Current through Register Vol. 46, No. 39, September 25, 2024
(a)
PCH and CAH administration. PCHs and CAHs shall comply with the requirements of
section 405.3 of this Title regarding
administration.
(b)
Admission/discharge/transfer.
(1) General.
(i) The administrative and
medical/professional staff shall develop for approval by the governing body
written admission and discharge policies designed to protect the health and
safety of patients, and shall not assign or delegate the functions of admission
and discharge to any referral agency.
(ii) The priority use of inpatient beds in
the hospital shall be for short stay acute cases that can be discharged or
transferred within a limited period of time. A PCH or CAH certified to provide
swing-bed services shall ensure the timely availability of acute care beds at
all times.
(iii) Long term cases
shall be assigned to the swing-bed capacity of the hospital.
(2) Admissions.
(i) Each patient shall be advised of his or
her rights pursuant to section
407.7 of this Part and, as
appropriate, the criteria for Medicaid eligibility.
(ii) No person shall be denied admission to
the hospital because of race, creed, national origin, sex, disability (subject
to the capacity of the hospital to provide necessary treatment), sexual
orientation or source of payment.
(iii) Except in emergencies, patients shall
be admitted only upon referral and under the care of a licensed and currently
registered practitioner who has been granted admitting privileges by the
governing body. The patient's condition and provisional diagnosis shall be
established on admission by the patient's admitting practitioner and shall be
noted in the patient's medical record.
(iv) Except in emergencies and under
exceptional circumstances (i.e., weather, availability of transport, equipment
or staff), a hospital shall admit as patients only those who require the type
of medical services authorized by the hospital's operating certificate and
specified in the hospital's written admission and discharge policies.
(a) Authorized admissions to CAHs shall
involve only patients that, by the judgment of the admitting practitioner, are
determined to have medical needs that can be managed and resolved within the
96-hour time period allowed for inpatient services pursuant to
42 CFR section
485.620 as expressly set forth in section
407.2(c) of this
Part. Patients presenting with conditions that have the reasonable potential
for requiring a greater amount of time to resolve shall be transferred to a
more appropriate full service hospital.
(b) Authorized admissions criteria for PCHs
shall be developed locally based on the service and resource capabilities of
the PCH, its supporting full service hospital(s) and, if appropriate, any
network in which it operates. Expected length of stay necessary to meet a
patient's medical needs shall not be used as a criterion for admission to
PCHs.
(v) PCHs and CAHs
shall comply with the provisions of section
405.9(b)(6)-(14)
of this Title.
(3)
Sexual offense evidence. PCHs and CAHs shall comply with the provision of
section 405.9(c) of this
title regarding the maintenance of sexual offense evidence.
(4) Child abuse and maltreatment. PCHs and
CAHs shall comply with the provisions of section
405.9(d) of this
Title with respect to identification, assessment, reporting and management of
cases of suspected child abuse and maltreatment.
(5) Domestic violence. PCHs and CAHs shall
comply with the provisions of section
405.9(e) of this
Title with regard to the identification, assessment, treatment and appropriate
referral of cases of suspected or confirmed domestic violence.
(6) Discharge/transfer. Hospitals shall
comply with the provisions of paragraph (1) of subdivision (i) of section
405.9 of this Title concerning
discharge/transfer. In addition, PCHs and CAHs shall comply with the following:
(i) in carrying out discharge planning
functions, PCHs and CAHs that are members of a rural health network may include
as the discharge planning coordinator a member of the network utilization
review committee who has appropriate training and experience to perform such
duties;
(ii) ensure that discharge
planning staff have available current information regarding home care programs,
institutional health care providers, and other support services, including
their scope of services, admission and discharge policies and payment
criteria;
(iii) each removal,
transfer or discharge shall be carried out in accordance with written PCH/CAH
policy, and, if the facility is a member of a rural health network, network
policy. Such policies shall specify referral arrangements and transfer
protocols outlining the duties and responsibilities involved in determining the
necessity of a transfer and for personnel involved in the transfer and shall be
set forth in written agreements between the PCH/CAH and appropriate receiving
hospital(s); and
(iv) each patient
being removed or discharged shall be provided with information and/or
assistance as required for linking the patient with a community based primary
care provider.
(c) Incident reporting. PCHs/CAHs shall
comply with the provisions of section
405.8 of this Title regarding
incident reporting.
(d) Medical
records. PCHs/CAHs shall comply with the provisions of section
405.10 of this Title regarding
medical records.
(e) Request for
consent to an anatomical gift. PCHs/CAHs shall comply with the provisions of
section 405.25 of this Title regarding
requests for consent to an anatomical gift.
(f) Utilization review. PCHs/CAHs shall
comply with the provisions of section
405.26 of this Title regarding
utilization review.
(g) Information
policy and other reporting requirements. PCHs/CAHs shall comply with the
provision of sections 405.27 and
400.18 of this Title regarding
information policy and other reporting requirements.