(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.
