Current through Register Vol. 42, No. 11, August 30, 2024
(1)
Classifications of Licenses. Each FED shall be licensed pursuant to the
regulations adopted herein. All licenses are granted for the calendar year and
shall expire on December 31 unless renewed by the owner for the succeeding
year.
(a) Unrestricted License. An
unrestricted license may be granted by the Board after it has determined that
the parent hospital and FED is willing and capable of maintaining compliance
with these rules.
(b) Probational
License. At its discretion, the Board may grant a probational license when it
determines that both of the following conditions exist:
1. The FED has engaged in one or more
deficient practices which are serious in nature, chronic in nature, or which
the FED and parent hospital have failed to correct; and
2. The parent hospital's current governing
authority has demonstrated the capability and willingness to correct cited
problems and to maintain compliance.
(c) A probational license shall be granted
for a specific period which may be extended but which shall in no case exceed
one year.
(2)
Application.
(a) Application. An applicant
for initial licensure shall provide all information on the application form
prescribed by the Department, including all information required by law, these
rules, and the policies and procedures of the Department, and shall submit such
additional information as shall be required by the Department in its discretion
to demonstrate that the applicant has the ability and the willingness to comply
with these rules. Each application shall be signed by a person authorized to
bind the applicant to the representations in the application and any supporting
documentation.
(b) Fee. An initial
license application, an application for license renewal, or an application for
a change in ownership, shall be accompanied by the application fee specified in
§
22-21-24, Code of Ala.
1975. An application for a name change is not subject to a license
application fee. An application fee is non-refundable. Any application fee
submitted in the incorrect amount shall nevertheless be deposited. If the fee
submitted is too large, a refund for the difference shall be processed using
the Department's usual procedures. If the fee submitted is too small, the
applicant shall be notified and the application shall not be considered until
the difference is received. Any application submitted without any fee shall be
returned to the applicant. If an incomplete application is submitted, the
application fee shall be deposited, and the applicant shall be notified in
writing of the defects in the application. If the applicant fails to submit all
required additional information within 10 working days of the date of the
notice, the application shall be denied. The Department may in its discretion
extend the deadline for submitting additional information. Denial of an
application as incomplete shall not prejudice the applicant from submitting a
new application, accompanied by the requisite fee, at a future date.
(c) Name of Facility. Every FED shall have a
unique name that reflects the name of the parent hospital of which it is a
department followed by the words "Freestanding Emergency Department." No FED
shall be allowed to use the term "Urgent Care" in its name. No FED shall change
its name without first applying for a change of name approval nor shall it
change its name until such approval is granted. The Department may in its
discretion deny an initial FED application or an application for a change of
name if the Department determines that the proposed name is misleading to the
public or that the name is overly similar to the name of an already licensed
FED. Separately licensed FEDs owned by the same governing authority may have
names that are similar to one another and distinguished from one another in
some other manner, such as a geographic description. If an initial FED
application is denied under this rule provision, the applicant shall be
provided a reasonable period of time to submit a revised application with a
different name.
(d) How to Obtain
Applications. Information on how to obtain applications and where to submit
applications can be found on the Department's Web site at
http://www.adph.org.
(3) Licensing.
(a) License. If an applicant submits a timely
and complete application accompanied by the appropriate license fee and any
supporting documentation that may be required by the Department, and if the
Department is satisfied on the basis of the application that the applicant is
willing and capable of compliance with these rules, and if granting such a
license would not violate any other state or federal law or regulation, then
the Department, as agent for the Board, may grant a license to the applicant.
All licenses granted shall expire at midnight on December 31 of the year in
which the license is granted. The Department, as agent for the Board, may deny
a license. A license shall only be valid at the licensed premises and for the
business entity licensed. It is a condition of licensure that the licensee
shall continuously occupy the licensed premises and remain open to the public
with an emergency physician on duty at all times, 24 hours a day, 7 days a
week. If an FED fails to remain open and fully staffed as required, its license
shall become void. Before such a facility which has closed may be relicensed, a
new license application is required.
(b) License Renewal. Licenses may be renewed
by the applicant as a matter of course upon submission of a completed renewal
application and payment of the required fee. When the Department has served
written notice on an FED of its intent to revoke or downgrade the license, a
renewal application shall be filed but does not affect the proposed adverse
licensure action.
(c) License
Certificate. A license certificate shall be issued by the Department to every
successful initial licensure applicant and to every successful renewal
applicant. It shall set forth the name and physical address of the FED, the
name of the governing authority, the name of the parent hospital, and the
expiration date of the license.
(d)
Change of Ownership. An FED license is not transferrable. A change of ownership
may only occur between hospitals duly licensed in Alabama by the Board. In the
event that the legal ownership of the right to occupy an FED's premises is
transferred to an individual or entity other than the licensee, the FED's
license shall become void and continued operation of the FED shall be unlawful
pursuant to §
22-21-22, Code of Ala.
1975, and subject to penalties as provided in §
22-21-33, Code of Ala.
1975, unless an application for a change of ownership has been
submitted to and approved by the Department prior to the transfer of legal
ownership. An application for change of ownership shall be submitted on the
form prescribed by the Department, shall be accompanied by the requisite
application fee set forth in §
22-21-24, Code of Ala.
1975, and shall be subject to the same requirements and
considerations as are set forth above for initial license applications. An
application for a change of ownership shall be submitted and signed by the
prospective new licensee, or its agent, in conjunction with a lawful
representative of the parent hospital, and also either signed by the current
licensee or its agent, or accompanied by a court order demonstrating that the
current licensee has been dispossessed of the legal right to occupy the
premises and that the prospective new licensee has been awarded the legal right
to occupy the premises. Upon approval of a change of ownership, the Department
shall notify the current licensee and the new license applicant, and shall
issue a license certificate to the new licensee.
(e) Change of Name. An FED may apply for a
change of name by submitting a completed application on a form prescribed by
the Department. There is no application fee for a change of name application.
Upon approval of a change of name, the Department shall notify the licensee and
shall issue a revised license certificate to the licensee, which may be
predicated on the return of the old license certificate.
(f) Relocation. An FED license is valid only
at the premises stated on the most recent license application or renewal
application, and recited as a physical address on the current FED license
certificate. Prior to physically relocating an FED, plans and specifications
shall be submitted for review and approval to the Department in accordance with
the Board's Rules for Submission of Plans and Specifications for Health Care
Facilities, Chapter 420-5-22, Ala. Admin. Code. The
parent hospital and the FED shall submit a relocation application for the FED
to the Department on a form prescribed by the Department. Upon approval of a
change of address, the Department shall notify the licensee and shall issue a
revised license certificate to the licensee, which may be predicated on the
return of the old license certificate.
(g) Denial and Revocation of a License.
1. The Board may deny a license to any
applicant or revoke the license to operate an FED on grounds of insufficient
evidence of the willingness or ability to comply with §§
22-21-20 through
22-21-34, Code of Ala.
1975, or these rules, including the reasons justifying denial or
revocation of a license as set out in the Board's Rules for Hospitals, Chapter
420-5-7, Ala. Admin. Code.
2. Hearing procedures concerning the denial
or revocation of a license shall be governed by the provisions of the Alabama
Administrative Procedure Act, §
41-22-1, et seq., Code
of Ala. 1975, and the Board's Rules for Hearing of Contested
Cases, Chapter 420-1-3, Ala. Admin. Code.
(4) Failure to Renew a
License. Any licensee who fails to renew a license on or before the close of
business on the last business day in December shall be assessed a late fee
equal to the amount of the original license fee. A license may only be renewed
with the payment of a late fee before the close of business on the last
business day in January of any calendar year. A license which has not been
renewed by the end of January has expired and shall be void.
(5) Compliance with federal, state, and local
laws. The parent hospital and FED shall be in compliance with applicable
federal, state and local laws.
(a) Licensing
of Staff. Staff of the facility shall be currently licensed, certified or
registered in accordance with applicable laws.
(b) Compliance with Other Laws. The parent
hospital and FED shall comply with laws relating to fire and life safety,
sanitation, communicable and reportable diseases, Certificate of Need review
and approval, reporting of health care acquired infections, adverse event
reporting, and other relevant health and safety requirements. If a parent
hospital or FED utilizes the services of a clinical laboratory located outside
the State of Alabama, the parent hospital or FED shall ensure that, in
connection with any work performed for the parent hospital or FED, the
laboratory complies with the requirements for the reporting of notifiable
diseases to the Department, as set forth in state law and the rules of the
Board.
(6) A parent
hospital or FED shall promptly notify the Department in writing when there is
any change in its accrediting organization or deemed status.
(7) An FED shall surrender its license and
cease all operations if the license of the parent hospital is voluntarily
terminated, revoked by the Board, or suspended by emergency order of the State
Health Officer.
Authors: W. T. Geary, Jr., M.D., Carter
Sims
Statutory Authority:
Code of Ala.
1975, §§
22-21-20,
et
seq.