Title 48.docx

Title 48.docx

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Title48

Title48

PUBLICHEALTH—GENERAL

PartI.GeneralAdministration

Subpart3.LicensingandCertification

Chapter45.AmbulatorySurgicalCenterPreface

ThroughcontractwithDepartmentofHealthandHumanServices,thestatehasagreedtoenforcecertainfederalregulations（ConditionsofParticipation）inadditiontothelicensureregulationslistedbelow.Thefederalregulationswhichapplytothischapterare42CFR416.1-416.75.

§4501.Definitions

A.AmbulatorySurgicalCenter—

1.anestablishmentwithanorganizedmedicalstaffofphysicians,withpermanentfacilitiesthatareequippedandoperatedprimarilyforthepurposeofperformingsurgicalprocedures,withcontinuousphysicianservicesandregisteredprofessionalnursingservicesavailablewheneverapatientisinthefacility,whichdoesnotprovideservicesorotheraccommodationsforpatientstostayovernight,andwhichoffersthefollowingserviceswheneverapatientisinthecenter:

a.drugservicesasneededformedicaloperationsandproceduresperformed;

b.provisionsforphysicalandemotionalwell-beingofpatients;

c.provisionofemergencyservices;

d.organizedadministrativestructure;and

e.administrative,statistical,andmedicalrecords.

2.AmbulatorySurgicalCenteralsomeansatreatmentcenterthatisoperatedprimarilyforthepurposeofofferingstereotacticradiosurgerybyuseofaGammaKnifeorsimilarneurosurgicaltool.

B.Standards—therules,regulationsandminimumstandardsdulyadoptedandpromulgatedbytheDepartmentofHealthandHospitalswithapprovalofthesecretary.

C.Division—theBureauofHealthServicesFinancingoftheDepartmentofHealthandHospitals.

D.Department—theDepartmentofHealthandHospitals.

E.Secretary—thesecretaryoftheDepartmentofHealthandHospitalsofthestateofLouisiana.

F.AppellateBoard—theagencyauthorizedtohearappealsasprovidedbytheAdministrativeProceduresAct.

G.Physician—adoctorofmedicine,osteopathy,podiatry,ordentalsurgerydulylicensedbythestateofLouisiana.

H.MedicalStaff—thosephysicians,dentists,podiatristsandothermedicalpractitionerswhoareauthorizedtopracticeinthecenteraccordingtothesestandardsandtherequirementsofthegoverningauthority.

I.GoverningAuthority—thatindividualorgroupofindividualswhoislegallyresponsiblefortheoperationofthefacility.

J.RegisteredNurse—agraduateorprofessionalnursedulylicensedbytheLouisianaStateBoardofNurseExaminers.

K.LicensedPracticalNurse,abbreviatedLPN,—apersondulylicensedbytheLouisianaStateBoardofPracticalNurseExaminers.

L.Alladjectivesandadverbs,suchasadequate,approved,qualified,reasonable,reputable,satisfactory,sufficiently,suitableorsubstantialusedinthesestandardstoqualifyaperson,aprocedure,equipmentorbuildingshallbedeterminedbythesecretary.

M.Wheretheword"shall"isusedinthesestandards,theruleorregulationismandatory.

N.Wheretheword"should"isused,itindicatessuggestionorrecommendationbutnotrequirements.

O.Wheretheword"may"isusedinthesestandards,itispermissiveordiscretionary.

P.TemporaryPermit—awrittenauthorizationissuedbythedepartmentinaccordancewiththelawandthesestandardstoanambulatorysurgicalcenterwhichhasnotqualifiedforlicensingtocontinuetooperateforthelimitedperiodoftimeasspecifiedinthepermit.

Q.NewConstruction—includesanyofthefollowingstartedafterpromulgationofthesestandards:

1.newbuildingstobeusedasanambulatorysurgicalcenter;

2.additionstoexistingbuildingstobeusedasanambulatorysurgicalcenter;

3.conversionsofexistingbuildingsorportionsthereofforuseasanambulatorysurgicalcenter;

4.alterationsotherthanminoralterationstoanexistingambulatorysurgicalcenter.

AUTHORITYNOTE:

PromulgatedinaccordancewithR.S.40:

2131-2143.

HISTORICALNOTE:

PromulgatedbytheDepartmentofHealthandHumanResources,OfficeoftheSecretary,DivisionofLicensingandCertification,LR13:

246（April1987）,amendedLR14:

155（March1988）,amendedbytheDepartmentofHealthandHospitals,OfficeoftheSecretary,BureauofHealthServicesFinancing,LR28:

2536（December2002）.

§4503.AgencyResponsibilities

A.ResponsibilitiesforlicensingproceduresforambulatorysurgicalcentersshallbeaccomplishedbytheBureauofHealthServicesFinancing.

AUTHORITYNOTE:

PromulgatedinaccordancewithR.S.40:

2131-2141.

HISTORICALNOTE:

PromulgatedbytheDepartmentofHealthandHumanResources,OfficeoftheSecretary,DivisionofLicensingandCertification,LR13:

246（April1987）,amendedbytheDepartmentofHealthandHospitals,OfficeoftheSecretary,BureauofHealthServicesFinancing,LR28:

2536（December2002）.

§4505.LicensingProcedures

A.Licensingprocedures,assetforthinvarioussectionsofthelaw,aresummarizedasfollows.

1.Applicationforlicenseshallbesubmittedannuallybyapplicantsonformssuppliedbythedepartment.

2.Thecentershallcompletetheapplicationformandreturnittothedivisionatleast90dayspriortotheexpirationdateofthecurrentlicense,accompaniedbyaperannumlicensefeeof$500.

3.Ifacenterisincompliancewiththeminimumstandards,alicenseshallbeissuedbythedepartment.Thecentershallbelicensedtoprovideserviceswithoutlimitationorlicensedtoprovidelimitedservices.

4.Ifacenterfailstomeettheminimumstandardsbutiscorrectingexistingdeficiencies,atemporarypermitmaybeissuedpendingcompliancewiththeminimumstandards.

5.Ifacenterfailstomeettheminimumstandardsafteranysubsequenttemporarypermitissuedtoithasexpired,alicensemaybedeniedorrevoked.

6.Ifalicenseisdeniedorrevoked,theapplicanthastherightofappealasspecifiedwithinthelaw.TheappealprocedureissubjecttomodificationsaccordingtotheAdministrativeProceduresActR.S.49:

951-968.

7.Ambulatorysurgicalcentersarehereinadvisedthatstandardsandregulationsofothergroups,organizationandentitieswithwhichthecentermayelecttoalignitselforenterintocontractmayexceedthestandardscontainedhereinormayaddressregulationsandstandardsnotaddressedinthesestandards.Suchalignmentsorcontractsmaybewiththird-partypayers,professionalorganizationsorstateandfederalgovernmentalagencies.Thefactthatthecentermeetsthestatelicensurelawdoesinnowayabsolvethecenterofitsrequirementtomeetthemorestringentrequirementsofotherentities,nordoesmembershipinanyotherorganizationexemptthecenterfrommeetingthestandardscontainedherein.

8.Theambulatorysurgicalcenterhasbeenestablishedanddefinedasafacilitywhichoccupiesauniquepositioninthehealthcaredeliverysystem.Eachcentershallcontinuouslyevaluateitscaseloadandmonitoritsowndirectpatientcaretoassurethatpatientsbeingtreatedareappropriatecandidatesfortreatmentatthecenter.Eachcentershalldocumentitsreviewofarepresentativesamplingofadmissionstoassurethatthefacilityisbeingproperlyutilizedandtofurtherassurethatpatientstreatedatthecentercouldnothavebeenmoreproperlytreatedatahospitaloratadoctor'sclinic.

AUTHORITYNOTE:

PromulgatedinaccordancewithR.S.40:

2131-2143.

HISTORICALNOTE:

PromulgatedbytheDepartmentofHealthandHumanResources,OfficeoftheSecretary,DivisionofLicensingandCertification,LR13:

246（April1987）,amendedLR14:

155（March1988）.

§4507.ApprovalofPlans

A.Allnewconstruction,otherthanminoralterations,shallbedoneinaccordancewiththespecificminimumrequirementsoftheOfficeofStateFireProtectionandtheOfficeofPreventiveandPublicHealthServices.

B.Theapplicantmustfurnishonecompletesetofplansandspecificationtothefollowing:

1.DivisionofLicensingandCertification;

2.OfficeofStateFireProtection;

3.OfficeofPreventionandPublicHealthServices.

C.Thedivisionwillretainonecopyoftheplansandspecificationsandstudytheminrelationtoallapplicablerequirementsofthesestandards,andmakeinvestigationsasitmaydeemnecessary.

D.Whentheplansandspecificationshavebeenfullyreviewedandallinspectionsandinvestigationshavebeenmade,includingthoseoftheOfficeofStateFireProtectionandtheOfficeofPreventiveandPublicHealthServices,thedepartmentwillwithin30daysofreceiptbyitofreportsfromtheOfficeofStateFireProtectionandtheOfficeofPreventiveandPublicHealthServicesnotifytheapplicantwhetherornottheplansfortheproposedambulatorysurgicalcenteralterationorexpansionhavebeenapproved.Incaseofdisapproval,thedepartmentwillwithinalike30daysspecifyinwritingthereasonstherefor.

AUTHORITYNOTE:

PromulgatedinaccordancewithR.S.40:

2131-2143.

HISTORICALNOTE:

PromulgatedbytheDepartmentofHealthandHumanResources,OfficeoftheSecretary,DivisionofLicensingandCertification,LR13:

246（April1987）,amendedLR14:

155（March1988）.

§4509.General

A.Exceptasotherwisespecifiedin§4571,ambulatorysurgicalcentersshallcomplywiththefollowing:

1.alllicensingrequirementscontainedinthisChapter45;and

2.allapplicablesectionsoftheGuidelinesforDesignandConstructionofHospitalandHealthCareFacilities.

B.Allapplicablelocalandstatefire,safety,sanitationandbuildingcodesshallbemet.

C.Achiefexecutiveofficershallbenamedbythegoverningbodytoberesponsibleforassistingindevelopingandenforcingpoliciesandproceduresestablishedbythecenter.Additionally,thisofficershallberesponsibleforassuringthattheoperationofthecenterisinconformitywithallfederal,stateandlocallawsandapplicabletotheoperatio