reglab/statecodes huggingface dataset:
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 44 - Abortion Facilities › Subchapter D - Physical Environment › Section I-4451 - Pharmaceutical Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. All
					 outpatient abortion facility's shall have a controlled dangerous substance
					 (CDS) license issued by the Louisiana Board of Pharmacy and a Drug Enforcement
					 Agency (DEA) registration in accordance with applicable state and federal
					 laws.
B. The outpatient abortion
					 facility shall develop, implement, enforce, monitor, and annually review
					 written policies and procedures that govern the safe storage, prescribing,
					 dispensing, preparing and administering of drugs and biologicals on the
					 licensed premises.
C. Storage
					 Areas. The outpatient abortion facility shall provide a designated secure
					 storage area for storing drugs and biologicals.
1. The designated storage area shall be
					 constructed and maintained to prevent unauthorized access.
2. The designated storage area shall adhere
					 to the manufacturers suggested recommendations for storage of drugs.
3. Locked areas that are used to store
					 medications including controlled substances, shall conform to all applicable
					 federal and state laws, and the outpatient abortion facility's policies and
					 procedures.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 44 - Abortion Facilities › Subchapter D - Physical Environment › Section I-4453 - Inactivation of License due to a Declared Disaster or Emergency

Current through Register Vol. 50, No. 6, June 20, 2024
A. An outpatient
					 abortion facility located in a parish which is the subject of an executive
					 order or proclamation of emergency or disaster issued in accordance with
					 applicable state laws, may seek to inactivate its license for a period not to
					 exceed one year, provided that the facility:
1. submits written notification to HSS within
					 60 days of the date of the executive order or proclamation of emergency or
					 disaster that:
a. the facility has
					 experienced an interruption in the provisions of services as a result of events
					 that are the subject of such executive order or proclamation of emergency or
					 disaster issued in accordance with applicable state law;
b. the facility intends to resume operation
					 as an outpatient abortion facility in the same service area;
c. includes an attestation that the emergency
					 or disaster is the sole casual factor in the interruption of the provision of
					 services; and
d. includes an
					 attestation that all clients have been discharged or transferred to another
					 facility in accordance with the provisions of this Chapter;
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter A - General Provisions › Section I-4501 - Introduction

Current through Register Vol. 50, No. 6, June 20, 2024
A. These
					 regulations contain the minimum licensing standards for ambulatory surgical
					 centers, pursuant to R.S. 40:2131-2141. Ambulatory surgical centers are
					 established for the purpose of rendering surgical procedures to its patients on
					 an outpatient basis.
B. The care
					 and services to be provided by an ambulatory surgical center (ASC) shall
					 include:
1. surgical procedures;
2. medications as needed for medical and
					 surgical procedures rendered;
3.
					 services necessary to provide for the physical and emotional well-being of
					 patients;
4. emergency medical
					 services; and
5. organized
					 administrative structure and support services.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter A - General Provisions › Section I-4503 - Definitions

Current through Register Vol. 50, No. 6, June 20, 2024
Administrator
-the person responsible for
						the on-site, daily implementation and supervision of the overall ASCs operation
						commensurate with the authority conferred by the governing body.
Ambulatory Surgical Center
(
ASC
)-a distinct entity that is wholly separate and clearly
						distinguishable from any other healthcare facility or office-based physicians
						practice. An ASC shall be composed of operating room(s) and/or procedure
						room(s) with an organized medical staff of physicians and permanent facilities
						that are equipped and operated primarily for the purpose of performing surgical
						procedures. An ASC provides continuous physician and professional nursing
						services to patients whenever a patient is in the ASC, but does not provide
						services or accommodations for patients to stay overnight.
1. The following services shall be offered by
					 the ASC when a patient is in the center:
a.
					 drug services as needed for medical operations and procedures
					 performed;
b. provisions for the
					 physical and emotional well-being of patients;
c. provision of emergency services;
d. organized administrative structure;
					 and
e. administrative, statistical
					 and medical records.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter A - General Provisions › Section I-4505 - Licensing Requirements

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 Department of Health, Health Standards Section (HSS) is the only licensing
					 authority for ASCs in the state of Louisiana.
B. Each ASC license shall:
1. be issued only to the person or entity
					 named in the license application;
2. be valid only for the ASC to which it is
					 issued and only for the specific geographic address of that ASC;
3. be valid for one year from the date of
					 issuance, unless revoked, suspended, modified or terminated prior to that date,
					 or unless a provisional license is issued:
a.
					 a provisional license shall be valid for a period of six months if the
					 department determines that there is no immediate and serious threat to the
					 health and safety of patients;
4. expire on the last day of the twelfth
					 month after the date of issuance, unless timely renewed by the ASC;
5. not be subject to sale, assignment,
					 donation or other transfer, whether voluntary or involuntary; and
6. be posted in a conspicuous place on the
					 licensed premises at all times.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter A - General Provisions › Section I-4507 - Initial Licensure Application Process

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 An initial application for licensing as an ASC shall be obtained from the
					 department. A completed initial license application packet for an ASC shall be
					 submitted to, and approved by the department, prior to an applicant providing
					 services.
B. The initial licensing
					 application packet shall include:
1. a
					 completed licensure application and the non-refundable licensing fee as
					 established by statute;
2. a copy
					 of the approval letter(s) of the architectural and licensing facility plans
					 from the Office of the State Fire Marshal (OSFM) and any other office/entity
					 designated by the department to review and approve the facilitys architectural
					 and licensing plan review;
3. a
					 copy of the on-site inspection report with approval for occupancy by the Office
					 of the State Fire Marshal, if applicable;
4. a copy of the on-site health inspection
					 report with approval for occupancy from the Office of Public Health
					 (OPH);
5. proof of each insurance
					 coverage as follows:
a. general liability
					 insurance of at least $300,000 per occurrence;
b. workers compensation insurance as required
					 by state law;
c. professional
					 liability insurance of at least $100,000 per occurrence/$300,000 per annual
					 aggregate, or proof of self-insurance of at least $100,000, along with proof of
					 enrollment as a qualified health care provider with the Louisiana Patient's
					 Compensation Fund (PCF):
i. if the ASC is not
					 enrolled in the PCF, professional liability limits shall be $1 million per
					 occurrence/$3 million per annual aggregate; and
d. the LDH Health Standards Section shall
					 specifically be identified as the certificate holder on any policies and any
					 certificates of insurance issued as proof of insurance by the insurer or
					 producer (agent);
6.
					 proof of a line of credit issued from a federally insured, licensed lending
					 institution in the amount of at least $100,000;
7. disclosure of ownership and control
					 information;
8. the usual and
					 customary days and hours of operation;
9. an organizational chart and names,
					 including position titles, of key administrative personnel and governing
					 body;
10. controlled dangerous
					 substance application;
11. fiscal
					 intermediary, if applicable;
12.
					 Secretary of States articles of incorporation;
13. clinical laboratory improvement
					 amendments (CLIA) certificate or CLIA certificate of waiver, if
					 applicable;
14. an 8.5 x 11 inch
					 mapped floor plan; and
15. any
					 other documentation or information required by the department for
					 licensure.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter A - General Provisions › Section I-4509 - Initial Licensing Surveys

Current through Register Vol. 50, No. 6, June 20, 2024
A. Prior to the
					 initial license being issued, an initial on-site licensing survey shall be
					 conducted to ensure compliance with the licensing laws and standards.
1. The initial licensing survey of an ASC
					 shall be an announced survey. Follow-up surveys to the initial licensing
					 surveys are unannounced surveys.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter A - General Provisions › Section I-4511 - Types of Licenses and Expiration Dates

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 The department shall have the authority to issue the following types of
					 licenses.
1. Full Initial License. The
					 department shall issue a full license to the ASC when the initial licensing
					 survey finds that the ASC is compliant with all licensing laws and regulations,
					 and is compliant with all other required statutes, laws, ordinances, rules,
					 regulations, and fees. The license shall be valid until the expiration date
					 shown on the license, unless the license is modified, revoked, suspended, or
					 terminated.
2. Provisional Initial
					 License. The department may issue a provisional initial license to the ASC when
					 the initial licensing survey finds that the ASC is noncompliant with any
					 licensing laws or regulations or any other required statutes, laws, ordinances,
					 rules, regulations or fees, but the department determines that the
					 noncompliance does not present a threat to the health, safety or welfare of the
					 patients.
3. Full Renewal License.
					 The department may issue a full renewal license to an existing licensed ASC
					 that is in substantial compliance with all applicable federal, state,
					 departmental, and local statutes, laws, ordinances, rules, regulations and
					 fees. The license shall be valid until the expiration date shown on the
					 license, unless the license is modified, revoked, suspended or
					 terminated.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter A - General Provisions › Section I-4513 - Changes in Licensee Information or Personnel

Current through Register Vol. 50, No. 6, June 20, 2024
A. An ASC license shall be valid only for the
					 person or entity named in the license application and only for the specific
					 geographic address listed on the license application.
B. Any permanent change regarding the entity
					 ASCs name, "doing business as" name, mailing address, telephone number, stated
					 days and hours of operation, or any combination thereof, shall be reported in
					 writing to the department within five business days of the change.
1. For any temporary closures of the ASC
					 greater than 24 hours, other than weekends or holidays, the ASC shall notify
					 HSS in advance.
2. At any time that
					 the ASC has an interruption in services or a change in the licensed location
					 due to an emergency situation, the ASC shall notify HSS no later than the next
					 stated business day.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter A - General Provisions › Section I-4515 - Renewal of License

Current through Register Vol. 50, No. 6, June 20, 2024
A. The ASC
					 shall submit a completed license renewal application packet to the department
					 at least 30 days prior to the expiration of the current license. The license
					 renewal application packet shall include:
1.
					 the license renewal application;
2.
					 the non-refundable license renewal fee;
3. the stated days and hours of
					 operation;
4. a current State Fire
					 Marshal report;
5. a current OPH
					 inspection report;
6. proof of each
					 insurance coverage as follows:
a. general
					 liability insurance of at least $300,000 per occurrence;
b. workers compensation insurance of at least
					 $100,000 as required by state law;
c.professional liability insurance of at
					 least $100,000 per occurrence/$300,000 per annual aggregate, or proof of
					 self-insurance of at least $100,000, along with proof of enrollment as a
					 qualified health care provider with the Louisiana Patient's Compensation Fund
					 (PCF):
i. if the ASC is not enrolled in the
					 PCF, professional liability limits shall be $1,000,000 per
					 occurrence/$3,000,000 per annual aggregate;
d. the LDH Health Standards Section shall
					 specifically be identified as the certificate holder on the any policies and
					 any certificates of insurance issued as proof of insurance by the insurer or
					 producer (agent);
7.
					 proof of a line of credit issued from a federally insured, licensed lending
					 institution in the amount of at least $100,000;
8. statement of attestation of ASC compliance
					 with the provisions of §4581; and
9. any other documentation required by the
					 department or CMS if applicable.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter A - General Provisions › Section I-4517 - Survey Activities

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 department may conduct periodic licensing surveys and other surveys as deemed
					 necessary to ensure compliance with all laws, rules and regulations governing
					 ASCs and to ensure patient health, safety and welfare. These surveys may be
					 conducted on-site or by administrative review and shall be
					 unannounced.
B. The department may
					 require an acceptable plan of correction from the ASC for any survey where
					 deficiencies have been cited, regardless of whether the department takes other
					 action against the ASC for the deficiencies cited in the survey. The acceptable
					 plan of correction shall be submitted for approval to the department within the
					 prescribed timeframe.
C. A
					 follow-up survey may be conducted for any survey where deficiencies have been
					 cited to ensure correction of the deficient practices.
D. The department may issue appropriate
					 sanctions for noncompliance, deficiencies and violations of law, rules and
					 regulations. Sanctions may include, but are not limited to:
1. civil fines;
2. directed plans of correction;
3. denial of license renewal;
					 and/or
4. license
					 revocation.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter A - General Provisions › Section I-4519 - Statement of Deficiencies

Current through Register Vol. 50, No. 6, June 20, 2024
A. Any
					 statement of deficiencies issued by the department to an ASC shall be available
					 for disclosure to the public 30 days after the ASC submits an acceptable plan
					 of correction to the deficiencies or 90 days after the statement of
					 deficiencies is issued to the ASC, whichever occurs first.
B. Unless otherwise provided in statute or in
					 these licensing provisions, the ASC shall have the right to an informal
					 reconsideration of any deficiencies cited as a result of a survey or
					 investigation.
1. Correction of the
					 violation, noncompliance or deficiency shall not be the basis for the
					 reconsideration.
2. The informal
					 reconsideration of the deficiencies shall be requested in writing within 10
					 calendar days of receipt of the statement of deficiencies, unless otherwise
					 provided in these standards.
3. The
					 request for informal reconsideration of the deficiencies shall be made to HSS
					 and will be considered timely if received by HSS within 10 calendar days of the
					 ASCs receipt of the statement of deficiencies.
4. If a timely request for an informal
					 reconsideration is received, the department shall schedule and conduct the
					 informal reconsideration. The ASC shall be notified in writing of the results
					 of the informal reconsideration.
5.
					 Except as provided for complaint surveys pursuant to
					 R.S.
					 40:2009.13 et seq., and as provided in these
					 licensing provisions for initial license denials, license revocations and
					 denial of license renewals, the decision of the informal reconsideration team
					 shall be the final administrative decision regarding the
					 deficiencies.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter A - General Provisions › Section I-4521 - Denial of Initial License, Revocation of License, Denial of License Renewal

Current through Register Vol. 50, No. 6, June 20, 2024
A. The department
					 may deny an application for an initial license or a license renewal, or may
					 revoke a license in accordance with the provisions of the Administrative
					 Procedure Act.
B. Denial of an
					 Initial License
1. The department shall deny
					 an initial license in the event that the initial licensing survey finds that
					 the ASC is noncompliant with any licensing laws or regulations, or any other
					 required statutes or regulations that present a potential threat to the health,
					 safety or welfare of the patients.
2. The department shall deny an initial
					 license for any of the reasons a license may be revoked or denied renewal
					 pursuant to these licensing provisions.
3. If the department denies an initial
					 license, the applicant for an ASC license shall not render services to
					 patients.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter A - General Provisions › Section I-4523 - Notice and Appeal of Initial License Denial, License Revocation and Denial of License Renewal

Current through Register Vol. 50, No. 6, June 20, 2024
A. Notice of an
					 initial license denial, license revocation or denial of license renewal shall
					 be given to the ASC in writing.
B.
					 The ASC has a right to an administrative reconsideration of the initial license
					 denial, license revocation or denial of license renewal. There is no right to
					 an informal reconsideration of a voluntary non-renewal or surrender of a
					 license by the ASC.
1. The request for the
					 administrative reconsideration shall be submitted within 15 days of the receipt
					 of the notice of the initial license denial, license revocation or denial of
					 license renewal. The request for administrative reconsideration shall be in
					 writing and shall be forwarded to HSS.
2. The request for administrative
					 reconsideration shall include any documentation that demonstrates that the
					 determination was made in error.
3.
					 If a timely request for an administrative reconsideration is received by HSS,
					 an administrative reconsideration shall be scheduled and the ASC will receive
					 written notification of the date of the administrative
					 reconsideration.
4. The ASC shall
					 have the right to appear in person at the administrative reconsideration and
					 may be represented by counsel.
5.
					 Correction of a violation or deficiency which is the basis for the initial
					 license denial, revocation or denial of license renewal shall not be a basis
					 for reconsideration.
6. The
					 administrative reconsideration process is not in lieu of the administrative
					 appeals process.
7. The ASC will be
					 notified in writing of the results of the administrative
					 reconsideration.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter A - General Provisions › Section I-4525 - Cessation of Business

Current through Register Vol. 50, No. 6, June 20, 2024
A. Except as
					 provided in §4583 and §4585 of these licensing regulations, a license
					 shall be immediately null and void if an ASC ceases to operate.
B. A cessation of business is deemed to be
					 effective the date on which the ASC stopped offering or providing services to
					 the community.
C. Upon the
					 cessation of business, the ASC shall immediately return the original license to
					 the department.
D. Cessation of
					 business is deemed to be a voluntary action on the part of the ASC. The ASC
					 does not have a right to appeal a cessation of business.
E. The ASC shall notify the department in
					 writing 30 days prior to the effective date of the closure or cessation. In
					 addition to the notice, the ASC shall submit a written plan for the disposition
					 of patient medical records for approval by the department. The plan shall
					 include the following:
1. the effective date
					 of the closure;
2. provisions that
					 comply with federal and state laws on storage, maintenance, access and
					 confidentiality of the closed providers patients medical records; and
3. appointed custodian(s) who shall provide
					 the following:
a. access to records and copies
					 of records to the patient or authorized representative, upon presentation of
					 proper authorization(s); and
b.
					 physical and environmental security that protects the records against fire,
					 water, intrusion, unauthorized access, loss and destruction;
4. public notice regarding access
					 to records, in the newspaper with the largest circulation in close proximity to
					 the closing provider, at least 15 days prior to the effective date of
					 closure.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter B - Administration and Organization › Section I-4531 - Governing Body

Current through Register Vol. 50, No. 6, June 20, 2024
A. An ASC shall
					 have an identifiable governing body with responsibility for, and authority
					 over, the policies and activities of the ASC, which shall include use
					 agreements and all contracts. The governing body is the ultimate governing
					 authority of the ASC and shall adopt bylaws which address its responsibilities.
					 No contract or other arrangements, including use agreements, shall limit or
					 diminish the responsibilities of the governing body.
B. An ASC shall have documents identifying
					 the following information regarding the governing body:
1. names and addresses of all
					 members;
2. terms of
					 membership;
3. officers of the
					 governing body; and
4. terms of
					 office for any officers.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter B - Administration and Organization › Section I-4533 - Policy and Procedures

Current through Register Vol. 50, No. 6, June 20, 2024
A. An ASC,
					 through collaboration by the administrator, medical staff, director of nursing,
					 pharmacist, and other professional persons deemed appropriate by the ASC, shall
					 develop, implement and maintain written policies and procedures governing all
					 services rendered at the ASC. The ASC shall comply with all federal and state
					 laws, rules and regulations in the development and implementation of its
					 policies and procedures.
B. All
					 policies and procedures shall be reviewed at least annually and revised as
					 needed.
C. Direct care and medical
					 staff shall have access to information concerning patients that is necessary
					 for effective performance of the employees assigned tasks.
D. The ASC shall have written policies and
					 procedures for the maintenance and security of records specifying who shall
					 supervise the maintenance of records, who shall have custody of records and to
					 whom records may be released.
E.
					 The ASC shall allow designated representatives of the department, in the
					 performance of their mandated duties, to:
1.
					 inspect all aspects of an ASCs operations which directly or indirectly impact
					 patients; and
2. interview any
					 physician, staff member or patient.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter C - Admissions, Transfers and Discharges › Section I-4539 - Admissions and Assessments

Current through Register Vol. 50, No. 6, June 20, 2024
A. Each ASC
					 shall have written admission and assessment policies and criteria.
B. An individual or entity that enters into a
					 use agreement with a licensed ASC shall be required to adhere to all of the
					 provisions of this Section.
C. An
					 ASC shall ensure that each patient has the appropriate pre-surgical and
					 post-surgical assessments completed, inclusive of suitability for less than
					 23-hour timeframe of patient stay, ability of the ASC to provide services
					 needed in the post-operative period in accordance with prescribed plan of care,
					 and discharge plans to home or another licensed facility setting.
D. Within 30 days prior to the date of the
					 scheduled surgery, each patient shall have a comprehensive medical history and
					 physical assessment completed by a physician or other qualified licensed
					 professional practitioner in accordance with applicable state health and safety
					 laws, ASC policies, and standards of practice.
E. The history and physical assessment prior
					 to surgery shall specify that the patient is medically cleared for surgery in
					 an ambulatory setting and is required on all patients regardless of whether the
					 patient is referred for surgery on the same day that the referral is made and
					 the referring physician has indicated that it is medically necessary for the
					 patient to have the surgery on the same day.
F. Upon admission, each patient shall have a
					 pre-surgical assessment completed by a physician or other qualified licensed
					 health practitioner. The pre-surgical assessment shall include, at a minimum:
1. an updated medical record entry
					 documenting an examination for any changes in the patients condition since
					 completion of the most recently documented medical history and physical
					 assessment; and
2. documentation of
					 any known allergies to drugs and/or biological agents.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter C - Admissions, Transfers and Discharges › Section I-4541 - Transfer Agreements and Patient Transfers

Current through Register Vol. 50, No. 6, June 20, 2024
A. The ASC shall secure a written transfer
					 agreement with at least one licensed hospital in the community. A transfer
					 agreement shall serve as evidence of a procedure whereby patients can be
					 transferred to a hospital should an emergency arise which would necessitate
					 hospital admission.
1. - 2.
					 Repealed.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter C - Admissions, Transfers and Discharges › Section I-4543 - Discharges

Current through Register Vol. 50, No. 6, June 20, 2024
A. Each ASC shall
					 have written discharge policies and procedures. The written description of
					 discharge policies shall be provided to the department upon request and made
					 available to the patient or his/her legal representative. The ASC shall ensure
					 that all elements of the discharge requirements are completed.
B. Any individual or entity that enters into
					 a use agreement with a licensed ASC shall be required to adhere to all of the
					 provisions of this Section.
C. The
					 post-surgical needs of each patient shall be addressed and documented in the
					 discharge notes.
D. Upon discharge,
					 the ASC shall:
1. provide each patient with
					 written discharge instructions;
2.
					 provide each patient with all supplies deemed medically necessary per the
					 discharge orders, excluding medications;
3. make the follow-up appointment with the
					 physician, when appropriate; and
4.
					 ensure that all patients are informed, either in advance of their surgical
					 procedure or prior to leaving the ASC, of the following:
a. necessary prescriptions;
b. post-operative instructions; and
c. physician contact information for
					 follow-up care.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter D - Service Delivery › Section I-4549 - Surgical Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. Surgical
					 services shall be well organized and provided in accordance with current
					 acceptable standards of practice adopted from national associations or
					 organizations.
B. Private areas
					 should include pre- and post-operative care areas and should allow for parental
					 presence for pediatric patients.
C.
					 The ASC shall ensure that the scheduled surgeries do not exceed the
					 capabilities of the surgical center, including the post-anesthesia care area,
					 and any length of patient does not exceed 23 hours from patient admission to
					 discharge from the ASC.
D. At least
					 one RN trained in the use of emergency equipment and certified in advanced
					 cardiac life support (ACLS) and/or pediatric advanced life support (PALS), if a
					 pediatric patient is present, shall be immediately available whenever there is
					 a patient in the ASC.
E. A roster
					 of physicians and other medical practitioners, specifying the surgical
					 privileges of each, shall be kept in the surgical center and available to all
					 professional staff.
F. Medical
					 staff and approved policies shall define which surgical procedures require a
					 qualified first assistant physician, registered nurse or surgical technician.
1. A registered nurse or a surgical
					 technician may be a surgical assistant if the individual:
a. has been approved by the medical director
					 and director of nurses;
b. has
					 documented competency and training to assist in such procedures; and
c. is acting within the scope of practice of
					 his/her respective licensing board(s) and/or certification(s).
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter D - Service Delivery › Section I-4551 - Anesthesia Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. Anesthesia
					 services shall be available when surgical services are provided.
B. Anesthesia services shall be provided in a
					 well-organized manner under the direction of an anesthesiologist or the
					 treating physician who is licensed and in good standing with the State Board of
					 Medical Examiners.
C. Anesthesia
					 services and/or conscious sedation shall be administered by licensed
					 practitioners with clinical privileges for which they have been licensed,
					 trained and determined to be competent to administer anesthesia and/or
					 conscious sedation in accordance with their respective state licensing
					 board.
D. Anesthesia and conscious
					 sedation may be administered by the following practitioners who are qualified
					 to administer anesthesia under state law and within the scope of their
					 practice:
1. anesthesiologists;
2. doctors of medicine or
					 osteopathy;
3. dentists or oral
					 surgeons;
4. podiatrists;
5. certified registered nurse anesthetists
					 (CRNAs) licensed by the State Board of Nursing who are under the supervision of
					 a physician or an anesthesiologist who is immediately available if needed, as
					 defined in the medical staff bylaws; and
6. registered nurses who have documented
					 education and demonstrated competency to administer minimal or moderate
					 sedation in accordance with the Nurse Practice Act, and who are under the
					 supervision of the treating physician.
a. The
					 RN (non-CRNA) monitoring the patient shall have no additional responsibility
					 that would require leaving the patient unattended or would compromise
					 continuous monitoring during the procedure.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter D - Service Delivery › Section I-4555 - Laboratory Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. The ASC
					 shall either provide a clinical laboratory directly or make contractual
					 arrangements with a laboratory certified in accordance with the clinical
					 laboratory improvement amendments to perform services commensurate with the
					 needs of the ASC.
B. Contractual
					 arrangements for laboratory services shall be deemed as meeting the
					 requirements of this Section when those arrangements contain written policies
					 and procedures defining the scope of services.
C. When laboratory services are provided
					 directly by the ASC, the services shall be performed by a qualified and/or
					 licensed person with documented training and experience to supervise and
					 perform the testing.
1. The ASC shall have
					 sufficient numbers of licensed clinical laboratory and supportive technical
					 staff to perform the required tests.
2. The laboratory shall be of sufficient size
					 and adequately equipped to perform the necessary services of the ASC.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter D - Service Delivery › Section I-4557 - Pharmaceutical Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. The ASC
					 shall provide pharmacy services commensurate with the needs of the patients and
					 in conformity with state and federal laws. Pharmacy services may be provided
					 directly by the ASC or under a contractual agreement as long as all regulatory
					 requirements are met.
1. At a minimum, the
					 ASC shall designate a qualified and licensed healthcare professional to provide
					 direction to the ASCs pharmaceutical service.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter D - Service Delivery › Section I-4559 - Stereotactic Radiosurgery Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. Ambulatory surgical centers operated
					 primarily for the purpose of offering stereotactic radiosurgery by use of a
					 gamma knife or similar neurosurgical tool are exempt from the following
					 requirements:
1. having a minimum of two
					 operating/procedure rooms and one post-anesthesia recovery room within the
					 ASC;
2. caseload shall not exceed
					 the capabilities of the surgical center including the recovery room;
3. the surgical area shall be located within
					 the facility as to be removed from the general lines of traffic of both
					 visitors and other ASC personnel; and
4. the following requirements:
a. scrub station(s) shall be provided
					 directly adjacent to the entrance to each operating or procedure
					 room;
b. a scrub station may serve
					 two operating or procedure rooms if it is located directly adjacent to the
					 entrances to both; and
c. scrub
					 stations shall be arranged to minimize splatter on nearby personnel or supply
					 carts.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter E - Facility Responsibilities › Section I-4565 - General Provisions

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 Ambulatory surgical centers shall comply and show proof of compliance with all
					 relevant federal, state, local rules and regulations. It is the ASCs
					 responsibility to secure the necessary approvals from the following entities:
1. Health Standards Section;
2. Office of the State Fire Marshals plan
					 review;
3. Office of Public
					 Health;
4. Office of the State Fire
					 Marshals
Life Safety Code
inspection; and
5. the applicable local governing authority
					 (e.g., zoning, building department or permit office).
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter E - Facility Responsibilities › Section I-4567 - Staffing Requirements

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 Administrative Staff. The following administrative staff is required for all
					 ASCs:
1. a qualified administrator at each
					 licensed geographic location who shall meet the qualifications as established
					 in these provisions;
2. other
					 administrative staff as necessary to operate the ASC and to properly safeguard
					 the health, safety and welfare of the patients receiving services;
					 and
3. an administrative staff
					 person on-call after routine daytime or office hours for the length of any
					 patient stay in the ASC.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter E - Facility Responsibilities › Section I-4569 - Medical Records

Current through Register Vol. 50, No. 6, June 20, 2024
A. Each ASC
					 shall make provisions for securing medical records of all media types, whether
					 stored electronically or in paper form. The identified area or equipment shall
					 be secured to maintain confidentiality of records and shall be restricted to
					 staff movement and remote from treatment and public areas.
B. All records shall be protected from loss
					 or damage.
C. The ASC shall have a
					 designated area located within the ASC which shall provide for the proper
					 storage, protection and security for all medical records and
					 documents.
D. The ASC shall develop
					 a unique medical record for each patient. Records may exist in hard copy,
					 electronic format or a combination thereof.
E. ASCs that enter into a use agreement shall
					 integrate the medical records of patients into the medical records of the ASC
					 and shall comply with all requirements of this Section.
F. The ASC shall ensure the confidentiality
					 of patient records, including information in a computerized medical record
					 system, in accordance with the Health Insurance Portability and Accountability
					 Act (HIPAA) regulations and any state laws, rules and regulations.
1. If computerized records are used, the ASC
					 shall develop:
a. a back-up system for
					 retrieval of critical medical records;
b. safeguards/firewalls to prevent
					 unauthorized use and access to information; and
c. safeguards/firewalls to prevent
					 alterations of electronic records.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter E - Facility Responsibilities › Section I-4571 - Other Records and Reports

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 following indexes, records and registers shall be required of the licensed ASC,
					 including any individual or entity that enters into a use agreement:
1. a patients register;
2. an operating/procedure room
					 register;
3. a death
					 register;
4. a daily census report
					 of admissions and discharges;
5.
					 records of reportable diseases as required by state and/or federal
					 regulations;
6. a laboratory log
					 denoting laboratory specimens that are sent to pathology:
a. the laboratory log shall include, at a
					 minimum, the following information:
i. the
					 patients name;
ii. the specimen
					 site; and
iii. the date the
					 specimen was sent for pathology interpretation; and
7. an implant log, when
					 appropriate.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter E - Facility Responsibilities › Section I-4573 - Quality Assurance and Performance Improvement

Current through Register Vol. 50, No. 6, June 20, 2024
A. The governing body shall ensure that there
					 is an implemented, maintained, effective, written, data-driven and ongoing
					 program designed to assess and improve the quality of patient care. This
					 program shall include all services, provided directly or through contract, and
					 those services provided under a use agreement, where applicable.
B. The governing body shall ensure that it
					 allocates sufficient staff, time, information systems and training to implement
					 the Quality Assurance and Performance Improvement (QAPI) Program.
C. The ASC shall ensure there is a written
					 quality assurance plan for assessing and improving quality of care that is
					 focused on high risk, high volume and problem-prone areas, and which specifies
					 the intervals that the ASC shall actively collect data related to the quality
					 indicators. Performance improvement activities shall consider incidence,
					 prevalence and severity of problems and those that can affect health outcomes,
					 patient safety and quality of care. The plan shall describe the system for
					 overseeing and analyzing the effectiveness of monitoring, evaluation and
					 sustained improvement activities. All services related to patient care,
					 including services furnished by a contractor or under a use agreement, shall be
					 evaluated.
D. Nosocomial
					 infections, patient care outcomes, surgical services and other invasive
					 procedures performed in the ASC shall be evaluated as they relate to
					 appropriateness of diagnosis and treatment.
E. The services provided by each licensed
					 practitioner with ASC privileges shall be periodically evaluated to determine
					 whether they are of an acceptable level of quality and appropriateness and in
					 accordance with medical staff bylaws/rules and regulations.
F. Quality assurance and performance
					 improvement shall include monitoring of in-line gases.
G. The QAPI program shall monitor, identify
					 and develop a plan for elimination of medication errors and adverse patient
					 events.
H. Corrective actions to
					 problems identified through the QAPI program with on-going monitoring for
					 sustained corrective action shall be documented. All QAPI data shall be
					 documented and remain within the ASC. Staff education and training related to
					 the correction of problems shall be documented.
I. The number and scope of distinct QAPI
					 improvement projects conducted annually shall reflect the scope and complexity
					 of the ASCs services and operations.
J. The ASC shall document the projects that
					 are being conducted. The documentation, at a minimum, shall include:
1. the reason(s) for implementing the
					 project; and
2. a description of
					 the projects results.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 45 - Ambulatory Surgical Center › Subchapter F - Safety, Sanitization and Emergency Preparedness › Section I-4575 - General Provisions

Current through Register Vol. 50, No. 6, June 20, 2024
A. The ASC
					 shall have policies and procedures, approved and implemented by the medical
					 staff and governing body, that address provisions for:
1. sanitizing, disinfecting and sterilizing
					 supplies, equipment and utensils;
2. the safe use of cleaning supplies and
					 solutions that are to be used and the directions for use, including:
a. ...
b. cleaning of the OR/procedure rooms between
					 surgical and nonsurgical procedures; and
3. surgical smoke plume evacuation to
					 mitigate and remove surgical smoke plume during a surgical procedure that uses
					 heat-producing equipment, including but not limited to electrosurgery and
					 lasers.