(a) Licensing Procedure. - (i) For an initial license to be issued, the State Survey Agency shall receive:
- (A) A completed application form supplied by the State Survey Agency, including the completed items identified on the Rehabilitation Hospital Licensure Checklist supplied by the State Survey Agency.
- (B) Each completed application shall be accompanied by the required licensure fee identified in Chapter 1, Rules and Regulations for Health Care Facilities Licensure Fees. The check or money order shall be made payable to the Treasurer, State of Wyoming.
- (ii) For renewal of a full license for one (1) year beginning July 1, and unless suspended or revoked, expiring on June 30 of the following year, the State Survey Agency shall receive:
- (A) A completed application form submitted no later than the date indicated in the renewal notice posted on the State Survey Agency website at: http://www.health.wyo.gov/ohls [File Link Not Available] and
- (B) The licensure fee required in paragraph (a)(i)(B) of this section.
(b) Requirements for Licensure. The State Survey Agency shall consider: - (i) Initial, re-licensure, and complaint survey deficiencies cited by the State Survey Agency;
- (ii) Life Safety Code deficiencies cited by the State Survey Agency;
- (iii) Complaint investigations and resolutions;
- (iv) Compliance with all laws and standards relating to communicable and reportable diseases, as required by the Wyoming Department of Health, State Health Officer, and Public Health Division; and
- (v) The effectiveness of the quality management program to evaluate and improve patient care and services.
(c) Transfer of license. - (i) Transfer or assignment of a rehabilitation hospital license is prohibited. The rehabilitation hospital shall comply with licensure requirements in paragraph (d) of this section in the event of a change in the ownership of a rehabilitation hospital.
(d) Change of Ownership. - (i) A change in ownership of a rehabilitation hospital occurs when there is a change in the legal entity responsible for the operation of the rehabilitation hospital, whether by lease or by ownership.
- (ii) If the rehabilitation hospital is also certified for Medicare and/or Medicaid, the change of ownership determination by the Centers for Medicare and Medicaid Services will also be used to determine the licensure change in ownership.
- (iii) The new owner shall submit no later than sixty (60) calendar days prior to the event the following items:
- (A) A change in ownership application for licensure with the appropriate fee, as required in paragraph (a)(i)(B) of this section.
- (B) The checklist items required for an initial applicant.
- (iv) Within twenty-four (24) hours of the final transaction, the new owner shall submit a copy of the signed bill of sale or lease agreement that reflects the effective date of the sale or lease.
(e) Other changes. A licensure application and appropriate fee, as required in paragraph (a)(i)(B) of this section, shall be required for any of the following changes to be processed: - (i) Name change of the rehabilitation hospital.
- (ii) The number of licensed beds increased or decreased.
- (iii) Change in the main rehabilitation hospital address or ancillary locations.
(f) Provisional Licenses. - (i) A provisional license is a temporary license that may be issued in the following instances:
- (A) For a new licensed provider.
- (B) For a change in ownership, if deemed appropriate by the State Survey Agency.
- (C) Following a successful licensure construction inspection for space that has not previously been occupied by patient's, residents, or clients. During the aforementioned inspection, there can be no deficiencies cited that could potentially result in harm to the patient's, residents, or clients.
- (D) Following a successful licensure construction inspection for space that has undergone expansion and remodel to the extent that significant structural, mechanical, plumbing, or fire safety changes have been made to the space occupied by patient's, residents, or clients.
- (E) Whenever deficiencies are cited that are serious and have resulted in harm or potential harm to patient's, residents, or clients.
- (F) Whenever the facility fails to satisfactorily correct cited deficient practices.
- (G) Whenever the facility fails to comply with any requirement of these rules.
- (ii) The state Medicaid office will be notified by the State Survey Agency whenever a provisional license is issued or re-issued.
- (iii) A provisional license will be issued with an expiration date to be determined by the State Survey Agency at the time of issuance.
- (iv) A provisional license may be re-issued for an additional extended time, if deemed appropriate by the State Survey Agency.
- (v) If a provisional license is issued in lieu of a regular license, the facility must return the regular license to the State Survey Agency by certified mail or hand delivery to Wyoming Department of Health, Aging Division, Healthcare Licensing and Surveys, 6101 Yellowstone Rd., Ste. 186C, Cheyenne, WY 82002.
- (vi) The provisional license shall be displayed in a public area within the rehabilitation hospital.
(g) Conditions for Denying, Revoking, or Suspending a License. - (i) Denial, revocation, or suspension of a license may occur for noncompliance with any provisions of these licensure rules, with state statute or federal law or federal rules and regulations.
(h) Suspension of Admissions. - (i) The State Survey Agency may suspend new admissions or re-admissions to the rehabilitation hospital when conditions are such that patient needs cannot be met. Conditions in a rehabilitation hospital shall not jeopardize the patient's health or safety.
(i) Monitor. - (i) The State Survey Agency shall place a Wyoming Department of Health approved monitor at the rehabilitation hospital's expense when conditions are such that patient's needs are not being met by the rehabilitation hospital. The monitor shall insure that neither the health nor the safety of the patient's is jeopardized.
(j) Hearings. - (i) Any rehabilitation hospital aggrieved by a decision of the State Survey Agency may request a hearing by submitting a written request to the State Survey Agency within ten (10) calendar days of receipt of the notice of adverse action.
- (ii) The State Survey Agency (State Survey Agent or designee) shall provide an opportunity for a hearing, if requested, and shall present the evidence supporting any preliminary licensure decision(s) and reason(s) to the parties concerned. Any request for hearing shall adhere to the time frames in (i) above.
- (iii) In matters concerned with the spread of communicable disease that may require the utilization of quarantine or isolation, the Wyoming State Health Officer or designated representative shall provide an opportunity for a hearing as outlined in W.S. 35-4-112.
- (iv) Hearings requested under this rule shall be held in accordance with the provisions of the Wyoming Administrative Procedure Act.
(k) Posting of License. - (i) The current license issued by the State Survey Agency shall be displayed in a public area within the rehabilitation hospital.
(l) Surveys for Licensure. - (i) The State Survey Agency or its designated representative shall perform initial and periodic surveys for the renewal of licensure.
- (A) These surveys shall be based on the current Rules and Regulations for Licensure of Rehabilitation Hospitals promulgated by the Wyoming Department of Health.
- (B) The State Survey Agency shall provide copies of its cited deficiencies to the rehabilitation hospital within ten (10) working days after the last day of the surveys.
- (C) The rehabilitation hospital shall provide an acceptable plan of correction to the State Survey Agency for all cited deficiencies within ten (10) calendar days after receipt of the deficiencies. The plan of correction shall be a written document and shall provide, but not be limited to, the following information:
- (I) Who is responsible for the correction.
- (II) What was done or will be done to correct the deficiency.
- (III) Who will monitor to ensure that the situation does not again develop.
- (IV) An appropriate date, not to exceed forty-five (45) calendar days after the last day of survey, for the correction of deficiencies.
- (ii) At the time of survey, all records, including patient medical records, pertaining to matters involved in the survey shall be made available to members of the survey team as requested. Surveys may be conducted as focused, off-site administrative reviews, in which case specific records or categories of records will be requested by the State Survey Agency for review. The results of all surveys, including complaint investigations and administrative reviews, will be shared with the rehabilitation hospital's administrator and other pertinent staff.
(m) Voluntary Closure. - (i) If a rehabilitation hospital voluntarily ceases to operate, it shall notify the State Survey Agency in writing at least sixty (60) working days prior to closure.
- (ii) The first working day after closure, the facility must return the license to the State Survey Agency by certified mail or hand delivery to Wyoming Department of Health, Aging Division, Healthcare Licensing and Surveys, 6101 Yellowstone Rd., Ste. 186C, Cheyenne, WY 82002.
048-22 Wyo. Code R. § 22-5