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[Utah Code Table of Contents]
[TITLE 26. Table of Contents]
26-21-1 Title.
This chapter is known as the "Health Care Facility Licensing
and Inspection Act."
1997
26-21-2 Definitions.
As used in this chapter:
(1) "Abortion clinic" means a facility, other than a general acute or specialty hospital, that performs abortions and provides abortion services during the second trimester of pregnancy.
(2) "Activities of daily living" means essential activities including:
(a) dressing;
(b) eating;
(c) grooming;
(d) bathing;
(e) toileting;
(f) ambulation;
(g) transferring; and
(h) self-administration of medication.
(3) "Ambulatory surgical facility" means a freestanding facility, which provides surgical services to patients not requiring hospitalization.
(4) "Assistance with activities of daily living" means providing of or arranging for the provision of assistance with activities of daily living.
(5) (a) "Assisted living facility" means:
(i) a type I assisted living facility, which is a residential facility that provides assistance with activities of daily living and social care to two or more residents who:
(A) require protected living arrangements; and
(B) are capable of achieving mobility sufficient to exit the facility without the assistance of another person; and
(ii) a type II assisted living facility, which is a residential facility with a home-like setting that provides an array of coordinated supportive personal and health care services available 24 hours per day to residents who have been assessed under department rule to need any of these services.
(b) Each resident in a type I or type II assisted living facility shall have a service plan based on the assessment, which may include:
(i) specified services of intermittent nursing care;
(ii) administration of medication; and
(iii) support services promoting residents' independence and self sufficiency.
(6) "Birthing center" means a freestanding facility, receiving maternal clients and providing care during pregnancy, delivery, and immediately after delivery.
(7) "Committee" means the Health Facility Committee created in Section 26-1-7 .
(8) "Consumer" means any person not primarily engaged in the provision of health care to individuals or in the administration of facilities or institutions in which such care is provided and who does not hold a fiduciary position, or have a fiduciary interest in any entity involved in the provision of health care, and does not receive, either directly or through his spouse, more than 1/10 of his gross income from any entity or activity relating to health care.
(9) "End stage renal disease facility" means a facility which furnishes staff-assisted kidney dialysis services, self-dialysis services, or home-dialysis services on an outpatient basis.
(10) "Freestanding" means existing independently or physically separated from another health care facility by fire walls and doors and administrated by separate staff with separate records.
(11) "General acute hospital" means a facility which provides diagnostic, therapeutic, and rehabilitative services to both inpatients and outpatients by or under the supervision of physicians.
(12) "Governmental unit" means the state, or any county, municipality, or other political subdivision or any department, division, board, or agency of the state, a county, municipality, or other political subdivision.
(13) (a) "Health care facility" means general acute hospitals, specialty hospitals, home health agencies, hospices, nursing care facilities, residential-assisted living facilities, birthing centers, ambulatory surgical facilities, small health care facilities, abortion clinics, facilities owned or operated by health maintenance organizations, end stage renal disease facilities, and any other health care facility which the committee designates by rule.
(b) "Health care facility" does not include the offices of private physicians or dentists, whether for individual or group practice.
(14) "Health maintenance organization" means an organization, organized under the laws of any state which:
(a) is a qualified health maintenance organization under 42 U.S.C. Sec. 300e-9; or
(b) (i) provides or otherwise makes available to enrolled participants at least the following basic health care services: usual physician services, hospitalization, laboratory, x-ray, emergency, and preventive services and out-of-area coverage;
(ii) is compensated, except for copayments, for the provision of the basic health services listed in Subsection (14)(b)(i) to enrolled participants by a payment which is paid on a periodic basis without regard to the date the health services are provided and which is fixed without regard to the frequency, extent, or kind of health services actually provided; and
(iii) provides physicians' services primarily directly through physicians who are either employees or partners of such organizations, or through arrangements with individual physicians or one or more groups of physicians organized on a group practice or individual practice basis.
(15) (a) "Home health agency" means an agency, organization, or facility or a subdivision of an agency, organization, or facility which employs two or more direct care staff persons who provide licensed nursing services, therapeutic services of physical therapy, speech therapy, occupational therapy, medical social services, or home health aide services on a visiting basis.
(b) "Home health agency" does not mean an individual who provides services under the authority of a private license.
(16) "Hospice" means a program of care for the terminally ill and their families which occurs in a home or in a health care facility and which provides medical, palliative, psychological, spiritual, and supportive care and treatment.
(17) "Nursing care facility" means a health care facility, other than a general acute or specialty hospital, constructed, licensed, and operated to provide patient living accommodations, 24-hour staff availability, and at least two of the following patient services:
(a) a selection of patient care services, under the direction and supervision of a registered nurse, ranging from continuous medical, skilled nursing, psychological, or other professional therapies to intermittent health-related or paraprofessional personal care services;
(b) a structured, supportive social living environment based on a professionally designed and supervised treatment plan, oriented to the individual's habilitation or rehabilitation needs; or
(c) a supervised living environment that provides support, training, or assistance with individual activities of daily living.
(18) "Person" means any individual, firm, partnership, corporation, company, association, or joint stock association, and the legal successor thereof.
(19) "Resident" means a person 21 years of age or older who:
(a) as a result of physical or mental limitations or age requires or requests services provided in an assisted living facility; and
(b) does not require intensive medical or nursing services as provided in a hospital or nursing care facility.
(20) "Small health care facility" means a four to sixteen bed facility that provides licensed health care programs and services to residents who generally do not need continuous nursing care or supervision.
(21) "Specialty hospital" means a facility which provides specialized diagnostic, therapeutic, or rehabilitative services in the recognized specialty or specialties for which the hospital is licensed.
(22) "Substantial compliance" means in a department survey
of a licensee, the department determines there is an absence
of deficiencies which would harm the physical health, mental
health, safety, or welfare of patients or residents of a
licensee.
2000
26-21-2.1 Services.
(1) General acute hospitals and specialty hospitals shall remain open and be continuously ready to receive patients 24 hours of every day in a year and have an attending medical staff consisting of one or more physicians licensed to practice medicine and surgery under Title 58, Chapter 67, Utah Medical Practice Act, or Title 58, Chapter 68, Utah Osteopathic Medical Practice Act.
(2) A specialty hospital shall provide on-site all basic services required of a general acute hospital that are needed for the diagnosis, therapy, or rehabilitation offered to or required by patients admitted to or cared for in the facility.
(3) (a) A home health agency shall provide at least licensed nursing services or therapeutic services directly through the agency employees.
(b) A home health agency may provide additional services
itself or under arrangements with another agency, organization,
facility, or individual.
1997
26-21-3 Health Facility Committee - Members - Terms - Organization - Meetings.
(1) The Health Facility Committee created by Section 26-1-7 consists of 13 members appointed by the governor with the consent of the senate. No more than seven members may be from the same political party. The appointed members shall be knowledgeable about health care facilities and issues. The membership of the committee is:
(a) one physician, licensed to practice medicine and surgery under Title 58, Chapter 67, Utah Medical Practice Act, or Title 58, Chapter 68, Utah Osteopathic Medical Practice Act, who is a graduate of a regularly chartered medical school;
(b) one hospital administrator;
(c) one hospital trustee;
(d) one representative of the nursing care facility industry;
(e) one registered nurse, licensed to practice under Title 58, Chapter 31b, Nurse Practice Act;
(f) one professional in the field of mental retardation not affiliated with a nursing care facility;
(g) one licensed architect or engineer with expertise in health care facilities;
(h) two representatives of health care facilities, other than nursing care facilities or hospitals, licensed under this chapter; and
(i) four consumers, one of whom has an interest in or expertise in geriatric care.
(2) (a) Except as required by Subsection (b), members shall be appointed for a term of four years.
(b) Notwithstanding the requirements of Subsection (a), the governor shall, at the time of appointment or reappointment, adjust the length of terms to ensure that the terms of committee members are staggered so that approximately half of the committee is appointed every two years.
(c) When a vacancy occurs in the membership for any reason, the replacement shall be appointed for the unexpired term by the governor, giving consideration to recommendations made by the committee, with the consent of the Senate.
(d) A member may not serve more than two consecutive full terms or ten consecutive years, whichever is less. However, a member may continue to serve as a member until he is replaced.
(e) The committee shall annually elect from its membership a chair and vice chair.
(f) The committee shall meet at least quarterly, or more frequently as determined by the chair or five members of the committee.
(g) Seven members constitute a quorum. A vote of the majority
of the members present constitutes action of the committee.
1999
26-21-4 Per diem of committee members.
(1) Members shall receive no compensation or benefits for their services, but may receive per diem and expenses incurred in the performance of the member's official duties at the rates established by the Division of Finance under Sections 63A-3-106 and 63A-3-107 .
(2) Members may decline to receive per diem and expenses
for their service.
1996
26-21-5 Duties of committee.
The committee shall:
(1) make rules in accordance with Title 63, Chapter 46a, Utah Administrative Rulemaking Act:
(a) for the licensing of health-care facilities; and
(b) requiring the submission of architectural plans and specifications for any proposed new health-care facility or renovation to the department for review;
(2) approve the information for applications for licensure pursuant to Section 26-21-9 ;
(3) advise the department as requested concerning the interpretation and enforcement of the rules established under this chapter; and
(4) advise, consult, cooperate with, and provide technical
assistance to other agencies of the state and federal government,
and other states and affected groups or persons in carrying
out the purposes of this chapter.
1997
26-21-6 Duties of department.
(1) The department shall:
(a) enforce rules established pursuant to this chapter;
(b) authorize an agent of the department to conduct inspections of health-care facilities pursuant to this chapter;
(c) collect information authorized by the committee that may be necessary to ensure that adequate health-care facilities are available to the public;
(d) collect and credit fees for licenses as free revenue;
(e) collect and credit fees for conducting plan reviews as dedicated credits;
(f) designate an executive secretary from within the department to assist the committee in carrying out its powers and responsibilities;
(g) establish reasonable standards for criminal background checks by public and private entities;
(h) recognize those public and private entities which meet the standards established in Subsection (1)(g); and
(i) provide necessary administrative and staff support to the committee.
(2) The department may:
(a) exercise all incidental powers necessary to carry out the purposes of this chapter;
(b) review architectural plans and specifications of proposed health-care facilities or renovations of health-care facilities to ensure that the plans and specifications conform to rules established by the committee; and
(c) make rules as necessary to implement the provisions
of this chapter, except as authority is specifically delegated
to the committee.
1998
26-21-7 Exempt facilities.
This chapter does not apply to:
(1) a dispensary or first aid facility maintained by any commercial or industrial plant, educational institution, or convent;
(2) a health care facility owned or operated by an agency of the United States;
(3) the office of a physician or dentist whether it is an individual or group practice;
(4) a health care facility established or operated by any recognized church or denomination for the practice of religious tenets administered by mental or spiritual means without the use of drugs, whether gratuitously or for compensation, if it complies with statutes and rules on environmental protection and life safety; and
(5) any health care facility owned or operated by the
Department of Corrections, created in Section
64-13-2
.
1995
26-21-8 License required - Not assignable or transferable - Posting - Expiration and renewal - Time for compliance by operating facilities.
(1) (a) A person or governmental unit acting severally or jointly with any other person or governmental unit, may not establish, conduct, or maintain a health care facility in this state without receiving a license from the department as provided by this chapter and the rules of the committee.
(b) This Subsection (1) does not apply to facilities that are exempt under Section 26-21-7 .
(2) A license issued under this chapter is not assignable or transferable.
(3) The current license shall at all times be posted in each health care facility in a place readily visible and accessible to the public.
(4) (a) The department may issue a license for a period of time not to exceed 24 months from the date of issuance to health care facilities that meet the provisions of this chapter and department rules adopted pursuant to this chapter.
(b) Each license expires at midnight on the day designated on the license as the expiration date, unless previously revoked by the department.
(c) The license shall be renewed upon completion of the application requirements, unless the department finds the health care facility has not complied with the provisions of this chapter or the rules adopted pursuant to this chapter.
(5) A license may be issued under this section only for the operation of a specific facility at a specific site by a specific person.
(6) Any health care facility in operation at the time
of adoption of any applicable rules as provided under this
chapter shall be given a reasonable time for compliance as
determined by the committee.
2003
26-21-9 Application for license - Information required - Public records.
(1) An application for license shall be made to the department in a form prescribed by the department. The application and other documentation requested by the department as part of the application process shall require such information as the committee determines necessary to ensure compliance with established rules.
(2) Information received by the department in reports and inspections shall be public records, except the information shall not be disclosed if it directly or indirectly identifies any individual other than the owner or operator of a health facility (unless disclosure is required by law) or if its disclosure would otherwise constitute an unwarranted invasion of personal privacy.
(3) Information received by the department from a health
care facility, pertaining to that facility's accreditation
by a voluntary accrediting organization, shall be private
data except for a summary prepared by the department related
to licensure standards.
2000
26-21-9.5 Criminal background check and Licensing Information System check.
(1) In addition to the licensing requirements of Sections 26-21-8 and 26-21-9 , a covered health care facility, as defined in Subsection (10), at the time of initial application for a license and license renewal shall:
(a) submit the name and other identifying information of each person associated with the facility who:
(i) provides direct care to a patient; and
(ii) has been the subject of a criminal background check within the preceding three-year period by a public or private entity recognized by the department; and
(b) submit the name and other identifying information, which may include fingerprints, of each person associated with the facility who:
(i) provides direct care to a patient; and
(ii) has not been the subject of a criminal background check in accordance with Subsection (1)(a)(ii).
(2) (a) The department shall forward the information received under Subsection (1)(b) to the Criminal Investigations and Technical Services Division of the Department of Public Safety for processing to determine whether an individual has been convicted of any crime.
(b) If an individual has not had residency in Utah for the last five years, the individual shall submit fingerprints for an FBI national criminal history record check. The fingerprints shall be submitted to the FBI through the Criminal Investigations and Technical Services Division. The individual or licensee is responsible for the cost of the fingerprinting and national criminal history check.
(3) The department may determine whether:
(a) an individual whose name and other identifying information has been submitted pursuant to Subsection (1) and who provides direct care to children is listed in the Licensing Information System described in Section 62A-4a-116.2 or has a substantiated finding by a court of severe child abuse or neglect under Section 78-3a-320 , if identification as a possible perpetrator of child abuse or neglect is relevant to the employment activities of that individual; or
(b) an individual whose name and other identifying information has been submitted pursuant to Subsection (1) and who provides direct care to disabled or elder adults has a substantiated finding of abuse, neglect, or exploitation of a disabled or elder adult by accessing in accordance with Subsection (4) the database created in Section 62A-3-311.1 if identification as a possible perpetrator of disabled or elder adult abuse, neglect, or exploitation is relevant to the employment activities of that person.
(4) (a) The department shall:
(i) designate two persons within the department to access the Licensing Information System described in Section 62A-4a-116.2 and court records under Subsection 78-3a-320 (4) and two persons to access the database described in Subsection (3)(b); and
(ii) adopt measures to:
(A) protect the security of the Licensing Information System, the court records, and the database; and
(B) strictly limit access to the Licensing Information System, the court records, and the database to those designated under Subsection (4)(a)(i).
(b) Those designated under Subsection (4)(a)(i) shall receive training from the Department of Human Services with respect to:
(i) accessing the Licensing Information System, the court records, and the database;
(ii) maintaining strict security; and
(iii) the criminal provisions in Section 62A-4a-412 for the improper release of information.
(c) Those designated under Subsection (4)(a)(i):
(i) are the only ones in the department with the authority to access the Licensing Information System, the court records, and database; and
(ii) may only access the Licensing Information System, the court records, and the database for the purpose of licensing and in accordance with the provisions of Subsection (3).
(5) Within ten days of initially hiring an individual, a covered health care facility shall submit the individual's information to the department in accordance with Subsection (1).
(6) The department shall adopt rules under Title 63, Chapter 46a, Utah Administrative Rulemaking Act, consistent with this chapter, defining the circumstances under which a person who has been convicted of a criminal offense, or a person described in Subsection (3), may provide direct care to a patient in a covered health care facility, taking into account the nature of the criminal conviction or substantiated finding and its relation to patient care.
(7) The department may, in accordance with Section 26-1-6 , assess reasonable fees for a criminal background check processed pursuant to this section.
(8) The department may inform the covered health care facility of information discovered under Subsection (3) with respect to an individual associated with the facility.
(9) A covered health care facility is not civilly liable for submitting information to the department as required by Subsection (1).
(10) For purposes of this section, "covered health care facility" only includes:
(a) home health care agencies;
(b) hospices;
(c) nursing care facilities;
(d) assisted-living facilities;
(e) small health care facilities; and
(f) end stage renal disease facilities.
2002
26-21-11 Violations - Denial or revocation of license - Restricting or prohibiting new admissions - Monitor.
If the department finds a violation of this chapter or any rules adopted pursuant to this chapter the department may take one or more of the following actions:
(1) serve a written statement of violation requiring corrective action, which shall include time frames for correction of all violations;
(2) deny or revoke a license if it finds:
(a) there has been a failure to comply with the rules established pursuant to this chapter;
(b) evidence of aiding, abetting, or permitting the commission of any illegal act; or
(c) conduct adverse to the public health, morals, welfare, and safety of the people of the state;
(3) restrict or prohibit new admissions to a health care facility or revoke the license of a health care facility for:
(a) violation of any rule adopted under this chapter; or
(b) permitting, aiding, or abetting the commission of any illegal act in the health care facility;
(4) place a department representative as a monitor in the facility until corrective action is completed;
(5) assess to the facility the cost incurred by the department in placing a monitor;
(6) assess an administrative penalty as allowed by Subsection 26-23-6 (1)(a); or
(7) issue a cease and desist order to the facility.
1997
26-21-12 Issuance of new license after revocation - Restoration.
(1) If a license is revoked, the department may issue a new license only after it determines by inspection that the facility has corrected the conditions that were the basis of revocation and that the facility complies with all provisions of this chapter and applicable rules.
(2) If the department does not renew a license because
of noncompliance with the provisions of this chapter or the
rules adopted under this chapter, the department may issue
a new license only after the facility complies with all renewal
requirements and the department determines that the interests
of the public will not be jeopardized.
1997
26-21-13 License issued to facility in compliance or substantial compliance with chapter and rules.
(1) The department shall issue a standard license for a health care facility which is found to be in compliance with the provisions of this chapter and with all applicable rules adopted by the committee.
(2) The department may issue a provisional or conditional
license for a health care facility which is in substantial
compliance if the interests of the public will not be jeopardized.
1990
26-21-13.5 Intermediate care facilities for the mentally retarded - Licensing.
(1) (a) It is the Legislature's intent that developmentally disabled persons be provided with an environment and surrounding that, as closely as possible, resembles small community-based, homelike settings, to allow those persons to have the opportunity, to the maximum extent feasible, to exercise their full rights and responsibilities as citizens.
(b) It is the Legislature's purpose, in enacting this section, to provide assistance and opportunities to enable persons with developmental disabilities to achieve their maximum potential through increased independence, productivity, and integration into the community.
(2) After July 1, 1990, the department may only license intermediate care beds for the mentally retarded in small health care facilities.
(3) The department may define by rule "small health care facility" for purposes of licensure under this section and adopt rules necessary to carry out the requirements and purposes of this section.
(4) This section does not apply to the renewal of a license
or the licensure to a new owner of any facility that was
licensed on or before July 1, 1990, and that licensure has
been maintained without interruption.
1993
26-21-13.6 Rural hospital - Optional service designation.
(1) The Legislature finds that:
(a) the rural citizens of this state need access to hospitals and primary care clinics;
(b) financial stability of remote-rural hospitals and their integration into remote-rural delivery networks is critical to ensure the continued viability of remote-rural health care; and
(c) administrative simplicity is essential for providing large benefits to small-scale remote-rural providers who have limited time and resources.
(2) After July 1, 1995, the department may grant variances to remote-rural acute care hospitals for specific services currently required for licensure under general hospital standards established by department rule.
(3) For purposes of this section, "remote-rural hospitals"
are hospitals that are in a county with less than 20 people
per square mile.
1995
26-21-14 Closing facility - Appeal.
(1) If the department finds a condition in any licensed health care facility that is a clear hazard to the public health, the department may immediately order that facility closed and may prevent the entrance of any resident or patient onto the premises of that facility until the condition is eliminated.
(2) Parties aggrieved by the actions of the department
under this section may obtain an adjudicative proceeding
and judicial review.
1990
26-21-15 Action by department for injunction.
Notwithstanding the existence of any other remedy, the
department may, in the manner provided by law, upon the advice
of the attorney general, who shall represent the department
in the proceedings, maintain an action in the name of the
state for injunction or other process against any person
or governmental unit to restrain or prevent the establishment,
conduct, management, or operation of a health care facility
which is in violation of this chapter or rules adopted by
the committee.
1990
26-21-16 Operating facility in violation of chapter or rules a misdemeanor.
(1) Any person owning, establishing, conducting, maintaining, managing, or operating a health care facility in violation of this chapter or rules of the committee is guilty of a class A misdemeanor.
(2) This section takes precedence over Section
26-23-6
.
1997
26-21-17 Department agency of state to contract for certification of facilities under Social Security Act.
The department is the sole agency of the state authorized
to enter into a contract with the United States government
for the certification of health care facilities under Title
XVIII and Title XIX of the Social Security Act, and any amendments
thereto.
1990
26-21-19 Life and Health Insurance Guaranty Association Act not amended.
The provisions of this chapter do not amend, affect, or
alter the provisions of Title 31A, Chapter 28.
1985
26-21-20 Requirement for hospitals to provide statements of itemized charges to patients.
(1) Each hospital, as defined in Section 26-21-2 , shall provide a statement of itemized charges to any patient receiving medical care or other services from that hospital.
(2) The statement shall be provided to the patient or his personal representative or agent at the hospital's expense, personally, by mail, or by verifiable electronic delivery at the time any statement is provided to any person or entity for billing purposes. If the statement is not provided to a third party, it shall be provided to the patient as soon as possible and practicable.
(3) The statement shall itemize each of the charges actually provided by the hospital to the patient.
(4) The statement may not include charges of physicians who bill separately.
(5) The requirements of this section do not apply to patients who receive services from a hospital under Title XIX of the Social Security Act.
(6) A statement of charges to be paid by a third party
and related information provided to a patient pursuant to
this section shall be marked in bold: "DUPLICATE: DO NOT
PAY" or other appropriate language.
2000
26-21-21 Authentication of medical records.
Any entry in a medical record compiled or maintained by a health care facility may be authenticated by identifying the author of the entry by:
(1) a signature including first initial, last name, and discipline; or
(2) the use of a computer identification process unique
to the author that definitively identifies the author.
1992
26-21-22 Reporting of disciplinary information - Immunity from liability.
A health care facility licensed under this chapter which
reports disciplinary information on a licensed nurse to the
Division of Occupational and Professional Licensing within
the Department of Commerce as required by Section
58-31b-702
is entitled to the immunity from liability
provided by that section.
1998
