Ariz. Admin. Code § R9-10-202 - Supplemental Application, Notification, and Documentation Submission Requirements
A. In
addition to the license application requirements in A.R.S. §
36-422 and Article 1 of this
Chapter, an applicant for a hospital license shall include:
1. On the application the requested licensed
capacity for the hospital, including:
a. The
number of inpatient beds for each organized service, not including well-baby
bassinets; and
b. If applicable,
the number of inpatient beds for each multi-organized service unit;
2. On the application, if
applicable, the requested licensed occupancy for providing behavioral health
observation/stabilization services to:
a.
Individuals who are under 18 years of age, and
b. Individuals 18 years of age and older;
and
3. A list, in a
Department-provided format, of medical staff specialties and
subspecialties.
B. For a
single group license authorized in A.R.S. §
36-422(F), in
addition to the requirements in subsection (A), a governing authority applying
for a license shall submit the following to the Department, in a
Department-provided format, for each satellite facility under the single group
license: 2.
3. The
name and e-mail address of the administrator;
3.
5. The hours of
operation during which the satellite facility provides medical services,
nursing services, behavioral health services, or health-related
services.
1. The name, address, e-mail
address, and telephone number of the satellite facility;
2. The class or subclass of the satellite
facility, according to
R9-10-102 ;
4. A list of services to be provided at the
satellite facility; and
C. For a
single group license authorized in A.R.S. §
36-422(G), in
addition to the requirements in subsection (A), a governing authority applying
for a license shall submit the following to the Department in a
Department-provided format for each accredited satellite facility under the
single group license: 2.
3. The
name and e-mail address of the administrator;
3.
5. The hours of
operation during which the accredited satellite facility provides medical
services, nursing services, behavioral health services, or health-related
services; and
4.
6. A copy of the accredited satellite facility's
current accreditation report.
1. The name, address,
e-mail address, and telephone number of the accredited satellite
facility;
2. The class or subclass
of the accredited satellite facility, according to
R9-10-102 ;
4. A list of services to be provided at the
accredited satellite facility;
D. A licensee with a single group license
shall submit to the Department, with the relevant fees required in
R9-10-106(D) and
in a Department-provided format, the following, as applicable:
1. The information required in subsections
(B)(1) through (5), or
2. The
information and documentation required in subsections (C)(1) through (6).
1. Notify the Department:
a. At least 30 calendar days before a
satellite facility or an accredited satellite facility on a single group
license terminates operations;
b.
Within 30 calendar days after adding a satellite facility or an accredited
satellite facility under a single group license and provide, as applicable:
i. The information required in subsections
(B)(1) through (5), or
ii. The
information and documentation required in subsections (C)(1) through (6);
and
c. At least 60
calendar days before a satellite facility or an accredited satellite facility
licensed under a single group license anticipates providing medical services,
nursing services, behavioral health services, or health-related services under
a license separate from the single group license; and
2. Upon notifying the Department according to
subsection (E)(1)(c), submit an application, according to the requirements in 9
A.A.C. 10, Article 1, at least 60 calendar days but not more than 120 calendar
days before a satellite facility or an accredited satellite facility licensed
under a single group license anticipates providing medical services, nursing
services, behavioral health services, or health-related services under a
license separate from the single group license.
Notes
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