Ariz. Admin. Code § R9-10-110 - Modification of a Health Care Institution
A. A licensee shall submit a request for
approval of a modification of a health care institution when planning to make:
1. An addition or removal of an authorized
service;
2. An addition or removal
of a colocator;
3. A change in a
health care institution's licensed capacity, licensed occupancy, respite
capacity, or the number of dialysis stations;
4. A change in the physical plant, including
facilities or equipment, that costs more than $300,000; or
5. A change in the building where a health
care institution is located that affects compliance with:
a. Applicable physical plant codes and
standards incorporated by reference in
R9-10-104.01, or
b. Physical plant requirements in the
specific Article in this Chapter applicable to the health care
institution.
B.
A licensee of a health care institution that is required by this Chapter to
comply with any of the physical plant codes and standards incorporated by
reference in
R9-10-104.01 shall submit an
application packet, according to
R9-10-104(A), for
approval of architectural plans and specifications for a modification of the
health care institution described in subsection (A)(3) through (5).
C. A licensee of a health care institution
shall submit a written request an application packet for a modification of the
health care institution in a Department-provided format that contains:
1. The following information in a
Department-provided format:
a. The health
care institution's name, mailing address, e-mail address, and license
number;
b. A narrative description
of the modification, including as applicable:
i. The services the licensee is requesting be
added or removed as an authorized service;
ii. The name and license number of an
associated licensed provider being added or removed as a colocator;
iii. The name and professional license number
of an exempt health care provider being added or removed as a
colocator;
iv. If an associated
licensed provider or exempt health care provider is being added as a colocator,
the proposed scope of services;
v.
The current and proposed licensed capacity, licensed occupancy, respite
capacity, and number of dialysis stations;
vi. The change being made in the physical
plant; and
vii. The change being
made that affects compliance with applicable physical plant codes and standards
incorporated by reference in
R9-10-104.01 ;
and
c. The name and
e-mail address of the health care institution's administrator's or individual
representing the health care institution as designated in according to A.R.S.
§
36-422 and the dated signature of
the administrator or individual; and
2. Documentation that demonstrates that the
requested modification complies with applicable requirements in this Chapter,
including as applicable:
a. A floor plan
showing the location of each colocator's proposed treatment area and the areas
of the collaborating outpatient treatment center's premises shared with a
colocator;
b. For a change in the
licensed capacity, licensed occupancy, respite capacity, or number of dialysis
stations or a modification of the physical plant:
i. A floor plan showing, for each story of
the facility affected by the modification, the room layout, room usage, each
door and each window, plumbing fixtures, each exit, and the location of each
fire protection device; or
ii. For
a health care institution or part of the health care institution that is
required to comply with the physical plant codes and standards incorporated by
reference in
R9-10-104.01 or the building,
documentation of the Department's approval of the health care institution's
architectural plans and specifications in
R9-10-104(D) ;
and
c. Any other
documentation to support the requested modification; and
3. If applicable, a copy of the written
agreement the associated licensed provider or exempt health care provider has
with the collaborating outpatient treatment center.
D. The Department shall approve or deny a
request for a modification described in subsection (B) (C) according to
R9-10-108.
E. A licensee shall not implement a
modification described in subsection (B) (C) until an approval or amended
license is issued by the Department.
Notes
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