Ga. Comp. R. & Regs. 111-8-40-.38

Current through Rules and Regulations filed through November 22, 2024

Rule 111-8-40-.38 - Special Requirements for Critical Access Hospitals

Critical access hospitals (CAHs) shall be required to comply with the entirety of this chapter, as applicable to the scope of services offered, with the following exceptions and/or additions:

(a) Prior to application for a hospital permit, the hospital shall be approved for critical access hospital status by the Georgia Department of Community Health.

(b) The CAH shall be a member of a rural health network having at least one (1) additional hospital that furnishes acute care hospital services, which will serve as an affiliate hospital for the CAH. The CAH shall have current written agreement(s) with affiliate hospital(s) which include provisions for:

1. Patient referral and transfer between the facilities, with the use of emergency and non-emergency transportation;

2. Credentialing of medical and professional staff; and

3. Participation in quality management activities.

(c) The CAH's organization, scope, and availability of patient care services shall be defined and approved by the governing body, medical staff, and affiliate hospital. The CAH shall have:

1. Operational policies for the CAH shall be developed with participation from one (1) or more licensed physicians, one (1) or more healthcare practitioners if on the staff of the critical access hospital, and at least one (1) member of the affiliated hospital's staff who is not on the staff of the CAH;

2. Operational policies for the CAH which describe the patient care services the CAH will provide directly and those that will be provided through contract or other arrangement;

3. No more than twenty-five (25) inpatient beds or as currently defined in federal regulations. Of these beds, at least two (2), but no more than fifteen (15), shall be used for acute inpatients. If the CAH has approved swing bed services, a maximum of twenty-three (23) beds may be utilized for swing bed patients;

4. An average length of stay for patients of no more than ninety-six (96) hours or as currently defined in federal regulations;

5. A mechanism in place to ensure that emergency care is available twenty-four (24) hours per day. The CAH shall not be required to remain open twenty-four (24) hours per day when it does not have inpatients.

(i) The CAH shall, in accordance with the local emergency response systems, establish procedures under which a physician is immediately available by telephone or radio contact, on a 24-hour per day basis, to receive emergency calls, provide information or treatment of emergency patients, and refer patients to the CAH or other appropriate location for treatment.

(ii) A physician or limited health care practitioner with training in emergency care shall be on-call and immediately available by telephone or radio contact and available to be on-site at the CAH within thirty (30) minutes.

(iii) The CAH shall have equipment, supplies, and medications available for treating emergencies, as are required of other organized hospital emergency services.

(iv) Staff assigned to provide emergency patient care shall have training in handling medical and non-medical emergencies; and

6. A registered nurse or licensed practical nurse shall be on duty whenever the critical access hospital has one (1) or more inpatients.

Ga. Comp. R. & Regs. R. 111-8-40-.38

O.C.G.A. § 31-7-2.1.

Original Rule entitled "Special Requirements for Critical Access Hospitals" adopted. F. Feb. 20, 2013; eff. Mar. 12, 2013.