Arkansas Administrative Code › Agency 007 - ARKANSAS DEPARTMENT OF HEALTH › Division 35 - Center for Health Protection › Rule 007.35.23-002 - Rules for Hospitals and Related Institutions

Current through Register Vol. 49, No. 6, June, 2024
SECTION 1
: AUTHORITY.
The following Rules 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 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. Abortion complication means
			 any harmful event or adverse outcome with respect to a patient related to an
			 abortion that is performed on the patient and that is diagnosed or treated by a
			 physician or at a healthcare facility including not limited to shock, uterine
			 perforation, cervical laceration, hemorrhage, aspiration, or allergic response,
			 infection, sepsis, death, incomplete abortion, damage to the uterus, and an
			 infant born alive after an abortion.
B. Administrator means the person responsible
			 for the management of any facility requiring licensure under these
			 rules.
C. Alcohol/Drug Abuse
			 Inpatient Treatment Center means a distinct unit within a hospital facility in
			 which services are provided for the diagnosis, treatment and rehabilitation of
			 alcohol and drug abuse.
D. 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.
E. 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 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.
NOTE: 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.
F.
			 Department means the Arkansas Department of Health.
G. 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.
H. 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.
I. 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.
J. 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.
K. 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.
L. 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.
M. 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.
N. 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.
O.
			 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.
"Outpatient surgery center" does not include:
1. 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
2. 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.
P. 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.
Q. 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.
R. 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.
S.
			 Rural Emergency Hospital means a facility that:
1. Meets the eligibility requirements
			 described in these Rules, including SECTION 84:;
2. Provides rural emergency hospital
			 services;
3. Provides rural
			 emergency services in the facility twenty-four (24) hours per day by
			 maintaining an emergency department that is staffed twenty-four (24) hours per
			 day and seven (7) days per week with a physician, nurse practitioner, clinical
			 nurse specialist, or physician assistant;
4. Has a transfer agreement in effect with a
			 Level I or Level II trauma center;
5. Provides other outpatient medical and
			 health services in which the annual per patient average length of stay does not
			 exceed twenty-four (24) hours; and
6. Was a critical access hospital or a
			 general hospital with not more than fifty (50) licensed beds located or deemed
			 located in a rural area under Social Security Act §1886(d)(2)(D) or
			 §1886(d)(2)(E) on or before December 27, 2020.
T. Rural emergency hospital services means
			 the followings services provided by a rural emergency hospital that do not
			 require more than twenty-four (24) hours on average in a rural emergency
			 hospital:
1. Emergency department services,
			 observation care, and;
2. At the
			 election of the rural emergency hospital, other medical and health services
			 provided on an outpatient basis as specified in regulations adopted by the
			 United States Secretary of Health and Human Services and authorized by the
			 Department of Health.
U.
			 Shall means mandatory.
V. State
			 Health Officer means the Secretary of the State Board of Health.
W. Surgery and General Medical Care Hospital
			 means any facility limited to providing short-term inpatient surgical and
			 general medical diagnostic care and treatment.