reglab/statecodes huggingface dataset:
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-17 - HOSPICES › Section 420-5-17-.18 - Medical Records

Current through Register Vol. 42, No. 9, June 28, 2024
The hospice develops policies and procedures governing all
				aspects of the medical record.
(1)
Records Shall be Confidential.
When an individual enters a hospice
			 program, records and information regarding him are confidential. Access to
			 these records shall be limited to the patient, designated team members,
			 physicians, others having professional responsibility, representatives of the
			 State Board of Health, and such other persons as the patient may
			 delegate.
(2) Each hospice care
			 program shall establish and maintain a central clinical record for each hospice
			 patient receiving care and services from the program and his or her family. The
			 record shall be established and maintained in accordance with accepted
			 principles of practice.
(3) The
			 clinical record shall be a comprehensive compilation of information that is
			 documented promptly for all services provided. The record shall be organized
			 systematically to facilitate retrieval of information. Entries to the clinical
			 record shall be made and signed by the person providing the service. All
			 services, whether furnished by employees, persons under contract, or
			 volunteers, shall be documented in the clinical record.
(4) Each clinical record shall contain at
			 least the following information:
(a)
			 Identification data.
(b) Pertinent
			 medical history.
(c) Consent and
			 authorization forms.
(d) Initial
			 and subsequent assessments.
(e) The
			 interdisciplinary plan of care.
(f)
			 Documentation of all services and events, such as evaluations, treatments, and
			 progress notes.
(g) The hospice
			 care program shall provide for storage of the central clinical records to
			 protect them against loss, destruction, and unauthorized use.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-17 - HOSPICES › Section 420-5-17-.19 - Dietetic Services

Current through Register Vol. 42, No. 9, June 28, 2024
Those facilities located within a hospital or nursing home
				shall meet the dietary licensure requirements of that facility. In the
				inpatient hospice classified as a health care-limited care facility, the
				provision of dietary services shall comply with the following:
(1)
Staffing
. A consulting
			 qualified dietitian is available to assist in nutritional assessment menu
			 planning, inservicing staff and evaluating safe food production. This
			 information shall be included in the quality assurance program. A facility
			 which does not provide the services of a certified dietary manager must, as a
			 minimum, train all employees through the county health departments' food
			 managers training course or a comparable course.
(a) If consultant dietetic services are used,
			 the consultant's visits are at appropriate times and of sufficient duration and
			 frequency based upon the size and needs of the hospice to provide continuing
			 liaison with medical and nursing staffs, advice to the manager, patient
			 counseling, guidance to the supervisor and staff of dietetic service, approval
			 of all menus, and participation in development or revision of dietetic policies
			 and procedures and in planning and conducting inservice education
			 programs.
(b) The hospice employees
			 sufficient supportive dietetic personnel competent to provide a hygienic
			 dietary service that meets the daily nutritional and special dietary needs of
			 patients, and provides palatable and attractive meals.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-17 - HOSPICES › Section 420-5-17-.20 - Medical Supplies, Pharmaceuticals And Biologicals

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Each hospice care program shall arrange
			 for provision of medical supplies, appliances, drugs, and biologicals to
			 patients as needed for the palliation and management of the patient's terminal
			 illness and related conditions. The program shall ensure that drugs and
			 biologicals can be obtained at all times.
(2) Each hospice care program shall ensure
			 that instruction is provided to patient and/or family regarding proper
			 administration of drugs and biologicals and their side effects with
			 documentation in the patient's record.
(3) The inpatient hospice has written
			 policies and procedures, developed with the advice of a pharmacist, which
			 ensures that drugs and biologicals are obtained for patients on a timely basis,
			 they are dispensed and administered according to all federal, state and local
			 laws, and provide for appropriate handling and control of all drugs and
			 biologicals. Whether drugs or biologicals are obtained from community or
			 institutional pharmacies or stocked by the hospice, the hospice is responsible
			 for ensuring the availability of such drugs or biologicals for its patients and
			 that pharmaceutical services are provided in accordance with accepted
			 professional principles and all appropriate federal, state and local
			 laws.
(4) All policies and
			 procedures shall be reviewed and updated at least annually by at least a
			 pharmacist, the director of nursing services, the manager and one
			 physician.
(5) Supervision of
			 services in the inpatient hospice. Pharmaceutical services are under the
			 general supervision of a qualified, registered pharmacist. The pharmacist may
			 serve the inpatient hospice on a full-time, part-time, or consultant basis.
(a) If the pharmacist is not employed
			 full-time, a sufficient number of hours are devoted on a regularly scheduled
			 visit to carry out all responsibilities. The number of hours devoted are based
			 on the size and needs of the hospice.
(b) The pharmacist reviews the drug regimen
			 of each patient on admission, every 14 days and reports any irregularities to
			 the individual who is authorized to make a change.
(c) The pharmacist submits a written report
			 each month to the medical director, director of nurses, and the manager that
			 defines his/her activities, drug regimen review result findings and
			 recommendations. There shall be documented evidence by the director of nurses
			 and/or the manager as to corrective action taken.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-17 - HOSPICES › Section 420-5-17-.21 - Laboratory And Radiological Services

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Policies and procedures list the source
			 of laboratory and radiology services and defines whether these services are
			 provided by the hospice or under arrangement with an outside source.
(2) A hospice which does not provide
			 laboratory, radiology, or other diagnostic services, must make arrangements for
			 obtaining these services.
(3)
			 Services provided must meet all applicable federal, state and local
			 laws.
(4) Laboratory services shall
			 be obtained from a laboratory which is CLIA (1988) certified to provide these
			 services. X-ray services may be provided by a portable X-ray supplier, a
			 facility licensed by the state to provide X-ray services, or a radiologist's
			 office.
Author:
Jimmy D. Prince
Statutory Authority:
Code of Ala.
				  1975
, §§
										22-21-20,
et
seq
.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-17 - HOSPICES › Section 420-5-17-.22 - Transfer Agreement

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The
			 home care hospice has a written transfer agreement with one or more hospitals
			 sufficiently close to the hospice's service area to make feasible the transfer
			 of the patient and their records. This agreement provides the basis for
			 effective working arrangements under which inpatient hospital care or other
			 hospital services are available promptly to the facility's patients when
			 needed. The agreement delineates the responsibilities assumed by both the
			 hospital and the hospice.
(2) A
			 hospital and a hospice shall be considered to have a transfer agreement in
			 effect if, by reason of a written agreement between them or (in case the two
			 institutions are under common control) by reason of a written understanding by
			 the person or body which controls them, there is reasonable assurance that:
(a) Timely transfer and admission of patients
			 will be effected whenever such transfer is medically appropriate as determined
			 by the attending physician.
(b)
			 There will be interchange of pertinent medical and other information necessary
			 to determine appropriateness and/or degree of care required.
(c) Security and accountability for patients'
			 personal effects are provided on transfer by the inpatient hospice.
Author:
Jimmy D. Prince
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-17 - HOSPICES › Section 420-5-17-.23 - Infection Control

Current through Register Vol. 42, No. 9, June 28, 2024
All hospices shall establish an infection control policy. The
				inpatient hospice shall also comply with the following:
(1)
Reasonable Accommodations.
Reasonable accommodations shall be made for all patients with contagious
			 disease. The nature and extent of said accommodations shall be determined by
			 the interdisciplinary team.
(2)
Housekeeping.
The hospice employs sufficient housekeeping
			 personnel and provides all necessary equipment to maintain a safe, clean, and
			 orderly interior. An employee is designated as responsible for the services and
			 for supervision and training of personnel. Nursing personnel are not assigned
			 housekeeping duties. A hospice contracting with an outside source for
			 housekeeping may be found to be in compliance with this section provided the
			 hospice and/or outside resources meet the requirements of this section.
			 Cleaning carts shall not be carried into patient rooms.
(3)
Linen.
The inpatient hospice
			 has available at all times a quantity of linen essential for proper care and
			 comfort of patients.
(a) Linens are handled,
			 stored, processed, and transported in such a manner as to prevent the spread of
			 infection.
(b) Linens on patients
			 beds shall be free of tears and stains and shall be removed from linen storage
			 when it is no longer suitable for patient use.
(c) Linens shall be washed in a final wash
			 cycle of 160 degree F. unless chemicals are used.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-17 - HOSPICES › Section 420-5-17-.24 - Disaster Preparedness

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The
			 inpatient hospice has a written plan with procedures to be followed in the
			 event of an internal or external disaster and for the care of casualties
			 (patients and personnel) arising from such disasters.
(2) The hospice has an acceptable disaster
			 plan with procedures to be followed in the event of fire, explosion, or other
			 disaster. The plan is developed and maintained with the assistance of qualified
			 fire, safety, and other appropriate experts, and includes procedures for prompt
			 transfer/transport of casualties and records, instructions regarding the
			 location and use of alarm systems, signals, and fire fighting equipment,
			 information regarding methods of containing fire, procedures for notification
			 of appropriate persons, specifications of evacuation routes and procedures,
			 procurement of food, water, medical supplies, and other materials, detail
			 personnel responsibilities relative to patient movement in and outside of the
			 hospice for various situations such as tornadoes, fires, and other disasters.
			 The plan shall be located in each department in a conspicuous place and kept
			 current.
(3) The disaster program
			 includes orientation and on-going training and drills for all personnel in all
			 procedures so that each employee promptly and correctly carries out his
			 specific role in case of a disaster.
(a) All
			 employees are trained, as part of their employment orientation, in all aspects
			 of preparedness for any disaster, and a record of this training is maintained
			 in the employee's personnel record.
(b) Fire drills shall be conducted at least
			 quarterly for each shift.
(c)
			 Disaster drills shall be conducted at least semi-annually and all hospice
			 personnel shall participate in at least one drill annually.
(d) Written observations of the effectiveness
			 of the plan shall be filed and kept for at least three years for each fire
			 drill and disaster drill. These observations shall include a list of all
			 attendees.
Author:
Jimmy D. Prince
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-17 - HOSPICES › Section 420-5-17-.25 - Physical Plant Inpatient Hospices

Current through Register Vol. 42, No. 9, June 28, 2024
The provisions of this section shall apply to all inpatient
				hospices licensed by the State Board of Health.
(1)
General Requirements
. The
			 hospice shall have physical space for private patient and family visiting.
(a) The hospice shall provide accommodations
			 for family members to remain with the patient throughout the night.
(b) The hospice shall provide accommodations
			 for family privacy after a patient's death.
(c) The patient areas in the hospice shall
			 have decor which is homelike in design and function.
(d) Patients shall be permitted to receive
			 visitors, including small children, at any hour.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-17 - HOSPICES › Addendum - ADDENDUM

Current through Register Vol. 42, No. 9, June 28, 2024
National Fire Protection Association
1 Battery March Park
P.O. Box 9101
Quincy, MA 02269 - 9904
1-800-344-3555
Life Safety Code, NFPA-101
National Electrical Code, NFPA-70
Installation of Sprinkler Systems, NFPA-13
Air Conditioning and Ventilation Systems, NFPA - 90a &
				90b
Standard Building and Plumbing Codes
Standard Plumbing Gas & Mechanical
Southern Building Code Congress International
900 Montclair Road
Birmingham, AL 35213
1-205-591-1853
National Plumbing Code
American Society of Heating, Refrigeration and Air
Conditioning Engineers (ASHREA)
Publication Sales
1791 Tullie Circle, NE
Atlanta, GA 30329 - 2305
American Society of Mechanical Engineers
United Engineering Center
345 East 47th Street, NE
New Yo rk, NY 10017
American Gas Association
1515 Wilson Boulevard
Arlington, VA 22209
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-18 - SLEEP DISORDERS FACILITIES › Section 420-5-18-.01 - General

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
Legal Authority for Adoption of Regulations
. Pursuant
			 to the authority granted by
Code of Ala. 1975
,
			 §§
								22-21-20 to §
								22-21-33, and in accordance with
			 the Alabama Administrative Procedures Act,
Code of Ala.
			 1975
, §§
								41-22-1 to §
								41-22-27, the State Board of
			 Health does hereby adopt and promulgate rules governing all free-standing sleep
			 disorders facilities in Alabama except these exempt by law from
			 licensure.
(2)
Definition
.
(a) "AAC
			 Rules" means Alabama Administrative Code Rules.
(b) "Applicant" means a person or public
			 agency that applies for Sleep Disorders Facility Licensure.
(c) "Advisory Board". See Section
			 22-21-27 of Appendix A.
(d) "Board or State Board of Health" means
			 the Alabama State Board of Health.
(e) "License" means the document issued by
			 the State Board of Health and signed by the State Health Officer. The license
			 shall constitute the authority to receive patients and perform the services
			 included within the scope of the applicable rules. The license shall be posted
			 in a conspicuous place on the premises.
(f) "Licensee" means the individual owner,
			 partnership, corporation, association, city, county, or other organization to
			 whom the license is issued and upon whom rests the responsibility for
			 compliance with these rules.
(g)
			 "May" indicates permission.
(h)
			 "Medical Director". The Medical Director of a facility must be a physician who
			 has been granted a certificate by the American Board of Sleep Medicine or an
			 individual who is boarded or board-eligible in another primary specialty of
			 medicine. This physician must be able to show that he/she is knowledgeable not
			 only concerning sleep related breathing disorders, but also able to recognize
			 other sleep disorders.
(i)
			 "Patient" means any person who is referred to or presents him/herself to a
			 licensed sleep disorders facility for evaluation or treatment.
(j) "Physician". A person currently licensed
			 to practice medicine in accordance with Title 34, Chapter 24, Article 8,
Code of Ala. 1975
.
(k) "Shall" indicates a mandatory
			 requirement.
(l) "Sleep Disorders
			 Facility". A free-standing outpatient medical facility that evaluates and
			 treats patients with sleep disorders.
(m) "Technical Personnel". Sleep Disorders
			 facility personnel that are basic CPR Certified and have at least one of the
			 following credentials:
(a) Be registered by
			 the Board of Polysomnographic Technologists,
(b) Formal training in any Allied health
			 area,
(c) Verifiable training in
			 the field of Sleep Disorders.
(n) "Polysomnographic Technologist". An
			 individual who is currently registered by the Board of Polysomnographic
			 Technologists.
Author:
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-18 - SLEEP DISORDERS FACILITIES › Section 420-5-18-.02 - Licensing And Administrative Procedures

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
Types of
			 License
. All licenses are issued for the calendar year and shall
			 expire December 31 unless renewed by the owner for the succeeding year.
(a) Regular license. A regular license shall
			 be issued by the State Board of Health after the Board has determined that the
			 sleep disorders facility is in substantial compliance with rules herein
			 adopted.
(b) Probational license.
			 The State Board of Health may, in its discretion and in lieu of license
			 revocation, issue a probational license to a facility when inspection shows
			 that the maintenance and operation of the facility are such that the sleep
			 disorders facility no longer substantially complies with the rules adopted
			 herein. However, the Board may issue a probational license only after
			 determining that the health and safety of patients are adequately protected
			 despite non-compliance, and that the facility has submitted an adequate written
			 plan to correct the non-compliance in a timely manner.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-18 - SLEEP DISORDERS FACILITIES › Section 420-5-18-.03 - Governing Body

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The overall
			 conduct and operation of the sleep disorders facility shall be the full legal
			 responsibility of a clearly defined, organized governing body which shall
			 perform the following functions.
(a)
			 Establish and review policies for the management, operation, and evaluation of
			 the sleep disorders facility program, including establishing qualifications of
			 employees and independent contractors;
(b) Arrange for a physician to serve as
			 medical director for the sleep disorders facility.
(c) Appoints in writing an individual who is
			 responsible for the day to day management of the sleep disorders
			 facility.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-18 - SLEEP DISORDERS FACILITIES › Section 420-5-18-.04 - Administration and Organization

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
Medical
			 Supervision
. Sleep disorders facilities are medical units and the
			 core responsibility must be medical. While other health care professionals may
			 participate in a patient's evaluation, each patient must have a
			 clearly-identifiable staff physician who is responsible for his/her care
			 throughout the patient's active status at the sleep disorders
			 facility.
(2)
Medical
			 Director
. Every facility must have a physician who is designated
			 as the medical director who must perform all the following duties on site:
(a) Assure and document that each patient has
			 an appropriate diagnostic evaluation.
(b) Be involved with all phases of the
			 facility's functions, including patient care decisions.
(c) Review and certify the accuracy of
			 polysomnographic scoring and interpretations.
(d) Supervise the training and performance of
			 the technical personnel.
(e) Be
			 responsible for quality assurance review, and
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-18 - SLEEP DISORDERS FACILITIES › Section 420-5-18-.05 - Patient Evaluation

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
Outside Information
. Any available outside information
			 must be properly obtained with suitable releases. The receipt of this
			 information by the facility must be reflected in the patient's chart.
(2)
Medical and Sleep History,
			 Physical Examination, Laboratory Tests
. Evidence of a recent
			 general clinical work-up obtained sleep evaluation must be contained in the
			 chart, as well as evidence that this information was reviewed by a staff
			 physician prior to testing. Laboratory test results must always be available in
			 the patient records. An evaluation at a sleep disorders facility is a medical
			 evaluation and appropriate medical procedures must be followed.
(3) Consultative Evaluations and Procedures.
			 Sleep disorders require careful and total evaluation. Such evaluation often
			 requires utilization of knowledgeable consultants. Evidence should appear in
			 the charts that appropriate consultants have been consistently utilized. Prompt
			 communications between the facility's professional and technical personnel and
			 consultants is crucial to an integrated clinical effort.
(4) Scoring and Interpretation of
			 Polysomnographic Data. A facility must have evidence that its recordings are
			 adequate and have been properly scored and interpreted. An appropriate
			 technical monitoring log regarding nocturnal patient activity, position, and
			 events must be maintained throughout the night of recording. An oximetry strip
			 chart may be used for this purpose. Scoring may be performed by technologists
			 or staff physician, but interpretation of polysomnograms is the responsibility
			 of the Medical Director or staff physician who must submit a signed and dated
			 report for each separate polysomnographic procedure. In addition, a written and
			 signed assessment of the clinical significance of these results is the role of
			 the physician responsible for the case and must be a component of the patient's
			 chart.
Author:
Statutory Authority:
Code of Ala.
				  1975
, Title 22, Chapter 21.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-18 - SLEEP DISORDERS FACILITIES › Section 420-5-18-.07 - Physical Plant

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
Local Restrictions
. The location and construction of
			 sleep disorders facilities shall comply with all local zoning and building
			 codes and fire or other emergency ordinances.
(2)
Personal
			 Amenities
. A facility must demonstrate a high sense of
			 responsibility toward and sensitivity to the dignity and comfort of the
			 patient. The patient's surroundings should be similar to a comfortable bedroom
			 at home.
(3)
Bedrooms
. Certain minimum space requirements are
			 essential. The overall concept of a sleep disorders facility includes a private
			 bedroom for each patient and a centralized control room for equipment and for
			 staff to perform on-line monitoring of polysomnographic data.
(a) The bedrooms must conform to local
			 standards with regard to entrances, exits, fire precautions, and other building
			 codes. They must be sound and light attenuated and should possess either
			 effective insulation or independent temperature controls to avoid variations in
			 sleep parameters secondary to seasonal variations in temperature. White noise
			 background sound is acceptable. The rooms should be isolated to ensure minimal
			 interaction with the external environment.
(b) The bedroom should be a minimum of eight
			 by ten feet and be a single room. A sleep disorders facility will determine the
			 appropriate number of bedrooms equipped for polysomnographic recording based on
			 space availability and patient demand. The rooms must be within easy access to
			 the polysomnographic technologists.
(c) Each bedroom must be furnished with a bed
			 and mattress in good repair. The patient should be able to hang his/her
			 clothes, dress, and sit comfortably while waiting to get into bed. Bathroom and
			 shower facilities must be conveniently located to the patient's room.
			 Cleanliness and tidiness must be apparent.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-19 - ADVANCE DIRECTIVES › Section 420-5-19-.01 - Advance Directives

Current through Register Vol. 42, No. 9, June 28, 2024
Surrogate health care decision makers, as authorized by Act
				97-187, shall complete the form attached hereto as Appendix I which, when
				properly completed and duly notarized, shall constitute the certification of
				the surrogate as required by the act and shall authorize the surrogate,
				including a representative of the ethics committee or another duly appointed
				committee at the facility where the patient is being treated, acting by
				unanimous consent as the surrogate, to make standard health care decisions for
				the patient as well as to make decisions regarding the providing, withholding,
				or withdrawal of life-sustaining treatment and artificially provided nutrition
				and hydration in instances involving terminal illness or injury and permanent
				unconsciousness. This form is to be used in fulfillment of the purposes of Act
				97-187.
Authors:
Rick Harris, Dennis Blair
Statutory Authority:
Act No. 97-187.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-19 - ADVANCE DIRECTIVES › Section 420-5-19-.02 - Portable Physician Do Not Attempt Resuscitation Orders

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Definitions.
(a) Do Not Attempt Resuscitation (DNAR)
			 Order. A physician's order that resuscitative measures not be provided to a
			 person under a physician's care in the event the person is found with
			 cardiopulmonary cessation. A DNAR order would include, without limitation,
			 physician orders written as "do not resuscitate," "do not allow resuscitation,"
			 "do not allow resuscitative measures," "DNAR," "DNR," "allow natural death," or
			 "AND." A DNAR order must be entered with the consent of the person, if the
			 person is competent; or in accordance with instructions in an advance directive
			 if the person is not competent or is no longer able to understand, appreciate,
			 and direct his or her medical treatment and has no hope of regaining that
			 ability; or with the consent of a health care proxy or surrogate functioning
			 under the provisions of Title 22, Chapter 8A,
Code of Ala.
			 1975
; or instructions by an attorney in fact under a durable power
			 of attorney that duly grants powers to the attorney in fact to make those
			 decisions described in Section 22-8 A-4(b)(1),
Code of Ala.
			 1975
.
(b) Portable
			 Physician DNAR Order. A DNAR order entered into the medical record by a
			 physician using the required form designated by this rule and substantiated by
			 completion of all applicable sections of the form.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-19 - ADVANCE DIRECTIVES › Section 420-5-19-.03 - Pediatric Palliative and End of Life (PPEL) Care Orders

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Definitions.
(a) Attending Physician. The physician
			 selected by, or assigned to, the patient who has primary responsibility for the
			 treatment and care of the patient.
(b) Health Care Provider. A person who is
			 licensed, certified, registered, or otherwise authorized by the law of this
			 state to administer or provide health care in the ordinary course of business
			 or in the practice of a profession.
(c) Pediatric Palliative and End of Life
			 (PPEL) Care Order. A directive that, once executed by the representative of a
			 qualified minor and entered into the record by the attending physician of the
			 qualified minor in accordance with Section
			 22-8A-15,
Code of Ala.
			 1975
, becomes the medical order for all health care providers with
			 respect to the extent of use of emergency medical equipment and treatment,
			 medication, and any other technological or medical interventions available to
			 provide palliative and supportive care to the qualified minor.
(d) Physician. A person licensed to practice
			 medicine and osteopathy in the state of Alabama.
(e) Qualified Minor. An individual ranging in
			 age from birth until the age of 19 who has been diagnosed as a terminally ill
			 or injured patient and whose diagnosis has been confirmed by at least one
			 additional physician who is not the patient's attending physician.
(f) Representative of a Qualified Minor. Any
			 of the following:
1. A parent of a qualified
			 minor whose medical decision-making rights have not been restricted.
2. A legal guardian of a qualified
			 minor.
3. A person acting as a
			 parent, as the term is defined in Section
			 30-3B-102,
Code of
			 Ala. 1975
, of a qualified minor.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-19 - ADVANCE DIRECTIVES › Appendix I - CERTIFICATION OF HEALTH CARE DECISION SURROGATE

Current through Register Vol. 42, No. 9, June 28, 2024
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Author
: Rick Harris
Statutory Authority
: Act No. 97-187.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-19 - ADVANCE DIRECTIVES › Appendix II

Current through Register Vol. 42, No. 9, June 28, 2024
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Author:
Walter T. Geary Jr., M.D.
Statutory Authority:
Act 2 016-96.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-19 - ADVANCE DIRECTIVES › Appendix III - ALABAMA ORDER FOR PEDIATRIC PALLIATIVE AND END OF LIFE (PPEL) CARE

Current through Register Vol. 42, No. 9, June 28, 2024
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Author:
Dennis Blair
Statutory Authority:
Act No.
				  2018-466.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-20 - SPECIALTY CARE ASSISTED LIVING FACILITIES › Section 420-5-20-.02 - The License

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
Classifications of Licenses.
All licenses are granted for the
			 calendar year and shall expire on December 31 unless renewed by the owner for
			 the succeeding year.
(a) Regular License. A
			 regular license shall be granted by the State Board of Health upon a
			 determination by the Board or its authorized agents that the operator or
			 operators of the specialty care assisted living facility are willing and
			 capable of achieving and maintaining substantial compliance with the rules
			 herein adopted.
(b) Probational
			 License. At its discretion, the Board may grant a probational license when it
			 determines that the following conditions exist:
1. The facility has engaged in one or more
			 deficient practices which are serious in nature, chronic in nature, or which
			 the facility has failed to correct.
2. The facility's current governing authority
			 has demonstrated the capability and willingness to correct cited problems and
			 to maintain compliance.
3. This
			 license shall be granted when the Board is satisfied that the health and safety
			 of residents will not be endangered during this period. Maximum length of time
			 for probationary status is 1 year.
(c) A facility on probation may not add
			 additional beds during the probational period.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-20 - SPECIALTY CARE ASSISTED LIVING FACILITIES › Section 420-5-20-.03 - Administration

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
The
			 Specialty Care Assisted Living Facility Governing Authority.
(a) A specialty care assisted living facility
			 shall have an identified sole proprietorship, corporation, partnership, limited
			 partnership, or other business entity that is its governing authority, or it
			 shall have a designated individual or group of designated individuals who serve
			 as its governing authority. A facility must give complete information to the
			 Department identifying:
1. Each person who
			 has an ownership interest of 10 percent or more of the governing
			 authority.
2. Each person or entity
			 who has an ownership interest of 10 percent or more in the real property or
			 building used by the specialty care assisted living facility to offer its
			 services.
3. Each officer and each
			 director of the corporation if the governing authority is a
			 corporation.
4. Each partner,
			 including any limited partners, if the governing authority is a
			 partnership.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-20 - SPECIALTY CARE ASSISTED LIVING FACILITIES › Section 420-5-20-.04 - Personnel

Current through Register Vol. 42, No. 9, June 28, 2024
(1) A specialty
			 care assisted living facility shall ensure adequate personnel are employed and
			 on duty to meet the care and safety needs of all residents 24 hours a day, 7
			 days a week. No specialty care assisted living facility shall have fewer staff
			 on duty than specified in Table A below. Even if this minimum staffing ratio is
			 met, the governing authority of a specialty care assisted living facility shall
			 have additional staff on duty to meet the care and safety needs of all
			 residents 24 hours a day, 7 days a week. Facilities with resident bedroom wings
			 separated from the remainder of the facility by a lockable door shall maintain
			 dedicated staff to these areas adequate to meet all care and safety needs of
			 the residents in these areas at all times.
Table A
Staff Number
7 AM - 3 PM
3 PM - 11PM
11 PM - 7 AM
2
1-16 Residents
1-16 Residents
1-16 Residents
3
17-24 Residents
17-36 Residents
17-48 Residents
4
25 - 32 Resident
37 - 48 Residents
49 - 64 Residents
5
33 - 40 Residents
49 - 60 Residents
65 - 80 Residents
6
41-48 Residents
61-72 Residents
81 -96 Residents
7
49-56 Residents
73 - 84 Residents
97- 112 Residents
8
57 - 64 Residents
85 - 96 Residents
113 - 128 Residents
9
65 - 72 Residents
97-108 Residents
129-144 Residents
10
73 - 80 Residents
109-120 Residents
145 - 160 Residents
11
81-88 Residents
120-132 Residents
161 - 176 Residents
1 Additional Staff
For each 8 residents, or any fraction thereof, by
							 which the census
For each 12 residents, or any fraction thereof, by
							 which the census
For each 16 residents, or any fraction thereof, by
							 which the census
(a) A specialty
			 care assisted living facility shall be staffed at all times by at least one
			 individual who has a current certification in cardiopulmonary resuscitation
			 (CPR).
(b) A specialty care
			 assisted living facility must be sufficiently staffed to ensure the safe
			 evacuation of all residents in the event of a fire or emergency.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-20 - SPECIALTY CARE ASSISTED LIVING FACILITIES › Section 420-5-20-.05 - Records And Reports

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
General.
(a) Responsibility for
			 Records. The administrator shall prepare and file all records, or shall oversee
			 the preparation and filing of records. This duty shall be assigned to other
			 employees in the administrator's absence.
(b) All records and reports required by these
			 rules shall be completed in a timely manner, and shall be maintained and filed
			 in an orderly manner within the specialty care assisted living facility
			 premises.
(c) Storage and Safety.
			 Provision shall be made for the safe storage of records within the facility.
			 Records shall be stored in a manner to reasonably protect them from water or
			 fire damage. Records shall be safeguarded from unauthorized access.
(d) All facility records, including resident
			 medical records, shall be made readily available for review and copying by
			 representatives of the Alabama Department of Public Health upon
			 request.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-20 - SPECIALTY CARE ASSISTED LIVING FACILITIES › Section 420-5-20-.06 - Care Of Residents

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
Medical Direction and Supervision.
The medical care of residents
			 shall be under the direction and supervision of a physician.
(a) Designation of Attending Physician. Upon
			 admission, each resident shall be asked to designate an attending physician of
			 his or her choice. If the resident is unable to designate an attending
			 physician, or does not wish to designate an attending physician, the facility
			 shall assist the resident in identifying an attending physician who will serve
			 the resident. A resident shall be permitted to change the designation of his or
			 her attending physician at any time. Whenever a resident requires medical
			 attention, an attempt shall first be made to contact the resident's attending
			 physician, except in medical emergencies requiring activation of the local EMS
			 system (911 or other emergency call).
(b) Back-up Physician Support. Each specialty
			 care assisted living facility shall have an agreement with one or more duly
			 licensed physicians to serve in those instances when a resident's own attending
			 physician cannot be reached, and to provide temporary medical attention to any
			 resident whose attending physician is temporarily not available. A nurse
			 practitioner or physician's assistant shall not serve as the back-up physician
			 in a specialty care assisted living facility.
(c) All physician orders shall be written in
			 accordance with community standards. If verbal orders are used, they are to be
			 used infrequently. A physician verbal order shall only be accepted by an R.N.
			 or L.P.N. employed by the facility and authorized to do so by facility policy
			 and procedures and state law. All verbal orders shall be reduced to writing on
			 the physicians' order sheet by a licensed facility nurse and shall be dated and
			 signed by the nurse receiving the order. All orders, including verbal orders,
			 shall be dated, timed, and authenticated promptly by the ordering practitioner,
			 or another practitioner who is responsible for the care of the resident and
			 authorized to write orders by facility policy. All verbal orders must be
			 authenticated within such time period as provided by facility policy, but in no
			 case shall exceed 30 days following entry of the order.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-20 - SPECIALTY CARE ASSISTED LIVING FACILITIES › Section 420-5-20-.07 - Food Service

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
General.
(a) Direction and
			 Supervision. The services of a dietitian shall be provided to any resident of a
			 specialty care assisted living facility who requires a therapeutic diet. A
			 congregate specialty care assisted living facility shall be under the direction
			 and supervision of a full or part-time professionally qualified dietitian or a
			 consulting dietitian that is licensed in the state of Alabama. Responsibility
			 for the supervision of dietary services shall be delegated to a responsible
			 employee who is a graduate of a Dietary Managers course or has completed an
			 approved course that includes basic sanitation. The facility shall provide
			 meals, fluids, and snacks to the residents that meet the Dietary References
			 Intakes from the basic food groups. The meals shall be of the quality and
			 quantity necessary to meet the residents' needs, and must be in accordance with
			 the recommended dietary allowances of the Food and Nutrition Board of the
			 National Research Council, National Academy of Sciences.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-20 - SPECIALTY CARE ASSISTED LIVING FACILITIES › Section 420-5-20-.08 - Physical Facilities

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
Administrative Facilities.
Each specialty care assisted living
			 facility shall provide office space(s) or administrative office(s).
(a) As a minimum, the administrative
			 office(s) shall be provided with a desk, file cabinet, and related office
			 equipment and supplies.
(b)
			 Congregate Specialty Care Assisted Living facilities shall provide separate
			 rooms for administrative and office purposes.
(c) Communication Facilities. Each specialty
			 care assisted living facility shall have an adequate number of telephones to
			 summon help in case of fire or other emergency, and these shall be located so
			 as to be quickly accessible from all parts of the building.
(d) Fire Protection Arrangements. The
			 facility shall have arrangements for fire protection with the nearest available
			 fire department for assistance in case of fire. Each facility shall have a
			 monitoring service for its fire alarm system.
(e) Central Staff Station. New Group and
			 Congregate facilities, and existing Group and Congregate facilities that are
			 enlarged or renovated to accommodate bed increases, shall have a centrally
			 located staff station with call for assistance and fire alarm system
			 annunciation panels.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-20 - SPECIALTY CARE ASSISTED LIVING FACILITIES › Section 420-5-20-.09 - Laundry

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
General
.
(a) Direction and
			 Supervision. Responsibility for laundry services shall be assigned to an
			 employee.
(b) Linen. Linens shall
			 be handled, stored, processed, and transported in a manner consistent with
			 generally accepted infection control practices.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-20 - SPECIALTY CARE ASSISTED LIVING FACILITIES › Section 420-5-20-.10 - Sanitation And Housekeeping

Current through Register Vol. 42, No. 9, June 28, 2024
(1)
Sanitation.
(a) Water Supply.
1. If at all possible, all water shall be
			 obtained from a public water supply. If it is impossible to connect to a public
			 water system, the private water supply shall meet the approval of the local
			 County Health Department.
2. Water
			 under pressure of not less than 15 pounds per square inch shall be piped within
			 the building to all sinks, toilets, lavatories, tubs, showers, and other
			 fixtures requiring water. Tubs, showers, sinks, lavatories, and other fixtures
			 used by residents shall have hot water supplied. Hot water accessible to
			 residents shall in no case exceed 110 degrees Fahrenheit.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-20 - SPECIALTY CARE ASSISTED LIVING FACILITIES › Appendix A - Forms

Current through Register Vol. 42, No. 9, June 28, 2024
Click to view
				image
Click to view
				image
Authors:
Rick Harris, Kelley Mitchell
Statutory Authority:
Code of Ala.
				  1975
, §§
										22-21-20, et seq.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-21 - PAYMENT OF PLAN REVIEW FEES › Section 420-5-21-.01 - Applicability

Current through Register Vol. 42, No. 9, June 28, 2024
The following procedures are applicable to submittals of
				drawings and specifications for new construction, addition or alteration
				projects to hospitals or other health care facilities in the State of Alabama
				as defined by Section
				22-21-20,
Code of Ala.
				1975
. These rules apply to projects having the first project
				submittal received for review, by the Technical Services Unit of the Alabama
				Department of Public Health, on or after the effective date of these
				rules.
Author:
Victor C. Hunt, AIA
Statutory Authority:
Code of Ala.
				  1975
, §§
										22-21-40,
et
seq
.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-21 - PAYMENT OF PLAN REVIEW FEES › Section 420-5-21-.02 - Fees Required

Current through Register Vol. 42, No. 9, June 28, 2024
(1) FEE
			 SCHEDULE: Fees are based on a percentage of the cost of construction of each
			 project. The fee schedule is set out in Alabama Administrative Code Rule
			 420-1-5-.08, "State Level Fees,"
			 and is available online at
www.adph.org/facmgmt
.
(2) Initial Fee: The first submittal of each
			 new project shall be accompanied by a $500.00 fee payment. This includes
			 projects consisting only of fire alarm or fire sprinkler work. Submittals sent
			 in without this initial fee will not be logged in until the fee payment is
			 received.
(3) Final Stage Drawing
			 Approval Fee: Upon receipt by the architect or owner of the Department's
			 written notice of approval of the final drawings and specifications, payment
			 shall be due for 75 percent of the total fee. The following conditions apply:
(a) Written review comments must be sent by
			 the Department of Public Health to the project architect within 60 calendar
			 days of the Department's receipt of each submittal (120 calendar days on
			 projects costing more than $15,000,000) . If the Department of Public Health
			 does not meet this time limitation, the Drawing Approval fee payment is
			 waived.
(b) Final Inspection will
			 not be scheduled prior to receipt of Final Stage Drawing Approval fee
			 payment.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-21 - PAYMENT OF PLAN REVIEW FEES › Section 420-5-21-.03 - Payment Of Fees

Current through Register Vol. 42, No. 9, June 28, 2024
(1) Final
			 Stage Drawing Approval Fee Payment shall be accompanied by the completed "Final
			 Stage Drawing Approval Fee Worksheet" and a copy of the architect's or
			 contractor's latest estimated cost of building construction. The cost estimate
			 will be the basis for calculating the estimated total fee on the fee
			 worksheet.
(2) Final Inspection fee
			 payment shall be accompanied by the completed "Final Inspection Fee Worksheet"
			 and a copy of the contractor's latest pay request. The pay request will be the
			 basis for calculating the total fee on the fee worksheet.
(3) "Cost of construction" shall include the
			 cost of the actual building construction, addition or alteration, including
			 sitework.
(4) Fee payments are
			 nonrefundable.
(5) All payments to
			 the Department shall be by check or money order, made payable to "Alabama
			 Department of Public Health."
(6)
			 Fee payments shall be received only at the office of the Technical Services
			 Unit in Montgomery.
Author:
Victor C. Hunt, AIA
Statutory Authority:
Code of Ala.
				  1975
, §§
										22-21-40,
et
seq
.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-21 - PAYMENT OF PLAN REVIEW FEES › Appendix A - Forms (Repealed)

Current through Register Vol. 42, No. 9, June 28, 2024
Author:
Victor C. Hunt, AIA
Statutory Authority:
Code of Ala.
				  1975
, §§
										22-21-40,
et
				  seq
.
Alabama Administrative Code › Title 420 - ALABAMA STATE BOARD OF HEALTH › Chapter 420-5-21 - PAYMENT OF PLAN REVIEW FEES › Appendix - Final Inspection Fee Worksheet (Repealed)

Current through Register Vol. 42, No. 9, June 28, 2024
Author:
Victor C. Hunt, AIA
Statutory Authority:
Code of Ala.
				  1975
, §§
										22-21-40, et
				  seq.