Utah Administrative Code

The Utah Administrative Code is the body of all effective administrative rules as compiled and organized by the Division of Administrative Rules (see Subsection 63G-3-102(5); see also Sections 63G-3-701 and 702).

NOTE: For a list of rules that have been made effective since August 1, 2019, please see the codification segue page.

NOTE TO RULEFILING AGENCIES: Use the RTF version for submitting rule changes.

R432. Health, Family Health and Preparedness, Licensing.

Rule R432-106. Specialty Hospital - Critical Access.

As in effect on August 1, 2019

Table of Contents

R432-106-1. Legal Authority.

This rule is adopted pursuant to Title 26, Chapter 21.

R432-106-2. Purpose.

The purpose of this rule is to promote the public health and welfare through establishment of a specialty hospital category for rural hospitals. Its intent is to allow rural communities to: preserve access to primary care and emergency health care services, provide health care services which meet community needs, and help assure the financial viability of program participants through improved reimbursement and different operating requirements. The rule sets standards for the operation of a Critical Access Hospital,(CAH). The standards of patient care apply to inpatient, outpatient, and satellite services.

R432-106-3. Definitions.

For purposes of this rule the definitions in R432-1-3 apply. In addition the following definitions apply:

(1) "Critical Access Hospital" means a nonprofit, profit or public hospital that is enrolled as a Medicaid provider and qualifies as a Critical Access Hospital under 42 CFR, Section 485, Subpart F.

(2) "Referral Hospital" means a hospital that has sufficient resources to receive emergency or non-emergency patient transfers and referrals from a CAH. Sufficient resources include at least three full-time physicians on staff and licensure as a general hospital.

R432-106-4. Licensure.

A license is required as identified in section R432-2.

R432-106-5. Construction, Facilities, and Equipment Standards.

(1) Each rural hospital, licensed prior to July 1, 2000, which elects to convert to a CAH, may maintain the physical plant which is currently licensed, without having to meet the current construction or building code for a general acute care hospital.

(2) New hospitals constructed as a CAH, or when a CAH is re-modeled, shall be constructed and maintained in accordance with R432-4-1 through R432-4-24.

R432-106-6. Critical Access Hospital Swing-Bed Units.

The CAH participating in the swing-bed program may maintain up to 25 swing-beds for care at one time. In addition to R432-106, designated hospital swing beds shall comply with the following sections of R432-150, Nursing Care Facility Rules:

(1) R432-150-4, Definitions.

(2) R432-150-12, Resident Rights.

(3) R432-150-13, Resident Assessment.

(4) R432-150-14, Restraint Policy.

(5) R432-150-15, Quality of Care.

(6) R432-150-17, Social Services.

(7) R432-150-20, Recreation Therapy.

R432-106-7. Hospital Rules.

The following sections of R432-100, General Hospital Rules, are adopted and incorporated by reference.

(1) A CAH shall comply with the following:

(a) R432-100-5, Governing Body.

(b) R432-100-6, Administrator.

(c) R432-100-7, Medical and Professional Staff.

Credentialing of medical and professional staff may be performed by a network hospital or a Department approved equivalent.

(d) R432-100-8, Personnel Management Services.

(e) R432-100-9, Quality Improvement Plans.

Quality improvement may be performed by a network hospital or a Department approved equivalent.

(f) R432-100-10, Infection Control.

(g) R432-100-11, Patient Rights.

(h) R432-100-12, Nursing Services.

A qualified registered nurse is not required to be on duty on a 24-hour basis, but shall be on duty if one acute care patient is admitted.

(i) R432-100-16, Emergency Services.

The hospital must make available 24-hour emergency care services, seven days a week, regardless of inpatient census. The CAH shall ensure at least one physician is on call at all times. The 30 minute response requirement is amended to 60 minutes if the CAH qualifies under Section 485.618 (d) (2) of the Federal Conditions of Participation.

(j) R432-100-21, Radiology Services.

Radiology services may be provided off-site through a network hospital or through other arrangements approved by the Department.

(k) R432-100-22, Laboratory and Pathology Services.

(l) R432-100-24, Pharmacy Services.

(m) R432-100-29, Respite Services.

(n) R432-100-31, Dietary Services.

(o) R432-100-33, Medical Records.

(p) R432-100-36, Housekeeping Services.

(q) R432-100-37, Maintenance Services.

(r) R432-100-38, Emergency and Disaster Plans.

(2) If the CAH provides the following clinical or ancillary services then the following shall apply:

(a) R432-100-14, Surgical Services.

(b) R432-100-15, Anesthesia Services.

(c) R432-100-17, Perinatal Services.

(d) R432-100-19, Respiratory Services.

(e) R432-100-23, Blood Services.

(f) R432-100-32, Telemedicine Services.

(g) R432-100-34, Central Supply.

(h) R432-100-35, Laundry Services.

R432-106-8. Rural Health Network.

(1) The participating CAH shall be a member of a rural health network, as evidenced by a signed, written agreement with at least one Referral Hospital that is a member of the network.

(2) The agreement shall address the following:

(a) Patient referral and transfer;

(b) The development and use of communications system; and

(c) Emergency and non-emergency transportation.

R432-106-9. Conversion to a General Hospital.

Within 18 months of conversion to the specialty CAH, a hospital may submit a Request for Agency Action to convert to a General Hospital category without being required to meet the current R432-104, General Construction standards.

R432-106-10. Penalty.

Any person who violates any provision of this rule may be subject to the penalties enumerated in 26-21-11 and R432-3-6 and be punished for violation of a class A misdemeanor as provided in Section 26-21-16.


health care facilities

Date of Enactment or Last Substantive Amendment

January 5, 2006

Notice of Continuation

November 9, 2015

Authorizing, Implemented, or Interpreted Law

26-21-5; 26-21-2.1; 26-21-13.6

Additional Information


For questions regarding the content or application of rules under Title R432, please contact the promulgating agency (Health, Family Health and Preparedness, Licensing). A list of agencies with links to their homepages is available at http://www.utah.gov/government/agencylist.html or from http://www.rules.utah.gov/contact/agencycontacts.htm.