reglab/statecodes huggingface dataset:
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 3 - CONSTRUCTION RULES AND REGULATIONS FOR HEALTHCARE FACILITIES › Section 3-8 - Electrical Safety

Current through July 13, 2024
(a) Electrical
				installations shall be in accordance with
				W.S.
				35-9-119, including plan reviews and
				inspections.
Contact:
Wyoming Department of Fire Prevention and Electrical
				  Safety
Herschler Building, 1W, 122 West 25th Street
Cheyenne, WY 82002
Telephone: (307) 777-7288
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 3 - CONSTRUCTION RULES AND REGULATIONS FOR HEALTHCARE FACILITIES › Section 3-9 - Variances

Current through July 13, 2024
(a) A healthcare facility may submit a
				request to the Department to obtain a variance from the above rules and
				regulations at any time.
(i) An applicant
				requesting a variance shall file a Request for Agency Action/Variance
				Application with the Department on the form furnished by the
				Department.
(ii) The Department may
				require additional information from the facility before acting on the
				request.
(iii) The Department shall
				act upon each request for a variance in writing within sixty (60) days of
				receipt of a completed request.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-4 - Definitions

Current through July 13, 2024
The following definitions shall apply in the interpretation
				  and enforcement of this rule. Where the context in which words are used in this
				  rule indicates that such is the intent, words in the singular number shall
				  include the plural and vice-versa. Throughout this rule gender pronouns are
				  used interchangeably. The drafters have attempted to utilize each gender
				  pronoun in equal numbers, in random distribution. Words in each gender shall
				  include individuals of the other gender. For purpose of this rule, the
				  following shall apply:
(a) "Acceptable
				Plan of Correction" means the State Survey Agency approved the Hospital's plan
				to correct the deficiencies identified during a survey conducted by the State
				Survey Agency or its designated representative. The plan of correction shall be
				a written document and shall provide, but not be limited to, the following
				information:
(i) Who is responsible for the
				correction.
(ii) What was done or
				will be done to correct the problem.
(iii) Who will monitor to ensure that the
				situation does not again develop.
(iv) An appropriate date, not to exceed
				forty-five (45) calendar days after the last day of survey, for the correction
				of deficiencies.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-5 - Licensure

Current through July 13, 2024
(a) Licensing Procedure.
(i) For an initial license to be issued, the
				State Survey Agency shall receive:
(A) A
				completed application form supplied by the State Survey Agency, including the
				completed items identified on the Hospital Licensure Checklist supplied by the
				State Survey Agency.
(B) Each
				completed application shall be accompanied by the required licensure fee
				identified in Chapter 1, Rules and Regulations for Health Care Facilities
				Licensure Fees. The check or money order shall be made payable to the
				Treasurer, State of Wyoming.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-6 - Governing Body

Current through July 13, 2024
There shall be a governing body legally responsible for the
				  management and operation of the hospital.
(a) Bylaws shall be adopted by the governing
				body in accordance with legal requirements.
(i) The bylaws shall:
(A) Stipulate the basis upon which members
				are selected, term of office, and duties.
(B) Specify to whom responsibilities for the
				operation and maintenance of the hospital, including evaluation of hospital
				practices, shall be delegated.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-7 - Medical Staff

Current through July 13, 2024
The hospital shall have a medical staff organized under
				  bylaws approved by the governing body and responsible to the governing body for
				  the quality of all medical care provided patients and for the ethical and
				  professional practices of its members.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-8 - Emergency Services

Current through July 13, 2024
The hospital shall meet the emergency needs of patients in
				  accordance with acceptable standards of practice.
(a) Diagnostic and treatment equipment, drug
				and supply space, and treatment rooms shall be adequate in number and
				size.
(b) The following equipment,
				as a minimum, shall be available to the emergency suites: cardiac monitor,
				resuscitator, defibrillator, aspirator, thoracotomy set, and tracheotomy
				set.
(c) Services shall be
				available twenty-four (24) hours a day, seven (7) days a week, and emergency
				room staff coverage shall be adequate to ensure that a patient for treatment
				will be seen within a reasonable length of time relative to his illness or
				injury.
(d) Adequate medical
				records shall be kept on every patient.
(i)
				The emergency room record shall contain:
(A)
				Patient identification.
(B) Time
				and date of service.
(C) History of
				disease or injury.
(D) Physical
				findings.
(E) Laboratory and x-ray
				reports (if any).
(F)
				Diagnosis.
(G) Record of
				treatment.
(H) Medications
				prescribed.
(I) Discharge
				instructions.
(J) Signature of
				physician.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-9 - Surgical Services

Current through July 13, 2024
If the hospital provides surgical services, the services
				  shall be well organized and provided in accordance with acceptable standards of
				  practice. If outpatient surgical services are offered, the services shall be
				  consistent in quality with inpatient care in accordance with the complexity of
				  services offered.
(a) There shall be
				written policies and procedures covering staffing, records consultation,
				cleaning procedures, supplies, dress attire, emergency situations, legal
				procedures, specimens, and recovery of patients.
(b) Traffic shall be controlled to avoid any
				through traffic.
(c) Rules and
				regulations related to the operating room(s) shall be available and
				posted.
(d) There shall be adequate
				and appropriate equipment and supplies maintained relating to the nature of the
				needs and services offered.
(e) All
				equipment and supplies shall be protected from contamination.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-10 - Anesthesia Services

Current through July 13, 2024
If the hospital furnishes anesthesia services, they shall be
				  provided under the direction of a qualified doctor of medicine or
				  osteopathy.
(a) Policies and
				procedures for the administration of all anesthetics shall be in place. In
				hospitals where there is no department of anesthesia, the department of surgery
				and/or medical staff shall assume the responsibility for establishing general
				policies regarding the administration of anesthetics.
(b) For hospitals with (twenty-five) 25
				licensed beds or less, a CRNA may administer anesthetics without physician
				supervision if the CRNA's practice is otherwise consistent with the medical
				staff bylaws.
(c) The medical staff
				shall designate those individuals qualified to administer anesthetics and shall
				delineate what each individual is qualified and approved to do.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-11 - Radiology Services

Current through July 13, 2024
The hospital shall maintain or have radiological services
				  readily available.
(a) Personnel
				adequate to supervise and conduct radiology services shall be provided and
				interpretations of radiological examinations shall be made by physicians
				competent to make such interpretations.
(b) Written policies and procedures shall be
				in place for the operation of equipment, the use of radium or other radioactive
				isotopes, safety precautions, and radiation exposure.
(c) Yearly inspection of x-ray equipment
				shall be made by competent personnel.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-12 - Laboratories

Current through July 13, 2024
(a) The hospital shall have a well organized
				CLIA of 1988 (Clinical Laboratory Improvement Act of 1988) certified,
				supervised clinical laboratory with the necessary space, facilities, equipment,
				and suitable location to perform those services commensurate with the
				hospital's needs for its patients.
(b) Anatomical and/or clinical pathology
				services and blood bank services shall be available either in the hospital or
				by other arrangements with a CLIA-certified laboratory.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-13 - Special Care Unit

Current through July 13, 2024
A separate unit designed for intensive treatment of seriously
				  ill patients who require extraordinary care on a concentrated and continuous
				  basis may be provided. The unit may be multipurpose for a variety of diagnoses
				  or for special diagnostic categories. If this service is provided, the
				  following requirements must be met:
(a) The unit shall have a defined
				organization and shall be integrated with other departments and services of the
				hospital.
(i) The unit shall be under the
				direction of a Wyoming-licensed physician.
(ii) Services shall be governed by written
				policies and procedures.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-14 - Obstetric Services

Current through July 13, 2024
Hospitals that choose to provide obstetric services shall
				  have policies and procedures to ensure adequate and comprehensive care to
				  mothers and their newborn infants in an environment which provides protection
				  from infection.
(a) The obstetrical
				suite and accessory services shall be so located that traffic in and out can be
				controlled and there is no through traffic.
(b) Policies and procedures shall be in
				writing to ensure safety to patients and personnel.
(c) A registered nurse shall be in charge of
				labor, delivery room, post partum, and nursery.
(d) A registered nurse shall be present in
				the delivery room at the time of delivery.
(i)
				The registered nurse shall be responsible for maintaining a complete register
				of delivery, which shall contain the name and hospital number of each patient
				admitted, date and time of admission, date and time of birth, sex, Apgar score
				of infant at birth, type of delivery, all operative procedures, names of
				physicians, assistants, and anesthetists and/or
				anesthesiologists.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-15 - Outpatient Services

Current through July 13, 2024
If the hospital provides outpatient services, there shall be
				  policies and procedures relating to the staff, functions of the service,
				  outpatient medical records, and necessary facilities in order to assure the
				  health and safety of the patients.
(a)
				Outpatient services shall be organized into sections (clinics); the number will
				depend on the size of the medical staff, available facilities, and patient
				needs.
(i) Outpatient services shall have
				arrangements and communications with community agencies such as other
				outpatient agencies, public health nursing, and health and welfare
				agencies.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-16 - Nursing Services

Current through July 13, 2024
The hospital shall provide nursing services twenty-four (24)
				  hours per day, seven (7) days a week. These services shall be supervised by a
				  registered nurse.
(a) Job descriptions
				delineating the qualifications, responsibilities, and duties for each category
				of nursing personnel shall be in writing and approved by the hospital
				administrator or her designee.
(b)
				Personnel records, including the application and verification of credentials,
				shall be maintained for each member of the nursing staff. Documentation shall
				be maintained which verifies the current Wyoming licensure status for those
				persons requiring licenses. Electronic verification must be evidenced in the
				personnel file by hard copy.
(c)
				Medications shall be administered by a registered nurse, LPN, a certified
				medication aide (MA-C) if allowed by the hospital's policy, or a student nurse
				in an approved school of nursing under the direct supervision of a registered
				nurse. In all instances, this activity shall be in accordance with the Wyoming
				Nurse Practice Act.
(d) All
				medication orders shall be in writing and signed by the practitioner. Telephone
				orders shall be used sparingly, and shall be signed or initialed by the
				practitioner within forty-eight (48) hours.
(e) Blood transfusions and intravenous
				medications shall be administered in accordance with state law. If administered
				by a registered nurse and/or LPN, they shall be administered only by those who
				have been specially trained.
(f)
				There shall be monthly meetings of the nursing staff. Minutes of these meetings
				shall be recorded.
(i) The minutes, when
				appropriate, shall reflect:
(A) The purpose
				of the staff meeting;
(B) Review
				and evaluation of nursing care, ways of improving nursing services, discussion
				of nursing care, and plans for individual patients;
(C) Consideration of specific nursing
				techniques and procedures;
(D)
				Establishment and/or interpretation of nursing services policies;
(E) Interpretation of administrative and
				medical staff policies, reports of meetings, etc.; and
(F) The names of individuals attending the
				meeting.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-17 - Dietary Services

Current through July 13, 2024
The hospital shall have an organized dietary service function
				  directed by qualified personnel.
(a)
				The hospital shall provide dietary services that meet the nutritional needs of
				patients according to the science of nutrition.
(i) Dietary services must operate with safe
				food handling practices in accordance with the current edition of the Food
				Code, published by the U.S. Public Health Service, Food and Drug
				Administration, from receipt through production and service.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-18 - Social Services

Current through July 13, 2024
There shall be policies and procedures for the social
				  services' staff and its functions.
(a)
				Social services shall be under the direction of a qualified social
				worker.
(b) Social services and
				other hospital services shall perform as an integrated unit.
(i) Social services shall participate in
				appropriate in-service training programs and conferences.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-19 - Rehabilitation, Physical Therapy, Speech Therapy, Audiology, and Occupational Therapy Services

Current through July 13, 2024
If the facility provides rehabilitation/therapy services, the
				  following requirements must be met:
(a) Written policies and procedures shall be
				in place to address the scope of services provided.
(b) Therapy personnel shall have the
				necessary knowledge, training, experience, and capabilities to properly
				supervise and administer the applicable therapy services. The
				rehabilitation/therapy services program shall be under the direction of an
				individual qualified by education and experience as appropriate to the scope of
				the rehabilitation/therapy services provided.
(c) Facilities and equipment for physical
				therapy, speech therapy, audiology, and occupational therapy shall be in good
				condition and adequate to meet patient needs.
(d) All therapies shall be given in
				accordance with a physician's orders and such orders shall be incorporated in
				the patient's record.
(e) Complete
				records shall be maintained for each patient who receives
				rehabilitation/therapy services and shall be part of the patient's permanent
				medical record.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-20 - Dental Services

Current through July 13, 2024
If the hospital provides dental services, the department
				  shall be organized comparable to other hospital services or departments. The
				  appointment of dentists shall be in accordance with the hospital's medical
				  staff bylaws and rules and regulations.
(a) The following requirements shall be met:
(i) Members of the dental staff shall be
				licensed in Wyoming pursuant to
				W.S.
				33-15-120.
(ii) There shall be a physician in attendance
				who is responsible for the medical care of the patient throughout the hospital
				stay;
(iii) Patients admitted for
				dental services shall be admitted in compliance with hospital
				regulations;
(iv) There shall be
				specific bylaws concerning the dental staff written as combined medical-dental
				staff bylaws or as separate or adjunct dental bylaws;
(v) Bylaws and rules and regulations shall
				specifically delineate the rights and privileges of the dentists; and
(vi) Complete records, both medical and
				dental, shall be required for each dental patient and shall be part of the
				hospital records.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-21 - Pharmacy

Current through July 13, 2024
The hospital shall have a pharmacy directed by a registered
				  pharmacist. The pharmacy shall be administered in accordance with accepted
				  professional principles.
(a) The
				pharmacist shall be responsible to the hospital administrator for developing,
				supervising, and coordinating all the activities of the pharmacy.
(b) Prescription medications shall be
				compounded in a proper location by a qualified pharmacist.
(c) Facilities shall be provided for storing,
				safeguarding, preparing, and dispensing of drugs.
(i) Drugs shall be issued to floor units in
				accordance with approved policies and procedures.
(ii) Drug cabinets on the nursing units shall
				be routinely checked by the pharmacist and all floor stocks shall be
				controlled.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-22 - Inpatient Psychiatric Services

Current through July 13, 2024
Hospitals which provide inpatient psychiatric services shall
				  also meet the State's Rules and Regulations for Licensure of Psychiatric
				  Hospitals.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-23 - Health Information and Management System

Current through July 13, 2024
The health information and management system shall be
				  maintained in accordance with accepted professional principles, for every
				  patient evaluated or treated in the hospital.
(a) There shall be qualified personnel
				adequate to supervise, maintain, and conduct the health information and
				management system function. Preferably, a Registered Health Information
				Administrator (RHIA) or Medical Records/Health Information Technician (MRHIT)
				will be in charge. If such a professional is not in charge, a qualified RHIA or
				MRHIT on a consultant or part-time basis shall organize the function, train the
				personnel, and make periodic on-site visits to evaluate the medical records
				function.
(b) All medical records
				and health information shall be maintained in accordance with the Health
				Insurance Portability and Accountability Act (HIPAA) of 1996, 42 CFR Part 2,
				and any other relevant state or federal laws relating to the maintenance of
				protected health information.
(c)
				Records of public hospitals shall be preserved, either in the original form or
				by other permanent means, for a period of time determined by the hospital
				administrator, based upon the legally approved retention schedules for
				publically-funded hospitals established by the Wyoming State Archives and the
				State Records Committee.
(d) A
				system of identification and filing to ensure the prompt location of a
				patient's medical records shall be maintained.
(e) Indexing shall be current within three
				(3) months following discharge of the patient.
(f) Medical records shall contain sufficient
				information to justify the diagnosis and warrant the treatment and end results.
(i) The medical records shall contain the
				following information:
(A) Identification
				data;
(B) Chief
				complaint;
(C) Present
				illness;
(D) Past
				history;
(E) Family
				history;
(F) Physical
				examination;
(G) Provisional
				diagnosis;
(H) Clinical laboratory
				reports;
(I) X-ray
				reports;
(J)
				Consultations;
(K) Treatment,
				medical and surgical;
(L) Tissue
				report;
(M) Progress
				notes;
(N) Final
				diagnosis;
(O) Discharge summary;
				and
(P) Autopsy
				findings.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-24 - Infection Control Program

Current through July 13, 2024
An infection control program shall be established based on
				  nationally recognized standards of practice. The program shall prevent,
				  identify, and control infections and communicable diseases.
(a) The infection control program is
				coordinated by the hospital administrator, the medical staff, and director of
				nursing services in conjunction with the hospital's quality assurance and
				performance improvement programs.
(b) Problems identified are reported to the
				medical staff, nursing, administration, and addressed in the hospital's quality
				assurance and in-service training programs.
(c) Documentation concerning corrective
				actions and outcomes is maintained.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-25 - Sanitary Environment

Current through July 13, 2024
The hospital shall provide for housekeeping, maintenance, and
				  laundry services.
(a) There shall be
				written policies and procedures for each of these functions to ensure the use
				of approved practices, procedures, and products.
(i) A designated person shall be responsible
				for plant maintenance, laundry, and general housekeeping. These
				responsibilities may be assigned to a single person in small
				hospitals.
(ii) Housekeeping shall
				be responsible for keeping the hospital free of offensive odors, accumulations
				of dirt, rubbish, dust, insects, and rodents.
(iii) Laundry facilities shall have physical
				separation of clean and dirty areas, adequate ventilation, and temperature
				control.
(iv) There shall be
				written policies and procedures covering the sterilization process used on
				various types of equipment, surfaces, supplies, and instruments.
(A) There shall be a procedure for quality
				control in relation to the sterilization process.
(B) Humidifiers and any associated tubing
				shall be replaced after each usage and the length of continuous usage shall not
				exceed twenty-four (24) hours.
(v) There shall be written policies and
				procedures covering the disinfectants used on various types of equipment,
				surfaces, and instruments.
(vi)
				There shall be a written policy covering the cleaning and disinfecting of ice
				machines.
(vii) All garbage and
				kitchen refuse shall be kept in leak proof, nonabsorbent containers with tight
				fitting covers. All garbage containers kept within the hospital buildings shall
				be washed, inside and out, daily. Other dry waste materials, normally
				designated "trash," may be stored in plastic bags.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-26 - Physical Environment

Current through July 13, 2024
The hospital buildings shall be designed, constructed,
				  arranged, equipped, and maintained to ensure the safety of patients, personnel,
				  and visitors, and to provide adequate and efficient care and treatment to the
				  patients.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-27 - Disaster Plan

Current through July 13, 2024
All hospitals shall develop and adopt a written disaster
				  preparedness plan. For hospitals that are federally certified, the disaster
				  preparedness plan shall be in accordance with, at a minimum, the edition of the
				  NFPA 99, Standards for Health Care Facilities, required by the federal
				  government.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-28 - Construction and Remodeling

Current through July 13, 2024
Wyoming Department of Health Chapter 3, Construction Rules
				  and Regulations for Healthcare Facilities, shall apply to all construction and
				  remodeling of hospitals.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 12 - Licensure of Hospitals › Section 12-29 - Life Safety and Electrical Safety

Current through July 13, 2024
Existing life safety and electrical safety in hospitals shall
				  be maintained in accordance with the requirements of the edition of the NFPA
				  101 Life Safety Code that was in effect at the time the facility was licensed
				  as a hospital.
(a) Where portions of a
				hospital have been licensed at different times, the existing life safety and
				electrical safety in each portion shall be maintained in accordance with the
				requirements of the NFPA 101 Life Safety Code that was in effect at the time
				that portion was added to the license.
(b) Hospitals that are federally certified
				shall meet, at a minimum, the edition of the NFPA 101 Life Safety Code required
				by the federal government.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 17 - Licensure of Critical Access Hospitals › Section 17-2 - Purpose and Applicability

Current through July 13, 2024
(a) These rules have been adopted to protect
				the health, safety and welfare of patients and employees in Critical Access
				Hospitals.
(b) The Department may
				issue manuals, bulletins, or both, to interpret the provisions of these rules
				and regulations. Such manuals and bulletins shall be consistent with and
				reflect the policies contained in these rules and regulations. The provisions
				contained in manuals or bulletins shall be subordinate to the provisions of
				these rules and regulations.
(c)
				The incorporation by reference of any external standard is intended to be the
				incorporation of that standard as it is in effect on the effective date of
				these rules and regulations.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 17 - Licensure of Critical Access Hospitals › Section 17-4 - Definitions

Current through July 13, 2024
The following definitions shall apply in the interpretation
				  and enforcement of these rules. Where the context in which words are used in
				  these rules indicates that such is the intent, words in the singular number
				  shall include the plural and visa versa. Throughout these rules gender pronouns
				  are used interchangeably. The drafters have attempted to utilize each gender
				  pronoun in equal numbers, in random distribution. Words in each gender include
				  individuals of the other gender.
For the purpose of these rules, the following shall
				  apply:
(a) "Acceptable Plan of
				Correction" means the Licensing Division approved the Critical Access
				Hospital's plan to correct the deficiencies identified during an on-site survey
				conducted by the Survey Division or its designated representative. The plan of
				correction shall be a written document and shall provide, but not be limited
				to, the following information:
(i) Who is
				responsible for the correction;
(ii) What was done to correct the
				problem;
(iii) Who will monitor to
				ensure that the situation does not develop again; and
(iv) An appropriate date, not to exceed sixty
				(60) days after the last day of survey, for the correction of
				deficiencies.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 17 - Licensure of Critical Access Hospitals › Section 17-5 - Licensure

Current through July 13, 2024
(a) Licensing Procedure.
(i) For an initial license to be issued, the
				Licensing Division shall receive:
(A) A
				completed application form as supplied by the Licensing Division;
(B) A copy of the Director, Department of
				Health's written notice of designation to become a Critical Access
				Hospital;
(C) The required
				licensure fee identified in Chapter 1, Rules and Regulations for Health Care
				Facilities Licensure Fees. The check or money order shall be made payable to
				the Treasurer, State of Wyoming.
(D) Applicant shall demonstrate full
				compliance with the licensure requirements in paragraph (b) of this
				section.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 17 - Licensure of Critical Access Hospitals › Section 17-7 - Medical Staff

Current through July 13, 2024
(a) The facility shall have a medical staff
				that includes at least one (1) physician, and may also include one (1) or more
				mid-level practitioners, who:
(i) Examines
				the credentials of candidates for medical staff membership and makes
				recommendations to the governing body on the appointment of candidates;
				and
(ii) Adopts a collaborative
				plan containing the following, and enforces the collaborative plan after
				approval by the governing body:
(A) A
				statement of the duties and privileges of each category of medical staff (e.g.,
				physician and mid-level practitioner); and
(B) A requirement that a physical examination
				be made and medical history taken of a patient by a member of the medical staff
				no more than twenty-four (24) hours after the patient's admission to the
				facility.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 17 - Licensure of Critical Access Hospitals › Section 17-8 - Emergency Services

Current through July 13, 2024
(a) The Critical Access Hospital shall meet
				the emergency needs of patients in accordance with acceptable standards of
				practice.
(i) Diagnostic and treatment
				equipment, drugs, supplies, and space, including space for a sufficient number
				of treatment rooms, shall be adequate in terms of the size and scope of
				service.
(ii) The following
				equipment shall be available to the emergency suites: cardiac monitor,
				resuscitator, defibrillator, aspirator, thoracotomy set and tracheotomy
				set.
(iii) Service shall be
				available twenty-four (24) hours a day, and emergency room staff shall be
				adequate to ensure that an applicant for treatment will be seen within a
				reasonable length of time relative to his/her illness.
(iv) Medical records for patients receiving
				emergency services shall be in accordance with Section
				15.
(v) Critical Access Hospitals must receive,
				and maintain, formal designation through the Department of Health's trauma
				system enhancement program
				W.S.
				35-1-801). The level of designation shall be
				at the discretion of the hospital.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 17 - Licensure of Critical Access Hospitals › Section 17-9 - Nursing Services

Current through July 13, 2024
(a) A Critical Access Hospital shall have a
				nursing service program that provides twenty-four (24) hour services, whenever
				a patient is in the facility, and meets the following requirements:
(i) The director of nursing services shall:
(A) Be a Wyoming licensed registered
				nurse;
(B) Determine the type and
				number of nursing personnel and staff necessary to provide nursing care;
				and
(C) Schedule adequate numbers
				of licensed registered nurses, licensed practical nurses, certified nursing
				assistants and other personnel to provide nursing care as
				needed.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 17 - Licensure of Critical Access Hospitals › Section 17-10 - Pharmaceutical Services

Current through July 13, 2024
(a) The facility shall have pharmaceutical
				services that meet the needs of the patients and comply with the following:
(i) A drug storage area under the supervision
				of the Director of Nursing who shall develop, supervise, and coordinate all of
				the pharmacy services;
(ii) The
				pharmacy or drug storage area shall be administered according to accepted
				professional standards;
(iii) All
				compounding, packaging, and dispensing of drugs and biologicals shall be
				consistent with federal and state laws;
(iv) Drugs and biologicals shall be kept in a
				locked storage area;
(v) Outdated,
				mislabeled, or otherwise unusable drugs and biologicals shall be destroyed by
				grinding in a garbage disposal or incineration; and
(vi) Drug administration errors, adverse drug
				reactions, and incompatibilities shall be immediately reported to the attending
				practitioner.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 17 - Licensure of Critical Access Hospitals › Section 17-11 - Radiologic Services

Current through July 13, 2024
(a) The facility shall maintain, or have
				available, diagnostic radiologic services, which shall meet the following:
(i) The radiologic services shall be free
				from radiation hazards for patients and personnel;
(ii) Annual inspection of equipment shall be
				made and hazards identified are promptly corrected;
(iii) Radiation workers shall continuously
				wear monitoring badges that are to be checked quarterly to determine the amount
				of radiation to which they are routinely exposed;
(iv) A qualified full-time, part-time, or
				consulting radiologist shall be utilized to interpret those radiographic tests
				that are determined by the medical staff to require a radiologist's specialized
				knowledge;
(A) The radiologist or other
				practitioner who provides radiology services shall sign each report containing
				his/her interpretations.
(v) Only personnel designated as qualified by
				the medical staff, and meeting the requirements of state law, may use the
				radiographic equipment and administer procedures; and
(vi) The facility shall maintain any
				radiographic studies and their interpretations for at least six (6)
				years.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 17 - Licensure of Critical Access Hospitals › Section 17-12 - Laboratory Services

Current through July 13, 2024
(a) The facility shall maintain, or have
				available, clinical laboratory services adequate to fulfill the needs of its
				patients and meets the following:
(i) The
				facility, at a minimum, shall provide basic laboratory services essential to
				the immediate diagnosis and treatment of patients, including:
(A) Chemical examinations of urine by stick
				or tablet methods, or both (including urine ketones);
(B) Microscopic examinations of urine
				sediment;
(C) Hemoglobin and
				hematocrit;
(D) Blood
				sugar;
(E) Gram stain;
(F) Examination of stool specimens for occult
				blood;
(G) Pregnancy
				test;
(H) Primary culturing for
				transmittal to a CLIA certified laboratory;
(I) Sediment rate;
(J) CBC; and
(K) Chemistry Panel.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 17 - Licensure of Critical Access Hospitals › Section 17-13 - Dietary Services

Current through July 13, 2024
(a) The facility shall provide dietary
				services that are directed and staffed by adequate personnel and meet the
				following:
(i) The facility shall assign an
				employee, or contract with a consultant, to direct dietetic services and be
				responsible for the daily management of dietary services. The individual shall
				be qualified by experience and training as a food service supervisor.
(ii) The facility shall utilize a qualified
				dietitian, full-time, part-time, or on a consultant basis; and
(iii) The facility shall provide dietetic
				services that meet the nutritional needs of patients according to the science
				of nutrition:
(A) The dietetic service must
				operate from receipt through production and service with safe food handling
				practices in accordance with the most current edition of FOOD CODE from the
				U.S. Public Health Service, Food and Drug Administration; and
(B) Therapeutic diets shall be prescribed by
				the practitioner responsible for the care of the
				patients.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 17 - Licensure of Critical Access Hospitals › Section 17-14 - Required Contracted Services

Current through July 13, 2024
(a) The facility shall enter into agreements
				with one or more hospitals participating in the Medicare/Medicaid programs to
				provide services which the Critical Access Hospital is unable to
				provide.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 17 - Licensure of Critical Access Hospitals › Section 17-15 - Medical Records

Current through July 13, 2024
(a) The facility shall maintain a medical
				records system in accordance with written policies and procedures.
(i) Professional standards of practice for
				medical records shall be met.
(ii)
				A medical record shall be created and maintained for each patient receiving
				health care services that includes, if applicable:
(A) Identification and social data;
(B) Admitting diagnosis;
(C) Pertinent medical history;
(D) Properly executed consent
				forms;
(E) Reports of physical
				examinations, diagnostic and laboratory test results, and consultation
				findings;
(F) All physicians'
				orders, nurses' notes, and reports of treatment and medications;
(G) Final diagnosis;
(H) Discharge summary; and
(I) Any other pertinent information necessary
				to monitor the patient's prognosis.
(iii) Each record shall include the
				signatures of the physician and the health care professional's
				documentation.
(iv) Records of a
				discharged patient shall be completed within fifteen (15) days of the discharge
				date.
(v) The facility shall have
				written policies and procedures ensuring the confidentiality of patient
				records, safeguards against loss, destruction, or unauthorized use, in
				accordance with applicable state and federal laws. These policies and
				procedures shall:
(A) Govern the use and
				removal of records from the record storage area;
(B) Specify the conditions under which record
				information may be released and to whom; and
(C) Specify when the patient's written
				consent is required for release of information.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 17 - Licensure of Critical Access Hospitals › Section 17-16 - Quality Improvement

Current through July 13, 2024
(a) The governing body, in accordance with
				W.S.
				35-2-910, shall ensure there is an effective,
				on-going, facility-wide, written quality improvement program which ensures and
				evaluates the quality of patient care provided and includes an annual review of
				the following:
(i) The utilization of facility
				services, including at least the number of patients served and volume of
				services; and
(ii) The facility's
				health care policies.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 17 - Licensure of Critical Access Hospitals › Section 17-17 - Infection Control

Current through July 13, 2024
(a) The facility shall:
(i) Maintain a sanitary environment which
				prevents the transmission and sources of infections and communicable
				diseases;
(ii) Develop and
				implement policies governing control of infections and communicable diseases;
				and
(iii) Maintain a log of
				incidents related to infections and communicable diseases.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 17 - Licensure of Critical Access Hospitals › Section 17-18 - Disaster Plan

Current through July 13, 2024
(a) All Critical Access Hospitals shall
				develop and adopt a written disaster preparedness plan in accordance with the
				Health Care Emergency Preparedness chapter of the applicable Life Safety Code
				(Ref: Page 17, Section
				21(a)(i)).
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 17 - Licensure of Critical Access Hospitals › Section 17-19 - Physical Environment

Current through July 13, 2024
(a) The Critical Access Hospital building(s)
				shall be designed, constructed, arranged, equipped and maintained to ensure the
				safety of patients, personnel and visitors and to provide adequate and
				efficient care and treatment of patients.
Fire safety shall be in accordance with the requirements of
				  the applicable NFPA Life Safety Code 101 (Ref: Page 17, Section
				  21(a)(i)).
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 17 - Licensure of Critical Access Hospitals › Section 17-21 - Life Safety and Electrical Safety

Current through July 13, 2024
(a) Department of Health Chapter III,
				Construction Rules for Health Facilities apply.
(i) Designated Critical Access Hospitals
				shall meet the Life Safety Code of the National Fire Protection Association
				that was in effect at the time the facility was licensed as a hospital, health
				clinic or health center.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 20 - HEALTH CARE FACILITIES JURISDICTION AND DELEGATION › Section 20-1 - Authority

Current through July 13, 2024
These rules are promulgated by the Department of Health
				  pursuant to
				  W.S.
				  35-2-906, W.S. W.S.
				  W.S.
				  35-9-121.1
et seq
.,
				  and the Wyoming Administrative Procedures Act at W.S. W.S.
				  W.S.
				  16-3-101
et
				  seq
.
Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0061 - Healthcare Licensing and Surveys › Chapter 20 - HEALTH CARE FACILITIES JURISDICTION AND DELEGATION › Section 20-2 - Applicability

Current through July 13, 2024
(a) These rules shall apply to and govern
				Health Care Facilities jurisdiction and delegation, on and after the effective
				date of these rules.
(b) The Office
				of Health Facilities may issue manuals, bulletins, or both, to interpret the
				provisions of these rules and regulations. Such manuals and bulletins shall be
				consistent with and reflect the policies contained in these rules and
				regulations. The provisions contained in manuals or bulletins shall be
				subordinate to the provisions of these rules and regulations.
(c) The incorporation by reference of any
				external standard is intended to be the incorporation of that standard as it is
				in effect on the effective date of these rules.