Ala. Admin. Code r. 420-5-7-.03
Current through Register Vol. 43, No. 1, October 31, 2024
Section 420-5-7-.03 - Classification Of Hospitals(1) General. (a) Classification According to Services. Each hospital shall be classified as a General Acute Care Hospital, a Critical Access Hospital or a Specialized Hospital, corresponding to the services offered by the particular institution.(b) Confinement of Services. A hospital shall confine its services to those designated in the classification, except emergency cases when the life or welfare of the patient is imperiled. In such case the attending physician shall state on the patient record that emergency conditions existed.(2) General Acute Care Hospitals. (a) Number of Beds. A General Acute Care Hospital shall have an authorized bed capacity of not fewer than 15 beds for the care and treatment of patients.(b) Basic Requirements. A General Acute Care Hospital shall provide care for medical and surgical patients, operate a dedicated emergency department, and may not restrict its services to any particular specialty or specialties. Nothing in these rules shall prohibit a hospital from contracting exclusively with one or more specific physician practice groups to provide physician care in a particular specialty or practice area.(c) A General Acute Care Hospital shall have the following services and facilities available on its campus: 1. A formally organized governing authority with a duly appointed chief executive officer or administrator.2. A formally organized medical staff which can support the services available at the hospital.3. A nursing staff under the leadership of a registered professional nurse (RN) who shall report to the hospital's chief executive officer.4. An adequate staff of professional and technical personnel.5. Laboratory facilities.7. If surgery is performed, surgical facilities.8. If obstetrical patients are admitted, obstetrical facilities.9. A medical records department.11. A kitchen for the preparation of patient meals and a dietary department.12. A maintenance and housekeeping department.13. Inpatient beds equal to the number of beds in the hospital's authorized bed capacity.14. A dedicated emergency department. A dedicated emergency department shall include the following: (1) accessibility: shall be operated 24 hours a day/7 days per week; (2) a registered nurse shall be available at all times to the emergency department; (3) an emergency department shall be able to screen patients and if an emergency medical condition is found to exist, provide medical care within the hospital's capacity; and (4) the hospital shall arrange for the provision of emergency medical care beyond the hospital's capacity. The requirement for a dedicated emergency department shall not apply to hospitals operating solely as a Long Term Care Hospital, Rehabilitation Hospital, or Psychiatric Hospital.(3) Critical Access Hospital. (a) Basic Requirements. A licensed hospital may apply to become a Critical Access Hospital provided it is first reviewed and approved by the Department's Office of Rural Health. It may provide inpatient care for an average annual length of stay not to exceed 96 hours. It must comply with Alabama's Rural Health Plan and all requirements of these rules applicable to general hospitals.(b) Number of Beds. A Critical Access Hospital shall have a maximum authorized bed capacity of 45 beds or its licensed bed capacity, whichever is smaller, subject to any additional restrictions imposed by the State Rural Health Plan, Alabama Certificate of Need requirements, and applicable federal laws and regulations.(c) A hospital may apply to the Department for designation as a Critical Access Hospital by submitting the necessary forms accompanied by the appropriate fee based on its licensed bed capacity. The certificate of licensure issued by the Department shall contain a notation that the facility has been designated as a Critical Access Hospital.(d) If the hospital's designation as a Critical Access Hospital is denied, revoked, or rescinded, it shall remain a General Acute Care Hospital. A hospital may voluntarily surrender its status as a Critical Access Hospital at any time by submitting an application to the Department accompanied by the appropriate licensure fee based on its licensed bed capacity. A hospital that has, for any reason, reverted from the status of Critical Access Hospital to the status of General Acute Care Hospital shall no longer be restricted in its length of stay for inpatient care, and may apply for any authorized bed capacity not to exceed its licensed bed capacity.(4) Specialized Hospitals. (a) Number of Beds. A Specialized Hospital shall have at least 20 licensed beds.(b) Basic Requirements. To be classified as a Specialized Hospital, an institution shall provide hospital services to pediatric patients only, pediatric, obstetrical, and gynecological patients only, ophthalmic patients only, psychiatric patients only, long term care patients only, or rehabilitation patients only, and shall have a medical staff and other professional and technical personnel especially qualified in the particular specialty for which the hospital is operated.(c) Pediatric hospitals; pediatric, obstetrical, and gynecological hospitals; and ophthalmic hospitals shall meet all requirements for General Acute Care Hospitals, except they shall restrict their services offered, patients admitted, and medical privileges to the specialties they serve.Ala. Admin. Code r. 420-5-7-.03
Filed September 1, 1982. Repealed and New Rule: Filed November 18, 1994; effective December 23, 1994. Amended: Filed December 16, 1999; effective January 20, 2000. Amended: Filed January 5, 2001; effective February 9, 2001. Amended: Filed December 17, 2004; effective January 21, 2005. Amended: Filed: September 22, 2008; effective October 27, 2008. Repealed and New Rule: Filed August 24, 2012; effective September 28, 2012.Author: W.T. Geary, Jr., M.D., Carter Sims
Statutory Authority:Code of Ala. 1975, §§ 22-21-20, et seq.