H*2539 Session 107 (1987-1988)
H*2539(Rat #0794, Act #0670 of 1988) General Bill, By P. Evatt, D. Blackwell,
M.J. Cooper, S.R. Foster, R.L. Helmly, R.O. Kay, S.V. Shelton, J.J. Snow,
L.L. Taylor and Townsend
A Bill to amend Sections 44-7-110 through 44-7-340, Code of Laws of South
Carolina, 1976, relating to the State Hospital Construction and Franchising
Act, so as to change the citation of the Article to the Certification of Need
and Health Facility Licensure Act, provide for a State Medical Facilities
Plan, provide for the consolidation of licensing requirements for health
facilities including hospitals, psychiatric hospitals, skilled nursing care,
intermediate care, ambulatory surgical, chiropractic inpatient, community
residential care, and adult day-care facilities, facilities for chemically
dependent or addicted persons, end-stage renal disease units, and to provide
penalties; to amend Sections 44-7-350 through 44-7-370, relating to the
issuance of and grounds for denial, suspension, or revocation of licenses and
procedure for the assessment of a penalty or denial, suspension, or revocation
of a license, so as to establish requirements for the placement of persons in
a community residential care facility and special committees to provide advice
for the licensing and inspection of these facilities; and to repeal Articles 4
and 6, Chapter 7, Title 44, relating to licensing, regulation and inspection
of community residential facilities and outpatient facilities for chemically
dependent or addicted persons; Chapter 39 of Title 44, relating to renal
disease; Chapter 65 of Title 44, relating to day-care facilities for adults;
Section 44-7-355, relating to the requirement of persons in need of emergency
care; and Sections 44-7-375 through 44-7-460, relating to administrative
review of decisions pertaining to certificates of need and penalties under the
State Hospital Construction and Franchising Act.-amended title
02/25/87 House Introduced and read first time HJ-726
02/25/87 House Referred to Committee on Medical, Military,
Public and Municipal Affairs HJ-726
03/31/87 House Committee report: Favorable Medical, Military,
Public and Municipal Affairs HJ-1470
04/01/87 House Recommitted to Committee on Medical, Military,
Public and Municipal Affairs HJ-1524
05/05/87 House Committee report: Favorable with amendment
Medical, Military, Public and Municipal Affairs
HJ-2404
05/06/87 House Amended HJ-2481
05/06/87 House Read second time HJ-2483
05/07/87 House Read third time and sent to Senate HJ-2561
05/12/87 Senate Introduced and read first time SJ-1791
05/12/87 Senate Referred to Committee on Medical Affairs SJ-1791
05/05/88 Senate Recalled from Committee on Medical Affairs SJ-29
05/26/88 Senate Read second time SJ-67
05/26/88 Senate Ordered to third reading with notice of
amendments SJ-67
05/31/88 Senate Amended SJ-42
05/31/88 Senate Read third time SJ-42
05/31/88 Senate Returned SJ-42
06/02/88 House Concurred in Senate amendment and enrolled HJ-4695
06/20/88 Ratified R 794
06/21/88 Signed By Governor
06/21/88 Effective date 06/21/88
06/21/88 Act No. 670
06/21/88 See act for exception to or explanation of
effective date
08/01/88 Copies available
(A670, R794, H2539)
AN ACT TO AMEND SECTIONS 44-7-110 THROUGH 44-7-340, CODE OF LAWS OF SOUTH
CAROLINA, 1976, RELATING TO THE STATE HOSPITAL CONSTRUCTION AND FRANCHISING ACT,
SO AS TO CHANGE THE CITATION OF THE ARTICLE TO THE CERTIFICATION OF NEED AND
HEALTH FACILITY LICENSURE ACT, PROVIDE FOR A STATE MEDICAL FACILITIES PLAN,
PROVIDE FOR THE CONSOLIDATION OF LICENSING REQUIREMENTS FOR HEALTH FACILITIES
INCLUDING HOSPITALS, PSYCHIATRIC HOSPITALS, SKILLED NURSING CARE, INTERMEDIATE
CARE, AMBULATORY SURGICAL, CHIROPRACTIC INPATIENT, COMMUNITY RESIDENTIAL CARE,
AND ADULT DAY-CARE FACILITIES, FACILITIES FOR CHEMICALLY DEPENDENT OR ADDICTED
PERSONS, END-STAGE RENAL DISEASE UNITS, AND TO PROVIDE PENALTIES; TO AMEND
SECTIONS 44-7-350 THROUGH 44-7-370, RELATING TO THE ISSUANCE OF AND GROUNDS FOR
DENIAL, SUSPENSION, OR REVOCATION OF LICENSES AND PROCEDURE FOR THE ASSESSMENT
OF A PENALTY OR DENIAL, SUSPENSION, OR REVOCATION OF A LICENSE, SO AS TO
ESTABLISH REQUIREMENTS FOR THE PLACEMENT OF PERSONS IN A COMMUNITY RESIDENTIAL
CARE FACILITY AND SPECIAL COMMITTEES TO PROVIDE ADVICE FOR THE LICENSING AND
INSPECTION OF THESE FACILITIES; AND TO REPEAL ARTICLES 4 AND 6, CHAPTER 7, TITLE
44, RELATING TO LICENSING, REGULATION, AND INSPECTION OF COMMUNITY RESIDENTIAL
FACILITIES AND OUTPATIENT FACILITIES FOR CHEMICALLY DEPENDENT OR ADDICTED
PERSONS; CHAPTER 39 OF TITLE 44, RELATING TO RENAL DISEASE; CHAPTER 65 OF TITLE
44, RELATING TO DAY-CARE FACILITIES FOR ADULTS; SECTION 44-7-355, RELATING TO THE
REQUIREMENT OF PERSONS IN NEED OF EMERGENCY CARE; AND SECTIONS 44-7-375 THROUGH
44-7-460, RELATING TO ADMINISTRATIVE REVIEW OF DECISIONS PERTAINING TO
CERTIFICATES OF NEED AND PENALTIES UNDER THE STATE HOSPITAL CONSTRUCTION AND
FRANCHISING ACT.
Be it enacted by the General Assembly of the State of South Carolina:
Certification of need, licensure of health facilities
SECTION 1. Sections 44-7-110 through 44-7-370 of the 1976 Code are amended to
read:
"Section 44-7-110. This article may be cited as the 'State Certification
of Need and Health Facility Licensure Act'.
Section 44-7-120. The purpose of this article is to promote cost containment,
prevent unnecessary duplication of health care facilities and services, guide the
establishment of health facilities and services which will best serve public
needs, and ensure that high quality services are provided in health facilities
in this State. To achieve these purposes, this article requires:
(1) the issuance of a Certificate of Need prior to the undertaking of any
project prescribed by this article;
(2) adoption of procedures and criteria for submittal of an application and
appropriate review prior to issuance of a Certificate of Need;
(3) preparation and publication of a State Medical Facilities Plan;
(4) the licensure of facilities rendering medical, nursing, and other health
care.
Section 44-7-130. As used in this article:
(1) 'Affected person' means the applicant, any person residing within the
geographic area served or to be served by the applicant, health care facilities
located in the health service area in which the project is to be located and
which provide similar services to the proposed project, health care facilities
which prior to receipt by the department of the proposal being reviewed have
formally indicated an intention to provide similar services in the future, and
the State Ombudsman.
(2) 'Ambulatory surgical facility' means a facility organized and administered
for the purpose of performing surgical procedures for which patients are
scheduled to arrive, receive surgery, and be discharged on the same day. The
owner or operator makes the facility available to other providers who comprise
an organized professional staff.
(3) 'Board' means the State Board of Health and Environmental Control.
(4) 'Chiropractic inpatient facility' means a facility organized and
administered to provide overnight care for patients requiring chiropractic
services, including vertebral sublaxation, analysis, and adjustment.
(5) 'Competing applicants' means two or more persons or health care facilities
as defined in this article who apply for Certificates of Need to provide similar
services or facilities in the same service area within a time frame as
established by departmental regulations and whose applications, if approved,
would exceed the need for services or facilities.
(6) 'Community residential care facility' means a facility which offers room
and board and provides a degree of personal assistance for two or more persons
eighteen years old or older.
(7) 'Day-care facility for adults' means a facility for adults eighteen years
or older which offers in a group setting a program of individual and group
activities and therapies. The program is directed toward providing
community-based care for those in need of a supportive setting for less than
twenty-four hours a day, thereby preventing unnecessary institutionalization, and
shall provide a minimum of four and a maximum of fourteen hours of operation a
day.
(8) 'Department' means the Department of Health and Environmental Control.
(9) 'The federal act' means Title VI of the United States Public Health
Service Act (the Hill-Burton Construction Program); Title XVI of the United
States Public Health Service Act (National Health Planning and Resources
Development Act of 1974--Public Law 93-641); grants for all center and facility
construction under Public Law 91-211 (community mental health centers' amendments
to Title II, Public Law 88-164, Community Mental Health Centers Act); grants for
all facility construction under Public Law 91-517 (developmental disabilities
services and facilities construction amendments of 1970 to Part C, Title I,
grants for construction of facilities for the mentally retarded--Public Law
88-164); and other federal programs as may exist or be enacted which provide for
the construction of hospitals or related health facilities.
(10) 'Health care facility' means acute care hospitals, psychiatric
hospitals, alcohol and substance abuse hospitals, tuberculosis hospitals, nursing
homes, kidney disease treatment centers, including freestanding hemodialysis
centers, ambulatory surgical facilities, rehabilitation facilities, residential
treatment facilities for children and adolescents, and any other facility for
which Certificate of Need review is required by federal law.
(11) 'Health service' means clinically related, diagnostic, treatment, or
rehabilitative services, and includes alcohol, drug abuse, and mental health
services for which specific standards or criteria are prescribed in the State
Medical Facilities Plan.
(12) 'Hospital' means a facility organized and administered to provide
overnight medical or surgical care or nursing care of illness, injury, or
infirmity and may provide obstetrical care, and in which all diagnoses,
treatment, or care is administered by or under the direction of persons currently
licensed to practice medicine, surgery, or osteopathy.
(13) 'Nursing home' means a facility with an organized nursing staff to
maintain and operate organized facilities and services to accommodate two or more
unrelated persons over a period exceeding twenty-four hours which is operated
either in connection with a hospital or as a freestanding facility for the
express or implied purpose of providing intermediate or skilled nursing care for
persons who are not in need of hospital care.
(14) 'Facility for chemically dependent or addicted persons' means a facility
organized to provide outpatient or residential services to chemically dependent
or addicted persons and their families based on an individual treatment plan
including diagnostic treatment, individual and group counseling, family therapy,
vocational and educational development counseling, and referral services.
(15) 'Person' means an individual, a trust or estate, a partnership, a
corporation including an association, joint stock company, insurance company, and
a health maintenance organization, a state, a political subdivision, or an
instrumentality including a municipal corporation of a state, or any legal entity
recognized by the State.
(16) 'Residential treatment facility for children and adolescents' means a
facility operated for the assessment, diagnosis, treatment, and care by two or
more persons of 'children and adolescents in need of mental health treatment'
which provides:
(a) a special education program with a minimum program defined by the South
Carolina Department of Education;
(b) recreational facilities with an organized youth development program; and
(c) residential treatment for a child or adolescent in need of mental health
treatment.
(17) 'Solely for research' means a service, procedure, or equipment which has
not been approved by the Food and Drug Administration (FDA) but which is
currently undergoing review by the FDA as an investigational device. FDA
research protocol and any applicable Investigational Device Exemption (IDE)
policies and regulations must be followed by a facility proposing a project
'solely for research'.
(18) 'Children and adolescents in need of mental health treatment' in a
residential treatment facility means a child or adolescent under age eighteen who
manifests a substantial disorder of cognitive or emotional process, which lessens
or impairs to a marked degree that child's capacity either to develop or to
exercise age-appropriate or age-adequate behavior. The behavior includes, but
is not limited to, marked disorders of mood or thought processes, severe
difficulties with self-control and judgment including behavior dangerous to self
or others, and serious disturbances in the ability to care for and relate to
others.
Section 44-7-140. The department is designated the sole state agency for
control and administration of the granting of Certificates of Need and licensure
of health facilities and other activities necessary to be carried out under this
article.
Section 44-7-150. In carrying out the purposes of this article, the department
shall:
(1) require reports and make inspections and investigations as considered
necessary;
(2) to the extent that is necessary to effectuate the purposes of this
article, enter into agreements with other departments, commissions, agencies, and
institutions, public or private;
(3) adopt in accordance with Article I of the Administrative Procedures Act
substantive and procedural regulations considered necessary by the department and
approved by the board to carry out the department's licensure and Certificate of
Need duties under this article, including regulations to deal with competing
applications;
(4) accept on behalf of the State and deposit with the State Treasurer, any
grant, gift, or contribution made to assist in meeting the cost of carrying out
the purpose of this article and expend it for that purpose;
(5) The department may adopt a filing fee for Certificate of Need
applications. The fee must be approved by the board. Any fee collected pursuant
to this section must be deposited into the general fund of the State. The fee
must be collected prior to review of the application. A fee may not be increased
beyond the cost of administration of the Certificate of Need Program.
Section 44-7-160. Any person or health care facility as defined in this
article is required to obtain a Certificate of Need from the department prior to
undertaking any of the following:
(1) the construction or other establishment of a new health care facility;
(2) a change in the existing bed complement of a health care facility through
the addition of one or more beds or change in the classification of licensure of
one or more beds;
(3) an expenditure by or on behalf of a health care facility in excess of an
amount to be prescribed by regulation which, under generally acceptable
accounting principles consistently applied, is considered a capital expenditure
except those expenditures exempted in Section 44-7-170(B)(1). The cost of any
studies, surveys, designs, plans, working drawings, specifications, and other
activities essential to the development, acquisition, improvement, expansion, or
replacement of any plant or equipment must be included in determining if the
expenditure exceeds the prescribed amount;
(4) a capital expenditure by or on behalf of a health care facility which is
associated with the addition or substantial expansion of a health service for
which specific standards or criteria are prescribed in the State Medical
Facilities Plan;
(5) the offering of any health service by or on behalf of a health care
facility which has not been offered by the facility in the preceding twelve
months and which has an annual operating cost in excess of an amount to be
prescribed by regulation and for which specific standards or criteria are
prescribed in the State Medical Facilities Plan;
(6) the acquisition of medical equipment to be owned by or located in a health
care facility, if the total project cost is in excess of that prescribed by
regulation;
(7) the acquisition of medical equipment which is to be used for diagnosis or
treatment of an inpatient of a health care facility if the total project cost is
in excess of that prescribed by regulation;
(8) the acquisition or change in ownership or in controlling interest of a
health care facility or entity owning a health care facility directly or
indirectly by purchase, lease, gift, donation, sale of stock, or comparable
arrangement if the acquisition or change in ownership or controlling interest may
result in an increase in cost to the facility or increase in government-sponsored
reimbursement;
(9) the acquisition of an existing health care facility by any person who has
failed to notify the department and seeks an exemption prior to entering into a
contractual arrangement to acquire an existing facility;
(10) an expenditure or financial obligation made in preparation for the
offering or developing of any project which requires certification of need
pursuant to this section if the expenditure or financial obligation is in excess
of an amount to be prescribed by regulation.
Section 44-7-170. (A) The provisions of this article do not apply to:
(1) health care facilities owned and operated by the federal government;
(2) the offices of a licensed private practitioner whether for individual
or group practice except as provided for in Section 44-7-160(7);
(3) the acquisition by a health care facility of medical equipment to be
used solely for research, the offering of an institutional health service by a
health care facility solely for research, or the obligation of a capital
expenditure by a health care facility to be made solely for research if it does
not (a) affect the charges of the facility for the provision of medical or other
patient care services other than the services which are included in the research;
(b) change the bed capacity of the facility; or (c) substantially change the
medical or other patient care services of the facility. A written description
of the proposed research project must be submitted to the department in order for
the department to determine if the above conditions are met. A Certificate of
Need is required in order to continue use of the equipment or service after
research restrictions are removed;
(4) purchases of or agreements to purchase real estate; however, the costs
associated with the purchase of real estate must be included in determining the
total project cost at the time the real estate is proposed to be developed.
(B) The Certificate of Need provisions of this article do not apply to:
(1) an expenditure by or on behalf of a health care facility for nonmedical
projects for services such as refinancing existing debt, parking garages,
laundries, roof replacements, computer systems, telephone systems, heating and
air conditioning systems, upgrading facilities which do not involve additional
square feet or additional health services, replacement of like equipment with
similar capabilities, or similar projects as described in regulations;
(2) the initiation of services through contractual arrangements for shared
mobile diagnostic and therapeutic devices such as computerized tomography,
magnetic resonance imaging, lithotripsy, or nuclear medicine services;
(3) facilities owned and operated by the South Carolina Department of Mental
Health and the South Carolina Department of Mental Retardation, except an
addition of one or more beds to the total number of beds of the departments'
health care facilities existing on July 1, 1988;
(4) educational and penal institutions maintaining infirmaries for the
exclusive use of their respective student bodies and inmate populations;
(5) any federal health care facility sponsored and operated by this State.
Section 44-7-180. (A) The department shall prepare and submit to the board
for adoption a State Medical Facilities Plan for use in the administration of the
Certificate of Need Program provided in this article. The plan at a minimum must
include:
(1) an inventory of existing health care facilities, beds, specified health
services, and equipment;
(2) projections of need for additional health care facilities, beds, health
services, and equipment; and
(3) standards for distribution of health care facilities, beds, specified
health services, and equipment including scope of services to be provided,
utilization, and occupancy rates, travel time, regionalization, other factors
relating to proper placement of services, and proper planning of health care
facilities.
(B) The State Medical Facilities Plan must address and include projections and
standards for specified health services and equipment which have a potential to
substantially impact health care cost and accessibility.
(C) This plan may be revised upon approval of the board. The department shall
adopt by regulation a procedure to allow public review and comment prior to
adoption or revision of the plan.
Section 44-7-190. The department shall adopt, upon approval of the board,
Project Review Criteria which, at a minimum, must provide for the determination
of need for health care facilities, beds, services and equipment, to include
demographic needs, appropriate distribution, and utilization; accessibility to
underserved groups; availability of facilities and services without regard to
ability to pay; absence of less costly and more effective alternatives;
appropriate financial considerations to include method of financing, financial
feasibility, and cost containment; consideration of impact on health systems
resources; site and building suitability; consideration of quality of care; and
relevant special considerations as may be appropriate. The Project Review
Criteria must be adopted as a regulation pursuant to the Administrative
Procedures Act.
Section 44-7-200. (A) An application for a Certificate of Need must be
submitted to the department in a form established by regulation. The application
must address all applicable standards and requirements set forth in departmental
regulations, Project Review Criteria of the department, and the State Medical
Facilities Plan.
(B) Within ten days prior to submission of an application, the applicant shall
publish notification that an application is to be submitted to the department in
a newspaper serving the area where the project is to be located for three
consecutive days. The notification must contain a brief description of the scope
and nature of the project. No application may be accepted for filing by the
department unless accompanied by proof that publication has been made for three
consecutive days within the prior ten-day period.
(C) After receipt of an application with proof of publication, the department
shall publish in the State Register a notice that an application has been
accepted for filing.
Section 44-7-210. (A) After the department has determined that an application
is complete, affected persons must be notified in accordance with departmental
regulations. The notification of affected persons commences the review period.
(B) The department may hold a public hearing, if timely requested, to gather
information and obtain public comment and opinion about the proposed project.
(C) The department may not issue a Certificate of Need unless an application
is in substantial compliance with the State Medical Facilities Plan, Project
Review Criteria, and other regulations. In the case of competing applications,
the department shall award a Certificate of Need, if appropriate, on the basis
of which, if any, most fully complies with the requirements, goals, and purposes
of this article and the State Medical Facilities Plan, Project Review Criteria,
and the regulations adopted by the department.
(D) On the basis of staff review of the application, the staff of the
department shall make a proposed decision to grant or deny the Certificate of
Need. The proposed decision becomes the final agency decision within thirty days
after the mailing of a notice of the proposed decision to the applicant unless
one of the following occurs:
(1) a reconsideration hearing before the staff of the department is
requested within the thirty-day period by any person showing good cause for
reconsideration of the proposed decision; or
(2) a contested case hearing before the board, or its designee, regarding
the grant or denial of the Certificate of Need is requested within the thirty-day
period by the applicant or other affected person with standing to contest the
grant or denial of the application.
(E) The department's proposed decision is not final until the completion of
reconsideration or contested case proceedings. The burden of proof in a
reconsideration or contested case hearing
must be upon the moving party. The contested case hearing before the board or
its designee is conducted as a contested case under the Administrative Procedures
Act.
Section 44-7-220. After the contested case hearing is concluded and a final
board decision is made, any party who participated in the contested case hearing
and who is affected adversely by the board's decision may obtain judicial review
of the decision in the appropriate state court pursuant to the Administrative
Procedures Act.
Section 44-7-230. (A) The Certificate of Need, if issued, is valid only for
the project described in the application including location, beds and services
to be offered, physical plant, capital or operating costs, or other factors as
set forth in the application, except as may be modified in accordance with
regulations. Implementation of the project that is not in accordance with the
Certificate of Need application or conditions subsequently agreed to by the
applicant and the department may be considered a violation of this article.
(B) In issuing a Certificate of Need, the department shall specify the maximum
capital expenditure obligated under the certificate. The department shall
prescribe the method used to determine capital expenditure maximums, establish
procedures to monitor capital expenditures obligated under certificates, and
establish procedures to review projects for which the capital expenditure maximum
is exceeded or expected to be exceeded.
(C) Prior to any construction authorized by a Certificate of Need, final
drawings and specifications prepared by an architect or engineer legally
registered under the laws of this State must be submitted to the department for
approval. All construction must be completed in accordance with approved plans
and specifications and prior approval must be obtained from the department for
any changes that substantially alter the scope of work, function of construction,
or major items of equipment, safety, or cost of the facility during construction.
(D) A Certificate of Need is valid for twelve months from the date of
issuance; however, extensions may be granted upon evidence that substantial
progress has been made in accordance with procedures set forth in regulations.
(E) A Certificate of Need is nontransferable. A Certificate of Need or rights
thereunder may not be sold, assigned, leased, transferred, mortgaged, pledged,
or hypothecated, and any actual transfer or attempt to make a transfer of this
sort results in the immediate voidance of the Certificate of Need. The sale or
transfer of the controlling interest or majority ownership in a corporation,
partnership, or other entity holding, either directly or indirectly, a
Certificate of Need, results in the transfer and voidance of a Certificate of
Need.
Section 44-7-240. The department may establish a construction program
providing for adequate facilities in this State and, insofar as possible, shall
provide for the distribution of facilities and services throughout this State in
such manner as to make all types of health services reasonably accessible to all
persons in this State. The State Medical Facilities Plan as required by this
article may be used for purposes of establishing the relative need of projects
for which applications are submitted under this construction program.
Submittal of applications and review and approval of projects for which federal
funds are requested must be in accordance with regulations adopted by the
department and applicable federal act.
Section 44-7-250. The department shall establish and enforce basic standards
for the licensure, maintenance, and operation of health facilities and services
to ensure the safe and adequate treatment of persons served in this State.
Section 44-7-260. (A) If they provide care for two or more unrelated persons,
the following facilities or services may not be established, operated, or
maintained in this State without first obtaining a license in the manner provided
by this article and regulations promulgated by the department:
(1) hospitals, including general and specialized hospitals;
(2) nursing homes;
(3) residential treatment facilities for children and adolescents;
(4) ambulatory surgical facilities;
(5) chiropractic inpatient facilities;
(6) community residential care facilities;
(7) facilities for chemically dependent or addicted persons;
(8) end-stage renal dialysis units;
(9) day-care facilities for adults;
(10) any other facility operating for the diagnosis, treatment, or care of
persons suffering from illness, injury or other infirmity and for which the
department has adopted standards of operation by regulation.
(B) The licensing provisions of this article do not apply to infirmaries for
the exclusive use of the student bodies of privately-owned educational
institutions which maintain infirmaries.
(C) The department is authorized to investigate, by inspection or otherwise,
any facility to determine if its operation is subject to licensure.
(D) Each hospital must have a single organized medical staff that has the
overall responsibility for the quality of medical care provided to patients.
Medical staff membership must be limited to doctors of medicine or osteopathy who
are currently licensed to practice medicine or osteopathy by the State Board of
Medical Examiners, dentists licensed to practice dentistry by the State Board of
Dentistry and podiatrists licensed to practice podiatry by the State Board of
Podiatry Examiners. No individual is automatically entitled to membership on the
medical staff or to the exercise of any clinical privilege merely because he is
licensed to practice in any state, because he is a member of any professional
organization, because he is certified by any clinical examining board, or because
he has clinical privileges or staff membership at another hospital without
meeting the criteria for membership established by the governing body of the
respective hospital. Patients of podiatrists and dentists who are members of the
medical staff of a hospital must be coadmitted by a doctor of medicine or
osteopathy who is a member of the medical staff of the hospital who is
responsible for the general medical care of the patient. Oral surgeons who have
successfully completed a postgraduate program in oral surgery accredited by a
nationally recognized accredited body approved by the United States Office of
Education may admit patients without the requirement of coadmission if permitted
by the bylaws of the hospital and medical staff.
(E) No person, regardless of his ability to pay or county of residence, may
be denied emergency care if a member of the admitting hospital's medical staff
or, in the case of a transfer, a member of the accepting hospital's medical staff
determines that the person is in need of emergency care. 'Emergency care' means
treatment which is usually and customarily available at the respective hospital
and that must be provided immediately to sustain a person's life, to prevent
serious permanent disfigurement, or loss or impairment of the function of a
bodily member or organ, or to provide for the care of a woman in active labor if
the hospital is so equipped and, if the hospital is not so equipped, to provide
necessary treatment to allow the woman to travel to a more appropriate facility
without undue risk of serious harm. In addition to or in lieu of any action
taken by the South Carolina Department of Health and Environmental Control
affecting the license of any hospital, when it is established that any officer,
employee, or member of the hospital medical staff has recklessly violated the
provisions of this section, the department may require the hospital to pay a
civil penalty of up to ten thousand dollars.
Section 44-7-270. Applicants for a license shall file annually applications
under oath with the department upon prescribed forms. An application must be
signed by the owner, if an individual or a partnership, or in the case of a
corporation by two of its officers, or in the case of a government unit by the
head of the governmental department having jurisdiction over it. The application
must set forth the full name and address of the facility for which the license
is sought and the full name and address of the owner, the names of the persons
in control, and additional information as the department may require, including
affirmative evidence of ability to comply with standards and regulations adopted
by the department. Each applicant shall pay an annual license fee prior to
issuance of a license as established by regulation.
Section 44-7-280. Licenses issued pursuant to this article expire one year
after date of issuance or annually upon uniform dates prescribed by regulation.
Licenses must be issued only for the premises and persons named in the
application and are not transferable or assignable. Licenses must be posted in
a conspicuous place on the licensed premises.
Section 44-7-290. The department may not issue licenses for the operation of
facilities or services subject to this article unless the facility and persons
named in the application are found to comply with the provisions of this article
and the department's regulations.
Section 44-7-300. Prior to commencing the construction or alteration of
facilities required to be licensed by this department, plans and specifications
must be submitted to the department for review and approval in accordance with
regulations of the department. If construction has commenced without submittal
of plans and specifications, an applicant for a license is required to submit
certified drawings for review and approval prior to action upon the application
for a license.
Section 44-7-310. Information received by the Office of Health Licensing of
the department through inspection or otherwise which does not appear on the face
of the license may not be disclosed publicly in a manner as to identify
individuals or facilities except in a proceeding involving the licensure or
certification of need of the facility or licensing proceedings against an
employee of the facility or as ordered by a court of competent jurisdiction.
Section 44-7-320. (A) The department may deny, suspend, or revoke licenses
or assess a monetary penalty against any person or facility for:
(1) violation of any of the provisions of this article or departmental
regulations;
(2) permitting, aiding, or abetting the commission of any unlawful act
relating to the securing of a Certificate of Need or the establishment,
maintenance, or operation of a facility requiring certification of need or
licensure under this article;
(3) conduct or practices detrimental to the health or safety of patients,
residents, clients, or employees of a facility or service. This provision may
not be construed to have any reference to health practices authorized by law;
(4) refusing to admit and treat alcoholic and substance abusers, the
mentally ill, or mentally retarded, whose admission or treatment has been
prescribed by a physician who is a member of the facility's medical staff; or
discriminating against alcoholics, the mentally ill, or mentally retarded solely
because of the alcoholism, mental illness, or mental retardation;
(5) consideration to deny, suspend, or revoke licenses or assess monetary
penalties is not limited to information relating to the current licensing year
but includes consideration of all pertinent information regarding the facility
and the applicant.
(B) Should the department determine to assess a penalty, deny, suspend, or
revoke a license, it shall send to the appropriate person or facility, by
certified mail, a notice setting forth the particular reasons for the
determination. The determination becomes final thirty days after the mailing of
the notice, unless the person or facility, within such thirty-day period,
requests in writing a contested case hearing before the board, or its designee,
pursuant to the Administrative Procedures Act. On the basis of the contested
case hearing, the determination involved must be affirmed, modified, or set
aside. Judicial review may be sought in accordance with the Administrative
Procedures Act.
(C) The penalty imposed by the department for violation of this article or its
regulations must be not less than one hundred nor more than five thousand dollars
for each violation of any of the provisions of this article. Each day's
violation is considered a subsequent offense.
(D) Failure to pay a penalty within thirty days is grounds for suspension,
revocation, or denial of a renewal of a license. No license may be issued,
reissued, or renewed until all penalties finally assessed against a person or
facility have been paid.
(E) No Certificate of Need may be issued to any person or facility until a
final penalty assessed against a person or a facility has been paid.
(F) All penalties collected pursuant to this article must be deposited in the
state treasury and credited to the general fund of the State.
Section 44-7-330. The department, in accordance with the laws of this State
governing injunctions and other processes, may maintain an action in the name of
the State against any person or facility for violation of this article and
regulations promulgated under this article. In charging any defendant in a
complaint in an action, it is sufficient to charge that the defendant, upon a
certain day and in a certain county, did violate any provision of this article
or of the regulations promulgated without the necessity for showing irreparable
harm.
Section 44-7-340. Any person or facility violating any of the provisions of
this article or a regulation under this article is guilty of a misdemeanor and,
upon conviction, must be fined not more than one hundred dollars for the first
offense and not more than five thousand dollars for a subsequent offense. Each
day's violation after a first conviction constitutes a subsequent offense.
Section 44-7-350. The agency placing a client in a community residential care
facility shall develop an individual plan of care in cooperation with the
provider. The placing agency shall monitor the plan to the extent considered
appropriate by the placement agency.
Prior to a community residential care facility being licensed for operation in
an area which is outside incorporated areas of a county, the following conditions
must be met:
(1) The governing body for the area must be given notice of the proposed
location.
(2) Where the governing body objects to the proposed site for the facility,
the arbitration procedures set forth in Act 449 of 1978 must be employed.
Section 44-7-360. Community residential care facilities are required to
furnish an item-by-item billing for all charges to the resident or the person
paying the bill, upon request by the resident or person paying the bill. Items
which remain unpaid are not required to be itemized again. A request for itemized
billing remains in effect until further notification by the resident or person
paying the bill. The provisions of this section do not apply to the contracted
amount of a state agency. Any amount above the contract must be itemized
accordingly. Residents receiving an optional supplement from the State Department
of Social Services must not be charged an amount greater than that set by that
department.
Section 44-7-370. (A) The South Carolina Department of Health and
Environmental Control shall establish a Residential Care Committee to advise the
department regarding licensing and inspection of community residential care
facilities.
(1) The committee shall consist of the Ombudsman of the Office of the
Governor, three operators of homes with ten beds or less, four operators of homes
with eleven beds or more, and three members to represent the department,
appointed by the commissioner for terms of four years.
(2) The terms must be staggered and no member may serve more than two
consecutive terms. Any person may submit names to the commissioner for
consideration. The advisory committee shall meet at least once annually with
representatives of the department to evaluate current licensing regulations and
inspection practices. Members shall serve without compensation.
(B) The Department of Health and Environmental Control shall appoint a Renal
Dialysis Advisory Council to advise the department regarding licensing and
inspection of renal dialysis centers. The council must be consulted and have the
opportunity to review all regulations promulgated by the board affecting renal
dialysis prior to submission of the proposed regulations to the General Assembly.
(1) The council is composed of a minimum of fourteen persons, one member
recommended by the Palmetto Chapter of the American Nephrology Nurses
Association; one member recommended by the South Carolina Chapter of the National
Association of Patients on Hemodialysis and Transplants; three physicians
specializing in nephrology recommended by the South Carolina Renal Physicians
Association; two administrators of facilities certified for dialysis treatment
or kidney transplant services; one member recommended by the South Carolina
Kidney Foundation; one member recommended by the South Carolina Hospital
Association; one member recommended by the South Carolina Medical Association;
one member of the general public; one member representing technicians working in
renal dialysis facilities; one member recommended by the Council of Nephrology
Social Workers; and one member recommended by the Council of Renal Nutritionists.
The directors of dialysis programs at the Medical School of the University of
South Carolina and the Medical University of South Carolina, or their designees,
are ex officio members of the council.
(2) Members shall serve four-year terms and until their successors are
appointed and qualify. No member of council shall serve more than two
consecutive terms. The council shall meet as frequently as the board considers
necessary, but not less than twice each year. Members shall serve without
compensation."
Expiration of existing regulations
SECTION 2. The existing regulations of the department are effective until
regulations are promulgated under this act.
Sections repealed
SECTION 3. Articles 4 and 6 of Chapter 7 and Chapters 39 and 65 of Title 44, and
Sections 44-7-355 and 44-7-375 through 44-7-460 of the 1976 Code are repealed.
Time effective
SECTION 4. This act takes effect upon approval by the Governor, except that the
provisions of item (2) of subsection (B) of Section 44-7-170 of the 1976 Code,
as amended by the provisions of this act, take effect July 1, 1989. |