Current through Register Vol. XLI, No. 50, December 13, 2024
Section 64-54-3 - State Administrative Procedures3.1. General Licensure Provisions 3.1.a. A person, partnership, association, corporation, or any governmental unit or any division, department, board or agency thereof may not operate a hospice, satellite location or inpatient facility in the State of West Virginia without first obtaining a license under this rule.3.1.b. An original or a renewal license shall not be issued under this rule for a project reviewable under W. Va. Code § 16-2D-1, , unless the State Health Planning and Development Agency has issued a determination, after a final conformance review, that the completed project conforms to the terms of the Certificate of Need decision issued for the project. The hospice shall supply evidence of compliance with the State Health Planning and Development Agency when submitting licensure applications to the Director.3.1.c. A license is valid only for the premises and persons named and described in the application.3.1.d. A license is not transferable or assignable.3.1.e. A license is issued to applicants who are in compliance with the conditions of this rule, W. Va. Code § 16-51-1, and the Hospice Conditions of Participation promulgated by the Centers for Medicare and Medicaid Services.3.1.f. A hospice shall surrender its license to the Director: 3.1.f.1. Upon written demand stating the cause for the demand; or3.1.f.2. In the event the hospice ceases to provide services.3.1.g. A hospice shall report a proposed change of ownership, including a change in a controlling interest, to the Director a minimum of sixty (60) days prior to the change. 3.1.g.1. A new owner shall immediately apply for a new license.3.1.g.2. A new owner's application for a license has the effect of a valid license for three (3) months from the date the application is received by the Director.3.1.h. A license shall state: 3.1.h.1. The specific name of the hospice to which it applies;3.1.h.2. The date of its issuance; and3.1.h.3. Its expiration date.3.1.i. A hospice name change shall be shown on the next license issued.3.1.j. The license shall be posted in a conspicuous and public place of the hospice.3.1.k. Any hospice, satellite location or inpatient facility's advertisement shall contain the legal name provided to the Director at the time of application.3.1.l. A hospice shall apply and receive notification and approval from the Director before a hospice may operate an inpatient facility, satellite location or any other location.3.2. Initial License 3.2.a. An applicant shall submit a completed application to the Director, on a form prescribed by the Director, not less than thirty (30) days and not more than ninety (90) days prior to the date proposed for commencement of operation for a hospice office, satellite location or an inpatient facility. A non-refundable fee of one hundred dollars ($100) shall be submitted with the application for the initial license.3.2.b. A hospice shall identify the following as part of the application: 3.2.b.1. The hospice's operating name, the office location, the mailing address and telephone number;3.2.b.2. The name and title of its administrator or other contact person;3.2.b.3. A listing of services the hospice intends to offer either directly or by contractual agreement;3.2.b.4. Written evidence that the building or part of the building in which the hospice office, satellite location or inpatient facility is to be located is in compliance with applicable local zoning, building and fire safety laws and chapters;3.2.b.5. The mailing address, phone number and location of each satellite location or inpatient facility;3.2.b.6. A copy of a valid Certificate of Need or a letter of exemption from the West Virginia Healthcare Authority; and3.2.b.7. The name, address, principal occupation and official position of all persons who have an ownership interest in the hospice or the name, address, principal occupation, and official position of each member of the board of directors, if a corporation owns the hospice.3.2.c. If, at the initial licensing survey, an agency has more than five (5) violations of any minimum requirements or if any of the violations are determined to be of such a serious nature that they may cause or have the potential to cause harm, the Director shall deny licensing until the hospice is found to be in substantial compliance with this rule.3.2.d. The Director shall issue an initial license only after the Director or his or her designee inspects the hospice or inpatient facility and finds the hospice complies with this rule and W. Va. § 16-5I-1,3.2.e. An initial license issued is valid for a period of one (1) year from the date of issuance.3.2.f. The Director may inspect a satellite location prior to the issuance of a license.3.3. Renewal License 3.3.a. An applicant for a renewal license shall submit a completed application to the Director, on a form prescribed by the Director, not less than sixty (60) days and not more than ninety (90) days prior to the scheduled expiration date of the current license. A non-refundable fee of one hundred dollars ($100) shall be submitted with the license renewal application for a hospice whose yearly caseload exceeds ten (10) or more patients, and fifty dollars ($50) for a hospice whose yearly caseload is fewer than ten (10) patients.3.3.b. The Director shall issue a renewal license when he or she finds the hospice is determined to be in compliance with this rule and W. Va. 16-5I-1, . and the licensee submits a completed application and the correct renewal fee.3.3.c. A renewal license is valid for a period of one (1) year from the date of issuance.3.3.d. The Director shall issue a renewal license to each hospice office, satellite location and inpatient facility.3.4. Inspections 3.4.a. The Director shall inspect all hospices that are subject to the provisions of this rule and W. Va. Code §16-5I-1, periodically and at least as often as required by the Centers for Medicare and Medicaid Services in order to determine compliance with the provisions of this rule, W. Va. Code § 16-5I-l, and the Hospice Conditions of Participation promulgated by the Centers for Medicare and Medicaid Services.3.4.b. The Director shall inspect or investigate a main hospice office, satellite location, inpatient facility or office advertised with the hospice name as he or she considers necessary. 3.4.b.1. The Director shall conduct an unannounced inspection of a hospice, satellite location or inpatient facility. This inspection may include home visits with prior patient consent, interviews with agency staff and family members, reviews of clinical records, environmental and life safety inspections and any other documents necessary for the determination of compliance with this rule.3.4.c. The Director may enter the premises of any hospice the Director has reason to believe is being operated or maintained as a hospice without a license. 3.4.c.1. If the owner or person in charge of a licensed hospice or of an unlicensed hospice which the Director has reason to believe is being operated as a hospice refuses entry pursuant to this rule, the Director shall petition the Circuit Court of Kanawha County for an inspection warrant.3.4.c.2. If the Director finds on the basis of the inspection that any person, partnership, association or corporation and any local governmental unit or any division, department, board or agency thereof is operating as a hospice without a license, the hospice shall apply for a license within ten (10) days, in accordance with the provisions of this rule.3.4.d. A hospice that fails to apply for a license is subject to the penalties established by W. Va. Code §16-5I,3.4.e. The Director shall maintain a written report of the inspection on file.3.4.f. The Director shall send the inspection report to the hospice.3.4.g. The hospice shall submit to the Director a plan of correction to any violations of this rule or W. Va. Code 16-5I, . identified during an inspection of a hospice, satellite location or inpatient facility.3.5. Complaint Investigation 3.5.a. Any person may register a complaint with the Director alleging violation of applicable laws, rules or requirements by a hospice. The complaint shall state the substance of the complaint, the patient's name if applicable and the hospice involved.3.5.b. The Director may conduct an unannounced inspection of a hospice, satellite location or inpatient facility to determine the validity of the complaint.3.5.c. The Director shall notify the complainant in writing that an investigation was conducted.3.5.d. The Director shall notify the hospice in writing of the results of the investigation no later than fifteen (15) working days after completing the investigation. 3.5.d.1. If the complaint is substantiated by the investigation as a violation of this rule or W. Va. Code § 16-5I-1, the Director shall require the hospice to develop a plan of correction or may take other action authorized by state law or this rule.3.6. Plans of Correction 3.6.a. A hospice, satellite location or inpatient facility found to have deficiencies based on an inspection or complaint investigation shall develop a plan of correction and submit it to the Director within ten (10) calendar days of receipt of the inspection report.3.6.b. A plan of correction shall specify a reasonable time within which a hospice shall correct each deficiency cited in the report and in any case shall be no more than sixty (60) days after the date of the inspection.3.6.c. The Director may approve or reject a plan of correction submitted by a hospice. The Director shall notify the hospice within fifteen (15) working days whether a plan of correction has been approved or rejected. If the Director rejects the plan, he or she shall state the reasons for the action. When the Director rejects a plan of correction, the Director may give the hospice up to ten (10) calendar days for submission of a revised plan.3.6.d. Upon failure of a hospice to submit an approved plan of correction or to correct any deficiency within the time specified in the approved plan of correction, the Director may initiate action in accordance with W. Va. Code § 16-5I-1,3.7. Availability of Reports 3.7.a. The Director shall make a copy of the inspection report available upon written request. A reasonable fee may be charged to cover the cost of research and copying.3.7.b. The Director shall treat the inspection report as public information from the time a written plan of correction is received and accepted by the Director.3.7.c. The hospice shall submit a plan of correction to the Director within twenty (20) calendar days or the report will be made available to the public.3.7.d. Nothing contained in this section shall be construed to require or permit the public disclosure of confidential medical, social, personal or financial records of any patients.