Arkansas Administrative Code

20 CAR § 47-102. Purpose. (a) To establish rules for minimum standards for hospice programs operating in the State of Arkansas. (b) This part: (1) Will ensure high quality professional care for terminally ill patients and their families by providing for the safe, humane, and appr…

20 CAR § 47-103. Definitions. (a) The word “shall” as used in this part means mandatory. (b) As used in this part: (1) “Administrator” means the person responsible for the management of a hospice; (2) “Attending physician” means a doctor of medicine or osteopathy who is: (A) Lice…

20 CAR § 47-104. Requirements and codes. (a)(1) All agencies providing hospice services in the home shall comply with 20 CAR §§ 47-101 – 47-120. (2) Inpatient direct care hospices shall comply with 20 CAR §§ 47-101 – 47-132. (b) Licensure. (1) No public or private agency or perso…

20 CAR § 47-105. Governing body. (a) The hospice shall have a governing body that assumes full legal responsibility for determining, implementing, and monitoring policies governing the hospice’s total operation. (b) The governing body shall designate an individual who is responsi…

20 CAR § 47-106. Patient rights and responsibilities. (a) A hospice shall inform and document that each patient, or when appropriate the patient’s representative, has been informed of the following before or during the initial evaluation: (1)(A) The right to: (i) Appropriate and …

20 CAR § 47-107. Administration. (a) Administration shall provide and document the following: (1) Job descriptions for all employees and volunteers; (2) Policies and procedures for each available service; (3) In-services pertinent to hospice care shall be ongoing for: (A) Employe…

20 CAR § 47-108. Quality improvement (QI). (a)(1) The organization shall develop, implement, and maintain an ongoing program to assess and improve the quality of care and services provided. (2) A quality improvement (QI) plan shall be developed and maintained to describe the mann…

20 CAR § 47-109. Infection control. (a) Each hospice shall develop an infection control program that protects patients, family, and personnel from nosocomial or community-acquired infections. (b) The hospice shall develop and use a coordinated process that effectively reduces the…

20 CAR § 47-110. Physician services. (a) Medical director. The overall responsibility for the medical component of patient care shall be under the direction of a physician qualified by training and experience in hospice care, who shall also be responsible for no less than the fol…

20 CAR § 47-111. Nursing services. (a) A registered nurse shall assign the nursing care of each patient to other personnel in accordance with the patient’s needs. (b) A registered nurse shall plan, supervise, and evaluate the care for each patient. (c) Nursing services shall be p…

20 CAR § 47-112. Interdisciplinary group. (a) The interdisciplinary group or groups shall be composed of individuals who provide or supervise the care and services offered by the hospice. (b) Composition of the interdisciplinary group. The interdisciplinary group or groups shall …

20 CAR § 47-113. Volunteers. (a)(1) The hospice shall use volunteers in defined roles under the supervision of a designated hospice employee. (2) The hospice shall maintain documentation of active and ongoing efforts to recruit and retain volunteers. (b) Training. Orientation and…

20 CAR § 47-114. Counseling services. Counseling services shall: (1) Be available to the patient and the family; and (2) Include the following: (A)(i) Bereavement services. (ii) There shall be an organized program for provision of bereavement services under the supervision of an …

20 CAR § 47-115. Other services. A hospice shall ensure the following services are available and provided directly by hospice employees or under arrangement and offered in a manner consistent with acceptable standards of practice: (1) Physical therapy; (2) Occupational therapy; a…

20 CAR § 47-116. Hospice aide and homemaker services. (a)(1) Hospice aide services shall be available and adequate in frequency to meet the needs of the patient. (2) A hospice aide is a person who meets at least one (1) of the following requirements: (A)(i) Has at least one (1) y…

20 CAR § 47-117. Plan of care. (a) A written plan of care shall be established, maintained, and provided for each patient admitted to a hospice program. (b)(1) The plan shall include: (A) An assessment of the patient’s needs; and (B) Identification of the services, including the …

20 CAR § 47-118. Clinical records. (a)(1) In accordance with accepted principles of practice, the hospice shall establish and maintain a clinical record for every patient receiving care and services. (2) The record shall be: (A) Complete; (B) Accurate; (C) Readily accessible; and…

20 CAR § 47-119. Medical supplies/medications. (a) Medical supplies, appliances, drugs, and biologicals shall be provided as needed for the palliation and management of the terminal illness and related conditions. (b) Administration. All drugs and biologicals shall be administere…

20 CAR § 47-120. Short-term inpatient care. Inpatient care shall be: (1) Available for: (A) Pain control; (B) Symptom management; and (C) Respite purposes; and (2) Provided in licensed facilities, as stated below: (A) Inpatient care for symptom control. (i) Inpatient care for pai…

20 CAR § 47-121. Inpatient direct care. (a) In addition to the preceding sections, inpatient direct care shall also comply with 20 CAR §§ 47-121 – 47-132. (b) Administration shall be responsible for the following: (1)(A) Policies and procedures shall be provided for: (i) The gene…

20 CAR § 47-122. Infection control for IPU. (a)(1) There shall be a comprehensive list of communicable diseases for which: (A) Patients shall be isolated; and (B) There are visitation restrictions. (2) The list and other policies and procedures for isolation shall conform to the …

20 CAR § 47-123. Physical environment. (a)(1) A homelike setting design and functional program shall include the following: (A) A place where all family members, including children, may come and go in a natural, family-like manner; (B) Social areas where family members may: (i) B…

20 CAR § 47-124. Physical facilities. (a) General considerations. (1) The requirements set forth herein: (A) Have been established by the Department of Health; and (B) Constitute minimum requirements for the design, construction, renovation, and repair of facilities requiring lic…

20 CAR § 47-125. Physical facilities — Patient accommodations for hospice. (a) Patient rooms. Each patient room shall meet the following requirements. (1) Maximum room capacity shall be two (2) patients. (2)(A) In new construction, patient rooms shall have a minimum of one hundre…

20 CAR § 47-126. Physical facilities — Pharmacy. (a)(1) The size and type of services to be provided in the pharmacy can largely depend upon the: (A) Type of medication distribution system used; (B) Number of patients to be served; and (C) Extent of shared or purchased services. …

20 CAR § 47-127. Physical facilities — Waste processing services. (a) Hazardous waste and antineoplastic agent disposal. (1) The facility shall have policies and procedures for the identification, segregation, labeling, storage, transport, and disposal of hazardous waste. (2) The…

20 CAR § 47-128. Physical facilities — Details and finishes. (a) All details for alteration or expansion projects as well as for new construction shall comply with the following. (b) Details. (1) Compartmentation, exits, automatic extinguishing systems, and other details relating…

20 CAR § 47-129. Physical facilities — Construction, including fire-resistive requirements. (a) Design. Every building and every portion thereof shall be designed and constructed to sustain all dead and live loads in accordance with the American Society of Civil Engineers ASCE St…

20 CAR § 47-130. Physical facilities — Plumbing and other piping systems. All plumbing systems shall be designed and installed in accordance with the requirements of the latest edition of the: (1) Arkansas Plumbing Code, 17 CAR pt. 65; and (2) Boiler Inspection Rules, 20 CAR pt. …

20 CAR § 47-131. Physical facilities — Electrical standards. (a) Lighting. (1) Approaches to buildings and parking lots and all occupied spaces within buildings shall have fixtures that can be illuminated as necessary. (2) Patient rooms shall have general lighting and night light…

20 CAR § 41-132. Satellite office or alternate delivery site. (a)(1) A licensed agency shall file an application under oath with the Department of Health upon forms prescribed by the department prior to beginning operation of a satellite office. (2) The department will: (A) Revie…

20 CAR § 48-101. Purpose. (a)(1) This part has been prepared for the purpose of establishing criteria for minimum standards for the certification of facilities for in vitro fertilization in Arkansas. (2) By necessity, they are of regulatory nature, but are considered to be practi…

20 CAR § 48-102. Compliance. Any authorized representative of the Department of Health shall have the right to enter upon or into the premises of any institution at any time in order to make whatever inspection is deemed necessary in accordance with the minimum standards and rule…

20 CAR § 48-103. Responsibility. (a) All facilities for in vitro fertilization shall have an organized governing body or, in its absence, a person who shall be legally responsible for: (1) Maintaining quality patient care; (2) Establishing policies for the facility; and (3) Assur…

20 CAR § 48-104. Policy and procedure manual. (a) The policy and procedure manual shall include at a minimum: (1) Detailed job descriptions and duties, by job title, of each employee; (2) Policies and procedures for the general administration of the facility and for each departme…

20 CAR § 48-105. Credential files. An individual file shall: (1) Be maintained for each physician/paraprofessional practicing in the facility; and (2) Include at least the following: (A) Specific delineation of privileges, requested and granted; (B) A signed application with docu…

20 CAR § 48-106. Quality assurance. (a)(1) There shall be an ongoing, comprehensive quality assurance program established for each facility which will monitor and resolve any identified problems. (2) The program will include a written plan which shall include: (A) Methods of eval…

20 CAR § 48-107. Administration. (a) All medical, surgical laboratory, and procedural care rendered in a facility for in vitro fertilization certified by the Department of Health shall conform to the current standards acceptable to the: (1) American Medical Association; (2) Ameri…

20 CAR § 48-108. Personnel. (a)(1) The facility shall maintain a sufficient number of personnel to provide effective patient care and all other related services to an in vitro fertilization program. (2) There shall be written personnel policies and procedures which shall be made …

20 CAR § 48-109. Medical records. (a)(1) A medical record shall be maintained for each patient of the in vitro fertilization facility. (2) All these records must be kept separate from the other regular records of the facility. (3) The original or a copy of the original (when the …

20 CAR § 48-110. United States in vitro fertilization registry (U.S. IVF registry) (SART). (a)(1) In view of the continuing controversy about the success rate of in vitro fertilization, all facilities performing this procedure should participate in the United States In Vitro Fert…

20 CAR § 48-111. Required reasonable success rate. There shall be a required reasonable success rate as defined by current American Society for Reproductive Medicine standards.

20 CAR § 48-112. Informed consent. (a)(1) As with all medical procedures and treatments, the patients must make the final decision on what is appropriate and acceptable treatment in their particular situation. (2) To comply with this requirement, it is necessary that each prospec…

20 CAR § 48-113. Medications. (a) Security. All medications shall be locked when authorized personnel are not present. (b)(1) Crash carts or emergency medication kits shall be provided. (2) These carts/kits shall be: (A) Secured with a breakaway seal; and (B) Stored in an area ob…

20 CAR § 48-114. Surgical services. (a) Operating room facilities shall be provided for laparoscopic retrieval and ultrasound-guided retrieval. (b) The operating room availability must be rigidly controlled so patients can be moved in and out seven (7) days a week with a maximum …

20 CAR § 40-115. Embryology laboratory personnel. (a) Embryology laboratory director. (1) The embryology laboratory director shall be an individual with demonstrated knowledge of all laboratory aspects of assisted reproductive technology (ART). (2) To be acceptable as an embryolo…

20 CAR § 48-116. Laboratory services. (a) CLIA. (1) The laboratory must meet the conditions set forth under the Clinical Laboratory Improvement Amendments of 1988 (CLIA ’88), 42 U.S.C. § 263a, in order to be certified to perform testing on human specimens. (2) All laboratory serv…

20 CAR § 48-117. Physical environment of oocyte collection/procedure room, embryology laboratory, andrology laboratory. (a) Size of the oocyte collection/procedure room must meet all of the requirements of a general operating room, with a minimum clear area of two hundred fifty s…

20 CAR § 48-118. Infection control. (a) Universal precautions must be observed. (b) Medical waste. The facility must comply with the Rules Pertaining to the Management of Regulated Medical Waste from Health Care Related Facilities, 20 CAR pt. 53, promulgated under the authority o…

20 CAR § 48-119. Equipment maintenance. (a) Maintenance records. (1) There must be a documented preventive maintenance program for each piece of equipment, based upon the manufacturer’s recommendations. (2) Maintenance records must be maintained for the life of the instrument. (3…