reglab/statecodes huggingface dataset:
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 42 - Adult Day Health Care › Subchapter H - Direct Service Management › Section I-4273 - Admissions

Current through Register Vol. 50, No. 6, June 20, 2024
A. A center shall
					 have a written description of its admission policies and criteria. The
					 admission information for individual participants shall include:
1. the participant's name, date of birth,
					 home address and telephone number;
2. the name, address and telephone number of
					 the participant's closest relative or friend;
3. a brief social history that includes the
					 participant's marital status, general health status, education, former
					 occupation, leisure-time interest and existence of supportive family members or
					 friends;
4. the name, address and
					 telephone number of the participant's physician and/or medical center as well
					 as the date of participant's last physical exam;
5. a nursing assessment summary performed by
					 the center's RN or LPN at the time of the participant's admission to the center
					 which includes:
a. special dietary
					 needs;
b. prescribed
					 medication;
c. allergies;
d. any limitations on activity;
e. the degree to which the participant is
					 ambulant;
f. visual or hearing
					 limitations and/or other physical impairments;
g. apparent mental state or degree of
					 confusion or alertness;
h. the
					 ability to control bowel or bladder;
i. the ability to feed self;
j. the ability to dress self; and
k. the ability to self-administer medication.
NOTE: A current version of the interRAI Home Care (iHC)
						assessment can be used in place of the nursing assessment summary.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 42 - Adult Day Health Care › Subchapter H - Direct Service Management › Section I-4275 - Discharge

Current through Register Vol. 50, No. 6, June 20, 2024
A. The center shall
					 have written policies and procedures governing voluntary discharges (the
					 participant withdraws from the program on his/her own) and non-voluntary
					 discharges (center initiated discharges).
1.
					 The policy may include the procedures for non-voluntary discharges due to the
					 health and safety of the participant or that of other participants if they
					 would be endangered by the further stay of a particular participant in the
					 center.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 42 - Adult Day Health Care › Subchapter H - Direct Service Management › Section I-4277 - Interdisciplinary Team Responsibilities

Current through Register Vol. 50, No. 6, June 20, 2024
A. It shall be the responsibility of the ID
					 team to assess and develop an individualized service plan for each participant
					 prior to or within 20 days of admission of a participant.
B. Prior to the individual staffing of a
					 participant by the ID team, each team member shall complete an assessment to be
					 used at the team meeting. This assessment shall, at a minimum, include a
					 physical assessment and a social evaluation.
C. The ID team shall meet, reassess, and
					 reevaluate each participant at least quarterly to review the individualized
					 service plan to ensure that it is sufficient for each participant.
D. The ID team shall make referrals, as
					 indicated, to other disciplines and for any service which would enhance the
					 functional capacity of a participant.
AUTHORITY NOTE:
						Promulgated in accordance with R.S. 36:254 and
						40:2120.41-46.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 42 - Adult Day Health Care › Subchapter H - Direct Service Management › Section I-4279 - Interdisciplinary Team-Composition

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 ID team may be composed of either full-time staff members, contractual
					 consultants or a combination of both.
B. The ID team shall be composed of:
1. a registered nurse licensed to practice in
					 the state of Louisiana ;
2. a
					 social service designee/social worker; and
3. at least one direct care staff person from
					 the center.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 42 - Adult Day Health Care › Subchapter H - Direct Service Management › Section I-4281 - Individualized Service Plan

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 participant's ADHC individualized service plan shall:
1. be developed from the staffing performed
					 by the ID team of each participant;
2. state the individual needs and identified
					 problems of the participant for which intervention is indicated in assessments,
					 progress notes and medical reports;
3. include the number of days and time of
					 scheduled attendance required to meet the needs of the participant;
4. use the strengths of the participant to
					 develop approaches and list these approaches with the frequency that each will
					 be used to meet the needs of the participant;
5. identify the staff member who will be
					 responsible for carrying out each item in the plan (the position, rather than
					 the name of the employee, may be indicated in the plan);
6. ensure that all persons working with the
					 participant are appropriately informed of the services required by the
					 individualized service plan;
7.
					 propose a reasonable time-limited goal with established priorities. The
					 projected resolution date or review date for each problem shall be
					 noted;
8. contain the necessary
					 elements of the self-administration or other medication administration plan, if
					 applicable;
9. include discharge as
					 a goal;
10. be legible and written
					 in terminology which all staff personnel can understand;
11. be signed and dated by all the team
					 members; and
12. be included as a
					 part of the participant's case record.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 42 - Adult Day Health Care › Subchapter H - Direct Service Management › Section I-4283 - Individualized Service Plan Review

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 The individualized service plan shall be reviewed and updated at least
					 quarterly and whenever there is a change in problems, goals or approaches as
					 indicated.
B. This review shall be
					 done by the person indicated on the plan as the individual primarily
					 responsible for carrying out the plan.
C. This review shall be accomplished by
					 reviewing the individual reports of all persons responsible for meeting the
					 needs of the participant. These reports shall include any reports from
					 physicians, social service designees/social workers, nurses, therapists,
					 dietitians, and family members as well as incident reports.
AUTHORITY NOTE:
						Promulgated in accordance with R.S. 36:254 and
						40:2120.41-46.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 42 - Adult Day Health Care › Subchapter I - Emergency and Safety › Section I-4285 - Emergency and Safety Procedures

Current through Register Vol. 50, No. 6, June 20, 2024
A. A
					 center shall have a written overall plan of emergency and safety procedures.
					 The plan shall:
1. provide for the evacuation
					 of participants to safe or sheltered areas;
2. include provisions for training staff and,
					 as appropriate, participants in preventing, reporting and responding to fires
					 and other emergencies;
3. provide
					 means for an on-going safety program including continuous inspection of the
					 center for possible hazards, continuous monitoring of safety equipment, and
					 investigation of all accidents or emergencies; and
4. include provisions for training personnel
					 in their emergency duties and in the use of any fire-fighting or other
					 emergency equipment in their immediate work areas.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 42 - Adult Day Health Care › Subchapter I - Emergency and Safety › Section I-4287 - General Safety Practices

Current through Register Vol. 50, No. 6, June 20, 2024
A. A center
					 shall not maintain any firearms or chemical weapons where participants may have
					 access to them.
B. A center shall
					 ensure that all poisonous, toxic and flammable materials are safely stored in
					 appropriate containers that are labeled as to the contents. Such materials
					 shall be maintained only as necessary and shall be used in such a manner as to
					 ensure the safety of participants, staff and visitors.
C. The center shall not have less than two
					 remote exits.
D. Doors in means of
					 egress shall swing in the direction of exit travel.
E. Every bathroom door lock shall be designed
					 to permit opening of the locked door from the outside in an emergency, and the
					 opening device shall be readily accessible to the staff.
F. Unvented or open-flame heaters shall not
					 be utilized in center.
G. All
					 exterior and interior doors used by participants shall be at least 32 inches
					 wide.
H. All hallways/corridors
					 shall be at least 36 inches wide.
I. At least one primary entrance shall be
					 accessible to people with disabilities or impairments.
AUTHORITY NOTE:
						Promulgated in accordance with R.S. 36:254 and
						40:2120.41-46.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 42 - Adult Day Health Care › Subchapter J - Physical Environment › Section I-4289 - General Appearance and Conditions

Current through Register Vol. 50, No. 6, June 20, 2024
A. The center shall present an attractive
					 outside and inside appearance and be designed and furnished with consideration
					 for the special needs and interests of the population to be served as well as
					 the activities and services to be provided.
1. Illumination levels in all areas shall be
					 adequate and careful attention shall be given to avoiding glare.
2. The design shall facilitate the
					 participant's movement throughout the center and involvement in activities and
					 services.
3. Heating, cooling and
					 ventilation system(s) shall permit comfortable conditions.
4. Sufficient furniture shall be available to
					 facilitate usage by the entire participant population in attendance.
5. Furniture and equipment that will be used
					 by participants shall be selected for comfort and safety as well as be
					 appropriate for use by persons with visual and mobility limitations, and other
					 physical disabilities.
6. Floors
					 and steps shall have a non-slippery surface and be dry when in use by the
					 participants. Doorways and passageways shall be kept clear to allow free and
					 unhindered passage.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 42 - Adult Day Health Care › Subchapter J - Physical Environment › Section I-4291 - Space Requirements

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 center shall have sufficient space and equipment to accommodate the full range
					 of program activities and services.
B. The center shall provide at least 40
					 square feet of indoor space for each participant. The square footage excludes
					 hallways, offices, restrooms, storage rooms, kitchens, etc.
C. The center shall be flexible and adaptable
					 for large and small groups and individual activities and services.
D. There shall be sufficient office space to
					 permit staff to work effectively and without interruption.
E. There shall be adequate storage space for
					 program and operating supplies.
F.
					 There shall be sufficient parking area available for the safe daily delivery
					 and pick-up of participants.
AUTHORITY NOTE:
						Promulgated in accordance with R.S. 36:254 and
						40:2120.41-46.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 42 - Adult Day Health Care › Subchapter J - Physical Environment › Section I-4293 - ADHC Furnishings

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 center shall be furnished so as to meet the needs of the participants. All
					 furnishings and equipment shall be kept clean and in good repair.
B. Lounge and Recreational Areas. Adequate
					 furniture shall be available and shall be appropriate for use by the
					 participants in terms of comfort and safety.
C. Dining Area. Furnishings shall include
					 tables and comfortable chairs sufficient in number to serve all participants.
					 Meals may be served either cafeteria style or directly at the table depending
					 upon the method of food preparation or physical condition of the
					 participants.
D. Kitchen. If the
					 center has a kitchen area, it shall meet all health and sanitation requirements
					 and shall be of sufficient size to accommodate meal preparation for the
					 proposed number of participants.
E. Toilet Facilities. There shall be
					 sufficient toilet and hand-washing facilities to meet the needs of both males
					 and females. The number of toilets and hand- washing facilities shall be not
					 less than one for each 12 participants.
1.
					 There shall be at least two toilet facilities when males and females are
					 served.
2. Toilets and hand-washing
					 facilities shall be equipped so as to be accessible for people with
					 disabilities.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 42 - Adult Day Health Care › Subchapter J - Physical Environment › Section I-4295 - Location of Center

Current through Register Vol. 50, No. 6, June 20, 2024
A. An adult day
					 health care center that is located within any center or program that is also
					 licensed by the department shall have its own identifiable staff, space, and
					 storage. These centers shall meet specific requirements if they are located
					 within the same physical location as another program that is also licensed by
					 the department.
1. The program or center
					 within which the ADHC center is located shall meet the requirements of its own
					 license.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 44 - Abortion Facilities › Subchapter A - General Provisions › Section I-4403 - General Licensing Provisions

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 It shall be unlawful for outpatient abortion facility's in the initial
					 licensing application process to accept patients or provide abortion services
					 until licensed by the Department of Health and Hospitals (DHH). The department
					 is the only licensing authority for outpatient abortion facility's in
					 Louisiana.
B. Types of Licenses.
					 The department shall have the authority to issue the following types of
					 licenses:
1. full initial license;
2. provisional initial license;
3. full renewal license; and
4. provisional license.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 44 - Abortion Facilities › Subchapter A - General Provisions › Section I-4405 - Initial Licensing Application Process

Current through Register Vol. 50, No. 6, June 20, 2024
A. The initial licensing application process
					 requires submission and approval of plans and specifications (construction
					 documents) and requires submission and approval of an initial licensing
					 application packet, including but not limited to, a facility need review
					 approval letter. No outpatient abortion facility shall accept patients or
					 provide abortion services until in compliance with the provisions of this
					 Chapter.
B. Plan Review Approval.
					 All plans and specifications (construction documents) submitted by, or on
					 behalf of, the outpatient abortion facility are required to be submitted and
					 approved by the Office of State Fire Marshal (OSFM) as part of the licensing
					 application process.
C. Initial
					 Licensing Application Packet. An initial licensing application packet for an
					 outpatient abortion facility shall be obtained from the department. A complete
					 initial licensing application packet shall be submitted to the department for
					 approval and onsite survey. The applicant may not provide outpatient abortion
					 services until properly licensed by the department.
D. To be considered complete, the initial
					 licensing application packet shall include the following:
1. a completed outpatient abortion facility
					 initial licensing application and the non-refundable initial licensing
					 fee;
2. a copy of the approval
					 letter of the architectural facility plans for the outpatient abortion facility
					 by the OSFM;
3. a copy of the
					 on-site inspection report with approval for occupancy from the OSFM;
4. a copy of the health inspection report
					 from the Office of Public Health (OPH);
5. an organizational chart identifying the
					 name, position, and title of each person composing the governing body and key
					 administrative personnel;
6. a
					 floor sketch or drawing of the premises to be licensed;
7. pursuant to
					 R.S.
					 40:2116, a copy of the facility need review
					 approval letter; and
8. any other
					 documentation or information required by the department for licensure,
					 including but not limited to, a copy of any waiver approval letter, if
					 applicable.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 44 - Abortion Facilities › Subchapter A - General Provisions › Section I-4407 - Survey Activities

Current through Register Vol. 50, No. 6, June 20, 2024
A. Any
					 applicant or outpatient abortion facility shall be subject to licensing surveys
					 conducted by department surveyors to ensure that an applicant or outpatient
					 abortion facility is in compliance with all applicable federal, state, and
					 local statutes, laws, rules, regulations, and ordinances, including department
					 rules, regulations, and fees, governing or relating to outpatient abortion
					 facility's, abortion or termination procedures, reporting requirements,
					 ultrasound requirements, informed consent requirements or any other matter
					 addressed by law related to abortion or abortion procedures, and also to ensure
					 there is no present threat to the health, safety, and welfare of the
					 patient.
B. Any applicant or
					 outpatient abortion facility subject to licensing surveys conducted by the
					 department shall:
1. allow department
					 surveyors access to any and all requested documents and information on the
					 licensed premises, including, but not limited to, patient medical records and
					 outpatient abortion facility records that are relevant or necessary for the
					 survey;
2. allow department
					 surveyors access to interview any staff or other persons as necessary or
					 required; and
3. not interfere with
					 or impede the survey process for department surveyors while conducting any
					 survey.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 44 - Abortion Facilities › Subchapter A - General Provisions › Section I-4409 - Changes in Outpatient Abortion Facility Information or Key Administrative Personnel

Current through Register Vol. 50, No. 6, June 20, 2024
A. An
					 outpatient abortion facility license shall be valid for the person or entity
					 named as the outpatient abortion facility and for the physical address provided
					 by the applicant on the initial licensing application or by the outpatient
					 abortion facility in the licensing renewal application submitted to the
					 department.
B. Change of
					 Information. Any change regarding the outpatient abortion facility's entity
					 name, "doing business as" name, mailing address, telephone number, or any
					 combination thereof, shall be reported in writing to the department within five
					 calendar days of the change. Any change regarding the entity name or "doing
					 business as" name requires a change to the outpatient abortion facility license
					 and shall require a $25 fee for the issuance of an amended license.
C. Change of Key Administrative Personnel.
					 Any change regarding the outpatient abortion facility's key administrative
					 personnel shall be reported in writing to the department within five calendar
					 days of the change. For the purposes of this Chapter, key administrative
					 personnel includes the administrator and medical director, and the outpatient
					 abortion facility shall provide the individuals name, hire date, and
					 qualifications as defined in this Chapter.
D. Change of Ownership. A change of ownership
					 (CHOW) of an outpatient abortion facility shall be reported in writing to the
					 department at least five calendar days prior to the change. Within five
					 calendar days following the change, the new owner shall submit to HSS all legal
					 documents relating to the CHOW, an initial licensing application packet, and
					 the non-refundable initial licensing fee. Once all required documentation and
					 information is submitted and complete, HSS will review. If the CHOW is
					 approved, the department shall issue a new license in the name of the new
					 owner.
1. If the department has issued a
					 notice of license revocation, denial of renewal, provisional license, or a
					 notice of immediate suspension at the time the CHOW is submitted, the
					 department shall deny the CHOW.
2.
					 If there are any outstanding fees, fines, or monies owed to the department by
					 the existing licensed entity, the CHOW will be suspended until payment of all
					 outstanding amounts.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 44 - Abortion Facilities › Subchapter A - General Provisions › Section I-4411 - License Renewal Application Process

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 License Renewal Application Packet. A license renewal application packet for an
					 outpatient abortion facility shall be obtained from the department. A complete
					 license renewal application packet shall be submitted to the department at
					 least 30 calendar days prior to the expiration of the current
					 license.
B. To be considered
					 complete, the license renewal application packet shall include the following:
1. a completed outpatient abortion facility
					 license renewal application and the non-refundable license renewal
					 fee;
2. a copy of the most current
					 on-site inspection report with approval for occupancy from the OSFM;
3. a copy of the most current health
					 inspection report with recommendation for licensing from the OPH;
4. payment of any outstanding fees, fines, or
					 monies owed to the department; and
5. any other documentation required by the
					 department for licensure.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 44 - Abortion Facilities › Subchapter A - General Provisions › Section I-4413 - Cessation of Business

Current through Register Vol. 50, No. 6, June 20, 2024
A. Outpatient
					 Abortion Facility Duties and Responsibilities. An outpatient abortion facility
					 that voluntarily closes or ceases operations is considered to have surrendered
					 its license to operate.
B. Except
					 as provided in
					 §4453 of these
					 licensing regulations, a license shall be immediately null and void if an
					 outpatient abortion facility ceases to operate.
C. A cessation of business is deemed to be
					 effective the date on which the facility stopped offering or providing services
					 to the community.
D. Upon the
					 cessation of business, the facility shall immediately return the original
					 license to the department.
E.
					 Cessation of business is deemed to be a voluntary action on the part of the
					 facility. The outpatient abortion facility does not have a right to appeal a
					 cessation of business.
1. Notice of Cessation
					 of Business. To the extent possible, the outpatient abortion facility shall
					 provide advanced written notice of its cessation of business at least 30
					 calendar days prior to the date it intends to cease business operations. The
					 notice of cessation of business must be provided to all the outpatient abortion
					 facility's staff, including the medical director, to any patient having an
					 abortion procedure within the last 30 days of operation, and to HSS.
2. In addition to the notice, the outpatient
					 abortion facility shall submit a written plan for the disposition of patient
					 medical records for approval by the department. The plan shall include the
					 following:
a. the effective date of the
					 closure;
b. provisions that comply
					 with federal and state laws on storage, maintenance, access, and
					 confidentiality of the closed providers patients medical records;
c. the name of an appointed custodian(s) who
					 shall provide the following:
i. access to the
					 records and copies of the records to the patient or authorized representative,
					 upon presentation of proper authorization(s); and
ii. physical and environmental security that
					 protects the records against fire, water, intrusion, unauthorized access, loss,
					 and destruction; and
d.
					 public notice regarding access to records, in the newspaper with the largest
					 circulation in close proximity to the closing facility, 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 44 - Abortion Facilities › Subchapter A - General Provisions › Section I-4415 - Denial of an Initial License, Denial of License Renewal Application, and License Revocation

Current through Register Vol. 50, No. 6, June 20, 2024
A. Denial
					 of an Initial License
1. The department shall
					 deny an initial license in the event that the initial licensing survey finds
					 that the outpatient abortion facility is not in compliance with all applicable
					 federal, state, and local statutes, laws, rules, regulations, and ordinances,
					 including department rules, regulations, and fees, governing or relating to
					 outpatient abortion facility's, abortion or termination procedures, reporting
					 requirements, ultrasound requirements, informed consent requirements or any
					 other matter addressed by law related to abortion or abortion procedures, and a
					 potential threat to the health, safety, and welfare of the patients is
					 presented.
2. The department shall
					 deny an initial license for any of the reasons a license may be revoked or
					 non-renewed pursuant to the provisions of this Chapter.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 44 - Abortion Facilities › Subchapter A - General Provisions › Section I-4417 - Immediate Suspension of License

Current through Register Vol. 50, No. 6, June 20, 2024
A. Pursuant to applicable state law, the
					 secretary may issue an immediate suspension of a license if any investigation
					 or survey determines that the applicant or outpatient abortion facility is in
					 violation of any provision of applicable state laws, in violation of the rules
					 promulgated by the department, or in violation of any other federal or state
					 law or regulation, and the secretary determines that the violation or
					 violations pose an imminent or immediate threat to the health, welfare, or
					 safety of a client or patient.
B.
					 Notice of Immediate Suspension of License. The secretary shall provide written
					 notice of the immediate suspension of license.
C. Effective Date. The suspension of the
					 license is effective immediately upon the receipt of the written notice of
					 immediate suspension of license.
D.
					 Administrative Appeal. The outpatient abortion facility shall have the right to
					 request a devolutive administrative appeal of the immediate suspension of
					 license.
1. The request for a devolutive
					 administrative appeal must be in writing and submitted to the DHH Office of the
					 Secretary within 30 calendar days of receipt of the notice of immediate
					 suspension of license.
2. The
					 request for a devolutive administrative appeal shall specify in detail the
					 reasons why the appeal is lodged.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 44 - Abortion Facilities › Subchapter B - Administration and Organization › Section I-4421 - Governing Body

Current through Register Vol. 50, No. 6, June 20, 2024
A. The outpatient
					 abortion facility shall be in compliance with all applicable federal, state,
					 and local statutes, laws, rules, regulations, and ordinances.
B. The outpatient abortion facility shall
					 have a governing body that assumes full responsibility for the total operation
					 of the outpatient abortion facility.
1. The
					 governing body shall consist of at least one individual who will assume full
					 responsibility.
2. The outpatient
					 abortion facility shall maintain documentation on the licensed premises
					 identifying the following information for each member of the governing body:
a. name;
b. contact information;
c. address; and
d. terms of membership.
3. The governing body shall develop and adopt
					 bylaws which address its duties and responsibilities.
4. The governing body shall, at minimum, meet
					 annually and maintain minutes of such meetings documenting the discharge of its
					 duties and responsibilities.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 44 - Abortion Facilities › Subchapter B - Administration and Organization › Section I-4425 - Patient Medical Records and Reporting Requirements

Current through Register Vol. 50, No. 6, June 20, 2024
A. General Provisions
1. The outpatient abortion facility shall
					 establish and maintain a patient medical record on each patient.
2. The patient medical record shall be:
a. completely and accurately documented;
					 and
b. readily available and
					 systematically organized to facilitate the gathering of information.
3. The outpatient abortion
					 facility shall ensure compliance with privacy and confidentiality of patient
					 medical records, including information in a computerized medical record system,
					 in accordance with the Health Insurance Portability and Accountability Act
					 (HIPAA) regulations, and/or all applicable state laws, rules, and
					 regulations.
4. Safeguards shall be
					 established to protect the patient medical records from loss or damage and/or
					 breach of confidentiality in accordance with all applicable state laws, rules,
					 and regulations.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 44 - Abortion Facilities › Subchapter B - Administration and Organization › Section I-4427 - Quality Assurance and Performance Improvement Program (QAPI)

Current through Register Vol. 50, No. 6, June 20, 2024
A. The outpatient abortion facility shall
					 develop, implement, enforce, maintain, and annually review a written QAPI
					 program subject to approval by the governing body, which puts systems in place
					 to effectively identify issues for which quality monitoring and performance
					 improvement activities are necessary. The QAPI program shall include plans of
					 action to correct identified issues including, but not limited to, monitoring
					 the effect of implemented changes and making necessary revisions to the plan of
					 action.
1. Plans of Action. The outpatient
					 abortion facility shall develop and implement a QAPI plan of action designed to
					 effectively identify issues for which quality monitoring and performance
					 improvement activities are necessary.
2. The QAPI plan of action shall include on a
					 quarterly basis the following:
a. processes
					 for receiving input regarding the quality of medical and clinical services
					 received;
b. processes for review
					 of patient medical records to ensure that such are complete and
					 current;
c. processes for
					 identifying on a quarterly basis the risk factors that affect or may affect the
					 health and safety of the patients of the outpatient abortion facility receiving
					 medical and clinical services. Examples may include, but are not limited to:
i. review and resolution of patient
					 grievances; and
ii. review and
					 resolution of patient/employee incidents involving medication errors and
					 equipment failure;
d. a
					 process to review and develop action plans to resolve all system wide issues
					 identified as a result of the processes above.
3. The QAPI outcomes shall be documented and
					 reported to the administrator in writing for action, as necessary, for any
					 identified systemic problems.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 44 - Abortion Facilities › Subchapter C - Pre-operative, Intra-operative, and PostOperative Procedures › Section I-4431 - Screening and Pre-Operative Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. Verification of Pregnancy. The presence of an intrauterine
					 pregnancy shall be verified by the following:
1. urine or serum pregnancy test performed
					 on-site; and
2. either a detection
					 of fetal heart tones or ultrasonography.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 44 - Abortion Facilities › Subchapter C - Pre-operative, Intra-operative, and PostOperative Procedures › Section I-4433 - Drug or Chemically Induced Abortion

Current through Register Vol. 50, No. 6, June 20, 2024
A. When
					 any drug or chemical is used for the purpose of inducing an abortion as defined
					 in
					 R.S.
					 40:1299.35.1, the physician who prescribed
					 the drug or chemical shall be in the same room and in the physical presence of
					 the pregnant woman when the drug or chemical is initially administered,
					 dispensed, or otherwise provided to the pregnant woman.
B. The drug or chemical shall not be
					 administered, dispensed, or otherwise provided to the pregnant woman by a
					 physician or any person acting under the physician's direction unless the
					 physician has obtained the voluntary and informed consent of the pregnant woman
					 pursuant to the provisions of state laws, rules and regulations and the
					 requirements set forth in this Section.
C. If a physician prescribes, dispenses,
					 administers, or provides any drug or chemical to a pregnant woman for the
					 purpose of inducing an abortion as defined in
					 R.S.
					 40:1299.35.1, the physician shall report the
					 abortion to the Department of Health and Hospitals in accordance with
					 applicable state laws, rules, and regulations, including
					 R.S.
					 40:1299.35.10.
D. Documentation shall be recorded as to the
					 date, time, method and name and signature of the physician who initially
					 administered, dispensed, or otherwise provided the drug or chemical to the
					 pregnant woman. This documentation shall be maintained in the patients medical
					 record.
AUTHORITY NOTE:
						Promulgated in accordance with
						R.S.
						40:2175.1 et
						seq.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 44 - Abortion Facilities › Subchapter C - Pre-operative, Intra-operative, and PostOperative Procedures › Section I-4435 - Intra-operative Procedures

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 outpatient abortion facility shall ensure that emergency medical equipment and
					 supplies as required by the governing body, medical director and medical staff
					 are available for intra-operative care and shall include, but are not limited
					 to:
1. surgical or gynecologic
					 table;
2. surgical
					 instrumentation;
3. emergency drugs
					 for stabilizing and/or treating medical and surgical complications as approved
					 by the medical director;
4.
					 oxygen;
5. intravenous fluids;
					 and
6. sterile dressing
					 supplies.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 44 - Abortion Facilities › Subchapter C - Pre-operative, Intra-operative, and PostOperative Procedures › Section I-4437 - Post-Operative Care, Procedures, and Discharge

Current through Register Vol. 50, No. 6, June 20, 2024
A. Post-Operative Care and Procedures
1. The outpatient abortion facility shall
					 have immediately available a supply of emergency drugs for stabilizing and/or
					 treating medical and surgical complications for post-operative care on the
					 licensed premises.
2. The patient's
					 recovery shall be supervised by a licensed physician or a licensed nurse
					 trained in postoperative care.
3.
					 If general anesthesia is administered during the abortion procedure, the
					 outpatient abortion facility shall have licensed nursing personnel trained in
					 post-anesthesia care.
4. Upon
					 completion of an abortion procedure, the physician shall immediately perform a
					 gross examination of the uterine contents and shall document the findings in
					 the patients medical record. If no products of conception are visible, the
					 physician shall assess the patient for risk of complications of an incomplete
					 abortion or ectopic pregnancy.
5.
					 Upon admission to the post-anesthesia recovery area, the patient shall be
					 assessed by the licensed nurse for the following: level of consciousness,
					 respiratory status, cardio-vascular status, pain level, bleeding, any potential
					 outcomes related to the abortion procedure and any other medically appropriate
					 assessments. The results of this assessment shall be documented by the licensed
					 nurse in the patients medical record.
6. A patient shall not be left unattended in
					 the post-anesthesia recovery area.
7. RH immunoglobulin administration shall be
					 offered to the woman who is Rh-negative and such shall be documented in the
					 patients medical record. If Rh immunoglobulin is not administered in the
					 facility, one of the following is required:
a. informed waiver signed by a patient who
					 refuses RH immunoglobulin; or
b.
					 documentation of other arrangements for administration of RH
					 Immunoglobulin.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 44 - Abortion Facilities › Subchapter C - Pre-operative, Intra-operative, and PostOperative Procedures › Section I-4439 - Anesthesia Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. Subject to
					 the approval of the medical director, the outpatient abortion facility shall
					 develop, implement, monitor, enforce, and annually review written policies and
					 procedures governing the preparation of and administration of drugs relating to
					 the types of anesthesia administered during the abortion procedure.
B. Local anesthesia, nitrous oxide,
					 intramuscular, oral, and intravenous sedation shall be administered by the
					 physician performing the abortion or by licensed nursing staff who have been
					 deemed competent to administer sedation under the orders and supervision of the
					 physician and pursuant to their scope of practice.
C. The physician performing the abortion
					 shall be present on the licensed premises prior to and during the
					 administration of all types of anesthesia.
D. General anesthesia, if used, shall be
					 administered by an anesthesiologist or certified registered nurse-anesthetist
					 (CRNA) who is under the supervision of the physician performing the
					 abortion.
E. If general anesthesia
					 is administered, the outpatient abortion facility shall ensure that
					 professional staff, trained and deemed competent to provide post-anesthesia
					 care, shall be present on-site to meet the needs of the patient.
F. If general anesthesia is administered, the
					 outpatient abortion facility shall ensure that emergency medical equipment
					 related to the delivery of general anesthesia shall be available on the
					 premises.
G. A physician shall be
					 present on the licensed premises during the post-anesthesia recovery period
					 until the patient is fully reacted and stable.
AUTHORITY NOTE:
						Promulgated in accordance with
						R.S.
						40:2175.1 et
						seq.
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-4445 - General Requirements

Current through Register Vol. 50, No. 6, June 20, 2024
A. General
					 Provisions
1. The outpatient abortion
					 facility shall be designed, constructed, equipped, and maintained to protect
					 the health and safety of patients, personnel, and the public at all
					 times.
2. The outpatient abortion
					 facility shall meet the provisions for physical environment under this Section,
					 unless otherwise noted herein.
3.
					 For the purposes of this Section, major renovations are defined as such
					 renovations that affect the alteration to the functionality or original design
					 of the facility's construction. Painting walls, re-tiling floors, installation
					 of carpet, repairing roof damage or reroofing are not considered to be major
					 renovations for purposes of this Section.
4. A separate waiting area shall be provided
					 that is sufficient in size to provide seating space for patients, staff, and
					 visitors of the patient.
5. Toilet
					 facility's for patients, staff, and visitors shall be installed and maintained
					 in accordance with the requirements of
LAC Title 51, Public
					 Health-Sanitary Code.
a. Every
					 toilet room shall contain at least one water closet and one lavatory. Such
					 toilet facility's shall be provided with ventilation in accordance with the
					 requirements of
LAC Title 51, Public Health-Sanitary
					 Code.
b. Hot and cold
					 water delivered through a mixing faucet, soap, and mechanical hand drying
					 devices and/or disposable paper towels shall be provided at all hand washing
					 lavatories/stations.
c. Showers or
					 shower/tub combinations, if provided, shall meet the requirements
of
					 LAC Title 51, Public Health-Sanitary Code.
6. Additional General Provisions. For
					 outpatient abortion facility's that receive their initial outpatient abortion
					 license after the effective date of the promulgation of this Rule, receive plan
					 review approval for major renovations after the effective date of the
					 promulgation of this Rule or change their geographical address after the
					 effective date of the promulgation of this Rule, the following additional
					 general provisions shall apply:
a. flooring in
					 all patient areas shall be readily cleanable, monolithic and joint free, and
					 slip-resistant;
b. wall finishes in
					 all patient areas shall be smooth, moisture resistant, washable, and free of
					 fissures, open joints, or crevices that may retain or permit passage of dirt
					 particles; and
c. wall bases in all
					 patient areas shall be monolithic and coved with the floor, tightly sealed to
					 the wall, and constructed without voids.
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-4447 - Infection Control

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 outpatient abortion facility shall develop, implement, enforce, monitor, and
					 annually review its written infection control program. The purpose of this
					 program shall seek to minimize infections and communicable diseases through
					 prevention, investigation, and reporting of infections. This program shall
					 include all contracted services.
B.
					 The outpatient abortion facility shall develop, implement, enforce, monitor,
					 and annually review, with the approval of the medical director, written
					 policies and procedures for preventing, identifying, reporting, investigating,
					 controlling, and immediately implementing corrective actions relative to
					 infections and communicable diseases of patients and personnel. At a minimum,
					 the policies shall address:
1. alcohol based
					 hand rub and hand hygiene;
2. use
					 of all types of gloves;
3.
					 decontamination of equipment between each patient use, including, but not
					 limited to, chairs and procedure room tables;
4. linen cleaning, if applicable;
5. waste management including, but not
					 limited to, the requirements of Part XXVII
of LAC Title 51 Public
					 Health-Sanitary Code;
6.
					 environmental cleaning;
7.
					 reporting, investigating, and monitoring of surgical infections;
8. sterilization procedures and processes, if
					 applicable;
9. single use
					 devices;
10. disinfecting
					 procedures and processes; and
11.
					 breaches of infection control practices.
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-4449 - Laboratory Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 outpatient abortion facility shall have laboratory services available to meet
					 the needs of its patients.
B. The
					 outpatient abortion facility shall maintain a clinical laboratory improvement
					 amendment (CLIA) certificate for the laboratory services provided on the
					 licensed premises.
C. The
					 outpatient abortion facility shall ensure that all contracted laboratory
					 services are provided by a CLIA certified laboratory.
AUTHORITY NOTE:
						Promulgated in accordance with
						R.S.
						40:2175.1 et
						seq.