Arkansas Administrative Code › Agency 007 - ARKANSAS DEPARTMENT OF HEALTH › Division 05 - Health Facility Services › Rule 007.05.20-010 - Rules for Critical Access Hospitals (CAH)

Current through Register Vol. 49, No. 6, June, 2024
SECTION 1:
AUTHORITY.
The following Rules for Critical Access Hospitals in Arkansas
				are duly adopted and promulgated by the Arkansas State Board of Health pursuant
				to the authority expressly conferred by the laws of the State of Arkansas in
				Act 414 of 1961, as amended by Act 258 of 1971, Act 190 of 1975, Act 536 of
				1977, Act 273 of 1983, Act 980 of 1985, and Act 516 of 1987, along with Acts
				143 of 1987, 348 of 1987, and 399 of 1987 covered under these
				regulations.
SECTION 2:
PURPOSE.
These rules have been prepared for the purpose of establishing
				a criterion for minimum standards for licensure, operation and maintenance of
				hospitals and related institutions in Arkansas that is consistent with current
				trends in patient care practices. By necessity they are of a regulatory nature
				but are considered to be practical minimum design and operational standards for
				these facilities. These standards are not static and are subject to periodic
				revisions in the future as new knowledge and changes in patient care trends
				become apparent. However, it is expected that facilities will exceed these
				minimum requirements and that they shall not be dependent upon future revisions
				in these standards as a necessary prerequisite for improved services. Hospitals
				and related institutions have a strong moral responsibility for providing
				optimum patient care and treatment for the populations they serve.
SECTION 3:
DEFINITIONS.
For purposes of the rules, the following definitions
				apply.
A. Administrator means the
			 person responsible for the management of any facility requiring licensure under
			 these rules.
B. Alcohol/Drug Abuse
			 Inpatient Treatment Center means a distinct unit within a hospital in which
			 services are provided for the diagnosis, treatment and rehabilitation of
			 alcohol and drug abuse.
C. Basic
			 hospital services means the services that all licensed hospitals must provide.
			 Basic services consist of:
1. Governing
			 Body;
2. Medical Staff;
3. General Administration;
4. Patient Care;
5. Health Information;
6. Pharmacy;
7. Food and Nutrition;
8. Infection Prevention and
			 Control;
9. Laboratory;
10. Radiology;
11. Respiratory Therapy;
12. Emergency; and
13. Physical facility maintenance
D. Critical Access Hospital (CAH)
			 means a hospital located in a rural area that is:
1. Located more than a 35-mile drive (or, in
			 the case of mountainous terrain or in areas with only secondary roads
			 available, a 15-mile drive) from a hospital, or;
2. Provides 24-hour emergency care services
			 as determined necessary for ensuring access to emergency care in each area
			 served by a Critical Access Hospital;
3. Provides staffing according to Rules and
			 Regulations for Hospitals and Related Institutions in Arkansas;
4. Meets Centers of Medicare and Medicaid
			 Services (CMS) Conditions of Participation for Critical Access Hospitals;
			 or
5. Was operating as a licensed
			 Critical Access Hospital in Arkansas as of April 2007.
E. Department means the Arkansas Department
			 of Health.
F. Emergency Services
			 Facility means a facility originally operated as a licensed hospital that has
			 discontinued inpatient services but is licensed to continue to provide
			 emergency services.
G. General
			 Hospital means any facility used for the purpose of providing short-term
			 inpatient diagnostic care and treatment, including general medical care,
			 surgical care, obstetrical care, and specialized services or specialized
			 treatment.
H. Infirmary means any
			 facility used for the purpose of offering temporary medical care and/or
			 treatment exclusively for persons residing on a designated premise, e.g.,
			 schools, reformatories, prisons, etc. and where the persons are kept for 24
			 hours or more.
I. Institution
			 means, for the purpose of these rules, a facility which requires a license.
			 Institution does not include an establishment:
1. Operated by the federal government or by
			 any of its agencies; or
2. Licensed
			 or certified by the Office of Alcohol and Drug Abuse Prevention of the Division
			 of Behavioral Health of the Department of Human Services as an alcohol and drug
			 abuse inpatient treatment center.
J. Licensee means the person to whom a
			 license is issued for the purpose of operating the institution described in the
			 application for licensure, who shall be responsible for maintaining approved
			 standards for the institution of any state, county, or local government unit
			 and any division, board, or agency thereof.
K. Observation is a designated patient status
			 as opposed to a designated area. Patients in observation status are those
			 patients requiring periodic monitoring and assessment necessary to evaluate the
			 patient's condition or to determine the need for possible admissions to the
			 hospital in an inpatient status. Usually observation status shall be for 48
			 hours or less.
L. Off-campus
			 Emergency Department means an emergency services department located off- site
			 from the main hospital campus but functions as a fully integrated department of
			 the parent hospital.
M. Outpatient
			 Psychiatric Center means a facility in which psychiatric services are offered
			 for a period of 8 to 16 hours a day, and where, in the opinion of the attending
			 psychiatrist, hospitalization as defined in the present licensure law is not
			 necessary. This definition shall not include Community Mental Health Clinics
			 and Centers, as they now exist.
N.
1. Outpatient Surgery Center (Ambulatory
			 Surgery Center) means a facility in which surgical services are offered that
			 require the use of general or intravenous anesthetics, and where, in the
			 opinion of the attending physician, hospitalization is not necessary.
2. "Outpatient surgery Center" does not
			 include:
a. a medical office owned and
			 operated by a physician or more than one (1) physician licensed by the Arkansas
			 State Medical Board, if the medical office does not bill facility fees to a
			 third party payor; or
b. a dental
			 office that has a Facility Permit for Moderate Sedation or a Facility Permit
			 for General/Deep Sedation issued by the Arkansas State Board of Dental
			 Examiners.
O.
			 Psychiatric Hospital means any facility, or a distinct part of a facility, used
			 for the purpose of providing inpatient diagnostic care and treatment for
			 persons having mental disorders.
P.
			 Recuperation Center means any facility or distinct part of a facility, which
			 includes inpatient beds with an organized Medical Staff, and with medical
			 services that include physician services and continuous nursing services to
			 provide treatment for patients who are not in an acute phase of illness but who
			 currently require primarily convalescent or restorative services (usually
			 post-acute hospital care of relatively short duration). A facility that
			 furnishes primarily domiciliary care is not within this definition.
Q. Rehabilitation Hospital or Facility means,
			 for the purpose of these rules, an inpatient care facility, or a distinct part
			 of a facility, which provides rehabilitation services for two or more disabled
			 persons not related to the proprietor, for more than 24 hours through an
			 integrated program of medical and other restorative services. A disabled person
			 shall be considered to be an individual who has a physical or mental condition
			 which, if not treated, will probably result in limiting the performance or
			 activity of the person to the extent of constituting a substantial physical,
			 mental, or vocational handicap.
R.
			 Shall means mandatory.
S. State
			 Health Officer means the Secretary of the State Board of Health.
T. Surgery and General Medical Care Hospital
			 means any facility limited to providing short-term inpatient surgical and
			 general medical diagnostic care and treatment.