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Article 12
General Provisions

Section

600. Scope.

605. Background check requirements.

610. Licensure.

611. Exemptions from licensure.

612. Licensure of critical access hospitals.

615. Facility fees.

620. Enforcement actions; informal reconsideration of findings.

630. Governing body.

640. Administration.

650. Employee health program.

660. Personnel.

670. Nursing service.

680. Pharmaceutical service.

690. Physical therapy service.

700. Social work service.

710. Occupational therapy service.

720. Dietetic service.

730. Central service.

740. Laundry service.

750. Housekeeping service.

760. Infection control.

770. Medical record service.

780. Radiological service.

790. Laboratory service.

800. (Repealed).

810. (Repealed).

820. (Repealed).

830. Mailing of laboratory specimens.

840. Supervision and direction of laboratory service.

850. (Repealed).

860. Risk management.

870. Emergency care service.

880. Outpatient service.

890. Rights of patients, clients, and residents.

900. Physical plant.

910. Contracts.

920. Applicable federal, state, and local laws and regulations.

925. Accredited entities.

990. Definitions.

7 AAC 12.600. Scope

(a) Unless indicated otherwise in this chapter, a facility required to be licensed under AS 47.32 and this chapter must comply with the provisions of 7 AAC 10.9500 - 7 AAC 10.9535 (General Variance Procedures), 7 AAC 10.9600 - 7 AAC 10.9620 (Inspections and Investigations), 7 AAC 12.600, 7 AAC 12.605, 7 AAC 12.610, 7 AAC 12.620, and 7 AAC 12.920, and with the applicable provisions of this section for each type of facility. A critical access hospital must also comply with 7 AAC 12.612.

(b) A general acute care hospital, rural primary care hospital, long-term acute care hospital, critical access hospital, specialized hospital, and nursing facility must comply with 7 AAC 12.630 - 7 AAC 12.660, 7 AAC 12.730 - 7 AAC 12.770, 7 AAC 12.860, and 7 AAC 12.890 - 7 AAC 12.910.

(c) An intermediate care facility for individuals with an intellectual disability or related condition must comply with 7 AAC 12.650, 7 AAC 12.760, 7 AAC 12.860, and 7 AAC 12.900 - 7 AAC 12.910.

(d) An ambulatory surgical facility must comply with 7 AAC 12.630, 7 AAC 12.650 - 7 AAC 12.660, 7 AAC 12.730 - 7 AAC 12.770, 7 AAC 12.860, and 7 AAC 12.890 - 7 AAC 12.910.

(e) A free-standing birth center must comply with 7 AAC 12.650 - 7 AAC 12.660, 7 AAC 12.730 - 7 AAC 12.760, 7 AAC 12.860, 7 AAC 12.890, and 7 AAC 12.910.

(f) A home health agency must comply with 7 AAC 12.500 - 7 AAC 12.590.

(g) A facility licensed under this chapter, with the exception of a home health agency, that provides a service described in 7 AAC 12.670 - 7 AAC 12.720, 7 AAC 12.780, 7 AAC 12.790 - 7 AAC 12.850, 7 AAC 12.870, or 7 AAC 12.880 must comply with the section of this chapter governing the provision of that service, unless otherwise indicated.

(h) A frontier extended stay clinic must comply with 7 AAC 12.450 - 7 AAC 12.490, and the applicable provisions of 7 AAC 12.630 - 7 AAC 12.660, 7 AAC 12.730, 7 AAC 12.750, 7 AAC 12.760, 7 AAC 12.770, 7 AAC 12.860, 7 AAC 12.890, and 7 AAC 12.910.

(i) A hospice agency must also comply with the applicable provisions of 7 AAC 12.310 - 7 AAC 12.349, 7 AAC 12.690, 7 AAC 12.700, and 7 AAC 12.910. If the hospice agency provides inpatient care on agency premises, the hospice agency is also subject to the requirements for a nursing home set out in (b) of this section, except for 7 AAC 12.770.

History: Eff. 11/19/83, Register 88; am 9/6/96, Register 139; am 9/1/2000, Register 155; am 6/23/2006, Register 178; am 12/3/2006, Register 180; am 2/9/2007, Register 181; am 5/24/2007, Register 182; am 9/30/2007, Register 183

Authority: AS 18.05.040

AS 18.20.075

AS 18.20.080

AS 18.20.085

AS 47.05.300

AS 47.05.310

AS 47.05.340

AS 47.32.010

AS 47.32.020

AS 47.32.030

AS 47.32.040

AS 47.32.050

AS 47.32.060

AS 47.32.070

AS 47.32.080

AS 47.32.120

AS 47.32.130

AS 47.32.140

Editor's note: As of Register 207 (October 2013), and acting under AS 44.62.125 (b)(6) and sec. 29, ch. 42, SLA 2013, the regulations attorney made a technical change to 7 AAC 12.600(c) , to change "intermediate care facility for the mentally retarded" to "intermediate care facility for individuals with an intellectual disability or related condition." Chapter 42, SLA 2013 amended terminology in the Alaska Statutes to replace references to "mental retardation" and "mentally retarded" with more current terms. Section 29, ch. 42, SLA 2013 instructed that similar changes be made in the Alaska Administrative Code.

7 AAC 12.605. Background check requirements

An entity listed in AS 47.32.010 (b) that is required to be licensed under AS 47.32 and this chapter must also comply with the applicable requirements of AS 47.05.300 - 47.05.390 and 7 AAC 10.900 - 7 AAC 10.990 (barrier crimes and conditions; background checks).

History: Eff. 2/9/2007, Register 181; am 6/29/2017, Register 222

Authority: AS 47.05.300

AS 47.05.310

AS 47.05.320

AS 47.05.330

AS 47.05.340

AS 47.32.010

AS 47.32.030

7 AAC 12.610. Licensure

(a) Unless exempt under 7 AAC 12.611, before an individual or entity may operate a facility subject to AS 47.32 and this chapter, the individual or entity must obtain a license from the department under AS 47.32 and this section. The department may bring an action to enjoin the operation of a facility that has failed to obtain a license as required under AS 47.32 and this chapter. In addition to meeting the applicable requirements of this section, an applicant for licensure of a

(1) hospice agency must also meet the licensure requirements of 7 AAC 12.312;

(2) free-standing birth center must also meet the licensure requirements of 7 AAC 12.404;

(3) frontier extended stay clinic must also meet the licensure requirements of 7 AAC 12.457; or

(4) home health agency must also meet the licensure requirements of 7 AAC 12.500 - 7 AAC 12.590.

(b) An application for an initial license must be submitted on a form supplied by the department. The applicant must submit a complete application, providing all applicable documents and information required under this chapter, including the names and addresses of all owners, officers, directors, partners, members, and principals of the business organization that owns the entity for which licensure is sought. Within 30 days after receipt of an application, the department will review the application for completeness. If the application is incomplete, the department will return it to the applicant for additional information. If the application is complete, the department will conduct an onsite review and inspection of the facility. If, after the onsite review and inspection, and review of the application, the department determines that the applicant meets the applicable requirements of AS 47.32 and this chapter, the department will issue a provisional license in accordance with AS 47.32.050 (a). If the department determines that the applicant does not meet the applicable requirements of AS 47.32 and this chapter, the department will deny the application and issue the notice as required under AS 47.32.070 .

(c) If the department determines that the applicant is temporarily unable to comply with one or more applicable requirements and is taking appropriate steps to achieve compliance, the department will extend the application review period under (b) of this section for an additional 90 days.

(d) A biennial license issued under AS 47.32.050 (b) becomes valid July 1 of an even-numbered year and expires June 30 of the next even-numbered year. An application for renewal of a biennial license must be submitted, and will be reviewed, in accordance with AS 47.32.060 . A renewed biennial license becomes valid July 1 of the biennial licensing period after the previous license expired and expires June 30 of the next even-numbered year. In addition to any noncompliance with the applicable provisions of AS 47.32 and this chapter, grounds for nonrenewal include

(1) submission of false or fraudulent information to the department;

(2) failure or refusal to provide required information to the department;

(3) noncompliance that threatens the health, welfare, or safety of patients;

(4) the facility or individual, or an employee of the facility or individual,

(A) permitting, aiding, or abetting the commission of a criminal act under AS 11, AS 21, AS 28, or AS 47 related to facility operations covered by the license;

(B) engaging in conduct or practices detrimental to the health, welfare, or safety of patients, clients, or employees; or

(C) participating in, offering to participate, or implying an offer to participate in rebate, kickback, or fee-splitting arrangements or substantially similar arrangements; and

(5) an insufficient number of staff at the facility with the training, experience, or judgment to provide adequate care.

History: Eff. 11/19/83, Register 88; am 6/28/84, Register 90; am 9/1/2000, Register 155; am 12/3/2006, Register 180; am 9/30/2007, Register 183; am 6/29/2017, Register 222

Authority: AS 18.05.040

AS 18.20.080

AS 47.05.310

AS 47.32.010

AS 47.32.020

AS 47.32.030

AS 47.32.040

AS 47.32.050

AS 47.32.060

AS 47.32.130

AS 47.32.140

AS 47.32.900

7 AAC 12.611. Exemptions from licensure

(a) Unless operating as a frontier extended stay clinic under 7 AAC 12.450 - 7 AAC 12.490, a rural health clinic, including a community health center and a federally qualified health center, is exempt from the licensure requirements of AS 47.32 and this chapter.

(b) A facility owned and operated by the United States Indian Health Service, or a facility owned and operated by a tribal organization, as defined in 25 U.S.C. 450b(l), under a funding agreement under 25 U.S.C. 458aaa-4 (Indian Self-Determination and Education Assistance Act and Tribal Self-Governance Amendments of 2000) is exempt from the requirement to obtain a license under AS 47.32 and this chapter. However, a facility described in this subsection must meet the applicable licensure requirements set out in AS 47.32 and this chapter.

History: Eff. 12/3/2006, Register 180

Authority: AS 47.32.010

AS 47.32.020

AS 47.32.030

7 AAC 12.612. Licensure of critical access hospitals

(a) In addition to 7 AAC 12.610, the provisions of this section apply to the licensure of critical access hospitals.

(b) A hospital must hold a current license, or must have held a license at any time on or after November 29, 1999, as either a general acute care hospital or a rural primary care hospital at the time of its initial application for licensure as a critical access hospital.

(c) An applicant for licensure as a critical access hospital must submit the following as part of its initial application:

(1) a description of the area to be served by the applicant;

(2) a community needs assessment analyzing the availability and utilization of health care services in the applicant's service area, including acute care, primary care, and emergency services, and a discussion of how conversion to a critical access hospital will better serve community needs;

(3) the applicant's plan for the delivery of health services within the applicant's service area;

(4) a financial feasibility study that analyzes the financial impact on the applicant of conversion to a critical access hospital, taking into account relevant operational factors, including changes in utilization, services, staffing, and Medicare reimbursement;

(5) a community education plan that describes the steps that have been or will be taken to educate and involve the residents of the service area in the decision to convert to a critical access hospital;

(6) an emergency services plan that coordinates the provision of emergency medical services in the applicant's service area;

(7) a description of the volume capacity of the applicant and other related health care resources within the applicant's service area;

(8) the distance and travel time to other health care resources within the applicant's service area;

(9) identification of barriers to accessing health care in the applicant's service area.

(d) A critical access hospital must reapply for licensure under this section and provide updates, as applicable, to the information required under (c) of this section, if the hospital proposes to change the hospital's

(1) onsite or on-call medical staff to provide only mid-level practitioners; or

(2) hours of operation to less than 24 hours per day when no inpatients are in the facility.

(e) In addition to the requirement of reapplication for licensure under (d) of this section, if a critical access hospital proposes to change its hours of operation to less than 24 hours per day, each day of the year, the hospital must

(1) revise the emergency medical services plan submitted under (c)(6) of this section to ensure that, at a minimum, a registered nurse will be available at the hospital's emergency room to receive patients delivered by emergency medical services personnel; and

(2) obtain a waiver under 7 AAC 12.670(i) from the requirement of 7 AAC 12.670(g) that the hospital have a registered nurse on duty at all times.

History: Eff. 9/1/2000, Register 155

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