New York Codes, Rules and Regulations
Title 10 - DEPARTMENT OF HEALTH
Chapter V - Medical Facilities
Subchapter A - Medical Facilities-minimum Standards
Article 2 - Hospitals
Part 405 - Hospitals-Minimum Standards
Section 405.32 - Observation services

(1) Observation services are post-stabilization services appropriate for short-term treatments, assessment, and re-assessment of those patients for whom diagnosis and a determination concerning inpatient admission, discharge, or transfer can reasonably be expected within 48 hours.

(2) If observation services are provided, the services shall be provided in a manner which protects the health and safety of the patients in accordance with generally accepted standards of medical practice.

(3) Direct referral is defined as a patient referred to the hospital for observation services by a nursing home, hospital outpatient clinic, diagnostic and treatment center, private practice physician or appropriately licensed practitioner, without receiving emergency room or critical care services on the day observation care begins. The referring practitioner must be a licensed physician or appropriately licensed practitioner and must have conducted a physical assessment of the patient within the previous eight hours from the referral.

(4) Patients may be assigned to observation services only by order of a physician or appropriately licensed practitioner.

(5) Patients may be assigned to observation services only through the emergency department or by direct referral in accordance with hospital policies, procedures and bylaws, in conformance with applicable statutes and regulations.

(1) The medical staff shall develop and implement written policies and procedures, approved by the governing body, that are based on the clinical needs of the patient, that shall specify:

(2) The hospital, in conjunction with the discharge planning program of the hospital, shall establish and implement written criteria and guidelines specifying the circumstances, the actions to be taken, and the appropriate contact agencies and individuals to accomplish adequate discharge planning for persons in need of post observation treatment or services but not in need of inpatient hospital care.

(3) Patients in observation shall be cared for by staff appropriately trained and in sufficient numbers to meet the needs of the patients.

(4) Patients being assigned to the observation services, or the patient representative, shall be provided with an oral and written notice within 24 hours of such placement that the patient is not admitted to the hospital and is under observation status. The hospital shall make a good faith effort to obtain written acknowledgment of receipt of the notice by the patient or the patient representative, and if not obtained, document its good faith efforts to obtain such acknowledgment and the reason why the acknowledgment was not obtained. Such written notice shall include, but not be limited to the following information:

(1) inpatient beds;

(2) distinct observation units; or

(3) in a hospital designated as a critical access hospital pursuant to subpart F of part 485 of title 42 of the Code of Federal Regulations or a sole community hospital pursuant to section 412.92 of title 42 of the Code of Federal Regulations, or any successor provisions, observation services may be provided in the emergency department.

(1) Physical standards:

(2) Any hospital seeking to establish a distinct observation unit shall, not less than 90 days prior:

(3) Any hospital operating an observation unit pursuant to a waiver granted by the department shall be required to comply with the provisions of this subdivision within 12 months of its effective date.