216-40-10 R.I. Code R. § 5.3

Current through June 12, 2024

Section 216-RICR-40-10-5.3 - Licensing Procedures and Definitions

5.3.1General Requirements for Licensure

A. No person acting severally or jointly with any other person, shall establish, conduct or maintain a FASC in this state without a license in accordance with the requirements of R.I. Gen. Laws § 23-17-4.

B. A certificate of need is required as a precondition to the establishment of a new FASC and such other activities in accordance with R.I. Gen. Laws Chapter 23-15.

5.3.2Application for License or for Changes in Owner, Operator, or Lessee

A. Application for License and Renewal.

1. Application for an initial license to conduct, maintain or operate a FASC shall be made to the licensing agency upon forms provided by it and shall contain such information as the licensing agency reasonably requires which may include affirmative evidence of ability to comply with the provisions of R.I. Gen. Laws Chapter 23-17 and this Part.

2. Licenses will expire at the end of the calendar year unless renewed (prior to the expiration date of licensure).

a. Renewal applications must be submitted one month prior to the expiration date.

B. A notarized listing of names and addresses of direct and indirect owners whether individual, partnership or corporation with percentages of ownership designated shall be provided with the application for licensure and shall be updated annually. The list shall include each owner (in whole or in part) of any mortgage, deed or trust, note or other obligation.

C. Application for changes in the owner, operator, or lessee of a FASC shall be made on forms provided by the licensing agency and shall contain but not be limited to information pertinent to the statutory purpose expressed in R.I. Gen. Laws § 23-17-3 or to the considerations enumerated in §5.3.3(D)(5) of this Part. Three (3) paper copies and an electronic copy of such applications are required to be provided.

1. Each application filed pursuant the provisions of this section shall be accompanied by a non-refundable, non-returnable application fee, as set forth in the Fee Structure for Licensing, Laboratory, and Administrative Services Provided by the Department of Health (Part 10-05-2 of this Title).

5.3.3Issuance and Renewal of License

A. Upon receipt of an application for a license, the licensing agency shall issue a license or renewal thereof for a period of no more than one (1) year if the applicant meets the requirements of R.I. Gen. Laws Chapter 23-17 and this Part. Said license, unless sooner suspended or revoked, shall expire by limitation on the 31st day of December following its issuance and may be renewed from year to year after inspection and approval by the licensing agency.

B. A license shall be issued to a specific licensee for a specific location and shall not be transferable except with the written approval of the licensing agency. The license shall be issued only for the premises and the individual owner, operator or lessee, or to the corporate entity responsible for its governance.

1. Any change in owner, operator, or lessee of a licensed FASC shall require prior review by the Health Services Council and approval of the licensing agency as provided in §5.3.3(D) of this Part as a condition precedent to the transfer, assignment or issuance of a new license.

C. A license issued hereunder shall be the property of the state loaned to such licensee and it shall be kept posted in a conspicuous place on the licensed premises.

D. Reviews of applications for changes in the owner, operator, or lessee of licensed FASC shall be conducted according to the following procedures:

1. Within ten (10) working days of receipt, in acceptable form, of an application for a license in connection with a change in the owner, operator or lessee of an existing FASC, the licensing agency will notify and afford the public thirty (30) days to comment on such application.

2. The decision of the licensing agency will be rendered within ninety (90) days from acceptance of the application.

3. The decision of the licensing agency shall be based upon the findings and recommendations of the Health Services Council unless the licensing agency shall afford written justification for variance therefrom.

4. All applications reviewed by the licensing agency and all written materials pertinent to licensing agency review, including minutes of all Health Services Council meetings, shall be accessible to the public upon request.

5. Except as otherwise provided in R.I. Gen. Laws Chapter 23-17, a review of the Health Services Council of an application for a license in the case of a proposed change in the owner, operator, or lessee of a licensed FASC may not be made subject to any criterion unless the criterion directly relates to the statutory purpose expressed in R.I. Gen. Laws Chapter 23-17-3. In conducting reviews of such applications the Health Services Council shall specifically consider and it shall be the applicant's burden of proof to demonstrate:

6. The character, commitment, competence and standing in the community of the proposed owners, operators, or directors of the FASC as evidenced by:

a. In cases where the proposed owners, operators, or directors of the health care facility currently own, operate, or direct a health care facility, or in the past five years owned, operated or directed a health care facility, whether within or outside Rhode Island, the demonstrated commitment and record of that (those) person(s):

(1) In providing safe and adequate treatment to the individuals receiving the health care facility's services;

(2) In encouraging, promoting and effecting quality improvement in all aspects of health care facility services; and

(3) In providing appropriate access to health care facility services;

b. A complete disclosure of all individuals and entities comprising the applicant; and

c. The applicant's proposed and demonstrated financial commitment to the health care facility;

7. The extent to which the facility will continue, without material effect on its viability at the time of change of owner, operator, or lessee, to provide safe and adequate treatment for individuals receiving the facility's services as evidenced by:

a. The immediate and long term financial feasibility of the proposed financing plan;

(1) The proposed amount and sources of owner's equity to be provided by the applicant;

(2) The proposed financial plan for operating and capital expenses and income for the period immediately prior to, during and after the implementation of the change in owner, operator or lessee of the health care facility;

(3) The relative availability of funds for capital and operating needs;

(4) The applicant's demonstrated financial capability;

(5) Such other financial indicators as may be requested by the state agency;

8. The extent to which the facility will continue to provide safe and adequate treatment for individuals receiving the facility's services and the extent to which the facility will encourage quality improvement in all aspects of the operation of the health care facility as evidenced by:

a. The applicant's demonstrated record in providing safe and adequate treatment to individuals receiving services at facilities owned, operated, or directed by the applicant; and

b. The credibility and demonstrated or potential effectiveness of the applicant's proposed quality assurance programs;

9. The extent to which the facility will provide or will continue to provide appropriate access with respect to traditionally underserved populations as evidenced by:

a. In cases where the proposed owners, operators, or directors of the health care facility currently own, operate, or direct a health care facility, or in the past five years owned, operated or directed a health care facility, both within and outside of Rhode Island, the demonstrated record of that person(s) with respect to access of traditionally underserved populations to its health care facilities; and

b. The proposed immediate and long term plans of the applicant to ensure adequate and appropriate access to the programs and health care services to be provided by the health care facility;

10. In consideration of the proposed continuation or termination of health care services by the facility:

a. The effect(s) of such continuation or termination on access to safe and adequate treatment of individuals, including but not limited to traditionally underserved populations.

11. And, in cases where the application involves a merger, consolidation or otherwise legal affiliation of two or more health care facilities, the proposed immediate and long-term plans of such health care facilities with respect to the health care programs to be offered and health care services to be provided by such health care facilities as a result of the merger, consolidation or otherwise legal affiliation.

E. Subsequent to reviews conducted under §§5.3.3(D) and (D)(6) of this Part, the issuance of a license by the licensing agency may be made subject to any condition, provided that no condition may be made unless it directly relates to the statutory purpose expressed in R.I. Gen. Laws § 23-17-3, or to the review criteria set forth in §5.3.3(D)(6) of this Part. This shall not limit the authority of the licensing agency to require correction of conditions or defects which existed prior to the proposed change of owner, operator, or lessee and of which notice had been given to the facility by the licensing agency.

5.3.4Capacity

A. The license for a FASC shall be issued for a specified number of operating rooms and recovery beds. The numerical capacity of the FASC shall be determined by the number of recovery beds provided.

B. The post-surgical occupancy of a facility shall not exceed the determined capacity for which a FASC is licensed.

5.3.5Inspections

A. The licensing agency shall make or cause to be made such inspections and investigations as it deems necessary and in accordance with R.I. Gen. Laws § 23-17-10 and this Part.

B. Every FASC shall be given prompt notice by the licensing agency of any deficiencies reported as a result of an inspection or investigation.

C. Written reports and recommendations of inspections shall be maintained on file in each FASC for a period of no less than three (3) years.

5.3.6Denial, Suspension, Revocation of License or Curtailment of Activities

A. The licensing agency is authorized to deny, suspend or revoke the license or curtail activities of any FASC which:

1. has failed to comply with the rules and regulations pertaining to the licensing of FASC; and

2. has failed to comply with the provisions of R.I. Gen. Laws Chapter 23-17.

3. Lists of deficiencies noted in inspections conducted in accordance with §5.3.5 of this Part shall be maintained on file in the licensing agency, and shall be considered by the licensing agency in rendering determinations to deny, suspend or revoke the license or to curtail activities of a FASC.

B. Where the licensing agency deems that operation of a FASC results in undue hardship to patients as a result of deficiencies, the licensing agency is authorized to deny licensure to a FASC not previously licensed, or to suspend for a stipulated period of time or revoke the license of a FASC already licensed or curtail activities of the FASC.

C. Whenever an action shall be proposed to deny, suspend or revoke a FASC license, or curtail its activities, the licensing agency shall notify the FASC by certified mail, setting forth reasons for the proposed action, and the applicant or licensee shall be given an opportunity for a prompt and fair hearing in accordance with R.I. Gen. Laws §§ 23-17-8 and 42-35.9.

1. However, if the licensing agency finds that public health, safety or welfare imperatively requires emergency action and incorporates a finding to that effect in its order, the licensing agency may order summary suspension of license or curtailment of activities pending proceedings for revocation or other action in accordance with R.I. Gen. Laws §§ 23-1-21, and 42-35-14(c).

D. The appropriate state and federal placement and reimbursement agencies shall be notified of any action taken by the licensing agency pertaining to either denial, suspension or revocation of license, or curtailment of activities.

216 R.I. Code R. § 216-RICR-40-10-5.3