Title 48.docx

1、Title 48Title 48PUBLIC HEALTHGENERALPart I. General AdministrationSubpart 3. Licensing and CertificationChapter 45. Ambulatory Surgical Center PrefaceThrough contract with Department of Health and Human Services, the state has agreed to enforce certain federal regulations (Conditions of Participatio

2、n) in addition to the licensure regulations listed below. The federal regulations which apply to this chapter are 42 CFR 416.1-416.75.4501. DefinitionsA. Ambulatory Surgical Center1. an establishment with an organized medical staff of physicians, with permanent facilities that are equipped and opera

3、ted primarily for the purpose of performing surgical procedures, with continuous physician services and registered professional nursing services available whenever a patient is in the facility, which does not provide services or other accommodations for patients to stay overnight, and which offers t

4、he following services whenever a patient is in the center:a. drug services as needed for medical operations and procedures performed;b. provisions for physical and emotional well-being of patients;c. provision of emergency services;d. organized administrative structure; ande. administrative, statist

5、ical, and medical records.2. Ambulatory Surgical Center also means a treatment center that is operated primarily for the purpose of offering stereotactic radiosurgery by use of a Gamma Knife or similar neurosurgical tool.B. Standardsthe rules, regulations and minimum standards duly adopted and promu

6、lgated by the Department of Health and Hospitals with approval of the secretary.C. Divisionthe Bureau of Health Services Financing of the Department of Health and Hospitals.D. Departmentthe Department of Health and Hospitals.E. Secretarythe secretary of the Department of Health and Hospitals of the

7、state of Louisiana.F. Appellate Boardthe agency authorized to hear appeals as provided by the Administrative Procedures Act.G. Physiciana doctor of medicine, osteopathy, podiatry, or dental surgery duly licensed by the state of Louisiana.H. Medical Staffthose physicians, dentists, podiatrists and ot

8、her medical practitioners who are authorized to practice in the center according to these standards and the requirements of the governing authority.I. Governing Authoritythat individual or group of individuals who is legally responsible for the operation of the facility.J. Registered Nursea graduate

9、 or professional nurse duly licensed by the Louisiana State Board of Nurse Examiners.K. Licensed Practical Nurse, abbreviated LPN,a person duly licensed by the Louisiana State Board of Practical Nurse Examiners.L. All adjectives and adverbs, such as adequate, approved, qualified, reasonable, reputab

10、le, satisfactory, sufficiently, suitable or substantial used in these standards to qualify a person, a procedure, equipment or building shall be determined by the secretary.M. Where the word shall is used in these standards, the rule or regulation is mandatory.N. Where the word should is used, it in

11、dicates suggestion or recommendation but not requirements.O. Where the word may is used in these standards, it is permissive or discretionary.P. Temporary Permita written authorization issued by the department in accordance with the law and these standards to an ambulatory surgical center which has

12、not qualified for licensing to continue to operate for the limited period of time as specified in the permit.Q. New Constructionincludes any of the following started after promulgation of these standards:1. new buildings to be used as an ambulatory surgical center;2. additions to existing buildings

13、to be used as an ambulatory surgical center;3. conversions of existing buildings or portions thereof for use as an ambulatory surgical center;4. alterations other than minor alterations to an existing ambulatory surgical center.AUTHORITY NOTE: Promulgated in accordance with R.S. 40:2131-2143.HISTORI

14、CAL NOTE: Promulgated by the Department of Health and Human Resources, Office of the Secretary, Division of Licensing and Certification, LR 13:246 (April 1987), amended LR 14:155 (March 1988), amended by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Finan

15、cing, LR 28:2536 (December 2002).4503. Agency ResponsibilitiesA. Responsibilities for licensing procedures for ambulatory surgical centers shall be accomplished by the Bureau of Health Services Financing.AUTHORITY NOTE: Promulgated in accordance with R.S. 40:2131-2141.HISTORICAL NOTE: Promulgated by

16、 the Department of Health and Human Resources, Office of the Secretary, Division of Licensing and Certification, LR 13:246 (April 1987), amended by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 28:2536 (December 2002).4505. Licensing Procedu

17、resA. Licensing procedures, as set forth in various sections of the law, are summarized as follows.1. Application for license shall be submitted annually by applicants on forms supplied by the department.2. The center shall complete the application form and return it to the division at least 90 days

18、 prior to the expiration date of the current license, accompanied by a per annum license fee of $500. 3. If a center is in compliance with the minimum standards, a license shall be issued by the department. The center shall be licensed to provide services without limitation or licensed to provide li

19、mited services.4. If a center fails to meet the minimum standards but is correcting existing deficiencies, a temporary permit may be issued pending compliance with the minimum standards.5. If a center fails to meet the minimum standards after any subsequent temporary permit issued to it has expired,

20、 a license may be denied or revoked.6. If a license is denied or revoked, the applicant has the right of appeal as specified within the law. The appeal procedure is subject to modifications according to the Administrative Procedures Act R. S. 49:951-968.7. Ambulatory surgical centers are herein advi

21、sed that standards and regulations of other groups, organization and entities with which the center may elect to align itself or enter into contract may exceed the standards contained herein or may address regulations and standards not addressed in these standards. Such alignments or contracts may b

22、e with third-party payers, professional organizations or state and federal governmental agencies. The fact that the center meets the state licensure law does in no way absolve the center of its requirement to meet the more stringent requirements of other entities, nor does membership in any other or

23、ganization exempt the center from meeting the standards contained herein.8. The ambulatory surgical center has been established and defined as a facility which occupies a unique position in the health care delivery system. Each center shall continuously evaluate its caseload and monitor its own dire

24、ct patient care to assure that patients being treated are appropriate candidates for treatment at the center. Each center shall document its review of a representative sampling of admissions to assure that the facility is being properly utilized and to further assure that patients treated at the cen

25、ter could not have been more properly treated at a hospital or at a doctors clinic.AUTHORITY NOTE: Promulgated in accordance with R. S. 40:2131-2143.HISTORICAL NOTE: Promulgated by the Department of Health and Human Resources, Office of the Secretary, Division of Licensing and Certification, LR 13:2

26、46 (April 1987), amended LR 14:155 (March 1988).4507. Approval of PlansA. All new construction, other than minor alterations, shall be done in accordance with the specific minimum requirements of the Office of State Fire Protection and the Office of Preventive and Public Health Services.B. The appli

27、cant must furnish one complete set of plans and specification to the following:1. Division of Licensing and Certification;2. Office of State Fire Protection;3. Office of Prevention and Public Health Services.C. The division will retain one copy of the plans and specifications and study them in relat

28、ion to all applicable requirements of these standards, and make investigations as it may deem necessary.D. When the plans and specifications have been fully reviewed and all inspections and investigations have been made, including those of the Office of State Fire Protection and the Office of Preven

29、tive and Public Health Services, the department will within 30 days of receipt by it of reports from the Office of State Fire Protection and the Office of Preventive and Public Health Services notify the applicant whether or not the plans for the proposed ambulatory surgical center alteration or exp

30、ansion have been approved. In case of disapproval, the department will within a like 30 days specify in writing the reasons therefor.AUTHORITY NOTE: Promulgated in accordance with R.S. 40:2131-2143.HISTORICAL NOTE: Promulgated by the Department of Health and Human Resources, Office of the Secretary,

31、 Division of Licensing and Certification, LR 13:246 (April 1987), amended LR 14:155 (March 1988).4509. GeneralA. Except as otherwise specified in 4571, ambulatory surgical centers shall comply with the following:1. all licensing requirements contained in this Chapter 45; and2. all applicable section

32、s of the Guidelines for Design and Construction of Hospital and Health Care Facilities.B. All applicable local and state fire, safety, sanitation and building codes shall be met.C. A chief executive officer shall be named by the governing body to be responsible for assisting in developing and enforcing policies and procedures established by the center. Additionally, this officer shall be responsible for assuring that the operation of the center is in conformity with all federal, state and local laws and applicable to the operatio