North Carolina Administrative Code

SECTION .2100 – TRANSPARENCY IN HEALTH CARE COSTS 10A NCAC 13B .2101 definitions In addition to the terms defined in G.S. 131E-214.13, the following terms shall apply throughout this Section, unless text indicates to the contrary: (1) "Current Procedural Terminology (CPT)" means …

10A NCAC 13B .2102 REPORTING REQUIREMENTS (a) The Department shall establish the lists of the statewide 100 most frequently reported DRGs, 20 most common outpatient imaging procedures, and 20 most common outpatient surgical procedures performed in the hospital setting to be used …

SECTION .2200 - RESERVED FOR FUTURE CODIFICATION 10A NCAC 13B .2200 Reserved for future codification

SECTION .2300 - RESERVED FOR FUTURE CODIFICATION 10A NCAC 13B .2300 Reserved for future codification

SECTION .2400 - RESERVED FOR FUTURE CODIFICATION 10A NCAC 13B .2400 Reserved for future codification

SECTION .2500 - RESERVED FOR FUTURE CODIFICATION 10A NCAC 13B .2500 Reserved for future codification

SECTION .2600 - RESERVED FOR FUTURE CODIFICATION 10A NCAC 13B .2600 Reserved for future codification

SECTION .2700 - RESERVED FOR FUTURE CODIFICATION 10A NCAC 13B .2700 Reserved for future codification

SECTION .2800 - RESERVED FOR FUTURE CODIFICATION 10A NCAC 13B .2800 Reserved for future codification

SECTION .2900 - RESERVED FOR FUTURE CODIFICATION 10A NCAC 13B .2900 Reserved for future codification

SECTION .3000 - GENERAL INFORMATION 10A NCAC 13B .3001 DEFINITIONS Notwithstanding Section .1900 of this Subchapter, the following definitions shall apply throughout this Subchapter unless the context indicates to the contrary: (1) "Appropriate" means suitable or fitting, or conf…

SECTION .3100 - PROCEDURE 10A NCAC 13B .3101 GENERAL REQUIREMENTS (a) An application for licensure shall be submitted to the Division prior to a license being issued or patients admitted. (b) An existing facility shall not sell, lease, or subdivide a portion of its bed capacity w…

10A ncac 13B .3102 PLAN APPROVAL (a) For the purposes of this Rule, the Guidelines for the Design and Construction of Hospitals and Outpatient Facilities that is incorporated by reference in Rule .6105 of this Subchapter shall be referred to as the "FGI Guidelines." (b) The defin…

10A NCAC 13B .3103 CLASSIFICATION OF MEDICAL FACILITIES (a) For purpose of this Subchapter the classification of "hospital" shall be restricted to facilities that provide as their functions diagnostic services and medical and nursing care in the treatment of acute stages of illne…

10A NCAC 13B .3104 LENGTH OF LICENSE Licenses shall remain in effect until one of the following occurs: (1) Division imposes an administrative sanction which specifies license expiration; (2) change of ownership; (3) closure; (4) change of site; (5) failure to comply with Rule .3…

10A NCAC 13B .3105 STATISTICAL INFORMATION Utilization data shall be submitted annually upon request by the Division. Forms for collection of this data will be forward to each facility by the Division. History Note: Authority G.S. 131E-79; Eff. January 1, 1996; Pursuant to G.S. 1…

10A NCAC 13B .3106 LICENSURE SURVEYS (a) Prior to the initial issuance of a license to operate a facility, the Division shall conduct a survey to determine compliance with rules promulgated pursuant to G.S. 131E-79. (b) The Division may conduct an investigation of a complaint in …

10A NCAC 13B .3107 DENIAL, AMENDMENT OR REVOCATION OF LICENSE (a) The Department may deny any licensure application upon becoming aware that the applicant is not in compliance with any applicable provision of the Certificate of Need law located in G.S. 131E, Article 9 and the rul…

10A NCAC 13B .3108 SUSPENSION OF ADMISSIONS (a) The Department may amend a license, pursuant to G.S. 131E-78, by suspending the admission of any new patients to any facility when the conditions in the facility are detrimental to the health or safety of the patients in the facilit…

10A NCAC 13B .3109 PROCEDURE FOR APPEAL A facility may appeal any decision of the Department to deny, revoke or amend a license or any decision to suspend admissions by making such an appeal in accordance with G.S. 150B. History Note: Authority G.S. 131E-78; 131E-79; Eff. January…

10A NCAC 13B .3110 ITEMIZED CHARGES (a) The facility shall provide an itemized list of charges to discharged patients or the facility shall include on patients' bills that are not itemized, notification of the right to request an itemized bill within three years of receipt of the…

10A NCAC 13B .3111 TEMPORARY CHANGE IN BED CAPACITY (a) A hospital may temporarily increase its bed capacity by up to 10 percent over its licensed bed capacity, as determined by the administrator, by utilizing observational beds for inpatients for a period of no more than 60 cons…

SECTION .3200 - GENERAL HOSPITAL REQUIREMENTS 10A NCAC 13B .3201 HOSPITAL REQUIREMENTS A facility shall have all of the following: (1) an organized governing body; (2) a chief executive officer; (3) an organized medical staff; (4) an organized nursing staff; (5) continuous medica…

10A NCAC 13B .3202 ADMISSION AND DISCHARGE (a) The facility shall provide written admission and discharge, and referral policies. (b) There shall be on the premises at all times an employee authorized to receive patients and to make arrangements for their disposition. (c) A patie…

10A NCAC 13B .3203 DISCHARGE PLANNING (a) Discharge planning shall be an integral part of in-patient hospitalization. (b) The facility shall have written policies and procedures governing discharge planning. These shall include but need not be limited to the following: (1) approp…

10A NCAC 13B .3204 TRANSFER AGREEMENT (a) Any facility that does not provide hospital based nursing facility service shall maintain written agreements with institutions offering this kind of care. Such agreements shall provide for the transfer and admission of patients who no lon…

10A NCAC 13B .3205 DISCHARGE OF MINOR OR INCOMPETENT Individuals who cannot legally consent to his or her own care shall be discharged to the custody of parents, legal guardian, person standing in loco parentis, or patient representative pursuant to 42 CFR 483.12(a)(1) herein inc…

SECTION .3300 - PATIENT'S BILL OF RIGHTS 10A NCAC 13B .3301 PRINCIPLE It is the purpose of these requirements to promote the interests and well-being of the patients in facilities subject to this Subchapter even in those instances where the interests of the patients may be in opp…

10A NCAC 13B .3302 MINIMUM PROVISIONS OF PATIENT'S BILL OF RIGHTS This Rule does not apply to patients in licensed nursing facility beds since these individuals are granted rights pursuant to G.S. 131E-117. A patient in a hospital facility subject to this Rule has the following r…

10A NCAC 13B .3303 PROCEDURE (a) The facility shall develop and implement procedures to inform patients of his or her rights. Copies of the facilities' Patient's Bill of Rights shall be made available through one of the following ways: (1) locations posted in a public place in th…

SECTION .3400 - SUPPLEMENTAL RULES FOR THE LICENSURE OF critical access HOSPITALS 10A NCAC 13B .3401 SUPPLEMENTAL RULES The rules of this Section pertain only to designated Critical Access Hospitals in accordance with 42 CFR 485 Subpart F. The general requirements of this Subchap…

10A NCAC 13B .3402 DEFINITIONS The following definitions shall apply throughout this Section, unless context otherwise clearly indicates to the contrary: (1) "Available" means provided directly by the facility or by written agreement with a qualified provider of the service withi…

10A NCAC 13B .3405 DESIGNATED CRITICAL ACCESS HOSPITALS The requirements of 10A NCAC 13B shall apply to Critical Access Hospitals with the following modifications: (1) Autopsy facilities required in Rule .4907 of this Subchapter are not required provided that the facility has in …

SECTION .3500 - GOVERNANCE AND MANAGEMENT 10A NCAC 13B .3501 GOVERNING BODY (a) The governing body, owner, or the person or persons designated by the owner as the governing body shall be responsible for ensuring that the objectives specified in the facility's governing documents,…

10A NCAC 13B .3502 REQUIRED facility BYLAWS, POLICIES, RULES, AND REGULATIONS (a) The governing body shall adopt written bylaws, policies, rules, and regulations in accordance with all requirements contained in this Subchapter and in accordance with the community responsibility o…

10A NCAC 13B .3503 FUNCTIONS (a) The governing body shall: (1) provide management, physical resources, and personnel determined by the governing body to be required to meet the needs of patients for treatment as authorized by the facility's license; (2) require facility administr…

SECTION .3600 - MANAGEMENT AND ADMINISTRATION OF OPERATIONS 10A NCAC 13B .3601 CHIEF EXECUTIVE OFFICER (a) The governing body shall designate a chief executive officer whose qualifications, authority, responsibilities and duties shall be defined in a written statement adopted by …

10A NCAC 13B .3602 RESPONSIBILITIES The governing body shall adopt written policies, rules, and regulations that specify the officer or officers that shall: (1) act for the chief executive officer in his absence; (2) manage the facility consonant with its expressed aims and polic…

10A NCAC 13B .3603 PERSONNEL POLICIES AND PRACTICES The facility shall develop, establish and maintain personnel policies and practices which support sound patient care. The policies shall be in writing and made available to all employees, and they shall be reviewed periodically …

10A NCAC 13B .3604 JOB DESCRIPTIONS The facility shall develop and make available to the employee a written job description for each type of job in the facility, including the chief executive officer and heads of departments. Each job description shall include a written descripti…

10A NCAC 13B .3605 PERSONNEL RECORDS (a) The facility shall maintain accurate and complete personnel records for each facility employee during the term of employment and for two years thereafter. The chief executive officer may designate an individual to carry out this assignment…

10A NCAC 13B .3606 EDUCATION PROGRAMS The facility shall provide new employee orientation and continuing education programs for all employees to maintain the skills necessary for the performance of their duties and learn new developments in health care. Records shall be maintaine…

10A NCAC 13B .3607 PERSONNEL HEALTH REQUIREMENTS Employees shall have pre-employment medical examinations and interim examinations in accordance with medical criteria established by the facility. History Note: Authority G.S. 131E-79; Eff. January 1, 1996; Pursuant to G.S. 150B-21…

10A NCAC 13B .3608 INSURANCE The governing board shall have in place an insurance program which provides for the protection of the physical and financial resources of the facility. History Note: Authority G.S. 131E-79; Eff. January 1, 1996; Pursuant to G.S. 150B-21.3A, rule is ne…

10A NCAC 13B .3609 AUDIT OF FINANCIAL OPERATIONS An audit of the financial operations of the facility shall be performed by a public accountant at least once a year. History Note: Authority G.S. 131E-79; Eff. January 1, 1996; Pursuant to G.S. 150B-21.3A, rule is necessary without…

SECTION .3700 - MEDICAL STAFF 10A NCAC 13B .3701 GENERAL PROVISIONS (a) The facility shall have a self-governed medical staff that shall be accountable to the governing body for the quality of care provided by individuals with medical staff membership and clinical privileges to p…

10A NCAC 13B .3702 ESTABLISHMENT History Note: Authority G.S. 131E-79; Eff. January 1, 1996; Repealed Eff. July 1, 2020.