall not apply to the summary reports of violations required to be posted on the licensing agency’s website pursuant to section 1909 of this chapter. (Amended 2019, No. 55, § 3.)
2023 Vermont Statutes › Title 18 - Health › Chapter 43 - Licensing of Hospitals › § 1911a. Notice of hospital observation status

§ 1911a. Notice of hospital observation status
(a)(1) Each hospital shall provide oral and written notice to each Medicare beneficiary that the hospital places in observation status as soon as possible but not later than 24 hours following such placement, unless the individual is discharged or leaves the hospital before the 24-hour period expires. The written notice shall be a uniform form developed by the Department of Health, in consultation with interested stakeholders, for use in all hospitals.
(2) If a patient is admitted to the hospital as an inpatient before the notice of observation has been provided, and under Medicare rules the observation services may be billed as part of the inpatient stay, the hospital shall not be required to provide notice of observation status.
(b) Each oral and written notice shall include:
(1) a statement that the individual is under observation as an outpatient and is not admitted to the hospital as an inpatient;
(2) a statement that observation status may affect the individual’s Medicare coverage for hospital services, including medications and pharmaceutical supplies, and for rehabilitative or skilled nursing services at a skilled nursing facility if needed upon discharge from the hospital; and
(3) a statement that the individual may contact the Office of the Health Care Advocate or the Vermont State Health Insurance Assistance Program to understand better the implications of placement in observation status.
(c) Each written notice shall include the name and title of the hospital representative who gave oral notice; the date and time oral and written notice were provided; the means by which written notice was provided, if not provided in person; and contact information for the Office of the Health Care Advocate and the Vermont State Health Insurance Assistance Program.
(d) Oral and written notice shall be provided in a manner that is understandable by the individual placed in observation status or by his or her representative or legal guardian.
(e) The hospital representative who provided the written notice shall request a signature and date from the individual or, if applicable, his or her representative or legal guardian, to verify receipt of the notice. If a signature and date were not obtained, the hospital representative shall document the reason. (Added 2015, No. 54, § 5, eff. Dec. 1, 2015; amended 2023, No. 6, § 132, eff. July 1, 2023.)
2023 Vermont Statutes › Title 18 - Health › Chapter 43A - Patient Safety Surveillance and Improvement System › § 1912. Definitions

§ 1912. Definitions
As used in this chapter:
(1) “Adverse event” is any untoward incident, therapeutic misadventure, iatrogenic injury, or other undesirable occurrence directly associated with care or services provided by a health care provider or health care facility.
(2) “Causal analysis” means a formal root cause analysis, similar analytic methodologies, or any similarly effective but simplified processes that use a systematic approach to identify the basic or causal factors that underlie the occurrence or possible occurrence of a reportable adverse event, adverse event, or near miss.
(3) “Corrective action plan” means a plan to implement strategies intended to eliminate or significantly reduce the risk of a recurrence of an adverse event and to measure the effectiveness of such strategies.
(4) “Hospital” shall have the same meaning as in subdivision 1902(1) of this title.
(5) “Health care provider” shall have the same meaning as in subdivision 9402(7) of this title.
(6) “Intentional unsafe act” shall mean an adverse event or near miss that results from:
(A) a criminal act;
(B) a purposefully unsafe act;
(C) alcohol or substance abuse; or
(D) patient abuse.
(7) “Near miss” means any process variation that did not affect the outcome, but for which a recurrence carries a significant chance of a serious adverse outcome.
(8) “Reportable adverse event” means those adverse events a hospital is required to report to the Department pursuant to rules adopted under this chapter.
(9) “Safety system” means the comprehensive patient safety surveillance and improvement system established pursuant to this chapter and the rules adopted pursuant to this chapter.
(10) “Serious bodily injury” means bodily injury that creates a substantial risk of death or that causes substantial loss or impairment of the function of any bodily member or organ or substantial impairment of health or substantial disfigurement. (Added 2005, No. 215 (Adj. Sess.), § 324; amended 2023, No. 6, § 133, eff. July 1, 2023.)
2023 Vermont Statutes › Title 18 - Health › Chapter 43A - Patient Safety Surveillance and Improvement System › § 1913. Creation; implementation

§ 1913. Creation; implementation
(a) The Commissioner shall establish a comprehensive patient safety surveillance and improvement system for the purpose of improving patient safety, eliminating adverse events in Vermont hospitals, and supporting and facilitating quality improvement efforts by hospitals. The Department may contract with a qualified organization having expertise in patient safety to develop and implement all or part of the safety system.
(b) The Department shall:
(1) collect data concerning the occurrence of reportable adverse events;
(2) aggregate and analyze data for the purpose of developing and implementing strategies to target and eliminate specific adverse events;
(3) verify that hospitals are in compliance with all the requirements of this chapter and rules adopted pursuant to this chapter;
(4) for reportable adverse events, verify that hospitals are conducting causal analyses and developing corrective action plans consistent with standards set by the Department, current patient safety science, and relevant clinical standards;
(5) provide technical assistance or assist hospitals in locating technical assistance resources for analyzing adverse events and near misses and developing and implementing corrective action plans; and
(6) encourage hospitals to utilize anonymous in-hospital reporting when possible.
(c) The Commissioner may retain or contract with such additional professional or other staff as needed to carry out responsibilities under this chapter.
(d) Beginning on July 1, 2007, expenses incurred for development and implementation of the safety system shall be borne as follows: 50 percent from General Fund monies and 50 percent by the hospitals.
(e) Not later than January 15, 2008, the Commissioner of Health shall provide an interim report to the Senate Committee on Health and Welfare and the House Committees on Human Services and on Health Care on the status of the safety system, its effectiveness in improving patient safety and health care quality in the State, and cost savings. Not later than January 15, 2009, the Commissioner shall make a final report to those Committees on those subjects and shall make recommendations regarding expansion of the system to include health care facilities other than hospitals.
(f) The authority granted to the Commissioner under this chapter is in addition to any other authority granted to the Commissioner under law. (Added 2005, No. 215 (Adj. Sess.), § 324; amended 2023, No. 6, § 134, eff. July 1, 2023.)
2023 Vermont Statutes › Title 18 - Health › Chapter 43A - Patient Safety Surveillance and Improvement System › § 1914. Rulemaking

§ 1914. Rulemaking
(a) The Commissioner shall adopt rules pursuant to 3 V.S.A. chapter 25 establishing the hospital obligations listed in section 1915 of this title and otherwise necessary for the implementation of the safety system.
(b) The rules shall list reportable adverse events, which shall include the “serious reportable events” published by the National Quality Forum. The Commissioner shall consult with experts and hospitals when making changes to the list of reportable adverse events and shall consider the implications of reporting requirements that may be established as a result of the federal Patient Safety and Quality Improvement Act of 2005. The Department shall consult with other regulatory agencies and departments and, to the extent possible, avoid imposing duplicative reporting requirements. (Added 2005, No. 215 (Adj. Sess.), § 324.)
2023 Vermont Statutes › Title 18 - Health › Chapter 43A - Patient Safety Surveillance and Improvement System › § 1915. Hospital obligations

§ 1915. Hospital obligations
The rules adopted pursuant to this chapter shall require hospitals to:
(1) develop, maintain, and implement internal policies and procedures that meet the standards of the Department to:
(A) identify, track, and analyze reportable adverse events, adverse events, and near misses;
(B) determine what type of causal analysis, if any, is appropriate;
(C) conduct causal analyses and develop corrective action plans; and
(D) disclose to patients, or, in the case of a patient death, an adult member of the immediate family, at a minimum, adverse events that cause death or serious bodily injury;
(2) report reportable adverse events to the Department;
(3) provide the Department with copies of its causal analysis and corrective action plan in connection with each reportable adverse event;
(4) for reportable adverse events that must also by law be reported to other departments or agencies, notify the Department of Health or provide a copy of any written report and provide any causal analysis information required by the Department;
(5) for the purpose of evaluating a hospital’s compliance with the provisions of this chapter, provide the Commissioner and designees reasonable access to:
(A) information protected by the provisions of the patient’s privilege under 12 V.S.A. § 1612(a) or otherwise required by law to be held confidential; and
(B) the minutes and records of a peer review committee and any other information subject to peer review protection under 26 V.S.A. § 1443. (Added 2005, No. 215 (Adj. Sess.), § 324.)
2023 Vermont Statutes › Title 18 - Health › Chapter 43A - Patient Safety Surveillance and Improvement System › § 1916. Intentional unsafe acts

§ 1916. Intentional unsafe acts
(a) A hospital shall notify the Department, within the time frames established by regulation, if the information available supports a reasonable, good faith belief that an intentional unsafe act as it pertains to patients has occurred.
(b) For intentional unsafe acts reportable to other departments or agencies, a hospital shall notify the Department of Health or provide a copy of any written report. Such reports shall not constitute a waiver of peer review or any other privilege.
(c) If the Department confirms or independently concludes, based on a reasonable, good faith belief, that an intentional unsafe act occurred, it shall notify relevant State and federal licensing and other regulatory entities and, in the case of possible criminal activity, relevant State and federal law enforcement authorities.
(d) There shall be no liability on the part of and no cause of action for damages shall arise against any individual or hospital for any act or proceeding related to activities undertaken or performed within the scope of the obligations imposed by this section, provided that the individual or hospital acts without malice and with the reasonable belief that the action is warranted by the facts known after making reasonable efforts to obtain all the facts.
(e) Nothing in this section shall prevent a hospital from conducting its own investigation or peer review. (Added 2005, No. 215 (Adj. Sess.), § 324; amended 2017, No. 113 (Adj. Sess.), § 68.)
2023 Vermont Statutes › Title 18 - Health › Chapter 43A - Patient Safety Surveillance and Improvement System › § 1918. Enforcement

§ 1918. Enforcement
(a) If the Commissioner determines that a hospital has failed to comply with any of the provisions of this chapter, the Commissioner may sanction the hospital as provided in this title. In evaluating compliance, the Commissioner shall place primary emphasis on assuring good faith compliance and effective corrective action by the facility, reserving punitive enforcement or disciplinary action for those cases in which the facility has displayed recklessness, gross negligence, or willful misconduct or in which there is evidence, based on other similar cases known to the Department, the Agency of Human Services, or the Office of the Attorney General, of a pattern of significant substandard performance that has the potential for or has actually resulted in harm to patients.
(b) After notice and an opportunity for hearing, the Commissioner may impose on a hospital that knowingly violates a provision of this chapter or a rule or order adopted pursuant to this chapter a civil administrative penalty of not more than $10,000.00 or, in the case of a continuing violation, a civil administrative penalty of not more than $100,000.00 or one-tenth of one percent of the gross annual revenues of the health care facility, whichever is greater. A hospital aggrieved by a decision of the Commissioner under this section may appeal the Commissioner’s decision pursuant to section 128 of this title. (Added 2005, No. 215 (Adj. Sess.), § 324.)
2023 Vermont Statutes › Title 18 - Health › Chapter 43A - Patient Safety Surveillance and Improvement System › § 1919. Inclusion of data in hospital community reports

§ 1919. Inclusion of data in hospital community reports
The Commissioner shall consult with the Commissioner of Financial Regulation and with patient safety experts, hospitals, health care professionals, and members of the public and shall make recommendations to the Commissioner of Financial Regulation concerning which data should be included in the hospital community reports required by section 9405b of this title. Beginning in 2013, the community reports shall include at a minimum data from all Vermont hospitals of reportable adverse events aggregated in a manner that protects the privacy of the patients involved and does not identify the individual hospitals in which an event occurred together with analysis and explanatory comments about the information contained in the report to facilitate the public’s understanding of the data. The Commissioner shall make such recommendations no more than 18 months after data collection is initiated. (Added 2005, No. 215 (Adj. Sess.), § 324; amended 2011, No. 171 (Adj. Sess.), § 24f, eff. Feb. 1, 2013.)
2023 Vermont Statutes › Title 18 - Health › Chapter 46 - Nursing Home Administrators › § 2051. Definitions

§ 2051. Definitions
For the purposes of this chapter, unless the context otherwise clearly requires:
(1) “Director” means the Director of the Office of Professional Regulation.
(2) “Nursing home” means any institution or facility, whether proprietary or nonproprietary, defined as a nursing home for licensing purposes pursuant to 33 V.S.A. § 7102(7), or the equivalent facility or facilities as defined by the Secretary of the U.S. Department of Health and Human Services.
(3) “Nursing home administrator” means a person who is duly licensed by the Director and who is charged with the general administration of a nursing home whether or not the individual has an ownership interest in the home and whether or not his or her functions and duties are shared with one or more other individuals.
(4) [Repealed.] (Added 1969, No. 248 (Adj. Sess.), § 2, eff. April 1, 1970; amended 2005, No. 27, § 9; 2007, No. 29, § 3.)
2023 Vermont Statutes › Title 18 - Health › Chapter 46 - Nursing Home Administrators › § 2052. Advisor appointees

§ 2052. Advisor appointees
(a) The Secretary of State shall appoint two advisors as set forth in 3 V.S.A. § 129b. One of the initial appointments may be for less than a five-year term. One of the appointees shall have not less than three years’ experience as a nursing home administrator immediately preceding appointment and shall be actively engaged in nursing home administration in Vermont during incumbency. The other appointee shall have not less than three years’ experience as a licensed health care provider engaged in the care of the chronically ill.
(b) The Director shall seek the advice of the advisors in carrying out the provisions of this chapter. Advisor appointees shall be entitled to compensation and necessary expenses in the amount provided in 32 V.S.A. § 1010 for attendance at any meeting called by the Director for this purpose. (Added 1969, No. 248 (Adj. Sess.), § 2, eff. April 1, 1970; amended 1973, No. 72, §§ 1, 2, eff. July 1, 1973; 1989, No. 251 (Adj. Sess.), § 2; 1997, No. 40, § 14; 1999, No. 133 (Adj. Sess.), § 34; 2005, No. 27, § 10; 2007, No. 29, § 3.)
2023 Vermont Statutes › Title 18 - Health › Chapter 46 - Nursing Home Administrators › § 2053. Director; duties; powers

§ 2053. Director; duties; powers
(a) The Director shall:
(1) set requirements for licensure;
(2) provide general information to applicants;
(3) explain complaint and appeal procedures to licensees, applicants, and the public;
(4) receive applications for licensure; license applicants under this chapter; renew licenses; and revoke, reinstate, or condition licenses as ordered by an administrative law officer.
(b) The Director may:
(1) adopt rules concerning continuing education requirements;
(2) adopt rules necessary to perform his or her duties under this chapter;
(3) adopt rules of professional conduct. (Added 1969, No. 248 (Adj. Sess.), § 2, eff. April 1, 1970; amended 2005, No. 27, § 11; 2007, No. 29, § 3.)
2023 Vermont Statutes › Title 18 - Health › Chapter 46 - Nursing Home Administrators › § 2054. Exclusive jurisdiction of the Director

§ 2054. Exclusive jurisdiction of the Director
The Director, with the advice of the advisors appointed under this chapter, shall have exclusive authority to determine the qualifications, skill, and fitness of any person to serve as an administrator of a nursing home under the provisions of this chapter, and a licensee under the provisions of this chapter shall be qualified to serve as the administrator of a nursing home. (Added 1969, No. 248 (Adj. Sess.), § 2, eff. April 1, 1970; amended 2007, No. 29, § 3.)
2023 Vermont Statutes › Title 18 - Health › Chapter 46 - Nursing Home Administrators › § 2055. General requirements for licensure

§ 2055. General requirements for licensure
A person may not practice nursing home administration in this State unless:
(1) the applicant has made written application for license to the Director, accompanied by satisfactory proof that he or she is at least 18 years of age and is not in violation of the rules regarding this profession or Vermont law;
(2) in the judgment of the Director, the applicant has satisfactorily completed a course of instruction or training and met the requirements adopted by rule; or
(3) the applicant has passed an examination administered by the Director or his or her designee that is designed to test for proficiency and competence and an examination covering Vermont statutes and rules relating to nursing home administration. (Added 1969, No. 248 (Adj. Sess.), § 2, eff. April 1, 1970; amended 2005, No. 27, § 12; 2007, No. 29, § 3.)
2023 Vermont Statutes › Title 18 - Health › Chapter 46 - Nursing Home Administrators › § 2057. Licensing

§ 2057. Licensing
(a) The Director shall license nursing home administrators in accordance with rules adopted, and from time to time revised. A nursing home administrator’s license may not be transferred and shall be valid until surrendered for cancellation or suspended or revoked for violation of this chapter or any other laws or regulations relating to the proper administration and management of a nursing home. Denial of issuance or renewal, suspension, or revocation under any section of this chapter shall be appealable in the manner provided in 3 V.S.A. § 130a.
(b) Every holder of a nursing home administrator’s license shall renew it biennially, by making application to the Director. Renewals of licenses shall be granted as a matter of course, unless an administrative law officer finds, after due notice and hearing, that the applicant has acted or failed to act in such manner, or under circumstances, as would constitute grounds for suspension or revocation of a license. The Director may by rule require that a license holder complete not more than 40 hours of approved instruction every two years as a condition of renewal. (Added 1969, No. 248 (Adj. Sess.), § 2, eff. April 1, 1970; amended 1971, No. 185 (Adj. Sess.), § 186, eff. March 29, 1972; 1993, No. 108 (Adj. Sess.), § 16; 2007, No. 29, § 3.)
2023 Vermont Statutes › Title 18 - Health › Chapter 46 - Nursing Home Administrators › § 2058. License fees

§ 2058. License fees
Applicants and persons regulated under this chapter shall be subject to the following fees:
(1) Application $115.00
(2) Biennial renewal $275.00 (Added 1969, No. 248 (Adj. Sess.), § 2, eff. April 1, 1970; amended 1975, No. 118, § 91, eff. July 1, 1975; 1989, No. 250 (Adj. Sess.), § 86; 1991, No. 167 (Adj. Sess.), § 58; 1997, No. 59, § 46, eff. June 30, 1997; 1999, No. 49, § 168; 2001, No. 143 (Adj. Sess.), § 18, eff. June 21, 2002; 2011, No. 33, § 1; 2023, No. 77, § 17, eff. June 20, 2023.)
2023 Vermont Statutes › Title 18 - Health › Chapter 46 - Nursing Home Administrators › § 2059. Licensure by endorsement

§ 2059. Licensure by endorsement
The Director may issue a nursing home administrator’s license, without examination for proficiency and competence, to any person who holds a current license as a nursing home administrator from another jurisdiction, provided that the Director finds that the standards for licensing in the other jurisdiction are substantially equivalent to those in this State. (Added 1969, No. 248 (Adj. Sess.), § 2, eff. April 1, 1970; amended 2005, No. 27, § 13; 2007, No. 29, § 3.)
2023 Vermont Statutes › Title 18 - Health › Chapter 46 - Nursing Home Administrators › § 2060. Violations and penalties

§ 2060. Violations and penalties
A person who practices, or offers to practice, nursing home administration in this State, without being licensed in accordance with this chapter; or any person presenting or attempting to use as his or her own the license of another; or a person who gives any false or forged evidence of any kind in attempting to obtain a license; or a person who falsely impersonates another licensee; or a person who attempts to use an expired or revoked license or any person who violates any of the provisions of this chapter shall be subject to the penalties provided in 3 V.S.A. § 127(c). (Added 1969, No. 248 (Adj. Sess.), § 2, eff. April 1, 1970; amended 2007, No. 29, § 3.)
2023 Vermont Statutes › Title 18 - Health › Chapter 46 - Nursing Home Administrators › § 2061. Provisional license

§ 2061. Provisional license
In the event of the inability of the regular licensed administrator of a nursing home to perform his or her duties or if, through death or other causes, a nursing home is without a licensed administrator, a provisional administrator may, in the discretion of the Director, be issued a provisional license to administer that home for a period not to exceed 90 days from the date on which the regular licensed administrator first ceased to perform his or her duties. The Director shall not renew such a provisional license, nor shall the Director issue a provisional license to any other person to administer a home that has been administered for the preceding 90 days by a provisional administrator. (Added 1973, No. 72, § 4, eff. July 1, 1973; amended 2005, No. 27, § 14; 2007, No. 29, § 3.)
2023 Vermont Statutes › Title 18 - Health › Chapter 49 - Ambulatory Surgical Centers › § 2141. Definitions

§ 2141. Definitions
As used in this chapter:
(1) “Ambulatory surgical center” means any distinct entity that operates primarily for the purpose of providing surgical services to patients not requiring hospitalization and for which the expected duration of services would not exceed 24 hours following an admission. The term does not include:
(A) a facility that is licensed as part of a hospital; or
(B) a facility that is used exclusively as an office or clinic for the private practice of one or more licensed health care professionals, unless one or more of the following descriptions apply:
(i) the facility holds itself out to the public or to other health care providers as an ambulatory surgical center, surgical center, surgery center, surgicenter, or similar facility using a similar name or a variation thereof;
(ii) procedures are carried out at the facility using general anesthesia, except as used in oral or maxillofacial surgery or as used by a dentist with a general anesthesia endorsement from the Board of Dental Examiners; or
(iii) patients are charged a fee for the use of the facility in addition to the fee for the professional services of one or more of the health care professionals practicing at that facility.
(2) “Health care professional” means:
(A) a physician licensed pursuant to 26 V.S.A. chapter 23 or 33;
(B) an advanced practice registered nurse licensed pursuant to 26 V.S.A. chapter 28;
(C) a physician assistant licensed pursuant to 26 V.S.A. chapter 31;
(D) a podiatrist licensed pursuant to 26 V.S.A. chapter 7; or
(E) a dentist licensed pursuant to 26 V.S.A. chapter 12.
(3) “Patient” means a person admitted to or receiving health care services from an ambulatory surgical center. (Added 2019, No. 55, § 1, eff. Jan. 1, 2020.)
2023 Vermont Statutes › Title 18 - Health › Chapter 49 - Ambulatory Surgical Centers › § 2151. License

§ 2151. License
No person shall establish, maintain, or operate an ambulatory surgical center in this State without first obtaining a license for the ambulatory surgical center in accordance with this subchapter. (Added 2019, No. 55, § 1, eff. Jan. 1, 2020.)
2023 Vermont Statutes › Title 18 - Health › Chapter 49 - Ambulatory Surgical Centers › § 2152. Application; fee

§ 2152. Application; fee
(a) An application for licensure of an ambulatory surgical center shall be made to the Department of Health on forms provided by the Department and shall include all information required by the Department. Each application for a license shall be accompanied by a license fee.
(b) The annual licensing fee for an ambulatory surgical center shall be $600.00.
(c) Fees collected under this section shall be credited to the Hospital Licensing Fees Special Fund and shall be available to the Department of Health to offset the costs of licensing ambulatory surgical centers. (Added 2019, No. 55, § 1, eff. Jan. 1, 2020.)
2023 Vermont Statutes › Title 18 - Health › Chapter 49 - Ambulatory Surgical Centers › § 2153. License requirements

§ 2153. License requirements
(a) Upon receipt of an application for a license and the licensing fee, the Department of Health shall issue a license if it determines that the applicant and the ambulatory surgical center facilities meet the following minimum standards:
(1) The applicant shall demonstrate the capacity to operate an ambulatory surgical center in accordance with rules adopted by the Department.
(2) The applicant shall demonstrate that its facilities comply fully with standards for health, safety, and sanitation as required by State law, including standards set forth by the State Fire Marshal and the Department of Health, and municipal ordinance.
(3) The applicant shall have a clear process for responding to patient complaints.
(4) The applicant shall participate in the Patient Safety Surveillance and Improvement System established pursuant to chapter 43A of this title.
(5) The applicant shall maintain certification from the Centers for Medicare and Medicaid Services and shall accept Medicare and Medicaid patients for ambulatory surgical center facility services.
(6) The ambulatory surgical center facilities, including the buildings and grounds, shall be subject to inspection by the Department, its designees, and other authorized entities at all times.
(b) A license is not transferable or assignable and shall be issued only for the premises and persons named in the application. (Added 2019, No. 55, § 1, eff. Jan. 1, 2020.)
2023 Vermont Statutes › Title 18 - Health › Chapter 49 - Ambulatory Surgical Centers › § 2154. Revocation of license; hearing

§ 2154. Revocation of license; hearing
The Department of Health, after notice and opportunity for hearing to the applicant or licensee, is authorized to deny, suspend, or revoke a license in any case in which it finds that there has been a substantial failure to comply with the requirements established under this chapter. Such notice shall be served by registered mail or by personal service, shall set forth the reasons for the proposed action, and shall set a date not less than 60 days from the date of the mailing or service on which the applicant or licensee shall be given opportunity for a hearing. After the hearing, or upon default of the applicant or licensee, the Department shall file its findings of fact and conclusions of law. A copy of the findings and decision shall be sent by registered mail or served personally upon the applicant or licensee. The procedure governing hearings authorized by this section shall be in accordance with the usual and customary rules provided for such hearings. (Added 2019, No. 55, § 1, eff. Jan. 1, 2020.)
2023 Vermont Statutes › Title 18 - Health › Chapter 49 - Ambulatory Surgical Centers › § 2155. Appeal

§ 2155. Appeal
Any applicant or licensee, or the State acting through the Attorney General, aggrieved by the decision of the Department of Health after a hearing may, within 30 days after entry of the decision as provided in section 2154 of this title, appeal to the Superior Court for the district in which the appellant is located. The court may affirm, modify, or reverse the Department’s decision, and either the applicant or licensee or the Department or State may appeal to the Vermont Supreme Court for such further review as is provided by law. Pending final disposition of the matter, the status quo of the applicant or licensee shall be preserved, except as the court otherwise orders in the public interest. (Added 2019, No. 55, § 1, eff. Jan. 1, 2020.)
2023 Vermont Statutes › Title 18 - Health › Chapter 49 - Ambulatory Surgical Centers › § 2156. Inspections

§ 2156. Inspections
The Department of Health shall make or cause to be made such inspections and investigations as it deems necessary. If the Department finds a violation as the result of an inspection or investigation, the Department shall post a report on the Department’s website summarizing the violation and any corrective action required. (Added 2019, No. 55, § 1, eff. Jan. 1, 2020.)
2023 Vermont Statutes › Title 18 - Health › Chapter 49 - Ambulatory Surgical Centers › § 2157. Records

§ 2157. Records
(a) Information received by the Department of Health through filed reports, inspections, or as otherwise authorized by law shall:
(1) not be disclosed publicly in a manner that identifies or may lead to the identification of one or more individuals or ambulatory surgical centers;
(2) be exempt from public inspection and copying under the Public Records Act; and
(3) be kept confidential except as it relates to a proceeding regarding licensure of an ambulatory surgical center.
(b) The provisions of subsection (a) of this section shall not apply to the summary reports of violations required to be posted on the Department’s website pursuant to section 2156 of this chapter. (Added 2019, No. 55, § 1, eff. Jan. 1, 2020.)
2023 Vermont Statutes › Title 18 - Health › Chapter 49 - Ambulatory Surgical Centers › § 2158. Nonapplicability

§ 2158. Nonapplicability
The provisions of chapter 42 of this title, Bill of Rights for Hospital Patients, do not apply to ambulatory surgical centers. (Added 2019, No. 55, § 1, eff. Jan. 1, 2020.)
2023 Vermont Statutes › Title 18 - Health › Chapter 49 - Ambulatory Surgical Centers › § 2159. Rules

§ 2159. Rules
The Department of Health shall adopt rules pursuant to 3 V.S.A. chapter 25 as needed to carry out the purposes of this chapter. The rules shall include requirements regarding:
(1) the ambulatory surgical center’s maintenance of a transport agreement with at least one emergency medical services provider for emergency patient transportation;
(2) the ambulatory surgical center’s maintenance of a publicly accessible policy for providing charity care to eligible patients; and
(3) the ambulatory surgical center’s participation in quality reporting programs offered by the Centers for Medicare and Medicaid Services. (Added 2019, No. 55, § 1, eff. Jan. 1, 2020.)
2023 Vermont Statutes › Title 18 - Health › Chapter 50 - Home Health Services › § 2201. Furnishing supervision to home health agencies; contracts

§ 2201. Furnishing supervision to home health agencies; contracts
The Department may furnish supervision to any public agency or private organization engaged in providing skilled nursing services and other therapeutic services, or to any subdivision of such an agency or organization, for the purpose of enabling the agency or organization to qualify as a “home health agency” under Title I of Pub. L. No. 89-97, the Health Insurance for the Aged Act, at the request of the agency or organization. The Department may enter into agreements with any person, firm, corporation, association, agency, or organization, public or private, for the purpose of furnishing or coordinating supervisory services for a home health agency under this section, and may collect fees for the services rendered under the terms of such agreements. “Supervision” or “supervisory services” as used in this section, shall mean supervision by a physician or a registered professional nurse as required for a home health agency under the Health Insurance for the Aged Act. (Added 1969, No. 217 (Adj. Sess.), eff. March 27, 1970.)
2023 Vermont Statutes › Title 18 - Health › Chapter 50 - Home Health Services › § 2202. Contracts for departmental programs and services

§ 2202. Contracts for departmental programs and services
(a) Notwithstanding the provisions of 3 V.S.A. chapter 13, the Department may enter into agreements with a private or public organization for such organization to provide services or conduct programs for the benefit of the public that the Department by law is authorized to provide or conduct if the Department of Health finds that the organization is properly equipped and qualified for this purpose.
(b) This section shall apply to all services and programs that the Department conducts under this chapter, including the initiation of new combinations of public health and home health nursing services. (Added 1969, No. 217 (Adj. Sess.), eff. March 27, 1970; amended 1977, No. 144 (Adj. Sess.), § 1, eff. March 28, 1978.)
2023 Vermont Statutes › Title 18 - Health › Chapter 50 - Home Health Services › § 2203. Collection of fees

§ 2203. Collection of fees
The Department may provide home health care services, including public health nursing and other therapeutic services, to the public in geographical areas where such services are not otherwise available through public or private organizations, and may collect fees for such services where such service is of the type authorized under Pub. L. No. 89-97, the Social Security Amendments of 1965. (Added 1969, No. 217 (Adj. Sess.), eff. March 27, 1970.)
2023 Vermont Statutes › Title 18 - Health › Chapter 51 - Lien for Services Rendered Accident Victims › § 2251. Lien established [Effective until January 1, 2024]

§ 2251. Lien established [Effective until January 1, 2024]
A hospital in Vermont, as defined in section 1801 of this title, furnishing medical or other service, including charges of private duty nurses, to a patient injured by reason of an accident not covered by the Workers’ Compensation Act, 21 V.S.A. § 601 et seq., shall have a lien upon any recovery for damages to be received by the patient, or by his or her heirs or personal representatives in the case of his or her death, whether by judgment or by settlement or compromise after the date of the services. This lien shall not attach to one-third of the recovery or $500.00, whichever shall be the lesser, and in addition the lien shall be subordinate to an attorney’s lien. (Added 1963, No. 209, § 1, eff. Oct. 1, 1963; amended 1981, No. 165 (Adj. Sess.), § 1.)
2023 Vermont Statutes › Title 18 - Health › Chapter 51 - Lien for Services Rendered Accident Victims › § 2251. Lien established [Effective January 1, 2024]

§ 2251. Lien established [Effective January 1, 2024]
(a) Except as otherwise provided in this section, a hospital in Vermont, as defined in section 1801 of this title, furnishing medical or other service, including charges of private duty nurses, to a patient injured by reason of an accident not covered by the Workers’ Compensation Act, 21 V.S.A. chapter 9, may file a lien upon any recovery for damages to be received by the patient, or by the patient’s heirs or personal representatives in the case of the patient’s death, whether by judgment or by settlement or compromise after the date of the services.
(b)(1) Notwithstanding subsection (a) of this section, a hospital shall not have a lien under this chapter if the patient has health insurance, including coverage under Medicare, Medicaid, or a health plan issued by a health insurer, as defined in section 9402 of this title, and the patient, or the patient’s heirs or personal representatives in the case of the patient’s death, provides the hospital with proof of health insurance not later than 90 days after the patient’s discharge from or death at the hospital.
(2) Notwithstanding subdivision (1) of this subsection, a hospital may file a lien pursuant to subsection (a) of this section for any amount owed to the hospital for the patient’s deductible or coinsurance, or both, under the health insurance plan for the medical or other services furnished by the hospital by filing notice of a lien at least 120 days after the hospital billed the patient’s health insurance plan for the amount owed to the hospital for services furnished to the patient.
(3) The patient’s health insurance plan shall not deny payment for services furnished by the hospital to the patient on the basis that some or all of the patient’s medical costs may be covered by a property and casualty insurance plan, unless such denial is required or expressly permitted by State or federal law.
(c)(1) A hospital that recovers under this chapter shall be responsible for a pro rata share of the legal and administrative expenses incurred in obtaining the judgment, settlement, or compromise.
(2) In no event shall the hospital lien exceed one-third of the net judgment, settlement, or compromise received by the injured patient. (Added 1963, No. 209, § 1, eff. Oct. 1, 1963; amended 1981, No. 165 (Adj. Sess.), § 1; 2023, No. 51, § 7, eff. January 1, 2024.)
2023 Vermont Statutes › Title 18 - Health › Chapter 51 - Lien for Services Rendered Accident Victims › § 2252. Notice

§ 2252. Notice
The lien shall not be effective, however, unless a written notice containing the name and address of the injured person, the date of the accident, the name and location of the hospital, and the name of the person alleged to be liable is filed in the office of the clerk of the town in which the hospital is located, before the payment of any monies to the injured person, his or her attorneys, or legal representatives as compensation for the injuries; nor unless the hospital also mails, postage prepaid, a copy of the notice with a statement of the date of filing thereof to the injured person, and to the person alleged to be liable before payment to the injured person, his or her attorneys, or legal representative of compensation for the injuries. The hospital shall mail a copy of the notice to any insurance carrier that has insured the person against liability for the accident. (Added 1963, No. 209, § 2, eff. Oct. 1, 1963.)
2023 Vermont Statutes › Title 18 - Health › Chapter 51 - Lien for Services Rendered Accident Victims › § 2253. Liability

§ 2253. Liability
A person making payment to the patient or to his or her attorneys or heirs or legal representatives as compensation for the injury sustained, after the filing and mailing of the notice without paying to the hospital the amount of its lien or so much thereof as can be satisfied out of the monies due after any final judgment or compromise or settlement agreement after paying the amount of any prior liens, shall, for one year from the date of payment, be liable to the hospital for the amount that the hospital was entitled to receive; and the hospital may, within that year, enforce its lien by a civil action against the person making any such payment. Provided, however, that unless said action is brought within said year, such lien shall be void. (Added 1963, No. 209, § 3, eff. Oct. 1, 1963.)
2023 Vermont Statutes › Title 18 - Health › Chapter 51 - Lien for Services Rendered Accident Victims › § 2254. Hospital lien docket

§ 2254. Hospital lien docket
Every town clerk shall, at the expense of the town, provide a suitable well-bound book to be called the hospital lien docket in which, upon the filing of any lien claim under this chapter, he or she shall enter the name of the injured person, the name of the person alleged to be liable for the injuries, the date of the accident, and the name of the hospital or other institution making the claim. The clerk shall index the docket in the name of the injured person and the hospital. (Added 1963, No. 209, § 4, eff. Oct. 1, 1963.)
2023 Vermont Statutes › Title 18 - Health › Chapter 51 - Lien for Services Rendered Accident Victims › § 2255. Extension of lien

§ 2255. Extension of lien
In the event that a hospital entitled to a lien under this chapter shall have served a notice as provided for by 33 V.S.A. § 821, the lien herein provided for shall extend to the town receiving such notice, provided that the town so served shall follow the provisions of sections 2252 and 2253 of this title. (Added 1963, No. 209, § 5, eff. Oct. 1, 1963; amended 2023, No. 6, § 136, eff. July 1, 2023.)
2023 Vermont Statutes › Title 18 - Health › Chapter 51 - Lien for Services Rendered Accident Victims › § 2256. Discharge

§ 2256. Discharge
The hospital or town asserting a lien pursuant to the provisions of this chapter shall, within 30 days from the date its claim is satisfied, file its certificate of discharge with the town clerk where the lien is filed, and the town clerk shall make proper entry and index of the discharge in the hospital lien docket. All fees for recording of notices or discharges shall be at the expense of the hospital or town filing the same. (Added 1963, No. 209, § 6, eff. Oct. 1, 1963.)