DAR File No. 43005

Health, Family Health and Preparedness, Licensing

Rule R432-2

General Licensing Provisions

Notice of Proposed Rule

(Amendment)

DAR File No.: 43005
Filed: 06/15/2018 10:55:52 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this amendment is to modify Section R432-2-17 to match the current licensing inspection process for licensed health care facilities. In addition, it includes several technical corrections. The Health Facility Committee reviewed and approved this rule amendment on 05/09/2018. This amendment was recommended in 2017 by the legislative auditors.

Summary of the rule or change:

This amendment is to modify Section R432-2-17 to state previous survey instead of previous year survey which matches the current licensing inspection process for licensed health care facilities. In addition, it includes several technical corrections to be consistent with current practices. The Health Facility Committee reviewed and approved this rule amendment on 05/09/2018. This amendment was recommended in 2017 by the legislative auditors.

Statutory or constitutional authorization for this rule:

• Title 26, Chapter 21

Anticipated cost or savings to:

the state budget:

The state government health facility survey process was thoroughly reviewed. This proposed rule amendment could lead to increased health care facility sanctions, however, with all the variables within the survey process and the facility practices, this is an inestimable benefit.

local governments:

Local government city business licensing requirements were considered. This proposed rule amendment should not impact local governments revenues or expenditures.

small businesses:

After conducting a thorough analysis, it was determined that this rule amendment could lead to increased costs for small business licensed health care facilities as it may result in increased sanctions, however, with all the variables within the survey process and the facility practices, this is an inestimable cost. There are 661 small businesses (NAICS codes used - Homes for the Elderly 623312, Nursing Care Facilities 623110, General Medical/Surgical Hospital 622110, Psychiatric and Substance Abuse Hospitals 622210, Other Hospitals 622310, Home Health 621610, End Stage Renal Disease 621492, and Free Standing Ambulatory Surgical Centers 621493).

persons other than small businesses, businesses, or local governmental entities:

After conducting a thorough analysis, it was determined that this rule amendment will not result in a fiscal impact to other persons because this amendment modifies health care facility requirements.

Compliance costs for affected persons:

After conducting a thorough analysis, it was determined that this proposed rule amendment will not result in a fiscal impact to affected persons because this amendment modifies health care facility requirements and therefore, would not add any compliance costs to affected persons.

Comments by the department head on the fiscal impact the rule may have on businesses:

There may be a fiscal impact to businesses if there is an increase in sanctions for violation of this rule.

Joseph K. Miner, MD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Office of Administrative Rules, or at:

Health
Family Health and Preparedness, Licensing
3760 S HIGHLAND DR
SALT LAKE CITY, UT 84106

Direct questions regarding this rule to:

• Joel Hoffman at the above address, by phone at 801-273-2804, by FAX at 801-274-0658, or by Internet E-mail at jhoffman@utah.gov
• Carmen Richins at the above address, by phone at 801-273-2802, by FAX at 801-274-0658, or by Internet E-mail at carmenrichins@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

07/31/2018

This rule may become effective on:

08/07/2018

Authorized by:

Joseph Miner, Executive Director

Appendix 1: Regulatory Impact Summary Table*

Fiscal Costs	FY 2019	FY 2020	FY 2021
State Government	$0	$0	$0
Local Government	$0	$0	$0
Small Businesses	$0	$0	$0
Non-Small Businesses	$0	$0	$0
Other Person	$0	$0	$0
Total Fiscal Costs:	$0	$0	$0
Fiscal Benefits
State Government	$0	$0	$0
Local Government	$0	$0	$0
Small Businesses	$0	$0	$0
Non-Small Businesses	$0	$0	$0
Other Persons	$0	$0	$0
Total Fiscal Benefits:	$0	$0	$0
Net Fiscal Benefits:	$0	$0	$0

 

*This table only includes fiscal impacts that could be measured. If there are inestimable fiscal impacts, they will not be included in this table. Inestimable impacts for State Government, Local Government, Small Businesses and Other Persons are described above. Inestimable impacts for Non - Small Businesses are described below.

 

Appendix 2: Regulatory Impact to Non - Small Businesses

There are 114 non-small businesses (NAICS codes used -Homes for the Elderly 623312, Nursing Care Facilities 623110, General Medical/Surgical Hospital 622110, Psychiatric and Substance Abuse Hospitals 622210, Other Hospitals 622310, Home Health 621610, End Stage Renal Disease 621492,and Free Standing Ambulatory Surgical Centers 621493).

 

After conducting a thorough analysis, it was determined that this rule amendment could lead to increased costs for non-small business licensed health care facilities as it may result in increased sanctions,however,with all the variables within the survey process and the facility practices,this is an inestimable cost.

 

The Department of Health Executive Director Joseph K. Miner, MD,has reviewed and approved this fiscal analysis.

 

 

R432. Health, Family Health and Preparedness, Licensing.

R432-2. General Licensing Provisions.

R432-2-7. Applications for License Actions.

(1) An applicant for a license shall file a Request for Agency Action/License Application with the Utah Department of Health on a form furnished by the Department.

(2) Each applicant shall comply with all zoning, fire, safety, sanitation, building and licensing laws, regulations, ordinances, and codes of the city and county in which the facility or agency is located. The applicant shall obtain the following clearances and submit them as part of the completed application to the licensing agency:

(a) A certificate of fire clearance from the State Fire Marshal or designated local fire authority certifying compliance with local and state fire codes is required with initial and renewal application, change of ownership, and at any time new construction or substantial remodeling has occurred.

(b) A satisfactory Food Services Sanitation Clearance report by a local [or state sanitarian]Health Department is required for facilities providing food service at initial application and upon a change of ownership.

(c) Certificate of Occupancy from the local building official at initial application, change of location and at the time of any new construction or substantial remodeling.

(3) As used in this section, an "owner" is any person or entity:

(a) ultimately responsible for operating a health care facility; or

(b) legally responsible for decisions and liabilities in a business management sense or that bears the final responsibility for operating decisions made in the capacity of a governing body.

(4) The applicant shall submit contact information for the ownership of the legal entity including the names, email addresses and mailing addresses.

(5) The applicant shall provide the following written assurances on all individuals listed in R432-2-7(4):

(a) None of the persons has been convicted of a felony;

(b) None of the persons has been found in violation of any local, state, or federal law which arises from or is otherwise related to the individual's relationship to a health care facility; and

(c) None of the persons who has currently or within the five years prior to the date of application had previous interest in a licensed health care facility that has been any of the following:

(i) subject of a patient care receivership action;

(ii) closed as a result of a settlement agreement resulting from a decertification action or a license revocation;

(iii) involuntarily terminated from participation in either Medicaid or Medicare programs; or

(iv) convicted of patient abuse, neglect or exploitation where the facts of the case prove that the licensee failed to provide adequate protection or services for the person to prevent such abuse.

 

R432-2-10. Initial License Issuance or Denial.

(1) The Department shall render a decision on an initial license application within 60 days of receipt of a complete d application packet[or within six months of the date the first component of an application packet is received; provided, in either case, a minimum of 45 days is allowed for the initial policy and procedure manual review].

(2) Upon verification of compliance with licensing requirements the Department shall issue a provisional license.

(3) The Department shall issue a written notice of agency decision under the procedures for adjudicative proceedings (R432-30) denying a license if the facility is not in compliance with the applicable laws, rules, or regulations. The notice shall state the reasons for denial.

(4) An applicant who is denied licensing may reapply for initial licensing as a new applicant and shall be required to initiate a new request for agency action as described in R432-2-7.

(5) The Department shall assess an administrative fee on all denied license applications. This fee shall be subtracted from any fees submitted as part of the application packet and a refund for the balance returned to the applicant.

 

R432-2-17. Conditional License.

(1) A conditional license is a remedial license issued to a licensee if there is a determination of substandard quality of care, immediate jeopardy or a pattern of violations which would result in a ban on admissions at the facility or if the licensee is found to have:

(a) a Class I violation or a Class II violation that remains uncorrected after the specified time for correction;

(b) more than three cited repeat Class I or II violations from the previous [year]survey; or

(c) fails to fully comply with administrative requirements for licensing.

(2) A standard license is revoked by the issuance of a conditional license.

(3) The Department may not issue a conditional license after the expiration of a provisional license.

(4) In granting a conditional license, the Department shall be assured that the lack of full compliance does not harm the health, safety, and welfare of the patients.

(5) The Department shall establish the period of time for the conditional license based on an assessment of the nature of the existing violations and facts available at the time of the decision.

(6) The Department shall set conditions whereby the licensee must comply with an accepted plan of correction.

(7) If the licensee fails to meet the conditions before the expiration date of the conditional license, the license shall automatically expire.

 

R432-2-19. Variances.

(1) A health facility may submit a request for agency action to obtain a variance from state rules at any time.

(a) An applicant requesting a variance shall file a Request for Agency Action/Variance Application with the Utah Department of Health on forms furnished by the Department.

(b) The Department may require additional information from the facility before acting on the request.

(c) The Department shall act upon each request for variance in writing within 60 days of receipt of a completed request.

(2) [If the Department grants a variance, it shall amend the license in writing to indicate that the facility has been granted a variance. The]A variance may be renewable or non-renewable. The licensee shall maintain a copy of the approved variance on file in the facility and make the copy available to all interested parties upon request.

(a) The Department shall file the request and variance with the license application.

(b) The terms of a requested variance may be modified upon agreement between the Department and the facility.

(c) The Department may impose conditions on the granting of a variance as it determines necessary to protect the health and safety of the residents or patients.

(d) The Department may limit the duration of any variance.

(3) The Department shall issue a written notice of agency decision denying a variance upon determination that the variance is not justified.

(4) The Department may revoke a variance if:

(a) The variance adversely affects the health, safety, or welfare of the residents.

(b) The facility fails to comply with the conditions of the variance as granted.

(c) The licensee notifies the Department in writing that it wishes to relinquish the variance and be subject to the rule previously varied.

(d) There is a change in the statute, regulations or rules.

 

KEY: health care facilities

Date of Enactment or Last Substantive Amendment: [ March 22, ]2018

Notice of Continuation: January 29, 2018

Authorizing, and Implemented or Interpreted Law: 26-21-9; 26-21-11; 26-21-12; 26-21-13