reglab/statecodes huggingface dataset:
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-329 - Childbirth centers › Section 246-329-075 - Criminal history, disclosure, and background inquiries

Current through Register Vol. 24-14, July 15, 2024
The purpose of this section is to ensure criminal history
				  background inquiries are conducted for any employee or prospective employee who
				  has or will have unsupervised access to children, vulnerable adults, and
				  individuals with developmental disabilities.
(1) A childbirth center applicant or licensee
				must establish and implement policies and procedures regarding Washington state
				patrol criminal background inquiries and disclosure statements under
				RCW
				43.43.830 through
				43.43.845 for the administrator,
				owner, director of services and personnel, contractors, volunteers, students,
				and any other individual associated with the licensee having direct contact
				with children under sixteen years of age, individuals with developmental
				disabilities, or vulnerable adults.
(2) The department may require licensees to
				complete additional disclosure statements or background inquiries for a person
				associated with the licensed facility having direct contact with vulnerable
				adults if the department has reason to believe that offenses specified under
				RCW
				43.43.830 have occurred since completion of
				the previous disclosure statement or background inquiry.
Statutory Authority: Chapter 18.46 RCW and RCW 43.70.040.
					 07-07-075, § 246-329-075, filed 3/16/07, effective
					 4/16/07.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-329 - Childbirth centers › Section 246-329-095 - Staffing

Current through Register Vol. 24-14, July 15, 2024
The purpose of the staffing section is to ensure the birth
				  center provides competent staff consistent with the scope of services.
(1) The birth center shall have sufficient,
				qualified personnel and clinical staff to provide the services needed by
				clients and for safe maintenance and operation of the birth center.
(2) The birth center shall have written plans
				for consultation, referral, transfer of care, emergency transfer and transport
				of a newborn to a newborn nursery or neonatal intensive care nursery, and
				emergency transfer or transport of a maternal client to an appropriate
				obstetrical department, patient care area or hospital where appropriate care is
				available.
(3) The birth center
				shall:
(a) Employ, contract or use
				appropriately trained personnel and clinical staff; and
(b) Assure clinical staff or personnel have
				evidence of current training in neonatal and adult resuscitation.
(c) Assure a physician or midwife is present
				at each birth. A second person who is an employee, student or member of the
				clinical staff with evidence of current training in neonatal and adult
				resuscitation skills shall be immediately available in the birthing center
				during each birth.
(d) Ensure
				twenty-four hour coverage, including the provision that appropriate, qualified
				personnel and/or clinical staff shall be present in the birth center at all
				times when clients are present.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-329 - Childbirth centers › Section 246-329-110 - Personnel policy and procedures and records

Current through Register Vol. 24-14, July 15, 2024
The purpose of this section is to ensure the birth center
				  provides direction and standards in the employment, contracting and recording
				  of personnel procedures.
(1) A
				childbirth center applicant or licensee must establish and implement policy and
				procedures which include, but are not limited to:
(a) For those birth centers operated by an
				employer as defined by
				RCW
				49.60.040(3), employment
				criteria consistent with chapter 49.60 RCW;
(b) Job descriptions for employees,
				contractor agreements, volunteer responsibility statements and agreements with
				students commensurate with responsibilities and consent with health care
				professional credentialing and scope of practice as defined in relevant
				practice acts and associated rules;
(c) Verification of clinical staff
				credentials;
(d) Orientation to
				current agency policies and procedures and verification of skills or training
				for all clinical staff;
(e) Current
				neonatal and adult cardiopulmonary resuscitation training consistent with
				agency policies and procedures and community standards for all clinical
				staff;
(f) Infection control
				practices for clinical staff including communicable disease testing,
				immunization, vaccination and universal precautions or equivalent method of
				preventing the transmission of infection according to current local health
				authorities and shall include the availability of equipment necessary to
				implement plans of care and infection control policies and procedures;
(i) Birth centers must establish and
				implement a TB screening program for personnel;
(ii) Birth centers must provide or offer to
				employees Hepatitis B vaccination according to WAC 296-62-08001; and
(iii) Birth centers must assure that all
				contractors have received or been offered Hepatitis B vaccination according to
				WAC 296-62-08001;
(g)
				Performance evaluations of all personnel, including evaluations of contractor
				and student agreements to be conducted per birth center's policy and procedure;
				and
(h) Washington state patrol
				criminal background inquiries and disclosure statements under
				RCW
				43.43.830 through
				43.43.845 for the administrator,
				owner, director of services and personnel, contractors, volunteers, students,
				and any other individual associated with the licensee who has direct contact
				with children under sixteen years of age, people with developmental
				disabilities or vulnerable adults.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-329 - Childbirth centers › Section 246-329-120 - Birth center policies and procedures

Current through Register Vol. 24-14, July 15, 2024
The purpose of this section is to ensure the birth center is
				  able to provide safe and appropriate care to the clients of the birth
				  center.
(1) An applicant or licensee
				must establish and implement policy and procedures which include, but are not
				limited to:
(a) Definition of a low-risk
				maternal client who is eligible for birth services offered by the birth
				center.
(b) Definition of a client
				who is ineligible for birth services at the birth center.
(c) Identification and transfer of clients
				who, during the course of pregnancy, are determined to be ineligible.
(d) Identification and transfer of clients
				who, during the course of labor or recovery, are determined to be ineligible
				for continued care in the birth center.
(e) Written plans for consultation, referral
				and transfer of care for maternal client and newborn. Written plans for
				emergency transfer and transport of a newborn to a newborn nursery or neonatal
				intensive care nursery, and emergency transfer and transport of a maternal
				client to an appropriate obstetrical department, patient care area, or hospital
				where appropriate care is available.
(f) Transfer and discharge of neonates to
				minimize risk of newborn abduction.
(g) Protocol for medications and laboratory
				testing during labor and recovery if the birth center plans to deliver HIV
				positive clients.
(h) Rapid HIV
				testing using the opt out approach for women who have undocumented HIV test
				results when presenting to the birth center in labor.
(i) Protocol for electronic fetal heart
				monitoring or intermittent auscultation to monitor fetal status during
				labor.
(j) Protocol for the
				provision of MMR vaccine to nonimmune postpartum women.
(k) Protocol for the provision of anti D
				immune globulin to postpartum women who are unsensitized D-Negative and who
				deliver a D positive or Du positive infant.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-329 - Childbirth centers › Section 246-329-130 - Birth center equipment and supplies

Current through Register Vol. 24-14, July 15, 2024
The purpose of this section is to ensure the birth center
				  provides safe and appropriate equipment and supplies necessary to the safe
				  provision of care to the client of the birth center.
(1) The applicant or licensee shall assure
				the birth center has the adequate, appropriate size and type equipment and
				supplies maintained for the maternal client and the newborn to include:
(a) A bed suitable for labor, birth, and
				recovery;
(b) Separate oxygen with
				flow meters and masks or equivalent;
(c) Suction equipment for the maternal client
				and newborn to include suction apparatus, either operated from a wall outlet or
				portable equipment, and bulb suction as appropriate. These devices must be
				immediately available in the birth center;
(d) Resuscitation equipment to include adult
				and neonate resuscitation bags and term and preterm size face masks, and
				neonatal-sized oxygen bags for assisted ventilation. Newborn resuscitation
				equipment shall include method to deliver free flow oxygen;
(e) Firm surfaces suitable for
				resuscitation;
(f) Fetal monitoring
				equipment, minimally to include a fetoscope, doppler or electronic
				monitor;
(g) Equipment for
				monitoring and maintaining the optimum body temperature of the newborn. A heat
				source appropriate for use in warming newborns shall be available, and may
				include an incubator;
(h) A time
				keeping device;
(i) Sterile
				suturing equipment and supplies;
(j) Glucose meter appropriately calibrated to
				screen glucose level in newborn;
(k) Examination lighting device with a
				shatterproof bulb or protective shield;
(l) Containers for soiled linen and waste
				materials which shall be closed or covered.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-329 - Childbirth centers › Section 246-329-140 - Client records

Current through Register Vol. 24-14, July 15, 2024
The purpose of this section is to assure the center obtains,
				  manages, and uses information to improve patient outcomes and the performance
				  of the birth center in patient care.
(1) The birth center shall have a defined
				client record system, policies and procedures which provide for identification,
				security, confidentiality, control, retrieval, and preservation of client care
				data and information.
(2) The
				childbirth center must maintain a health record for each maternal and newborn
				client in a legally acceptable, integrated and chronological document on the
				licensee's standardized forms consistent with chapter 70.02 RCW, Medical
				records -- Health care information access and disclosure. Each record must
				include:
(a) Client's demographic information
				and client identification to include at a minimum client's name, birth date,
				age, and address;
(b) Client's
				informed consent for care, service, treatment and receipt of the client bill of
				rights;
(c) Signed and
				authenticated notes describing the newborn and maternal status during prenatal,
				labor, birth, and recovery including, but not limited to:
(i) Documentation that verifies the client's
				low-risk maternal client status; and
(ii) Labor summary;
(iii) Newborn status including Apgar scores,
				maternal newborn interaction; and
(iv) Physical assessment of the mother and
				newborn during recovery;
(d) Documentation that a newborn screening
				specimen was collected (or signed refusal on the back of the specimen form) and
				submitted to the department's newborn screening program under WAC
				246-650-020;
(e) Documentation and authentication of
				orders by clinical staff and birth center personnel who administer drugs and
				treatments or make observations and assessments;
(f) Laboratory and diagnostic testing
				results;
(g) Consultation
				reports;
(h) Referral, transfer of
				care, emergency transfer and transport documentation;
(i) Prophylactic treatment of the eyes of the
				newborn in accordance with WAC
				246-100-206(6)(b);
(j) Prenatal screening under chapters 70.54
				RCW and 246-680 WAC, including client's refusal;
(k) Documentation of refusal of rapid HIV
				testing if documentation of an HIV test during prenatal care is not
				available;
(l) For HIV positive
				women, the antiretroviral medications during delivery and recommended lab
				tests;
(m) Intrapartum antibiotics
				for Group B Strep positive women per the CDC protocol;
(n) For Hepatitis B positive women, HBIG and
				Hepatitis B immunization for newborn;
(o) Refusal of any recommended test or
				treatment;
(p) Documentation of
				birth registration per chapter 70.58 RCW.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-329 - Childbirth centers › Section 246-329-150 - Pharmaceuticals

Current through Register Vol. 24-14, July 15, 2024
The purpose of this section is to assure that client
				  pharmaceutical needs are met in a planned and organized manner.
(1) The licensee shall maintain written
				prescriptions or orders signed by a practitioner legally authorized to
				prescribe for all drugs administered to clients within the birth
				center.
(2) The licensee shall have
				written policies and procedures addressing the receiving, transcribing, and
				implementing of orders for administration of drugs.
(3) The licensee shall establish and
				implement written policies to address the type and intended use of any drug or
				device to be used by patients within the facility.
(4) The licensee shall assure that only local
				anesthetics are used.
(5) The
				licensee shall ensure:
(a) Drugs are only
				administered by personnel or clinical staff licensed to administer
				drugs;
(b) Drugs kept anywhere in
				the center are clearly labeled with drug name, strength, and expiration
				date;
(c) Expired drugs are removed
				from the storage units and destroyed properly;
(d) Drugs are stored and secured in
				specifically designated cabinets, closets, drawers, or storerooms and made
				accessible only to authorized persons;
(e) Drugs for external use must be stored
				apart from drugs for internal use;
(f) Poisonous or caustic medications and
				materials including housekeeping and personal grooming supplies must show
				proper warning or poison labels and must be stored safely and separately from
				other medications and food supplies;
(g) Drugs requiring refrigeration must be
				kept in a separate refrigeration unit according to manufacturer's
				directions;
(h) Schedule II-IV
				controlled substances are:
(i) Kept in a
				separate locked storage unit; and
(ii) If heat sensitive, kept in a locked
				refrigeration unit;
(i)
				Schedule II-IV controlled substances no longer needed by the patient must be
				disposed of in compliance with chapter 246-865 WAC.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-329 - Childbirth centers › Section 246-329-160 - Birth center - Physical environment

Current through Register Vol. 24-14, July 15, 2024
The purpose of this section is to reduce and control
				  environmental hazards and risks, prevent accidents and injuries, and maintain
				  safe conditions and equipment for clients, visitors, and staff.
(1) The licensee shall provide and maintain a
				safe and clean environment. The licensee shall maintain the facility consistent
				with this chapter. Birthing centers built before the adoption of this chapter
				shall be maintained to the standards that were in place at the time the
				facility was licensed. If the licensee modifies or alters the facility, the
				altered areas must meet and be maintained consistent with this chapter and in
				accordance with the approved plans.
(2) The licensee shall provide at least one
				birthing room that is a minimum of three hundred square feet and has a minimum
				dimension of fifteen feet. The room shall be adequate and appropriate to
				provide for the equipment, staff, supplies, and emergency procedures required
				for the physical and emotional care of a maternal client, her support person or
				persons, and the newborn during birth, labor, and the recovery period.
(a) Additional birthing rooms shall have a
				gross floor space of one hundred fifty-six square feet or fourteen and one-half
				square meters and a minimum room dimension of eleven feet.
(b) The licensee shall locate birthing rooms
				to provide unimpeded, rapid access to an exit of the building which will
				accommodate emergency transportation vehicles.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-329 - Childbirth centers › Section 246-329-170 - Emergency preparedness

Current through Register Vol. 24-14, July 15, 2024
The purpose of this section is to establish and implement a
				  disaster plan designed to meet both internal and external disasters.
Each applicant or licensee shall:
(1) Develop and implement written policies
				and procedures governing emergency preparedness and fire protection;
(2) Develop an acceptable written plan,
				periodically rehearsed with personnel, contractors, and volunteers, to be
				followed in the event of an internal or external emergency, and for the care of
				casualties of the patient and family, personnel, contractors and volunteers
				arising from such emergencies; and
(3) Develop a fire protection plan to
				include:
(a) Instruction for all personnel,
				contractors or volunteers in use of alarms, firefighting equipment, methods of
				fire containment, evacuation routes and procedures for calling the fire
				department and the assignment of specific tasks to all personnel, contractors
				and volunteers in response to an alarm; and
(b) Semiannual evacuation and fire drills for
				each shift of personnel.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-329 - Childbirth centers › Section 246-329-180 - Quality improvement

Current through Register Vol. 24-14, July 15, 2024
The purpose of this section is to ensure that performance
				  improvement activities of clinical staff result in continuous improvement of
				  client health outcomes.
Each childbirth center licensee must maintain a quality
				  improvement program to assure the quality of care and services provided that
				  includes, at a minimum:
(1) A
				complaint process that includes a procedure for the receipt, investigation, and
				disposition of complaints regarding services;
(2) A method to identify, monitor and
				evaluate:
(a) Services; and
(b) Referral, transfer, consultation, and
				transport experience and plans; and
(c) Complications of pregnancy, labor and
				postpartum; and
(d) Other aspects
				of services which affect quality care.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-329 - Childbirth centers › Section 246-329-990 - Fees

Current through Register Vol. 24-14, July 15, 2024
The purpose of the fees section is to describe the fees
				  associated with licensing, renewal and other charges assessed by the
				  department.
(1) Childbirth centers
				licensed under chapter 18.46 RCW shall submit an annual fee of seven hundred
				thirteen dollars and zero cents to the department unless a center is a
				charitable, nonprofit, or government-operated institution under
				RCW
				18.46.030.
(2) A change of ownership fee of one hundred
				seventy-eight dollars. A new license will be issued and valid for the remainder
				of the current license period.
(3)
				The department may charge and collect from a licensee a fee of eight hundred
				ninety-two dollars for:
(a) A second on-site
				visit resulting from failure of the licensee to adequately respond to a
				statement of deficiencies;
(b) A
				complete on-site survey resulting from a substantiated complaint; or
(c) A follow-up compliance survey.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-330 - Ambulatory surgical facilities › Section 246-330-001 - Purpose and applicability of chapter

Current through Register Vol. 24-14, July 15, 2024
The Washington state department of health adopts this chapter
				  to implement chapter 70.230 RCW and establish minimum health and safety
				  requirements for the licensing, inspection, operation, maintenance, and
				  construction of ambulatory surgical facilities.
(1) Compliance with the regulations in this
				chapter does not constitute release from the requirements of applicable
				federal, state and local codes and ordinances. Where regulations in this
				chapter exceed other codes and ordinances, the regulations in this chapter will
				apply.
(2) The department will
				update or adopt references to codes and regulations in this chapter as
				necessary.
Statutory Authority: Chapter 70.230 RCW. 09-09-032, §
					 246-330-001, filed 4/7/09, effective
					 5/8/09.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-330 - Ambulatory surgical facilities › Section 246-330-010 - Definitions

Current through Register Vol. 24-14, July 15, 2024
The definitions in this section apply throughout this
				  chapter unless the context clearly requires otherwise:
(1) "Abuse" means injury or sexual abuse of a
				patient indicating the health, welfare, and safety of the patient is harmed:
(a) "Physical abuse" means acts or incidents
				which may result in bodily injury or death.
(b) "Emotional abuse" means to impose willful
				or reckless mental or emotional anguish by threat, verbal behavior, harassment,
				or other verbal or nonverbal actions which may result in emotional or
				behavioral stress or injury.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-330 - Ambulatory surgical facilities › Part I - OPERATIONAL RULES › Section 246-330-020 - Department responsibilities - Licensing, change of ownership - Adjudicative proceeding

Current through Register Vol. 24-14, July 15, 2024
This section outlines the actions and roles of the
					 department for licensing an ambulatory surgical facility.
(1) For existing facilities currently doing
				  business, that apply for a license prior to July 1, 2009, the department will
				  verify compliance with chapter 70.230 RCW and this chapter before issuing an
				  initial license by:
(a) Receipt and approval
				  of the initial license application;
(b) Receipt of the correct licensing
				  fee;
(c) Receipt of a completed and
				  accepted inspection conducted by:
(i) The
				  Centers for Medicare and Medicaid Services;
(ii) The Joint Commission;
(iii) The Accreditation Association for
				  Ambulatory Health Care;
(iv) The
				  American Association for Accreditation of Ambulatory Surgery Facilities;
				  or
(d) For facilities
				  that have not been inspected by medicare or one of the accrediting
				  organizations listed in (c) of this subsection, the following:
(i) Receipt of a certificate of need, when
				  needed, as provided in chapter 70.38 RCW;
(ii) Receipt of a certificate of occupancy by
				  the local jurisdiction;
(iii)
				  Receipt of the ambulatory surgical facility's safety and emergency training
				  program; and
(iv) Successfully
				  completing an on-site licensing inspection conducted by the
				  department.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-330 - Ambulatory surgical facilities › Part I - OPERATIONAL RULES › Section 246-330-025 - Department responsibility - On-site survey and complaint investigation

Current through Register Vol. 24-14, July 15, 2024
This section outlines the department's on-site survey and
					 complaint investigation activities and roles.
(1) Surveys. The department will:
(a) Conduct on-site surveys of each
				  ambulatory surgical facility every eighteen months or more often using the
				  health and safety standards in this chapter and chapter 70.230 RCW;
(b) Accept, in accordance with
				  RCW
				  70.230.100(2), as a
				  substitute for the department's eighteen months on-site survey, on-site surveys
				  conducted by the Joint Commission, Accreditation Association for Ambulatory
				  Health Care, American Association for Accreditation of Ambulatory Surgery
				  Facilities or the Centers for Medicare and Medicaid Services as substituting
				  for the eighteen month state survey requirement once every three
				  years;
(c) Notify the ambulatory
				  surgical facility in writing the survey findings following each on-site
				  survey;
(d) Require each ambulatory
				  surgical facility to submit a corrective action plan addressing each deficient
				  practice identified in the survey findings; and
(e) Notify the ambulatory surgical facility
				  when their submitted plan of correction adequately addresses the survey
				  findings.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-330 - Ambulatory surgical facilities › Part I - OPERATIONAL RULES › Section 246-330-030 - Operating without a license - Adjudicative proceeding

Current through Register Vol. 24-14, July 15, 2024
This section outlines the department's responsibility and
					 authority over ambulatory surgical facilities that operate after July 1, 2009,
					 without a department issued license.
(1) The department will investigate
				  complaints of an ambulatory surgical facility operating without a
				  license.
(2) Upon confirming that
				  an ambulatory surgical facility is operating without a license, the secretary
				  of the department may:
(a) Issue a notice of
				  intention to issue a cease and desist order; or
(b) Issue a temporary cease and desist order
				  after making a written finding of fact that the public interest will be
				  irreparably harmed by delay in issuing the order. The temporary cease and
				  desist order will remain in effect until further order by the secretary of the
				  department.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-330 - Ambulatory surgical facilities › Part I - OPERATIONAL RULES › Section 246-330-035 - Exemptions, interpretations, alternative methods

Current through Register Vol. 24-14, July 15, 2024
(1) The department may exempt an ambulatory
				  surgical facility from complying with portions of this chapter when:
(a) The exemption will not change the purpose
				  and intent of chapter 70.230 RCW or this chapter;
(b) Patient safety, health or well-being is
				  not threatened;
(c) Fire and life
				  safety regulations, infection control standards or other codes or regulations
				  would not be reduced; and
(d)
				  Structural integrity of the building is not compromised.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-330 - Ambulatory surgical facilities › Part I - OPERATIONAL RULES › Section 246-330-100 - Application for license - Annual update of ambulatory surgical facilities information - License renewal - Right to contest a license decision

Current through Register Vol. 24-14, July 15, 2024
This section identifies the actions and responsibilities of
					 an applicant or ambulatory surgical facility for a license.
(1) Initial license. An applicant must submit
				  an application packet and fee to the department at least sixty days before the
				  intended opening date of the new ambulatory surgical facility.
(2) Annual update. Before December 31st of
				  each calendar year, a licensed ambulatory surgical facility must submit to the
				  department an annual update documentation form.
(3) License renewal. No later than thirty
				  days before the license expiration date, a licensed ambulatory surgical
				  facility must submit to the department a renewal application form and
				  fee.
(4) An applicant or ambulatory
				  surgical facility has the right to contest a department decision to deny,
				  modify, suspend or revoke a license by:
(a)
				  Sending a written request for an adjudicative proceeding within twenty-eight
				  days of receipt of the department's licensing decision showing proof of receipt
				  with the office of the Adjudicative Service Unit, Department of Health, P.O.
				  Box 47879, Olympia, WA 98504-7879; and
(b) Include as part of the written request:
(i) A specific statement of the issues and
				  law involved;
(ii) The grounds for
				  contesting the department decision; and
(iii) A copy of the contested department
				  decision.
(c) The
				  adjudicative proceeding is governed by the Administrative Procedure Act chapter
				  34.05 RCW, this chapter, and chapter 246-10 WAC.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-330 - Ambulatory surgical facilities › Part I - OPERATIONAL RULES › Section 246-330-105 - Ambulatory surgical facility responsibilities

Current through Register Vol. 24-14, July 15, 2024
This section identifies the actions and responsibilities of
					 a licensed ambulatory surgical facility.
(1) An ambulatory surgical facility must
				  comply with chapter 70.230 RCW and this chapter;
(2) An ambulatory surgical facility certified
				  by the Centers for Medicare and Medicaid Services or accredited by the Joint
				  Commission, Accreditation Association for Ambulatory Health Care or American
				  Association for Accreditation of Ambulatory Surgery Facilities must:
(a) Notify the department of a certification
				  or an accreditation survey within two business days following completion of the
				  survey; and
(b) Notify the
				  department in writing of the accreditation decision and any changes in
				  accreditation status within thirty calendar days of receiving the accreditation
				  report.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-330 - Ambulatory surgical facilities › Part I - OPERATIONAL RULES › Section 246-330-110 - Requests for exemptions, interpretations, alternative methods

Current through Register Vol. 24-14, July 15, 2024
This section outlines a process to request an exemption,
					 interpretation, or approval to use an alternative method and the department's
					 response. This section is not intended to prevent use of systems, materials,
					 alternate design, or methods of construction as alternatives to those
					 prescribed by this chapter.
(1) A
				  licensed ambulatory surgical facility requesting exemption from this chapter
				  must:
(a) Send a written request to the
				  department;
(b) Include in the
				  request:
(i) The specific section of this
				  chapter to be exempted;
(ii)
				  Explain the reasons for requesting the exemption;
(iii) How the exemption will not change the
				  purpose and intent of chapter 70.230 RCW or this chapter;
(iv) Why the exemption does not threaten
				  patient safety or health;
(v) How
				  the exemption will not reduce or alter fire and life safety or infection
				  control requirements; and
(vi) Why
				  the exemption does not compromise structural integrity of the
				  building.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-330 - Ambulatory surgical facilities › Part I - OPERATIONAL RULES › Section 246-330-115 - Governance

Current through Register Vol. 24-14, July 15, 2024
This section outlines the organizational guidance and
					 oversight responsibilities of ambulatory surgical facility resources and staff
					 to support safe patient care.
An ambulatory surgical facility must have a governing
					 authority that is responsible for determining, implementing, monitoring and
					 revising policies and procedures covering the operation of the facility that
					 includes:
(1) Selecting and
				  periodically evaluating a chief executive officer or administrator;
(2) Appointing and periodically reviewing a
				  medical staff;
(3) Approving the
				  medical staff bylaws;
(4) Reporting
				  practitioners according to
				  RCW
				  70.230.120;
(5) Informing patients of any unanticipated
				  outcomes according to
				  RCW
				  70.230.150;
(6) Establishing and approving a coordinated
				  quality performance improvement plan according to
				  RCW
				  70.230.080;
(7) Establishing and approving a facility
				  safety and emergency training program according to
				  RCW
				  70.230.060;
(8) Reporting adverse events and conducting
				  root cause analyses according to chapter 246-302 WAC;
(9) Providing a patient and family grievance
				  process including a time frame for resolving each grievance according to
				  RCW
				  70.230.080(1)(d);
(10) Defining who can give and receive
				  patient care orders that are consistent with professional licensing laws;
				  and
(11) Defining who can
				  authenticate written or electronic orders for all drugs, intravenous solutions,
				  blood, and medical treatments that are consistent with professional licensing
				  laws.
Statutory Authority: Chapter 70.56 RCW. 12-16-057, §
						246-330-115, filed 7/30/12, effective 10/1/12. Statutory Authority: Chapter
						70.230 RCW. 09-09-032, § 246-330-115, filed 4/7/09, effective
						5/8/09.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-330 - Ambulatory surgical facilities › Part I - OPERATIONAL RULES › Section 246-330-120 - Leadership

Current through Register Vol. 24-14, July 15, 2024
This section describes leaderships' role in assuring care
					 is provided consistently throughout the facility according to patient
					 needs.
The ambulatory surgical facility leaders must:
(1) Identify patient care responsibilities
				  for all nursing personnel;
(2)
				  Assure nursing services are provided in accordance with state nurse licensing
				  law and recognized standards of practice;
(3) Assure a registered nurse is available
				  for emergency treatment at all times a patient is present in the
				  facility;
(4) Establish and
				  implement a facility-wide procedure for double-checking drugs, biologicals, and
				  agents as designated by the facility;
(5) Ensure immediate staff access to and
				  appropriate dosages for emergency drugs;
(6) Require individuals conducting business
				  in the ambulatory surgical facility comply with facility policies and
				  procedures;
(7) Post the complaint
				  hotline notice according to
				  RCW
				  70.230.160; and
(8) Adopt and implement policies and
				  procedures to report suspected abuse within forty-eight hours to local police
				  or appropriate law enforcement agency according to
				  RCW
				  26.44.030.
Statutory Authority: Chapter 70.230 RCW. 09-09-032,
						§ 246-330-120, filed 4/7/09, effective
						5/8/09.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-330 - Ambulatory surgical facilities › Part I - OPERATIONAL RULES › Section 246-330-125 - Patient rights and organizational ethics

Current through Register Vol. 24-14, July 15, 2024
The purpose of this section is to improve patient care and
					 outcomes by respecting every patient and maintaining ethical relationships with
					 the public.
Ambulatory surgical facilities must:
(1) Adopt and implement policies and
				  procedures that define each patient's right to:
(a) Be treated and cared for with dignity and
				  respect;
(b) Confidentiality,
				  privacy, security, complaint resolution, spiritual care, and communication. If
				  communication restrictions are necessary for patient care and safety, the
				  facility must document and explain the restrictions to the patient and
				  family;
(c) Be protected from abuse
				  and neglect;
(d) Access protective
				  services;
(e) Complain about their
				  care and treatment without fear of retribution or denial of care;
(f) Timely complaint resolution;
(g) Be involved in all aspects of their care
				  including:
(i) Refusing care and treatment;
				  and
(ii) Resolving problems with
				  care decisions.
(h) Be
				  informed of unanticipated outcomes according to
				  RCW
				  70.230.150;
(i) Be informed and agree to their care;
				  and
(j) Family input in care
				  decisions, in compliance with existing legal directives of the patient or
				  existing court-issued legal orders.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-330 - Ambulatory surgical facilities › Part I - OPERATIONAL RULES › Section 246-330-130 - Adverse health events reporting requirements

Current through Register Vol. 24-14, July 15, 2024
The National Quality Forum identifies and defines
					 twenty-nine serious reportable events (adverse health events) as updated and
					 adopted in 2011.
(1) An ambulatory
				  surgical facility must report adverse health events to the
				  department.
(2) An ambulatory
				  surgical facility must comply with the reporting requirements under chapter
				  246-302 WAC.
(3) Adverse health
				  events are listed in chapter 246-302 WAC.
Statutory Authority: Chapter 70.56 RCW. 12-16-057, §
						246-330-130, filed 7/30/12, effective 10/1/12. Statutory Authority: Chapter
						70.230 RCW. 09-09-032, § 246-330-130, filed 4/7/09, effective
						5/8/09.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-330 - Ambulatory surgical facilities › Part I - OPERATIONAL RULES › Section 246-330-140 - Management of human resources

Current through Register Vol. 24-14, July 15, 2024
This section ensures that ambulatory surgical facilities
					 provide competent staff consistent with scope of services.
Ambulatory surgical facilities must:
(1) Create and periodically review job
				  descriptions for all staff;
(2)
				  Supervise staff performance to assure competency;
(3) Verify and document licensure,
				  certification, or registration of staff;
(4) Complete tuberculosis screening for new
				  and current employees consistent with the
Guidelines for Preventing the
				  Transmission of Mycobacterium Tuberculosis in Healthcare Facilities,
2005.
Morbidity Mortality Weekly Report (MM -WR) Volume
				  54
, December 30, 2005;
(5)
				  Provide infection control information to staff upon hire and annually which
				  includes:
(a) Education on general infection
				  control according to chapter 296-823 WAC blood borne pathogens exposure
				  control; and
(b) General and
				  specific infection control measures related to patient care.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-330 - Ambulatory surgical facilities › Part I - OPERATIONAL RULES › Section 246-330-145 - Medical staff

Current through Register Vol. 24-14, July 15, 2024
This section requires development of a medical staff
					 structure, consistent with clinical competence, to ensure a safe patient care
					 environment.
The medical staff must:
(1) Be accountable to the governing
				  body;
(2) Adopt bylaws, rules,
				  regulations, and organizational structure including an appointment and
				  reappointment process;
(3) Be
				  legally and professionally qualified for the positions to which they are
				  appointed and for the performance of privileges in accordance with
				  recommendations from qualified medical personnel;
(4) Periodically review and reappraise
				  medical staff privileges using peer review data;
(5) Periodically review and amend the scope
				  of procedures performed in the ambulatory surgical facility;
(6) If the ambulatory surgical facility
				  assigns patient care responsibilities to practitioners other than physicians,
				  it must have established policies and procedures, approved by the governing
				  body, for overseeing and evaluating their clinical activities; and
(7) Report practitioners for discipline of
				  unprofessional conduct according to
				  RCW
				  70.230.120.
Statutory Authority: Chapter 70.230 RCW. 09-09-032,
						§ 246-330-145, filed 4/7/09, effective
						5/8/09.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-330 - Ambulatory surgical facilities › Part I - OPERATIONAL RULES › Section 246-330-150 - Management of information

Current through Register Vol. 24-14, July 15, 2024
The purpose of this section is to improve patient outcomes
					 and ambulatory surgical facility performance through obtaining, managing, and
					 use of information.
An ambulatory surgical facility must:
(1) Provide medical staff, employees and
				  other authorized persons with access to patient information systems, resources,
				  and services;
(2) Maintain
				  confidentiality, security, and integrity of information;
(3) Initiate and maintain a medical record
				  for every patient assessed or treated including a process to review records for
				  completeness, accuracy, and timeliness;
(4) Create medical records that:
(a) Identify the patient;
(b) Have clinical data to support the
				  diagnosis, course and results of treatment for the patient;
(c) Have signed consent documents;
(d) Promote continuity of care;
(e) Have accurately written, signed, dated,
				  and timed entries;
(f) Indicates
				  authentication after the record is transcribed;
(g) Are promptly filed, accessible, and
				  retained according to facility policy; and
(h) Include verbal orders that are accepted
				  and transcribed by qualified personnel.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-330 - Ambulatory surgical facilities › Part I - OPERATIONAL RULES › Section 246-330-155 - Coordinated quality improvement program

Current through Register Vol. 24-14, July 15, 2024
The purpose of this section is to ensure the establishment
					 and on-going maintenance of a coordinated quality improvement program. The
					 intent is to improve the quality of health care services provided to patients
					 and to identify and prevent medical malpractice.
An ambulatory surgical facility must:
(1) Have a facility-wide approach to process
				  design and performance measurement, assessment, and improving patient care
				  services according to
				  RCW
				  70.230.080 including, but not limited to:
(a) A written performance improvement plan
				  that is periodically evaluated;
(b)
				  Performance improvement activities that are interdisciplinary and include at
				  least one member of the governing authority;
(c) Prioritize performance improvement
				  activities;
(d) Implement and
				  monitor actions taken to improve performance;
(e) Education programs dealing with
				  performance improvement, patient safety, medication errors, injury prevention;
				  and
(f) Review serious or
				  unanticipated patient outcomes in a timely manner.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-330 - Ambulatory surgical facilities › Part I - OPERATIONAL RULES › Section 246-330-176 - Infection control program

Current through Register Vol. 24-14, July 15, 2024
The purpose of this section is to identify and reduce the
					 risk of acquiring and transmitting infections and communicable diseases between
					 patients, staff, medical staff, and visitors.
An ambulatory surgical facility must:
(1) Develop, implement and maintain a written
				  infection control and surveillance program;
(2) Designate staff to:
(a) Manage the activities of the infection
				  control program;
(b) Assure the
				  infection control program conforms with patient care and safety policies and
				  procedures; and
(c) Provide
				  consultation on the infection control program, policies and procedures
				  throughout the entire facility.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-330 - Ambulatory surgical facilities › Part I - OPERATIONAL RULES › Section 246-330-199 - Fees-License, change of ownership, refund process

Current through Register Vol. 24-14, July 15, 2024
This section establishes the initial and renewal license
					 fees, change of ownership fee, late fee, and request for refund of an initial
					 license fee for an ambulatory surgical facility (ASF).
(1) Initial and renewal license fees. An
				  initial license or a renewal license and fee are valid for three years from
				  date of issuance. An applicant for an initial or renewal license must submit
				  one of the following fees to the department:
AMBULATORY SURGICAL FACILITY INITIAL AND
					 RENEWAL
FEES
Fee Type
Fees
Initial and Renewal License
Performs 1,000 or Fewer Surgical Procedures on an
							 Annual Basis
Performs 1,001 - 5,000 Surgical Procedures on an
							 Annual Basis
Performs More than 5,000 Surgical Procedures on an
							 Annual Basis
Accredited or Medicare Certified
$ 12,900
$ 16,000
$ 19,650
State Licensed Only
$ 17,550
$ 22,000
$ 27,200
(a) Accredited
				  means an ASF is accredited by one of the organizations identified in WAC
				  246-330-025(1)(b).
(b) Medicare certified means an ASF is
				  certified by the Centers for Medicare and Medicaid Services (CMS).
(c) State licensed only means an ASF that is
				  not accredited and is not medicare certified.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-330 - Ambulatory surgical facilities › Part I - OPERATIONAL RULES › Section 246-330-200 - Pharmaceutical services

Current through Register Vol. 24-14, July 15, 2024
This section assures patient pharmaceutical needs are met
					 in a planned and organized manner. This section is consistent with the
					 requirements for a health care entity license under
					 RCW
					 18.64.450 and chapter 246-904 WAC.
An ambulatory surgical facility must:
(1) Only administer, dispense or deliver
				  legend drugs and controlled substances to patients receiving care in the
				  facility;
(2) Assure drugs
				  dispensed to patients are dispensed and labeled consistent with the
				  requirements of
				  RCW
				  18.64.246, and chapters 69.41 and 69.50
				  RCW;
(3) Establish a process for
				  selecting medications based on evaluating their relative therapeutic merits,
				  safety, and cost; and
(4) Designate
				  a pharmacist consultant who is licensed in Washington state. The pharmacist
				  consultant can be either employed or contracted by the facility. The pharmacist
				  consultant is responsible for:
(a)
				  Establishing policy and procedures related to:
(i) Purchasing, ordering, storing,
				  compounding, delivering, dispensing and administering of controlled substances
				  or legend drugs;
(ii) Assuring
				  drugs are stored, compounded, delivered or dispensed according to all
				  applicable state and federal rules and regulations;
(iii) Maintaining accurate inventory records
				  and patient medical records related to the administration of controlled
				  substances and legend drugs;
(iv)
				  Maintaining any other records required by state and federal
				  regulations;
(v) Security of legend
				  drugs and controlled substances; and
(vi) Controlling access to controlled
				  substances and legend drugs.