reglab/statecodes huggingface dataset:
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1925 - REQUIRED SPACES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) A combination
				  or nursing facility shall meet the following requirements for bedrooms, dining,
				  recreation, and common use areas:
(1) single
				  bedrooms shall be provided with not less than 100 square feet of floor
				  area;
(2) bedrooms with more than
				  one bed shall be provided with not less than 80 square feet of floor area per
				  bed;
(3) dining, recreation, and
				  common use areas shall:
(A) total not less
				  than 25 square feet of floor area per bed for skilled nursing and intermediate
				  care beds;
(B) total not less than
				  30 square feet of floor area per bed for adult care home beds; and
(C) be contiguous to patient and resident
				  bedrooms.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1926 - NURSING HOME PATIENT OR RESIDENT RIGHTS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Written
				  policies and procedures shall be developed and enforced to implement
				  requirements in
				  G.S.
				  131E-115 et seq. (Nursing Home Patients' Bill
				  of Rights) concerning the rights of patients and residents. The administrator
				  shall make these policies and procedures known to the staff, patients and
				  residents, and families of patients and residents and shall ensure their
				  availability to the public by placing them in a conspicuous place.
(b) Any violation of patient rights contained
				  in G.S.
				  131E-117 shall be determined by
				  representatives of the Department by investigation or survey.
(c) If a licensed facility is found to be in
				  violation of any of the rights contained in
				  G.S.
				  131E-117, the Department shall impose
				  penalties for each violation as provided by
				  G.S.
				  131E-129.
(d) When the Department has been notified
				  that corrective action has been taken for each violation, verification of same
				  shall be made by a representative of the Department.
(e) The Department shall calculate a total of
				  all fines levied against a facility based on the number of violations and the
				  number of days and patients or residents involved in each violation.
(f) The Department shall mail a statement to
				  the facility showing a total fine for each violation and a total of fines due
				  to be paid for all violations. The facility shall pay the penalty within 60
				  days unless a hearing is requested under G.S. Chapter 150B.
(g) When it is found that a violation of
				  G.S.
				  131E-117 has occurred but corrective action
				  was taken prior to the date of discovery, fines shall be calculated and
				  assessed in accordance with (e) and (f) of this Rule.
(h) In matters of patient abuse, neglect or
				  misappropriation the definitions shall have the meanings defined for abuse,
				  neglect and exploitation respectively as contained in the North Carolina
				  PROTECTION OF THE ABUSED, NEGLECTED OR EXPLOITED DISABLED ADULT ACT,
				  G.S.
				  108A-99 et seq.
Authority
					 G.S.
					 131E-79;
					 42 U.S.C.
					 1396 r (e)(2)(B);
Eff. February
					 1, 1986;
Amended Eff. March 1, 1990;
Temporary
					 Amendment Eff. October 1, 1990 For a Period of 142 Days to Expire on February
					 28, 1991;
Amended Eff. March 1, 1991;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1927 - BRAIN INJURY LONG TERM CARE PHYSICIAN SERVICES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) For nursing
				  facility patients located in designated brain injury long-term care units,
				  there shall be an attending physician who is responsible for the patient's
				  specialized care program. The intensity of the program requires that there
				  shall be direct patient contact by a physician at least once per week and more
				  often as the patient's condition warrants. Each patient's interdisciplinary,
				  long-term care program shall be developed and implemented under the supervision
				  of a physiatrist (a physician trained in Physical Medicine and Rehabilitation)
				  or a physician of equivalent training and experience.
(b) If a physiatrist or physician of
				  equivalent training or experience, is not available on a weekly basis to the
				  facility, the facility shall provide for weekly medical management of the
				  patient, by another physician. In addition, oversight for the patient's
				  interdisciplinary, long-term care program shall be provided by a qualified
				  consultant physician who visits patients monthly, makes recommendations for and
				  approves the interdisciplinary care plan, and provides consultation as
				  requested to the physician who is managing the patient on a weekly
				  basis.
(c) The attending physician
				  shall actively participate in individual case conferences or care planning
				  sessions and shall review and sign discharge summaries and records within 15
				  days of patient discharge. When patients are to be discharged to either another
				  health care facility or a residential setting the attending physician shall
				  assure that the patient has been provided with a discharge plan which
				  incorporates optimum utilization of community resources and post discharge
				  continuity of care and services.
Authority
					 G.S.
					 131E-79;
Eff. December 1,
					 1991;
Amended Eff. February 1, 1993;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1928 - EXPIRED - BRAIN INJURY LONG TERM CARE PROGRAM REQUIREMENTS

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 131E-79;
Eff. December 1,
					 1991;
Amended Eff. February 1, 1993;
Expired Eff.
					 August 1, 2017 pursuant to
					 G.S.
					 150B-21.3A.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1929 - SPECIAL NURSING REQUIREMENTS FOR BRAIN INJURY LONG TERM CARE

Current through Register Vol. 39, No. 2, July 15, 2024
Direct care nursing personnel staffing ratio (NH/PD)
					 established in Rule.1912 of this Section shall not be applied to nursing
					 services for patients who require brain injury long-term care, due to their
					 more intensive maintenance and nursing needs. The minimum direct care nursing
					 staff shall be 5.5 hrs. per patient day allocated on a per shift basis as the
					 facility chooses to appropriately meet the patient's needs. It is also required
					 that regardless of how low the patient census the direct care nursing staff
					 shall not fall below a registered nurse and a nurse aide I at any time during a
					 24-hour period.
Authority
					 G.S.
					 131E-79;
Eff. December 1,
					 1991;
Amended Eff. February 1, 1993;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1930 - VENTILATOR DEPENDENCE

Current through Register Vol. 39, No. 2, July 15, 2024
The general requirements in this Subchapter shall apply
					 when applicable. In addition, facilities having patients requiring the use of
					 ventilators for more than eight hours a day must meet the following
					 requirements:
(1) Respiratory therapy
				  shall be provided and supervised by a respiratory therapist currently
				  registered by the National Board for Respiratory Care. The respiratory
				  therapist shall:
(a) make, as a minimum,
				  weekly on-site assessments of each patient receiving ventilator support with
				  corresponding progress notes;
(b)
				  be on-call 24 hours daily; and
(c)
				  assist the pulmonologist and nursing staff in establishing ventilator policies
				  and procedures, including emergency policies and procedures.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1931 - PHYSICIAN SERVICES FOR VENTILATOR DEPENDENT PATIENTS

Current through Register Vol. 39, No. 2, July 15, 2024
Hospitals with nursing facility beds with ventilator
					 dependent care patients shall contract with a physician who is licensed to
					 practice in North Carolina with Board Certification and who has specialized
					 training in pulmonary medicine. This physician shall be responsible for
					 respiratory services and shall:
(1)
				  establish, with the respiratory therapist and nursing staff, appropriate
				  ventilator policies and procedures, including emergency procedures;
(2) assess each ventilator patient's status
				  at least monthly with corresponding progress notes;
(3) be available on an emergency basis;
				  and
(4) participate in individual
				  patient case planning.
Authority
					 G.S.
					 131E-79;
Eff. December 1,
					 1991;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .1900 - SUPPLEMENTAL RULES FOR THE LICENSURE OF THE SKILLED: INTERMEDIATE: ADULT CARE HOME BEDS IN A HOSPITAL › Section 13B .1932 - EMERGENCY ELECTRICAL SERVICE

Current through Register Vol. 39, No. 2, July 15, 2024
(a) A minimum
				  of one dedicated emergency branch circuit per bed is required for ventilator
				  dependent patients in addition to the normal system receptacle at each bed
				  location required by the National Electrical Code. This emergency circuit shall
				  be provided with a minimum of two duplex receptacles identified for emergency
				  use. Additional emergency branch circuits/receptacles shall be provided where
				  the electrical life support needs of the patient exceed the minimum
				  requirements stated in this Paragraph. Each emergency circuit serving
				  ventilator dependent patients shall be fed from the automatically transferred
				  critical branch of the essential electrical system. This Paragraph shall apply
				  to both new and existing facilities.
(b) Heating equipment provided for ventilator
				  dependent patient bedrooms shall be connected to the critical branch of the
				  essential electrical system and arranged for delayed automatic or manual
				  connection to the emergency power source if the heating equipment depends upon
				  electricity for proper operation. This Paragraph shall apply to both new and
				  existing facilities.
(c) Task
				  lighting connected to the automatically transferred critical branch of the
				  essential electrical system shall be provided for each ventilator dependent
				  patient bedroom. This Paragraph shall apply to both new and existing
				  facilities.
Authority
					 G.S.
					 131E-79;
Eff. December 1,
					 1991;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .2000 - SPECIALIZED REHABILITATIVE AND HABILITATIVE SERVICES › Section 13B .2001-.2008 - EXPIRED

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 131E-79;
Eff. February 1,
					 1993;
Expired Eff. August 1, 2017 pursuant to
					 G.S.
					 150B-21.3A.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .2000 - SPECIALIZED REHABILITATIVE AND HABILITATIVE SERVICES › Section 13B .2021-.2032 - EXPIRED

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 131E-79;
					 143B-165;
Eff. May
					 1, 1993;
Amended Eff. December 1, 1993;
Expired Eff.
					 August 1, 2017 pursuant to
					 G.S.
					 150B-21.3A.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .2000 - SPECIALIZED REHABILITATIVE AND HABILITATIVE SERVICES › Section 13B .2033 - DEEMED STATUS FOR INPATIENT REHABILITATION FACILITIES OR UNITS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) If an inpatient rehabilitation facility
				  or unit with a comprehensive inpatient rehabilitation program is surveyed and
				  accredited by the Joint Commission for the Accreditation of Health Care
				  Organizations (JCAHO) or the Commission on Accreditation of Rehabilitation
				  Facilities (CARF) and has been approved by the Department in accordance with
				  Article 9 Chapter 131E of the North Carolina General Statutes, the Department
				  deems the facility to be in compliance with Rules.2020 through.2030 and.2033 of
				  this Section.
(b) Deemed status
				  shall be provided only if the inpatient rehabilitation facility or unit
				  provides copies of survey reports to the Division. The JCAHO report shall show
				  that the facility or unit was surveyed for rehabilitation services. The CARF
				  report shall show that the facility or unit was surveyed for comprehensive
				  rehabilitation services. The facility or unit shall sign an agreement
				  (Memorandum of Understanding) specifying these terms.
(c) The inpatient rehabilitation facility or
				  unit shall be subject to inspections or complaint investigations by
				  representatives of the Department at any time. If the facility or unit is found
				  not to be in compliance with the rules listed in Paragraph (a) of this Rule,
				  the facility shall submit a plan of correction and be subject to a follow-up
				  visit to assure compliance.
(d) If
				  the inpatient rehabilitation facility or unit loses or does not renew its
				  accreditation, the facility or unit shall notify the Division in writing within
				  30 days.
Authority
					 G.S.
					 131E-79;
Eff. May 1,
					 1993;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .2100 - TRANSPARENCY IN HEALTH CARE COSTS › Section 13B .2101 - DEFINITIONS

Current through Register Vol. 39, No. 2, July 15, 2024
In addition to the terms defined in
					 G.S.
					 131E-214.13, the following terms shall apply
					 throughout this Section, unless text indicates to the contrary:
(1) "Current Procedural Terminology (CPT)"
				  means a medical code set developed by the American Medical
				  Association.
(2) "Diagnostic
				  related group (DRG)" means a system to classify hospital cases assigned by a
				  grouper program based on ICD (International Classification of Diseases)
				  diagnoses, procedures, patient's age, sex, discharge status, and the presence
				  of complications or co-morbidities.
(3) "Department" means the North Carolina
				  Department of Health and Human Services.
(4) "Financial assistance" means a policy,
				  including charity care, describing how the organization will provide assistance
				  at its hospital(s) and any other facilities. Financial assistance includes free
				  or discounted health services provided to persons who meet the organization's
				  criteria for financial assistance and are unable to pay for all or a portion of
				  the services. Financial assistance does not include:
(a) bad debt;
(b) uncollectable charges that the
				  organization recorded as revenue but wrote off due to a
				  patient
'
s failure to pay;
(c) the cost of providing such care to the
				  patients in Sub-Item (4)(b) of this Rule; or
(d) the difference between the cost of care
				  provided under Medicare or other government programs, and the revenue derived
				  therefrom.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .2100 - TRANSPARENCY IN HEALTH CARE COSTS › Section 13B .2102 - REPORTING REQUIREMENTS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The Department
				  shall establish the lists of the statewide 100 most frequently reported DRGs,
				  20 most common outpatient imaging procedures, and 20 most common outpatient
				  surgical procedures performed in the hospital setting to be used for reporting
				  the data required in Paragraphs (c) through (e) of this Rule. The lists shall
				  be determined annually based upon data provided by the certified statewide data
				  processor. The Department shall make the lists available on its website. The
				  methodology to be used by the certified statewide data processor for
				  determining the lists shall be based on the data collected from all licensed
				  facilities in the State in accordance with
				  G.S.
				  131E-214.2 as follows:
(1) the 100 most frequently reported DRGs
				  shall be based upon all hospital's discharge data that has been assigned a DRG
				  based on the Centers for Medicare & Medicaid Services grouper for each
				  patient record, then selecting the top 100 to be provided to the
				  Department;
(2) the 20 most common
				  imaging procedures shall be based upon all outpatient data for both hospitals
				  and ambulatory surgical facilities and represent all occurrences of the
				  diagnostic radiology imaging codes section of the CPT codes, then selecting the
				  top 20 to be provided to the Department; and
(3) the 20 most common outpatient surgical
				  procedures shall be based upon the primary procedure code from the ambulatory
				  surgical facilities and represent all occurrences of the surgical codes section
				  of the CPT codes, then selecting the top 20 to be provided to the
				  Department.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3100 - PROCEDURE › Section 13B .3101 - GENERAL REQUIREMENTS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) An application
				  for licensure shall be submitted to the Division prior to a license being
				  issued or patients admitted.
(b) An
				  existing facility shall not sell, lease, or subdivide a portion of its bed
				  capacity without the approval of the Division.
(c) Application forms may be obtained by
				  contacting the Division.
(d) The
				  Division shall be notified in writing 30 days prior to the occurrence of any of
				  the following:
(1) addition or deletion of a
				  licensable service;
(2) increase or
				  decrease in bed capacity;
(3)
				  change of chief executive officer;
(4) change of mailing address;
(5) ownership change; or
(6) name change.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3100 - PROCEDURE › Section 13B .3102 - PLAN APPROVAL

Current through Register Vol. 39, No. 2, July 15, 2024
(a) For the
				  purposes of this Rule, the Guidelines for the Design and Construction of
				  Hospitals and Outpatient Facilities that is incorporated by reference in
				  Rule.6105 of this Subchapter shall be referred to as the "FGI
				  Guidelines."
(b) The definitions as
				  set forth in Rule .6003 of this Subchapter shall apply to this Rule.
(c) The facility design and construction
				  shall be in accordance with this Rule and the standards set forth in Sections
				  .6000 through.6200 of this Subchapter.
(d) The site where the facility is located
				  shall:
(1) be approved by the Construction
				  Section prior to the construction of a new facility or the construction of an
				  addition to an existing facility;
(2) be free from noise from railroads,
				  freight yards, main traffic arteries, and schools and children's playgrounds;
				  and
(3) not be exposed to smoke,
				  odors, or dust from industrial plants.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3100 - PROCEDURE › Section 13B .3103 - CLASSIFICATION OF MEDICAL FACILITIES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) For
				  purpose of this Subchapter the classification of "hospital" shall be restricted
				  to facilities that provide as their functions diagnostic services and medical
				  and nursing care in the treatment of acute stages of illness. On the basis of
				  specialized facilities and services available, the Division shall license each
				  such hospital according to the following medical types:
(1) general acute care hospital;
(2) rehabilitation hospital;
(3) critical access hospital; or
(4) long term acute care hospital which is a
				  hospital which has been classified and certified as a long term care hospital
				  pursuant to 42 CFR Part 412.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3100 - PROCEDURE › Section 13B .3104 - LENGTH OF LICENSE

Current through Register Vol. 39, No. 2, July 15, 2024
Licenses shall remain in effect until one of the following
					 occurs:
(1) Division imposes an
				  administrative sanction which specifies license expiration;
(2) change of ownership;
(3) closure;
(4) change of site;
(5) failure to comply with Rule.3105 of this
				  Section.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3100 - PROCEDURE › Section 13B .3105 - STATISTICAL INFORMATION

Current through Register Vol. 39, No. 2, July 15, 2024
Utilization data shall be submitted annually upon request
					 by the Division. Forms for collection of this data will be forward to each
					 facility by the Division.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3100 - PROCEDURE › Section 13B .3106 - LICENSURE SURVEYS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Prior to the
				  initial issuance of a license to operate a facility, the Division shall conduct
				  a survey to determine compliance with rules promulgated pursuant to
				  G.S.
				  131E-79.
(b) The Division may conduct an investigation
				  of a complaint in any facility.
(c)
				  Facilities that are accredited through an accrediting body approved pursuant to
				  section 1865(a) of the Social Security Act shall not be subject to routine
				  inspections.
(d) The Division shall
				  survey non-accredited facilities at least once every three years.
Authority
					 G.S.
					 131E-79;
					 131E-80;
Eff.
					 January 1, 1996;
Amended Eff. October 1, 2010;
Pursuant
					 to G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3100 - PROCEDURE › Section 13B .3107 - DENIAL, AMENDMENT OR REVOCATION OF LICENSE

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  Department may deny any licensure application upon becoming aware that the
				  applicant is not in compliance with any applicable provision of the Certificate
				  of Need law located in G.S. 131E, Article 9 and the rules adopted under that
				  law.
(b) The Department may amend a
				  license by reducing it from a full license to a provisional license whenever
				  the Department finds that:
(1) the licensee
				  has failed to comply with the provisions of G.S. 131E, Article 5 and the rules
				  promulgated under that article;
(2)
				  there is a probability that the licensee can remedy the licensure deficiencies
				  within a length of time not to exceed the expiration date on the license;
				  and
(3) there is a probability that
				  the licensee will be able thereafter to remain in compliance with the hospital
				  licensure rules for the foreseeable future.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3100 - PROCEDURE › Section 13B .3108 - SUSPENSION OF ADMISSIONS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The
				  Department may amend a license, pursuant to
				  G.S.
				  131E-78, by suspending the admission of any
				  new patients to any facility when the conditions in the facility are
				  detrimental to the health or safety of the patients in the facility.
(b) The Department shall notify the facility
				  by registered or certified mail or by personal service of the decision to
				  suspend admissions. Such notice will include:
(1) the period of the suspension;
(2) factual allegations;
(3) citation of statutes and rules alleged to
				  be violated; and
(4) notice of the
				  facility's right to a contested case hearing.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3100 - PROCEDURE › Section 13B .3109 - PROCEDURE FOR APPEAL

Current through Register Vol. 39, No. 2, July 15, 2024
A facility may appeal any decision of the Department to
					 deny, revoke or amend a license or any decision to suspend admissions by making
					 such an appeal in accordance with G.S. 150B.
Authority
					 G.S.
					 131E-78;
					 131E-79;
Eff.
					 January 1, 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3100 - PROCEDURE › Section 13B .3110 - ITEMIZED CHARGES

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The facility
				  shall provide an itemized list of charges to discharged patients or the
				  facility shall include on patients' bills that are not itemized, notification
				  of the right to request an itemized bill within three years of receipt of the
				  non-itemized bill or so long as the hospital, a collections agency, or other
				  assignee asserts the patient has an obligation to pay the bill.
(b) If requested, the facility shall provide
				  an itemized list of charges to the patient or the patient's representative.
				  This list shall detail in language comprehensible to an ordinary layperson the
				  specific nature of the charges or expenses incurred by the patient.
(c) The itemized listing shall include each
				  specific chargeable item or service in the following service areas:
(1) room rate;
(2) laboratory;
(3) radiology and nuclear medicine;
(4) surgery;
(5) anesthesiology;
(6) pharmacy;
(7) emergency services;
(8) outpatient services;
(9) specialized care;
(10) extended care;
(11) prosthetic and orthopedic appliances;
				  and
(12) professional services
				  provided by the facility.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3100 - PROCEDURE › Section 13B .3111 - TEMPORARY CHANGE IN BED CAPACITY

Current through Register Vol. 39, No. 2, July 15, 2024
(a) A hospital
				  may temporarily increase its bed capacity by up to 10 percent over its licensed
				  bed capacity, as determined by the administrator, by utilizing observational
				  beds for inpatients for a period of no more than 60 consecutive days following
				  approval by the Division of Health Service Regulation.
(b) To qualify for a temporary change in
				  licensed capacity, the hospital census shall be at least 90 percent of its
				  licensed bed capacity, excluding beds that are under renovation or
				  construction, and the hospital must demonstrate conditions requiring the
				  temporary increase that may include but are not limited to the following:
(1) natural disaster;
(2) catastrophic event; or
(3) disease epidemic.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3200 - GENERAL HOSPITAL REQUIREMENTS › Section 13B .3201 - HOSPITAL REQUIREMENTS

Current through Register Vol. 39, No. 2, July 15, 2024
A facility shall have all of the following:
(1) an organized governing body;
(2) a chief executive officer;
(3) an organized medical staff;
(4) an organized nursing staff;
(5) continuous medical services;
(6) continuous nursing services;
(7) permanent on-site facilities for the care
				  of patients 24 hours a day;
(8) a
				  hospital-wide infection control program;
(9) minimum on-site clinical provisions as
				  follows:
(a) appropriately equipped inpatient
				  care areas;
(b) nursing care
				  units;
(c) diagnostic and treatment
				  areas to include on-site laboratory and imaging facilities with the capacity to
				  provide immediate response to patient emergencies;
(d) pharmaceutical services in compliance
				  with the Pharmacy Laws of North Carolina;
(e) facilities to assure the sterilization of
				  equipment and supplies;
(f) medical
				  records services;
(g) provision for
				  social work services;
(h) current
				  reference sources to meet staff needs; and
(i) nutrition services.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3200 - GENERAL HOSPITAL REQUIREMENTS › Section 13B .3202 - ADMISSION AND DISCHARGE

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The facility
				  shall provide written admission and discharge, and referral policies.
(b) There shall be on the premises at all
				  times an employee authorized to receive patients and to make arrangements for
				  their disposition.
(c) A patient
				  shall be admitted only under the care of a member of the medical staff meeting
				  the provisions of Section.3700 of this Subchapter.
(d) The facility shall take appropriate
				  precautions to protect the safety and legal rights of patients and
				  employees.
(e) The facility shall
				  maintain a complete and permanent record of all outpatients and inpatients
				  including the date and time of admission and discharge. Effort shall be made to
				  verify the full and true name, address, date of birth, nearest of kin,
				  provisional diagnosis, condition on admission and discharge, referring
				  physicians, attending physician or service.
(f) Facility staff shall provide at the time
				  of admission an identification bracelet, band, or other suitable device for
				  positive identification of each patient.
(g) No mentally competent adult shall be
				  detained by the facility against his will, except as authorized by
				  law.
Authority
					 G.S.
					 131E-75;
					 131E-79;
Eff.
					 January 1, 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3200 - GENERAL HOSPITAL REQUIREMENTS › Section 13B .3203 - DISCHARGE PLANNING

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Discharge
				  planning shall be an integral part of in-patient hospitalization.
(b) The facility shall have written policies
				  and procedures governing discharge planning. These shall include but need not
				  be limited to the following:
(1) appropriate
				  screening to determine the need for discharge planning;
(2) methods to facilitate the provision of
				  follow-up care;
(3) information to
				  be given to the patient or his family or other persons involved in caring for
				  the patient on matters such as the patient's condition; his health care needs;
				  the amount of activity he should engage in; any necessary medical regimens
				  including drugs, nutrition therapy, appointments or other forms of therapy;
				  sources of additional help from other agencies; and procedures to follow in
				  case of complications; and
(4)
				  procedures for assisting the patient and his family in gaining information
				  regarding financial assistance in paying bills incurred as a result of the
				  hospitalization, including how to receive assistance from the various federal
				  and State government programs.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3200 - GENERAL HOSPITAL REQUIREMENTS › Section 13B .3204 - TRANSFER AGREEMENT

Current through Register Vol. 39, No. 2, July 15, 2024
(a) Any facility
				  that does not provide hospital based nursing facility service shall maintain
				  written agreements with institutions offering this kind of care. Such
				  agreements shall provide for the transfer and admission of patients who no
				  longer require the services of the hospital but do require nursing facility
				  services.
(b) A patient shall not
				  be transferred to another medical care facility unless prior arrangements for
				  admission have been made. Clinical records to provide continuity of care shall
				  accompany the patient.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Readopted Eff. April 1,
					 2020.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3200 - GENERAL HOSPITAL REQUIREMENTS › Section 13B .3205 - DISCHARGE OF MINOR OR INCOMPETENT

Current through Register Vol. 39, No. 2, July 15, 2024
Individuals who cannot legally consent to his or her own
					 care shall be discharged to the custody of parents, legal guardian, person
					 standing in loco parentis, or patient representative pursuant to
					 42 CFR
					 483.12(a)(1) herein
					 incorporated by reference with subsequent amendments and editions, unless
					 otherwise directed by the parent or guardian, or court of competent
					 jurisdiction. This regulation may be accessed at
https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/Hospitals
at no cost. If the parent or guardian directs that discharge be made otherwise,
					 he or she shall so state in writing, and the statement shall become a part of
					 the permanent medical record of the patient.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Readopted Eff. April 1,
					 2020.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3300 - PATIENT'S BILL OF RIGHTS › Section 13B .3301 - PRINCIPLE

Current through Register Vol. 39, No. 2, July 15, 2024
It is the purpose of these requirements to promote the
					 interests and well-being of the patients in facilities subject to this
					 Subchapter even in those instances where the interests of the patients may be
					 in opposition to the interests of the facility. The facility has the right to
					 expect the patient to fulfill patient responsibilities as may be stated in the
					 facilities' policies affecting patient care and conduct.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3300 - PATIENT'S BILL OF RIGHTS › Section 13B .3303 - PROCEDURE

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The facility
				  shall develop and implement procedures to inform patients of his or her rights.
				  Copies of the facilities' Patient's Bill of Rights shall be made available
				  through one of the following ways:
(1)
				  locations posted in a public place in the facility in addition to copies
				  available upon request; or
(2)
				  provided a copy to each patient or responsible party upon admission or as soon
				  after admission as is feasible.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3400 - SUPPLEMENTAL RULES FOR THE LICENSURE OF CRITICAL ACCESS HOSPITALS › Section 13B .3401 - SUPPLEMENTAL RULES

Current through Register Vol. 39, No. 2, July 15, 2024
The rules of this Section pertain only to designated
					 Critical Access Hospitals in accordance with
					 42 CFR
					 485 Subpart F. The general requirements of
					 this Subchapter shall apply to such facilities except where they are
					 specifically waived or modified by the rules of this Section.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Amended Eff. November 1, 2004;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3400 - SUPPLEMENTAL RULES FOR THE LICENSURE OF CRITICAL ACCESS HOSPITALS › Section 13B .3402 - DEFINITIONS

Current through Register Vol. 39, No. 2, July 15, 2024
The following definitions shall apply throughout this
					 Section, unless context otherwise clearly indicates to the contrary:
(1) "Available" means provided directly by
				  the facility or by written agreement with a qualified provider of the service
				  within one hour driving time.
(2)
				  "Critical Access Hospital" means a facility designated by the North Carolina
				  Office of Rural Health in accordance with
				  42 CFR
				  485 Subpart F.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Amended Eff. November 1, 2004;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22, 2017;
Amended Eff.
					 October 1, 2019.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3400 - SUPPLEMENTAL RULES FOR THE LICENSURE OF CRITICAL ACCESS HOSPITALS › Section 13B .3403-.3404

Current through Register Vol. 39, No. 2, July 15, 2024
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Repealed Eff. November 1,
					 2004.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3400 - SUPPLEMENTAL RULES FOR THE LICENSURE OF CRITICAL ACCESS HOSPITALS › Section 13B .3405 - DESIGNATED CRITICAL ACCESS HOSPITALS

Current through Register Vol. 39, No. 2, July 15, 2024
The requirements of
					 10A NCAC
					 13B shall apply to Critical Access Hospitals
					 with the following modifications:
(1)
				  Autopsy facilities required in Rule.4907 of this Subchapter are not required
				  provided that the facility has in effect a written agreement with another
				  facility meeting Rule.4907 of this Subchapter for providing autopsy
				  services.
(2) Radiological services
				  required in Section.4800 and Rule.6210 of this Subchapter are not required
				  provided that the facility has a written agreement with another licensed
				  facility meeting the requirements of Section.4800 and Rule.6210 of this
				  Subchapter which makes radiological service available.
(3) Emergency services required in
				  Rules.4102-.4110 of this Subchapter are not required. Emergency response
				  capability set forth in Rule.4101 of this Subchapter shall be provided. Medical
				  staff shall require that facility personnel are capable of initiating
				  life-saving measures at a first-aid level of response for any patient or person
				  in need of such services. This shall include:
(a) Establishing protocols or agreements with
				  any facility providing emergency services;
(b) Initiating basic cardio-pulmonary
				  resuscitation according to the American Red Cross or American Heart Association
				  standards;
(c) Availability of
				  intravenous fluids and supplies required to establish intravenous access;
				  and
(d) Availability of first-line
				  emergency drugs as specified by the medical staff.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3500 - GOVERNANCE AND MANAGEMENT › Section 13B .3501 - GOVERNING BODY

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The governing
				  body, owner, or the person or persons designated by the owner as the governing
				  body shall be responsible for ensuring that the objectives specified in the
				  facility's governing documents, such as the charter or resolution, are
				  attained.
(b) The governing body
				  shall be the final authority for decisions for which the facility
				  administration, the medical staff, and the facility personnel are directly or
				  indirectly responsible within the facility.
(c) A local advisory board shall be
				  established to provide non-binding advice to the governing body regarding the
				  health, safety, and welfare of the community, if the facility is owned by an
				  organization or persons outside of North Carolina. A local advisory board shall
				  include members from the county where the facility is located.
Authority
					 G.S.
					 131E-75;
					 131E-79;
Eff.
					 January 1, 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22, 2017;
Amended Eff. July
					 1, 2020.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3500 - GOVERNANCE AND MANAGEMENT › Section 13B .3502 - REQUIRED FACILITY BYLAWS, POLICIES, RULES, AND REGULATIONS

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The governing body shall adopt written
				  bylaws, policies, rules, and regulations in accordance with all requirements
				  contained in this Subchapter and in accordance with the community
				  responsibility of the facility. The written bylaws, policies, rules, and
				  regulations shall:
(1) state the
				  objectives;
(2) describe the powers
				  and duties of the governing body officers and committees and the
				  responsibilities of the chief executive officer;
(3) state the qualifications for governing
				  body membership, the procedures for selecting members, and the terms of service
				  for members, officers and committee chairmen;
(4) describe the authority delegated to the
				  chief executive officer and to the medical staff. No assignment, referral, or
				  delegation of authority by the governing body shall relieve the governing body
				  of its responsibility for the conduct of the facility. The governing body shall
				  retain the right to rescind any such delegation;
(5) require governing body approval of the
				  bylaws of any auxiliary organizations established by the facility;
(6) require the governing body to review and
				  approve the bylaws of the medical staff;
(7) establish procedures for processing and
				  evaluating the applications for medical staff membership and for the granting
				  of clinical privileges;
(8)
				  establish a procedure for implementing, disseminating, and enforcing a
				  Patient's Bill of Rights as set forth in Rule.3302 of this Subchapter and in
				  compliance with
				  G.S.
				  131E-117; and
(9) require the governing body to institute
				  procedures to provide for:
(A) orientation of
				  newly elected governing body members to board functions and
				  procedures;
(B) the development of
				  procedures for periodic reexamination of the relationship of the governing body
				  to the total facility community; and
(C) the recording of minutes of all governing
				  body and executive committee meetings and the dissemination of those minutes,
				  or summaries thereof, after the governing body and executive committee meetings
				  to all members of the governing body.
North Carolina Administrative Code › Title 10A - HEALTH AND HUMAN SERVICES › Chapter 13 - NC MEDICAL CARE COMMISSION › Subchapter B - LICENSING OF HOSPITALS › Section .3600 - MANAGEMENT AND ADMINISTRATION OF OPERATIONS › Section 13B .3601 - CHIEF EXECUTIVE OFFICER

Current through Register Vol. 39, No. 2, July 15, 2024
(a) The governing
				  body shall designate a chief executive officer whose qualifications, authority,
				  responsibilities and duties shall be defined in a written statement adopted by
				  the governing body.
(b) The chief
				  executive officer shall be the designated representative of the governing body
				  and may be given any one or more or all of the responsibilities set out in
				  Rule.3602 of this Section.
Authority
					 G.S.
					 131E-79;
Eff. January 1,
					 1996;
Pursuant to
					 G.S.
					 150B-21.3A, rule is necessary without
					 substantive public interest Eff. July 22,
					 2017.