Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 24 - Division of Health › Rule 016.24.07-003 - Rules for Hospitals and Related Institutions; & Rules for Critical Access Hospitals

Current through Register Vol. 49, No. 6, June, 2024
SECTION 1:
AUTHORITY.
The following
Rules and Regulations for Hospitals
				and Related Institutions 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 Ark. Code Ann.
				§§
									20-9-201 et.seq.,
				20-7-123, and other laws of the
				State of Arkansas.
SECTION
			 2:
PURPOSE.
These rules and regulations 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.
The word shall as used in these regulations means
				mandatory.
A. Administrator means the
			 person responsible for the management of any facility requiring licensure under
			 these regulations.
B. Department
			 means the Arkansas Department of Health.
C. 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.
D. State Health Officer means the Secretary
			 of the State Board of Health.
The following categories of facilities (G-Q), as defined
				herein, established for the purpose of providing inpatient diagnostic care and
				treatment for more than 24 hours for two or more persons not related to the
				proprietor, may not be conducted or maintained in this state without being
				licensed.
E. Alcohol/Drug
			 Abuse Inpatient Treatment Centers means a facility or distinct part of a
			 facility, in which services are provided for the diagnosis, treatment and
			 rehabilitation of alcohol and drug abuse; a facility which provides only
			 counseling and room and board is not included in this definition.
1. For the purpose of these regulations an
			 alcohol/drug abuse treatment center is a facility (either licensed as a
			 hospital or an established diagnostic unit of an acute psychiatric or
			 rehabilitation hospital) or a free-standing unit in which services are provided
			 over a continuous period, exceeding 24 hours for two or more persons not
			 related to the proprietor for the diagnosis, treatment and rehabilitation of
			 alcohol and drug abuse.
2. Alcohol
			 and drug abuse inpatient center regulations are to be applied in conjunction
			 with the
Rules and Regulations for Hospitals and Related
			 Institutions in Arkansas
where applicable. (See Section 45,
			 Alcohol/Drug Abuse Inpatient Treatment Centers.)
3. The requirements established for
			 alcohol/drug abuse inpatient treatment centers shall not be construed as
			 changes in the requirements already established for licensing of any health
			 care facility as delineated in these regulations.
F. 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 CAH;
3.
			 Provides staffing according to
Rules and Regulations for Hospitals
			 and Related Institutions in Arkansas
; and
4. Meets Centers for 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.
G. When a hospital converts to a CAH and then
			 at a later date decides to return to a full service with no limits on bed or
			 length of stay, the hospital shall be surveyed using the Life Safety Code under
			 which the hospital entered into the CAH program. The hospital shall be able to
			 show that it has continued to be licensed and complied consistently with the
			 Life Safety Code as a CAH.
H.
			 Emergency Services Facility means a facility that is licensed only for
			 emergency services. The Department is empowered to license hospitals which have
			 discontinued inpatient services to continue to provide emergency services if
			 there is no other hospital emergency service in the community Ark. Code Ann.
			 §
									20-9-218.
I. 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.
J. 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.
K. Institution means, for the purpose of
			 these regulations, a facility which requires a license.
L. Maternity and General Medical Care
			 Hospital means any facility limited to providing short-term inpatient
			 obstetrical and general medical diagnostic care and treatment.
M. Maternity Hospital means any facility
			 limited to providing short-term inpatient obstetrical diagnostic care and
			 treatment.
N. 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.
O. 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.
P. Rehabilitation Facility means, for the
			 purpose of these regulations, 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.
Q.
			 Surgery and General Medical Care Hospital means any facility limited to
			 providing short-term inpatient surgical and general medical diagnostic care and
			 treatment.
The following categories (Q-R) of outpatient facilities may not
				be conducted or maintained in this state without being licensed:
R. Outpatient Psychiatric Center
			 means a facility in which psychiatric services are offered for a period of 4 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. The requirements established for outpatient psychiatric centers
			 shall not be construed as changes in the requirements already established for
			 the licensing of any health care facility, as delineated in these
			 Regulations.
S. Outpatient Surgery
			 Center (Ambulatory Surgery Center) means any facility in which surgical
			 services, other than minor dental surgery, are offered which require the use of
			 general or intravenous anesthetics and/or render the patient incapable of
			 taking actions for self-preservation under emergency conditions without
			 assistance from others, and where, in the opinion of the attending physician,
			 hospitalization is not necessary.
T. 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 admission to the
			 hospital in an inpatient status. Usually observation status shall be for 48
			 hours or less.