Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-11 - REHABILITATION CENTERS › Appendix A

Current through Register Vol. 42, No. 9, June 28, 2024
CODE OF ALA. 1975
, SECTIONS
				22-21-20,
ET
.
SEQ
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§
									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, assisted living facilities,
				and specialty care assisted living facilities rising to the level of
				intermediate care. 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. The 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; Act 2001, No. 1058.)
§
									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 and of
				reputable and responsible character. The applicant shall 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;
				Act 2001, No. 1058.)
§
									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 other than
				an assisted living facility or a specialty care assisted living facility rising
				to the level of intermediate care shall be accompanied by a standard fee of two
				hundred dollars ($200), plus a fee of five dollars ($5) 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 two
				hundred dollars ($200) plus five dollars ($5) each for the net gain in beds.
				The initial licensure fee and subsequent annual licensure renewal fee for an
				assisted living facility and for a specialty care assisted living facility
				rising to the level of intermediate care shall be two hundred dollars ($200)
				plus fifteen dollars ($15) for each bed. A license renewal application for any
				hospital, as defined by this chapter, which is not received by the expiration
				date in a properly completed form and accompanied by the appropriate renewal
				fee shall be subject to a late penalty equal to two hundred fifty dollars
				($250) or 100 percent of the renewal fee, whichever is greater. 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. A license granted under this article shall expire on December
				31 of the year in which it was granted. A license certificate shall be on a
				form prescribed by the department, and shall be posted in a conspicuous place
				on the licensed premises. Licenses shall not be transferable or assignable and
				shall be granted only for the premises named in the application. Licenses 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; Act 2001,
				No. 1058.)
§
									22-21-25. License -- Issuance;
				suspension or revocation; new applications after revocation.
(a) The State Board of Health may grant licenses for the
				operation of hospitals which are found to comply with the provisions of this
				article and any regulations lawfully promulgated by the State Board of
				Health.
(b) The State Board of Health may suspend or revoke a license
				granted 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 the institution.
(3) Conduct or practices deemed by the State Board of Health to
				be detrimental to the welfare of the patients of the institution.
(c) Before any license granted 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 the
				complaint, which date of hearing shall be not less than 30 days from the date
				of the notice. The 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; Act 2001, No. 1058.)
§
									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 17 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.
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 Medical Association of the State of
				Alabama.
(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
				who shall 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 executive committee
				of the Alabama Pharmacy Association.
(6) Three members who shall be appointed by the executive
				committee of the Alabama Nursing Home Association, each of whom shall be the
				operator of a duly qualified licensed nursing home.
(7) One member shall be appointed by the Alabama Hospice
				Association.
(8) Two members shall be appointed by the Assisted Living
				Association of Alabama, one of whom shall be the operator of a licensed
				assisted living facility or licensed specialty care assisted living facility
				rising to the level of intermediate care with 16 or fewer beds, and one of whom
				shall be the operator of an assisted living facility or licensed specialty care
				assisted living facility rising to the level of intermediate care with more
				than 16 beds.
(9) One member who shall be appointed by the Governor to
				represent the interests of consumers. The consumer representative shall be at
				least 65 years of age and shall have no financial interest in any facility
				licensed under this article.
Each new appointee shall serve for five years or until his
				successor is appointed, whichever is later. Any vacancy caused by a member
				leaving the position before the expiration of his or her term shall be filled
				by the organization selecting the original member. The replacement member
				appointed shall serve for the remainder of the unexpired term.
(c) A member of the advisory board shall not be eligible to
				succeed himself or herself after serving one full five-year term, but shall be
				eligible for reappointment if he or she has not served immediately preceding
				the 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 the office at the same rate allowed state
				employees pursuant to general law. (Acts 1949, No. 530, p. 835, §9; Acts
				1959, No. 134, p. 656; Acts 1991, No. 91-548, p. 1010, §1; Act 2001, No.
				1058.)
§
									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. The
				procedure for adopting, amending, or rescinding any rules authorized by this
				chapter shall conform to the Alabama Administrative Procedure Act. At any
				public hearing called for the purpose of soliciting public comment on proposed
				rules, 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, pursuant to the Alabama Administrative
				Procedure Act. 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 as provided in the Alabama Administrative Procedure Act. (Acts 1949,
				No. 530, p. 835, §8; Act 2001, No. 1058.)
§
									22-21-29.
				Inspections.
(a) Every hospital licensed under this article shall be open to
				inspection to the extent authorized in this section by employees and agents of
				the State Board of Health, under rules as shall be promulgated by the board
				with the advice and consent of the advisory board. Employees and agents of the
				board shall also inspect unlicensed and suspected unlicensed facilities.
				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 any
				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 the 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; Act 2001, No. 1058.)
§
									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 Department of Human
				Resources or to any agency authorized or licensed by the Department of Human
				Resources to engage in child placing for such service as the child and the
				mother may require. In the rendering of service, representatives of the
				Department of Human Resources and agencies authorized or licensed by the
				Department of 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; Act 2001, No. 1058.)
§
									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, association, corporation, partnership,
				limited liability company, or other business entity who operates or causes to
				be operated a hospital of any kind as defined in this chapter or any
				regulations promulgated thereunder without having been granted a license
				therefore by the State Board of Health shall be guilty of a Class A misdemeanor
				upon conviction except that the fine may be up to five thousand dollars
				($5,000) upon conviction of a second or any subsequent offense. The State Board
				of Health, upon determination that a facility or business is operating as a
				hospital within the meaning of this statute or any rules promulgated
				thereunder, and that the facility does not have a current, valid license
				granted by the State Board of Health, may apply to the circuit court of the
				county in which the unlicensed facility is located for declaratory and
				injunctive relief. The proceedings shall be expedited. The sole evidentiary
				questions before the court in a proceeding shall be whether the facility that
				is the subject of the action meets the definition of a hospital within the
				meaning of this chapter and any rules promulgated thereunder, and whether the
				facility has been granted a current and valid license to operate by the State
				Board of Health. If the State Board of Health prevails on these questions, then
				the court shall, upon request of the State Board of Health, forthwith grant
				declaratory and injunctive relief requiring the operator or operators to close
				the facility and requiring the operator or operators to move all residents or
				patients to appropriate placements. Any individual failing to obey an
				injunction to close a hospital shall be guilty of a Class A misdemeanor except
				that the fine may be up to five thousand dollars ($5,000). Any individual,
				after having once been subject to such an injunction, who shall later operate
				or cause to be operated a hospital as defined in this chapter or any
				regulations promulgated thereunder without having been granted a license
				therefore by the State Board of Health shall be guilty of a Class A misdemeanor
				except that the fine may be up to five thousand dollars ($5,000). 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, or any individual, association, corporation, partnership, limited
				liability company, or other business entity, from operating, conducting or
				managing a hospital in violation of any provisions of this article, or any
				regulation promulgated thereunder. No county or municipality shall grant a
				business license to a hospital as defined in this chapter unless the facility
				holds a current license to operate granted by the State Board of Health. In any
				action to collect a fee for services brought against a resident or patient by a
				hospital as defined in this chapter or regulations promulgated thereunder, it
				shall be a defense to the action to demonstrate that the operator of the
				hospital did not have a current, valid license to operate pursuant to this
				chapter at the time the services in question were rendered. (Acts 1949, No.
				530, p. 835, §12.)
Act 2001, No. 1058. Under the circumstances listed below, an
				assisted living facility or a specialty care assisted living facility rising to
				the level of intermediate care may be subject to a civil money penalty imposed
				by the Board of Health not to exceed ten thousand dollars ($10,000) per
				instance. The imposition of the penalty may be appealed pursuant to the
				provisions of the Alabama Administrative Procedure Act. All money penalties
				imposed pursuant to this section shall be remitted to the Department of Public
				Health and shall be deposited in the State General Fund. The penalties shall be
				deposited in the General Fund and shall not be earmarked for the Department of
				Public Health. Failure of an assisted living facility or a specialty care
				assisted living facility rising to the level of intermediate care to pay a
				civil money penalty within 30 days after its imposition or within 30 days after
				the final disposition of any appeal shall be grounds for license revocation
				unless arrangements for payment are made that are satisfactory to the State
				Board of Health. No assisted living facility or specialty care assisted living
				facility rising to the level of intermediate care may renew its license to
				operate if it has any unpaid civil money penalties which were imposed more than
				30 days prior to the facility's license expiration date, except for any
				penalties imposed which are still subject to appeal and except for penalties
				for which arrangements for payment have been made that are satisfactory to the
				State Board of Health.
A civil money penalty may be imposed for falsification of any
				record kept by an assisted living facility or specialty care assisted living
				facility rising to the level of intermediate care, including a medication
				administration record or any record or document submitted to the State Board of
				Health, by an employee or agent of the facility, where such falsification is
				deliberate and undertaken with intent to mislead the Board of Health, or it
				agents or employees, or residents, sponsors, family members, another state,
				county, or municipal government agency, or the public, about any matter of
				legal compliance, regulatory compliance, compliance with fire or life safety
				codes, or quality of care.
A civil money penalty may be imposed as a result of a false
				statement made by an employee or agent of an assisted living facility or a
				specialty care assisted living facility rising to the level of intermediate
				care to an employee or agent of the State Board of Health, if the statement is
				made with intent to deceive or mislead the Board of Health, its agents or
				employees, about any matter of legal compliance, regulatory compliance,
				compliance with fire or life safety codes, or quality of care. A civil money
				penalty shall not be imposed if the facility's employee or agent makes a false
				statement when he or she has no reason to believe the false statement is
				authorized by the administrator or operator of the facility and if it is likely
				that the facility's employee or agent made the statement with the intent to
				cause damage to the facility.
Alabama Department of Public Health
Bureau of Health Provider Standards
Division of Provider Services
201 Monroe Street
P.O. Box 303017
Montgomery, AL 36130-3017
334-206-5175
www.adph.org/providers