Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-17 - HOSPICES › Appendix - CODE OF ALA. 1975, SECTIONS 22-21-20, ET SEQ

Current through Register Vol. 42, No. 9, June 28, 2024
§
									22-21-20. Definitions.
For
				the purpose of this article, the following terms shall have the meanings
				respectively ascribed to them by this section:
(1) HOSPITALS. General and specialized hospitals, including
				ancillary services; independent clinical laboratories; rehabilitation centers;
				ambulatory surgical treatment facilities for patients not requiring
				hospitalization; end stage renal disease treatment and transplant centers,
				including free-standing hemodialysis units; abortion or reproductive health
				centers; hospices; health maintenance organizations; and other related health
				care institutions when such institution is primarily engaged in offering to the
				public generally, facilities and services for the diagnosis and/or treatment of
				injury, deformity, disease, surgical or obstetrical care. Also included within
				the term are long term care facilities such as, but not limited to, skilled
				nursing facilities, intermediate care facilities, homes for the aged,
				domiciliary care facilities and related health care institutions when such
				institution is primarily engaged in offering room, board, laundry and personal
				assistance with activities of daily living and incidentals thereto. The term
				"hospitals" relates to health care institutions and shall not include the
				private offices of physicians or dentists, whether in individual, group,
				professional corporation or professional association practice. This section
				shall not apply to county or district health departments.
(2) PERSON. Such term includes individuals, partnerships,
				corporations and associations. (Acts 1975, 3rd Ex. Sess., No. 140, p. 382,
				§1; Acts 1979, No. 79-798, p. 1461; Acts 1991, No. 91-548, p. 1010,
				§1; Act 1997, No. 97-632, §1.)
§
									22-21-21. Purpose of
				article.
The purpose of this article is to promote the public health,
				safety and welfare by providing for the development, establishment and
				enforcement of standards for the treatment and care of individuals in
				institutions within the purview of this article and the establishment,
				construction, maintenance and operation of such institutions which will promote
				safe and adequate treatment and care of individuals in such institutions. (Acts
				1949, No. 530, p. 835, §1; Acts 1962, Ex. Sess., No. 122, p. 157,
				§1.)
§
									22-21-22. License -- Required;
				exceptions.
No person shall establish, conduct or maintain any hospital
				as defined in Section
				22-21-20 without first obtaining
				the license provided in this article. Hospitals operated by the federal
				government and mental hospitals under the supervision of the board of trustees
				of the Alabama State Hospitals shall be exempt from the provisions of this
				article. (Acts 1949, No. 530, p. 835, §2; Acts 1962, Ex. Sess., No. 122,
				p. 157, §2.)
§
									22-21-23. License --
				Application.
Any person desiring licensing under this article shall
				apply to the State Board of Health therefor. The applicant shall state the name
				of the applicant and whether an individual, partnership, corporation or other
				entity, the type of institution for which a license is desired, the location
				thereof and the name of the person in direct supervision and charge thereof.
				The person in charge of such hospital must be at least 19 years of age, of
				reputable and responsible character and in sound physical and mental health.
				Like evidence of fitness shall be submitted when required, except for age, as
				to those individuals employed at, or in, such hospital in a supervisory
				capacity. The applicant shall likewise submit evidence of ability to comply
				with the minimum standards provided in this article or by regulations issued
				under its authority. (Acts 1949, No. 530, p. 835, §4.)
§
									22-21-24. License -- Fees; term;
				form; nontransferable; posting; renewal; hospital licensable when accredited by
				joint commission.
The application for a license to operate a hospital
				shall be accompanied by a standard fee of $200.00, plus a fee of $5.00 per bed
				for each bed over 10 beds to be licensed in accordance with regulations
				promulgated under Section
				22-21-28. Increase in a hospital's
				bed capacity during the calendar year is assessed at the standard fee of
				$200.00 plus $5.00 each for the net gain in beds. No fee shall be refunded. All
				fees received by the State Board of Health under the provision of this article
				shall be paid into the State Treasury to the credit of the State Board of
				Health and shall be used for carrying out the provisions of this article. All
				licenses issued under this article shall expire on December 31 of the year in
				which it was issued. All licenses shall be on a form prescribed by said
				department, shall not be transferable or assignable, shall be issued only for
				the premises named in the application, shall be posted in a conspicuous place
				on the licensed premises and may be renewed from year to year upon application,
				investigation and payment of the required license fee, as in the case of
				procurement of the original license. All fees collected under this article are
				hereby appropriated for expenditure by the State Health Department. All
				hospitals which are accredited by the joint commission on accreditation of
				hospitals shall be deemed by the State Health Department to be licensable
				without further inspection or survey by the personnel of the State Department
				of Health. Further accreditation by the joint commission on accreditation of
				hospitals shall in no way relieve that hospital of the responsibility of
				applying for licensure and remitting the appropriate licensure fee as specified
				in this article. (Acts 1949, No. 530, p. 835, §5; Acts 1975, 3rd Ex.
				Sess., No. 140, p. 382, §2; Acts 1980, No. 80-642, p. 1213; Acts 1988, 1st
				Ex. Sess., No. 88-902, p. 470.)
§
									22-21-25. License -- Issuance;
				suspension or revocation; new applications after revocation.
(a) The State Board of Health is hereby authorized to issue
				licenses for the operation of hospitals which are found to comply with the
				provisions of this article and any regulations lawfully promulgated by the said
				State Board of Health.
(b) The State Board of Health is hereby authorized to suspend
				or revoke a license issued under this article on any of the following
				grounds:
(1) Violation of any of the provisions of this article or the
				rules and regulations issued pursuant thereto;
(2) Permitting, aiding or abetting the commission of any
				illegal act in such institution; or
(3) Conduct or practices deemed by the State Board of Health to
				be detrimental to the welfare of the patients of said institution.
(c) Before any such license issued under this article is
				suspended or revoked, written notice shall be given the licensee, stating the
				grounds of the complaint, and the date, time and place set for the hearing of
				said complaint, which date of hearing shall be not less than 30 days from the
				date of the notice. Such a notice shall be sent by registered or certified mail
				to the licensee at the address where the institution concerned is located. The
				licensee shall be entitled to be represented by legal counsel at the
				hearing.
(d) If a license is revoked as provided in this section, a new
				application for license shall be considered by the State Board of Health if,
				when and after the conditions upon which revocation was based have been
				corrected and evidence of this fact has been furnished. A new license shall
				then be granted after proper inspection has been made and all provisions of
				this article and rules and regulations promulgated under this article have been
				satisfied. (Acts 1949, No. 530, p. 835, §7.)
§
									22-21-26. License -- Judicial
				review of suspension or revocation.
Any party aggrieved by a final
				decision or order of the Board of Health suspending or revoking a license is
				entitled to a review of such decision or order by taking an appeal to the
				circuit court of the county in which the hospital is located or is to be
				located. (Acts 1949, No. 530, p. 835, §11.)
§
									22-21-27. Advisory
				board.
(a) There shall be an advisory board of 12 members to assist in
				the establishment of rules, regulations and standards necessary to carry out
				the provisions of this article and to serve as consultants to the State Health
				Officer. The board shall meet at least twice each year and at the call of the
				State Health Officer. The members of the board shall annually elect one of its
				members to serve as chairman.
(b) The advisory board shall be constituted in the following
				manner:
(1) Four representatives of hospitals, who shall be appointed
				by the Board of Trustees of the Alabama Hospital Association as follows:
a. One administrator of a governmental hospital;
b. One administrator of a nongovernmental nonprofit
				hospital;
c. One owner or administrator of a proprietary hospital;
				and
d. One member of a managing board of a nonprofit
				hospital;
(2) Three representatives who shall be doctors of medicine
				appointed by the Board of Censors of the Alabama State Medical
				Association;
(3) One representative who shall be a registered nurse
				appointed by the executive board of the Alabama State Nurses
				Association;
(4) One representative from the State Board of Human Resources
				to be appointed by the board;
(5) One registered pharmacist actively engaged in the practices
				of pharmacy in the State of Alabama, to be appointed by the Alabama State Board
				of Pharmacy;
(6) One member of the advisory board shall be appointed by the
				executive committee of the Alabama Nursing Home Association, who shall be the
				operator of a duly qualified licensed nursing home; and
(7) One member shall be appointed by the Alabama Hospice
				Association and said person shall vote only on issues relating to
				hospices.
Of the original representatives appointed by the Board of
				Trustees of the Alabama Hospital Association, one shall serve for three years,
				two shall serve for four years, and one shall serve for five years. One of the
				representatives appointed by the Board of Censors of the Alabama State Medical
				Association shall serve for two years, one shall serve for three years, and one
				shall serve for five years. The one representative appointed by the Alabama
				State Nurses Association shall serve for four years. The one representative
				from the State Board of Human Resources shall serve for four years, and the one
				representative from the State Board of Pharmacy shall serve for four years. The
				representative appointed by the executive committee of the Alabama Nursing Home
				Association shall serve for five years. Thereafter, each new appointee shall
				serve for five years or until his successor is appointed; except, that in the
				case of a vacancy, the appointee shall serve for the remainder of the unexpired
				term. Any vacancy shall be filled by the original organization selecting said
				member.
(c) Members of the advisory board shall not be eligible to
				succeed themselves after they have served one full five-year term, but shall be
				eligible for reappointment if they have not served immediately preceding their
				reappointment.
(d) Members of the advisory board shall serve without
				compensation, but shall be entitled to reimbursement for expenses incurred in
				the performance of the duties of their office pursuant to Article 2 of Chapter
				7 of Title 36. (Acts 1949, No. 530, p. 835, §9; Acts 1959, No. 134, p.
				656; Acts 1991, No. 91-548, p. 1010, §1.)
§
									22-21-28. Rules and
				regulations.
(a) In the manner provided in this section, the State Board of
				Health, with the advice and after approval by the advisory board, shall have
				the power to make and enforce, and may modify, amend and rescind, reasonable
				rules and regulations governing the operation and conduct of hospitals as
				defined in Section
				22-21-20. All such regulations
				shall set uniform minimum standards applicable alike to all hospitals of like
				kind and purpose in view of the type of institutional care being offered there
				and shall be confined to setting minimum standards of sanitation and equipment
				found to be necessary and prohibiting conduct and practices inimicable to the
				public interest and the public health. The board shall not have power to
				promulgate any regulation in conflict with law nor power to interfere with the
				internal government and operation of any hospital on matters of policy. Thirty
				days notice of any proposed amendment, rescission or new regulations shall be
				given in writing to all licensed hospitals of the date of such hearing and of
				the substance of any new regulation, amendment to or rescission of regulation
				proposed to be made. All hearings shall be joint hearings set by the Board of
				Health and the advisory board established in Section
				22-21-27 at Montgomery, Alabama.
				At such hearing, any interested hospital or any member of the public may be
				heard.
(b) Any person affected by any regulation, amendment or
				rescission thereof may appeal consideration thereof to the circuit court of the
				county of that person's residence or in which that person does business or to
				the Circuit Court of Montgomery County, within 30 days from the adoption of the
				same following the hearing provided in this section by giving security for
				costs and the filing of a petition with court, setting forth the interest of
				the appellant, the ruling complained of and the facts upon which the petitioner
				relies for relief. And upon appeal the question of the reasonableness of such
				regulation shall be a question of fact for the court to determine, and no
				presumption shall be indulged that the regulation adopted was and is a
				reasonable regulation.
(c) Regulations adopted under this section shall become
				effective upon the expiration of 30 days from the date of adoption, amendment
				or rescission or, if an appeal has been taken, upon the final disposition of
				the appeal. From any judgment of the circuit court in any case appealed to it,
				an appeal shall lie to the court of civil appeals of Alabama within 42 days
				from the date of entry of the judgment, in the same manner as other appeals are
				now authorized by law, and no presumption shall be indulged by the court of
				civil appeals as to the correctness of the trial court's finding of facts.
				(Acts 1949, No. 530, p. 835, §8.)
§
									22-21-29.
				Inspections.
(a) Every hospital licensed under this article shall be open to
				inspection to the extent authorized in this section by the State Board of
				Health, under rules as shall be promulgated by the board with the advice and
				consent of the advisory board. Nothing in this section shall authorize the
				board to inspect quarters therein occupied by members of any religious group or
				nurses engaged in work in such hospital or places of refuge for members of
				religious orders for whom care is provided, but any inspection shall be limited
				and confined to the parts and portions of such hospital as are used for the
				care and treatment of the patients and the general facilities for their care
				and treatment. No hospital shall, by reason of this section, be relieved from
				any other types of inspections authorized by law.
(b) All inspections undertaken by the State Board of Health
				shall be conducted without prior notice to the facility and its staff.
				Notwithstanding the foregoing, an inspection of a hospital or other health care
				facility, prior to its licensure, may be scheduled in advance. An employee or
				contract employee of the state shall not disclose in advance the date or the
				time of an inspection of a hospital or other health care facility to any person
				with a financial interest in any licensed health care facility, to any employee
				or agent of a licensed health care facility, to any consultant or contractor
				who performs services for or on behalf of licensed health care facilities, or
				to any person related by blood or marriage to an owner, employee, agent,
				consultant, or contractor of a licensed health care facility. For purposes of
				this section, the term inspection shall include periodic and follow-up
				compliance inspections and surveys on behalf of the State Board of Health,
				complaint investigations and follow-up investigations conducted by the State
				Board of Health, and compliance inspections and surveys, complaint
				investigations, and follow-up visits conducted on behalf of the United States
				Department of Health and Human Services, Health Care Financing Administration,
				or its successors. The board may prescribe by rule exceptions to the
				prohibition where considerations of public health or safety make advance
				disclosure of inspection dates or times reasonable. Disclosure in advance of
				inspection dates when such disclosure is required or authorized pursuant to
				federal law or regulation shall not be a violation of this section. Scheduling
				inspections of hospitals or other health care facilities by the board at
				regular, periodic intervals which may be predictable shall not be a violation
				of this section.
(c) Any employee or contract employee of the state who
				discloses in advance the date or time of an inspection in violation of
				subsection (b) shall be guilty of a Class A misdemeanor. Any person who
				solicits an employee or contract employee of the state to disclose in advance
				the date or time of an inspection in violation of subsection (b) for the
				purpose of disclosing the information to others shall be guilty of a Class A
				misdemeanor. (Acts 1949, No. 530, p. 835, §6; Act 1997, No. 97-632,
				§1.)
§
									22-21-30. Disclosure of
				information.
Information received by the State Board of Health through
				on-site inspections conducted by the State Licensing Agency is subject to
				public disclosure and may be disclosed upon written request. Information
				received through means other than inspection will be treated as confidential
				and shall not be directed publicly except in a proceeding involving the
				question of licensure or revocation of license. (Acts 1949, No. 530, p. 835,
				§10; Acts 1975, 3rd Ex. Sess., No. 140, p. 383, §3.)
§
									22-21-31. Practice of medicine,
				etc., not authorized; child-placing.
Nothing in this article shall be
				construed as authorizing any person to engage in any manner in the practice of
				medicine or any other profession nor to authorize any person to engage in the
				business of child-placing. Any child born in any such institution whose mother
				is unable to care for such child or any child who, for any reason, will be left
				destitute of parental support shall be reported to the State Department of
				Health and Human Resources or to any agency authorized or licensed by the State
				Department of Health and Human Resources to engage in child placing for such
				service as the child and the mother may require. In the rendering of such
				service, representatives of the State Department of Health and Human Resources
				and agencies authorized or licensed by the State Department of Health and Human
				Resources shall have free access to visit the child and the mother concerned.
				(Acts 1949, No. 530, p. 835, §2; Acts 1962, Ex. Sess., No. 122, p. 157,
				§2.)
§
									22-21-32.
Repealed by Acts
				1977, 1st Ex. Sess., No. 82, p. 1509, §19, effective June 16, 1977.
§
									22-21-33. Penalty for violation of
				article, etc.
Any individual establishing, conducting, managing or
				operating a hospital without first obtaining a license therefor as provided in
				this article or who shall violate any of the provisions of this article, or
				regulations promulgated thereunder, shall be guilty of a misdemeanor and, upon
				conviction, shall be punished by a fine of not to exceed $100.00 or by
				imprisonment in the county jail for a period not to exceed 90 days, or by both
				such fine and imprisonment in the discretion of the court. Any association,
				corporation or partnership operating a hospital in violation of any provisions
				of this article, or any regulation promulgated thereunder, shall be subject to
				the payment of a penalty of $25.00 per day for each day of such illegal
				operation, which may be recovered by the State Board of Health in an
				appropriate civil action. The State Board of Health may, upon the advice of the
				Attorney General, maintain an action in the name of the state for an injunction
				to restrain any state, county or local governmental unit, or any division,
				department, board or agency thereof, from operating, conducting or managing a
				hospital in violation of any provisions of this article, or any regulation
				promulgated thereunder. (Acts 1949, No. 530, p. 835,
				§12.)