CHapter 14 – Director, division of health service regulation

 

Subchapter 14A – rulemaking

 

SECTION .0100 ‑ RULEMAKING

 

10A NCAC 14A .0101       PETITIONS

(a)  Any person wishing to submit a petition requesting the adoption, amendment or repeal of a rule by the Director of the Division of Health Service Regulation shall address the petition to the Director, Division of Health Service Regulation, 2701 Mail Service Center, Raleigh, North Carolina, 27699-2701.

(b)  The petition shall contain the following information:

(1)           either a draft of the proposed rule or a summary of its contents and the statutory authority for the agency to promulgate the rule;

(2)           reason for proposal;

(3)           effect on existing rules or orders;

(4)           any data supporting the proposal;

(5)           effect of the proposed rule on existing practices in the area involved, including cost factors, if known;

(6)           names of those most likely to be affected by the proposed rule, with addresses, if known;

(7)           name(s) and address(es) of petitioner(s).

(c)  The Director, based on a study of the facts stated in the petition, will determine whether the public interest will be served by granting the petition.  He will consider all the contents of the submitted petition, plus any additional information he deems relevant.

(d)  Within 30 days of submission of the petition, the Director will render a final decision.  If the decision is to deny the petition, the Director will notify the petitioner in writing, stating the reasons for the denial.  If the decision is to approve the petition, the Director will initiate a rulemaking proceeding by issuing a rulemaking notice, as provided in these rules.

 

History Note:        Authority G.S. 143B‑10; 150B‑20;

Eff. June 10, 1977;

Readopted Eff. December 1, 1977;

Amended Eff. November 1, 1989.

10A NCAC 14A .0102       RULEMAKING PROCEDURES

(a)  The rulemaking procedures for the Secretary of the Department of Health and Human Services codified in 10A NCAC 01 are hereby adopted by reference pursuant to G.S. 150B‑14(c) to apply to the actions of the Director, with the following modifications:

(1)           Correspondence related to the Director's rulemaking actions shall be submitted to:

 

Director

Division of Health Service Regulation

2701 Mail Service Center

Raleigh, North Carolina 27699-2701

 

(2)           The Secretary's designee shall mean the Director of the Division of Health Service Regulation (hereinafter referred to as the Division).

(3)           The "Division" shall be substituted for the "Office of General Counsel" in 10A NCAC 01.

(4)           "Hearing officer" shall mean the Director of the Division of Health Service Regulation or his designee.

(b)  Copies of 10A NCAC 01 may be inspected in the Division at the address shown in (a)(1) of this Rule.  Copies may be obtained from the Office of Administrative Hearings, 424 North Blount Street, Raleigh, North Carolina, 27601.

 

History Note:        Authority G.S. 143B‑10;

Eff. November 1, 1989.

 

10A NCAC 14A .0103       DECLARATORY RULINGS

(a)  The Director of the Division of Health Service Regulation may make declaratory rulings.  All requests for declaratory rulings shall be written and submitted to:  the Director, Division of Health Service Regulation, 2701 Mail Service Center, Raleigh, North Carolina, 27699-2701.

(b)  All requests for a declaratory ruling must include the following information:

(1)           name and address of the petitioner;

(2)           statute or rule to which petition relates;

(3)           concise statement of the manner in which petitioner is aggrieved by the rule or statute or its potential application to him; and

(4)           the consequences of a failure to issue a declaratory ruling.

(c)  Whenever the Director believes for good cause that the issuance of a declaratory ruling will not serve the public interest, he may refuse to issue one.  When good cause is deemed to exist, the Director shall notify the petitioner of his decision in writing stating reasons for the denial of a declaratory ruling.

(d)  The Director may refuse to consider the validity of a rule and therefore refuse to issue a declaratory ruling:

(1)           if there has been similar controlling factual determination in a contested case, or if the factual context being raised for a declaratory ruling was specifically considered upon adoption of the rule being questioned as evidence by the rulemaking record; or

(2)           if circumstances stated in the request or otherwise known to the agency show that a contested case hearing would presently be appropriate.

(e)  Where a declaratory ruling is deemed to be in the public interest, the Director shall issue the ruling within 60 days of receipt of the petition.

(f)  A declaratory ruling procedure may consist of written submissions, oral hearings, or such other procedure as may be appropriate in a particular case.

(g)  The Director may issue notice to persons who might be affected by the ruling that written comments may be submitted or oral presentations received at a scheduled hearing.

(h)  A record of all declaratory ruling procedures shall be maintained for as long as the ruling has validity.  This record will contain:

(1)           the original request,

(2)           reasons for refusing to issue a ruling,

(3)           all written memoranda and information submitted,

(4)           any written minutes or audio tape or other record of the oral hearing, and

(5)           a statement of the ruling.

This record will be maintained in a file at the Division Office, Division of Health Service Regulation, 2701 Mail Service Center, Raleigh, North Carolina, 27699-2701 and will be available for public inspection during regular office hours.

 

History Note:        Authority G.S. 143B-10; 150B-4;

Eff. November 1, 1989;

Amended Eff. November 1, 2010.

 

section .0200 – contested cases

 

10A NCAC 14A .0201       DEFINITIONS

10A NCAC 14A .0202       REQUEST FOR DETERMINATION

10A NCAC 14A .0203       RECORD

10A NCAC 14A .0204       EXCEPTIONS TO RECOMMENDED DECISION

 

History Note:        Authority G.S. 143B‑10; 143B‑10(j)(3); 150B‑11; 150B‑22; 150B‑23; 150B‑23(e); 150B‑29(b); 150B‑36; 150B‑37;

Eff. November 1, 1989;

Repealed Eff. April 1, 2016.

 

SECTION .0300 ‑ HEARINGS:  TRANSFERS AND DISCHARGES

 

10A NCAC 14A .0301       DEFINITIONS

The following definitions will apply throughout this Subchapter:

(1)           "Agency" means the Hearing Officer and his office in the Division of Health Service Regulation, Department of Health and Human Services.

(2)           "Dismissal" means the dismissal of a request for a hearing if:

(a)           the applicant withdraws the request in writing; or

(b)           the applicant fails to appear at a scheduled hearing without good cause.

(3)           "Division" means the North Carolina Division of Health Service Regulation of the Department of Health and Human Services.

(4)           "Facility" means a nursing facility which meets the requirements of the Social Security Act as defined in 42 CFR 483.5.

(5)           "Hearing Officer" means the person designated to preside over hearings between residents and nursing facility providers regarding transfers and discharges.

(6)           "Notice" means a written notification of transfer or discharge by the facility to the resident and either an immediate family member, if known, or if an immediate family member is not known, the authorized representative.  The resident shall be handed the notice on the same day that it is dated.  The notice must include:

(a)           reason for the transfer or discharge;

(b)           the effective date of the transfer or discharge;

(c)           the location to which the resident is transferred or discharged;

(d)           statement that the resident has the right to appeal to the Hearing Officer;

(e)           the name, address, and telephone number of the state Long‑Term Care Ombudsman;

(f)            for nursing facility residents with developmental disabilities, the mailing address and telephone number of the agency responsible for the protection and advocacy of developmentally disabled individuals established under Part C of the Developmental Disabilities Assistance and Bill of Rights Act;

(g)           for nursing facility residents who are mentally ill, the mailing address and telephone number of the agency responsible for the protection and advocacy of mentally ill individuals established under the Protection and Advocacy for Mentally Ill Individuals Act;

(h)           statement that the resident has the right to review his records not later than five days prior to a hearing; and

(i)            statement that the appeal will be at no cost to the resident.

(7)           "Request for a Hearing" means a clear expression, in writing, by the resident or either an immediate family member, if known, or if an immediate family member is not known, the authorized representative, that he wants the opportunity to present his case to the hearing officer.  The "Request for Hearing Form" will suffice as a clear, expression, in writing, that a hearing is desired.

(8)           "Request for Hearing Form" means a form which is to be given to the resident and either an immediate family member, if known, or if an immediate family member is not known, the authorized representative, simultaneously with the Notice of Transfer or Discharge.  The request for hearing form must include at the least:

(a)           the date of Notice of Transfer or Discharge;

(b)           the date to be transferred or discharged;

(c)           Division of Health Service Regulation's correct mailing address and phone number;

(d)           resident's name, address, telephone number, and social security number;

(e)           the nursing facility's name and address;

(f)            name, address, and telephone number of authorized representative; and

(g)           space to elect the option of a hearing by telephone or in person.

(9)           "Resident" means any person who is receiving treatment or long‑term care in a facility.

(10)         "Serve" or "Service" means personal delivery, delivery by first class or certified United States Postal Service mail or delivery by licensed overnight express mail, postage prepaid and addressed to the party at his or her last known address.  Service by mail or licensed overnight express mail is complete upon placing the item to be served, enclosed in a wrapper addressed to the person to be served, in an official depository of the United States Postal Service or upon delivery, postage prepaid and wrapped in a wrapper addressed to the person to be served, to an agent of the overnight express mail service.  For purposes of service on the Division, the Hearing Officer of the Division shall be the designated agent.

 

History Note:        Authority 42 U.S.C.S. 1396r(e)(3) and (f)(3); 42 C.F.R. 483.5; 42 C.F.R. 483.12; G.S. 143B‑165(10);

Eff. August 3, 1992.

 

10A NCAC 14A .0302       GENERAL

(a)  The Division has established an appeal process for nursing facility residents who have been notified of transfer or discharge.  All residents who have been advised of the date of transfer or discharge in writing, may request that the Division Hearing Officer set a date for a fair hearing in accordance with and subject to these Rules.

(b)  The Rules of Civil Procedure as contained in G.S. 1A‑1 and the General Rules of Practice for the Superior and District Courts as authorized by G.S. 7A‑34 and found in the Rules Volume of the North Carolina General Statutes shall not apply in any hearings held by the Division Hearing Officer unless another specific statute or rule provides otherwise.  Division hearings are not hearings within the meaning of G.S. Chapter 150B and will not be governed by the provision of that Chapter unless otherwise stated in these Rules.  Parties may be represented by counsel at the hearing.

 

History Note:        Authority 42 U.S.C.S. 1396r(e)(3) and (f)(3); 42 C.F.R. 483.12; G.S. 143B‑165(10);

Eff. August 3, 1992.

 

10A NCAC 14A .0303       INITIATING A HEARING

(a)  In order to initiate a hearing with the Hearing Officer, a resident must first have been served by the facility administrator with a written Notice of Transfer or Discharge and must file a Request for Hearing in accordance with the Rules in 10 NCAC 14A .0300.  The Request for Hearing must be in writing and must be signed by the resident.  A Request for Hearing form shall be provided to the resident by the facility for this purpose.

(b)  The hearing is a mechanism for listening to appeals by residents concerning disputes over transfers and discharges.  The hearing shall be narrowly focused on discharge and transfer issues between the nursing facility and the resident and shall not involve Medicaid matters such as eligibility, which is the responsibility of the Medicaid hearing officer.

(c)  Should an appeal of the Notice of Transfer or Discharge be desired, a Request for a Hearing, accompanied by the Notice of Transfer or Discharge, shall be served to the Hearing Officer and must be received by him no later than 11 days from the date of the facility's Notice of Transfer or Discharge.  If the request for hearing has not been received within 11 days, the resident shall waive his right to appeal.  The resident must be notified of the option for the hearing to be in person (face‑to‑face) or by telephone.

(d)  The facility administrator must make available to the resident information and records at least five working days prior to the hearing to enable an opportunity for review and preparation.  The facility administrator must forward identical information relevant to the transfer or discharge to the agency, to be received at least five working days prior to the hearing.  A resident must authorize release of his medical records to the hearing officer.

 

History Note:        Authority 42 U.S.C.S. 1396r(e)(3) and (f)(3); 42 C.F.R. 483.12; G.S. 143B‑165(10);

Eff. August 3, 1992.

 

10A NCAC 14A .0304       NOTICE OF HEARING

Upon receipt of a timely request for a hearing, the Hearing Officer shall promptly notify all parties (the facility administrator, the resident, and either an immediate family member, if known or if an immediate family member is not known, the authorized representative) of receipt of the Request and shall arrange with the parties a time, date, and telephone numbers (if by phone conference).  If the hearing is to be conducted in person (face‑to‑face), hearings will be held in the Council Building, 701 Barbour Drive on the Dorothea Dix Campus in Raleigh, North Carolina, with time and date arranged with the parties by the hearing officer.  These parties will be served notice of the date of hearing.

 

History Note:        Authority 42 U.S.C.S. 1396r(e)(3) and (f)(3); 42 C.F.R. 483.12; G.S. 143B‑165(10);

Eff. August 3, 1992.

 

10A NCAC 14A .0305       DOCUMENTS

All documents required to be filed pursuant to these Rules shall be served on all other parties by the filing party.

 

History Note:        Authority 42 U.S.C.S. 1396r(e)(3) and (f)(3); 42 C.F.R. 483.12; G.S. 143B‑165(10);

Eff. August 3, 1992.

 

10A NCAC 14A .0306       HEARING OFFICER'S FINAL DECISION

The Hearing Officer's final decision will either uphold or reverse the facility's decision.  Copies of the final decision shall be served upon the parties.

 

History Note:        Authority 42 U.S.C.S. 1396r(e)(3) and (f)(3); G.S. 143B‑165(10);

Eff. August 3, 1992.

 

 

subchapter 14B - smfp

 

SECTION .0100 - PLANNING POLICIES AND NEED DETERMINATIONS FOR 1999 and 2000

 

10A NCAC 14B .0101       APPLICABILITY OF RULES RELATED TO THE 1999 STATE MEDICAL FACILITIES PLAN

10A NCAC 14B .0102       CERTIFICATE OF NEED REVIEW CATEGORIES

10A NCAC 14B .0103       CERTIFICATE OF NEED REVIEW SCHEDULE

10A NCAC 14B .0104       MULTI-COUNTY GROUPINGS

10A NCAC 14B .0105       SERVICE AREAS AND PLANNING AREAS

10A NCAC 14B .0106       REALLOCATIONS AND ADJUSTMENTS

10A NCAC 14B .0107       ACUTE CARE BED NEED DETERMINATION (REVIEW CATEGORY A)

10A NCAC 14B .0108       REHABILITATION BED NEED DETERMINATION (REVIEW CATEGORY E)

10A NCAC 14B .0109       AMBULATORY SURGICAL FACILITIES NEED DETERMINATION (REVIEW CATEGORY E)

10A NCAC 14B .0110       OPEN HEART SURGERY SERVICES NEED DETERMINATIONS (REVIEW CATEGORY H)

10A NCAC 14B .0111       HEART-LUNG BYPASS MACHINES NEED DETERMINATION (REVIEW CATEGORY H)

10A NCAC 14B .0112       FIXED CARDIAC CATHETERIZATION EQUIPMENT AND FIXED CARDIAC ANGIOPLASTY EQUIPMENT NEED DETERMINATION (REVIEW CATEGORY J)

10A NCAC 14B .0113       MOBILE CARDIAC CATHETERIZATION EQUIPMENT AND MOBILE CARDIAC ANGIOPLASTY EQUIPMENT NEED DETERMINATION (REVIEW CATEGORY J)

10a NCAC 14B .0114       BURN INTENSIVE CARE SERVICES NEED DETERMINATION (REVIEW CATEGORY H)

10A NCAC 14B .0115       POSITRON EMISSION TOMOGRAPHY SCANNERS NEED DETERMINATION (REVIEW CATEGORY H)

10A NCAC 14B .0116       BONE MARROW TRANSPLANTATION SERVICES NEED DETERMINATION (REVIEW CATEGORY H)

10A NCAC 14B .0117       SOLID ORGAN TRANSPLANTATION SERVICES NEED DETERMINATION (REVIEW CATEGORY H)

10A NCAC 14B .0118       GAMMA KNIFE NEED DETERMINATION (REVIEW CATEGORY H)

10A NCAC 14B .0119       LITHOTRIPTER NEED DETERMINATION (REVIEW CATEGORY H)

10A NCAC 14B .0120       RADIATION ONCOLOGY TREATMENT CENTERS NEED DETERMINATION (REVIEW CATEGORY H)

10A NCAC 14B .0121       MAGNETIC RESONANCE IMAGING SCANNERS NEED DETERMINATION (REVIEW CATEGORY H)

10A NCAC 14B .0122       NURSING CARE BED NEED DETERMINATION (REVIEW CATEGORY B)

10A NCAC 14B .0123       HOME HEALTH AGENCY OFFICE NEED DETERMINATION (REVIEW CATEGORY F)

10A NCAC 14B .0124       DIALYSIS STATION NEED DETERMINATION

10A NCAC 14B .0125       HOSPICE NEED DETERMINATION (REVIEW CATEGORY F)

10a NCAC 14B .0126       HOSPICE INPATIENT FACILITY BED NEED DETERMINATION (REVIEW CATEGORY F)

10A NCAC 14B .0127       PSYCHIATRIC BED NEED DETERMINATION (REVIEW CATEGORY C)

10A NCAC 14B .0128       CHEMICAL DEPENDENCY (SUBSTANCE ABUSE) TREATMENT BED NEED DETERMINATION (REVIEW CATEGORY C)

10A NCAC 14B .0129       INTERMEDIATE CARE BEDS FOR THE MENTALLY RETARDED NEED DETERMINATION (REVIEW CATEGORY C)

10A NCAC 14B .0130       POLICIES FOR GENERAL ACUTE CARE HOSPITALS

10A NCAC 14B .0131       POLICIES FOR INPATIENT REHABILITATION SERVICES

10A NCAC 14B .0132       POLICY FOR AMBULATORY SURGICAL FACILITIES

10A NCAC 14B .0133       POLICY FOR PROVISION OF HOSPITAL-BASED LONG-TERM NURSING CARE

10A NCAC 14B .0134       POLICY FOR NURSING CARE BEDS IN CONTINUING CARE FACILITIES

10A NCAC 14B .0135       POLICY FOR DETERMINATION OF NEED FOR ADDITIONAL NURSING BEDS IN SINGLE PROVIDER COUNTIES

10A NCAC 14B .0136       POLICY FOR RELOCATION OF CERTAIN NURSING FACILITY BEDS

10A NCAC 14B .0137       POLICY FOR HOME HEALTH SERVICES

10A NCAC 14B .0138       POLICY FOR END-STAGE RENAL DISEASE DIALYSIS SERVICES

10A NCAC 14B .0139       POLICIES FOR PSYCHIATRIC INPATIENT FACILITIES

10A NCAC 14B .0140       POLICY FOR CHEMICAL DEPENDENCY TREATMENT FACILITIES

10A NCAC 14B .0141       POLICIES FOR INTERMEDIATE CARE FACILITIES FOR MENTALLY RETARDED

 

History Note:        Authority G.S. 131E-176(25); 131E-177(1); 131E-183(b);

Temporary Adoption Eff. January 1, 1999;

Temporary Amendment Eff. July 22, 1999;

Temporary Expired on October 12, 1999;

Eff. August 1, 2000;

Repealed Eff. April 1, 2012.

10A NCAC 14B .0142       reserved for future codification

 

10A NCAC 14B .0143       reserved for future codification

 

10A NCAC 14B .0144       RESERVED FOR FUTURE CODIFICATION

 

10A NCAC 14B .0145       RESERVED FOR FUTURE CODIFICATION

 

10A NCAC 14B .0146       RESERVED FOR FUTURE CODIFICATION

 

10A NCAC 14B .0147       RESERVED FOR FUTURE CODIFICATION

 

10A NCAC 14B .0148       RESERVED FOR FUTURE CODIFICATION

 

10A NCAC 14B .0149       RESERVED FOR FUTURE CODIFICATION

 

10A ncac 14B .0150       APPLICABILITY OF RULES RELATED TO THE 2000 STATE MEDICAL FACILITIES PLAN

 

History Note:        Authority G.S. 131E-176(25); 131E-177(1); 131E-183(b);

Temporary Adoption Eff. January 1, 2000;

Eff. April 1, 2001;

Repealed Eff. April 1, 2012.

 

10A NCAC 14B .0151       RESERVED FOR FUTURE CODIFICATION

 

10A ncac 14B .0152       CERTIFICATE OF NEED REVIEW SCHEDULE

10A NCAC 14B .0153       MULTI-COUNTY GROUPINGS

10A ncac 14B .0154       SERVICE AREAS AND PLANNING AREAS

10A NCAC 14B .0155       REALLOCATIONS AND ADJUSTMENTS

10A NCAC 14B .0156       ACUTE CARE BED NEED DETERMINATION (REVIEW CATEGORY A)

10A NCAC 14B .0157       REHABILITATION BED NEED DETERMINATION (REVIEW CATEGORY E)

10A NCAC 14B .0158       AMBULATORY SURGICAL FACILITIES NEED DETERMINATION (REVIEW CATEGORY E)

10A NCAC 14B .0159       OPEN HEART SURGERY SERVICES NEED DETERMINATIONS (REVIEW CATEGORY H)

10A NCAC 14B .0160       HEART-LUNG BYPASS MACHINES NEED DETERMINATION (REVIEW CATEGORY H)

10A NCAC 14B .0161       FIXED CARDIAC CATHETERIZATION EQUIPMENT AND FIXED CARDIAC ANGIOPLASTY EQUIPMENT NEED DETERMINATION (REVIEW CATEGORY J)

 

History Note:        Authority G.S. 131E-176(25); 131E-177(1); 131E-177(I); 131E-183(b); 131E-183(1);

Temporary Adoption Eff. January 1, 2000;

Temporary Amendment Eff. August 17, 2000;

Eff. April 1, 2001;

Repealed Eff. April 1, 2012.

 

10A NCAC 14B .0162       RESERVED FOR FUTURE CODIFICATION

 

10A NCAC 14B .0163       BURN INTENSIVE CARE SERVICES NEED DETERMINATION (REVIEW CATEGORY H)

10A NCAC 14B .0164       POSITRON EMISSION TOMOGRAPHY SCANNERS NEED DETERMINATION (REVIEW CATEGORY H)

10a NCAC 14B .0165       BONE MARROW TRANSPLANTATION SERVICES NEED DETERMINATION (REVIEW CATEGORY H)

10A NCAC 14B .0166       SOLID ORGAN TRANSPLANTATION SERVICES NEED DETERMINATION (REVIEW CATEGORY H)

10A NCAC 14B .0167       GAMMA KNIFE NEED DETERMINATION (REVIEW CATEGORY H)

10A NCAC 14B .0168       LITHOTRIPTER NEED DETERMINATION (REVIEW CATEGORY H)

10A NCAC 14B .0169       RADIATION ONCOLOGY TREATMENT CENTERS NEED DETERMINATION (REVIEW CATEGORY H)

10A NCAC 14B .0170       MAGNETIC RESONANCE IMAGING SCANNERS NEED DETERMINATION (REVIEW CATEGORY H)

10A NCAC 14B .0171       MAGNETIC RESONANCE IMAGING SCANNERS NEED DETERMINATION FOR PLANNING RADIATION ONCOLOGY TREATMENTS (REVIEW CATEGORY H)

10A NCAC 14B .0172       NURSING CARE BED NEED DETERMINATION (REVIEW CATEGORY B)

10A NCAC 14B .0173       DEMONSTRATION PROJECT FOR CONTINUING CARE OF ADULTS WITH DEVELOPMENTAL DISABILITIES AND THEIR AGING CAREGIVERS (REVIEW CATEGORY J)

10A NCAC 14B .0174       HOME HEALTH AGENCY OFFICE NEED DETERMINATION (REVIEW CATEGORY F)

10A NCAC 14B .0175       DIALYSIS STATION NEED DETERMINATION METHODOLOGY

10A NCAC 14B .0176       DIALYSIS STATION ADJUSTED NEED DETERMINATION (REVIEW CATEGORY G)

10A NCAC 14B .0177       HOSPICE NEED DETERMINATION (REVIEW CATEGORY F)

10A NCAC 14B .0178       HOSPICE INPATIENT FACILITY BED NEED DETERMINATION (REVIEW CATEGORY F)

10A NCAC 14B .0179       PSYCHIATRIC BED NEED DETERMINATION (REVIEW CATEGORY C)

10A ncac 14B .0180       CHEMICAL DEPENDENCY (SUBSTANCE ABUSE) TREATMENT BED NEED DETERMINATION (REVIEW CATEGORY C)

10A NCAC 14B .0181       INTERMEDIATE CARE BEDS FOR THE MENTALLY RETARDED NEED DETERMINATION (REVIEW CATEGORY C)

10A NCAC 14B .0182       POLICIES FOR GENERAL ACUTE CARE HOSPITALS

10A NCAC 14B .0183       POLICIES FOR INPATIENT REHABILITATION SERVICES

10A NCAC 14B .0184       POLICY FOR AMBULATORY SURGICAL FACILITIES

10A NCAC 14B .0185       POLICY FOR PROVISION OF HOSPITAL-BASED LONG-TERM NURSING CARE

10A ncac 14B .0186       POLICY FOR PLAN EXEMPTION FOR CONTINUING CARE RETIREMENT COMMUNITIES

10A NCAC 14B .0187       POLICY FOR DETERMINATION OF NEED FOR ADDITIONAL NURSING BEDS IN SINGLE PROVIDER COUNTIES

10A NCAC 14B .0188       POLICY FOR RELOCATION OF CERTAIN NURSING FACILITY BEDS

10A NCAC 14B .0189       POLICIES FOR HOME HEALTH SERVICES

10A NCAC 14B .0190       POLICY FOR RELOCATION OF DIALYSIS STATIONS

10A NCAC 14B .0191       POLICIES FOR PSYCHIATRIC INPATIENT FACILITIES

10A NCAC 14B .0192       POLICY FOR CHEMICAL DEPENDENCY TREATMENT FACILITIES

10A NCAC 14B .0193       POLICIES FOR INTERMEDIATE CARE FACILITIES FOR MENTALLY RETARDED

 

History Note:        Authority G.S. 131E-176(25); 131E-177(1); 131E-183(b);

Temporary Adoption Eff. January 1, 2000;

Temporary Amendment Eff. August 17, 2000;

Eff. April 1, 2001;

Repealed Eff. April 1, 2012.

 

10A NCAC 14B .0194       EQUIPMENT NEED DETERMINATIONS for 1996 SMfp (REVIEW CATEGORY H)

10A NCAC 14B .0195       OPEN HEART SURGERY SERVICES NEED DETERMINATIONS for 1996 smfp (REVIEW CATEGORY H)

 

History Note:        Authority G.S. 131E-176(25); 131E-177(1); 131E-183(b);

Eff. August 1, 1998;

Repealed Eff. April 1, 2012.

 

section .0200 - planning policies and need determination for 2001 and 2002

 

10A ncac 14B .0201       APPLICABILITY OF RULES RELATED TO THE 2001 STATE MEDICAL FACILITIES PLAN

10A ncac 14B .0202       certificate of need review schedule

10A ncac 14B .0203       multi-county groupings

10A ncac 14B .0204       service areas and planning areas

10A ncac 14B .0205       reallocations and adjustments

10A ncac 14B .0206       acute care bed need determination (review category a)

10A ncac 14B .0207       rehabilition bed need determination (review category e)

 

History Note:        Authority G.S. 131E-176(25); 131E-177(1); 131E-183(b); 131E-183(1);

Temporary Adoption Eff. January 1, 2001;

Temporary Amendment Eff. May 1, 2001;

Eff. August 1, 2002;

Repealed Eff. April 1, 2012.

 

10A NCAC 14B .0208       reserved for future codification

 

10A ncac 14B .0209       open heart surgery services need determinations (review category h)

10A ncac 14B .0210       heart-lung bypass machines need determination (review category h)

10A ncac 14B .0211       fixed cardiac catheterization equipment and fixed cardiac angioplasty equipment need determinations (review category h)

10A ncac 14B .0212       shared fixed cardiac catheterization equipment need determination (review category H)

10A ncac 14B .0213       burn intensive care services need determination (review category h)

10A ncac 14B .0214       positron emission tomography scanners need determination (review category h)

10A ncac 14B .0215       bone marrow transplantation services need determination (review category h)

10A ncac 14B .0216       solid organ transplantation services need determination (review category H)

10A ncac 14B .0217       gamma knife unit need determination (review category h)

10A ncac 14B .0218       lithotripter need determination (review category h)

10A ncac 14B .0219       radiation oncology treatment centers need determination (review category h)

10A ncac 14B .0220       MAGNETIC RESONANCE IMAGING SCANNERS NEED DETERMINATION BASED ON FIXED MRI SCANNER UTILIZATION (REVIEW CATEGORY H)

10A ncac 14B .0221       MAGNETIC RESONANCE IMAGING SCANNERS NEED DETERMINATION BASED ON MOBILE MRI SCANNER UTILIZATION (REVIEW CATEGORY H)

10A ncac 14B .0222       nursing care bed need determination (review category b)

10A ncac 14B .0223       medicare-certified home health agency office need determination (review category f)

10A ncac 14B .0224       dialysis need determination methodology for reviews beginning january 1, 2001

10A ncac 14B .0225       dialysis station need determination methodology for reviews Beginning September 1, 2001

10A ncac 14B .0226       hospice care need determination (review category f)

10A ncac 14B .0227       hospice inpatient facility bed need determination (review category f)

10A ncac 14B .0228       psychiatric bed need determination (review category C)

10A ncac 14B .0229       chemical dependency (substance abuse) treatment bed need determination (review category c)

10A ncac 14B .0230       CHEMICAL DEPENDENCY (SUBSTANCE ABUSE) ADULT DETOX-ONLY BED NEED DETERMINATION (REVIEW CATEGORY C)

10A ncac 14B .0231       intermediate care beds for the mentally retarded need determination (review category c)

10A ncac 14B .0232       policies for general acute care hospitals

10a ncac 14B .0233       policies for cardiac catheterization equipment and services

10A ncac 14B .0234       policies for transplantation services

10A ncac 14B .0235       policy for mRi scanners

10A ncac 14B .0236       policy for provision of hospital-based long-term care nursing care

10a ncac 14B .0237       policy for plan exemption for continuing care retirement communities

10A ncac 14B .0238       policy for determination of need for additional nursing beds in single provider counties

10a ncac 14B .0239       policy for relocation of certain nursing facility beds

10A ncac 14B .0240       policy for transfer of beds from state psychiatric hospital nursing facilities to community facilities

10A ncac 14B .0241       policies for relocation of nursing facility beds

10A ncac 14B .0242       policies for medicare-certified home health services

10a ncac 14B .0243       policy for relocation of dialysis stations

10a ncac 14B .0244       policies for psychIAtric inpatient facilities

10A ncac 14B .0245       policy for chemical dependency treatment facilities

10A ncac 14B .0246       policies for intermediate care facilities for mentally retarded

 

History Note:        Authority G.S. 131E-176(25); 131E-177(1); 131E-183(b);

Temporary Adoption Eff. January 1, 2001;

Eff. August 1, 2002;

Repealed Eff. April 1, 2012.

 

10A NCAC 14B .0247       reserved for future codification

 

10A ncac 14B .0248       reserved for future codification

 

10A ncac 14B .0249       reserved for future codification

 

10A ncac 14B .0250       reserved for future codification

 

10A ncac 14B .0251       APPLICABILITY OF RULES RELATED TO THE 2002 STATE MEDICAL FACILITIES PLAN

10A ncac 14B .0252       CERTIFICATE OF NEED REVIEW SCHEDULE

10A ncac 14B .0253       MULTI-COUNTY GROUPINGS

10A NCAC 14B .0254       SERVICE AREAS AND PLANNING AREAS

10A ncac 14B .0255       REALLOCATIONS AND ADJUSTMENTS

10A ncac 14B .0256       ACUTE CARE BED NEED DETERMINATION (REVIEW CATEGORY A)

10A ncac 14B .0257       INPATIENT REHABILITATION BED NEED DETERMINATION (REVIEW CATEGORY E)

10A ncac 14B .0258       OPERATING ROOM NEED DETERMINATIONS (REVIEW CATEGORY E)

10A ncac 14B .0259       OPEN HEART SURGERY SERVICES NEED DETERMINATION (REVIEW CATEGORY H)

10A ncac 14B .0260       HEART-LUNG BYPASS MACHINES NEED DETERMINATIONS (REVIEW CATEGORY H)

10A ncac 14B .0261       FIXED CARDIAC CATHETERIZATION/ANGIOPLASTY EQUIPMENT NEED DETERMINATIONS (REVIEW CATEGORY H)

10A ncac 14B .0262       SHARED FIXED CARDIAC CATHETERIZATION/ANGIOPLASTY EQUIPMENT NEED DETERMINATION (REVIEW CATEGORY H)

10A ncac 14B .0263       BURN INTENSIVE CARE SERVICES NEED DETERMINATION (REVIEW CATEGORY H)

10A ncac 14B .0264       BONE MARROW TRANSPLANTATION SERVICES NEED DETERMINATION (REVIEW CATEGORY H)

10A ncac 14B .0265       SOLID ORGAN TRANSPLANTATION SERVICES NEED DETERMINATION (REVIEW CATEGORY H)

10A ncac 14B .0266       GAMMA KNIFE NEED DETERMINATION (REVIEW CATEGORY H)

10A ncac 14B .0267       LITHOTRIPTER NEED DETERMINATION (REVIEW CATEGORY H)

10A ncac 14B .0268       RADIATION ONCOLOGY TREATMENT CENTERS NEED DETERMINATION (REVIEW CATEGORY H)

10A ncac 14B .0269       POSITRON EMISSION TOMOGRAPHY SCANNERS NEED DETERMINATION (REVIEW CATEGORY H)

10A ncac 14B .0270       FIXED MAGNETIC RESONANCE IMAGING SCANNERS NEED DETERMINATION BASED ON FIXED MRI SCANNER UTILIZATION (REVIEW CATEGORY H)

10A ncac 14B .0271       MAGNETIC RESONANCE IMAGING SCANNERS NEED DETERMINATION FOR A DEDICATED FIXED BREAST MRI SCANNER (REVIEW CATEGORY H)

10A ncac 14B .0272       FIXED MAGNETIC RESONANCE IMAGING SCANNERS NEED DETERMINATION BASED ON MOBILE MRI SCANNER UTILIZATION (REVIEW CATEGORY H)

10A ncac 14B .0273       NURSING CARE BED NEED DETERMINATION (REVIEW CATEGORY B)

10A ncac 14B .0274       ADULT CARE HOME BED NEED DETERMINATION (REVIEW CATEGORY B)

10A ncac 14B .0275       MEDICARE-CERTIFIED HOME HEALTH AGENCY OFFICE NEED DETERMINATION (REVIEW CATEGORY F)

10A ncac 14B .0276       DIALYSIS STATION NEED DETERMINATION METHODOLOGY FOR REVIEWS BEGINNING APRIL 1, 2002

10A ncac 14B .0277       DIALYSIS STATION NEED DETERMINATION METHODOLOGY FOR REVIEWS BEGINNING OCTOBER 1, 2002

10A ncac 14B .0278       HOSPICE HOME CARE NEED DETERMINATION (REVIEW CATEGORY F)

10A ncac 14B .0279       SINGLE COUNTY HOSPICE INPATIENT BED NEED DETERMINATION (REVIEW CATEGORY F)

10A ncac 14B .0280       CONTIGUOUS COUNTY HOSPICE INPATIENT BED NEED DETERMINATION (REVIEW CATEGORY F)

10A ncac 14B .0281       PSYCHIATRIC BED NEED DETERMINATION (REVIEW CATEGORY C)

10A ncac 14B .0282       CHEMICAL DEPENDENCY (SUBSTANCE ABUSE) TREATMENT BED NEED DETERMINATION (REVIEW CATEGORY C)

10A ncac 14B .0283       CHEMICAL DEPENDENCY (SUBSTANCE ABUSE) ADULT DETOX-ONLY BED NEED DETERMINATION (REVIEW CATEGORY C)

10A ncac 14B .0284       INTERMEDIATE CARE BEDS FOR THE MENTALLY RETARDED NEED DETERMINATION (REVIEW CATEGORY C)

10A ncac 14B .0285       POLICIES FOR GENERAL ACUTE CARE HOSPITALS

 

History Note:        Authority G.S. 131E-176(25); 131E-177(1); 131E-183(b); 131E-183(1);

Temporary Adoption Eff. January 1, 2002;

Temporary Amendment Eff. April 8, 2002; March 15, 2002;

Eff. April 1, 2003;

Repealed Eff. April 1, 2012.

 

10A ncac 14B .0286       reserved for future codification

 

10a ncac 14B .0287       reserved for future codification

 

10A ncac 14B .0288       reserved for future codification

 

10A ncac 14B .0289       POLICIES FOR NURSING CARE FACILITIES

 

History Note:        Authority G.S. 131E-176(25); 131E-177(1); 131E-183(b);

Temporary Adoption Eff. January 1, 2002;

Eff. April 1, 2003;

Repealed Eff. April 1, 2012.

 

10A ncac 14B .0290       POLICY FOR PLAN EXEMPTION FOR CONTINUING CARE RETIREMENT COMMUNITIES ADULT CARE HOME BEDS

 

History Note:        Authority G.S. 131E-176(25); 131E-177(1); 131E-183(b);

Temporary Adoption Eff. January 1, 2002;

Temporary Adoption Expired on October 12, 2002.

 

10A ncac 14B .0291       POLICIES FOR MEDICARE-CERTIFIED HOME HEALTH SERVICES

10A ncac 14B .0292       POLICY FOR RELOCATION OF DIALYSIS STATIONS

10A ncac 14B .0293       POLICIES FOR PSYCHIATRIC INPATIENT FACILITIES

10A ncac 14B .0294       POLICY FOR CHEMICAL DEPENDENCY TREATMENT FACILITIES

10A ncac 14B .0295       POLICIES FOR INTERMEDIATE CARE FACILITIES FOR MENTALLY RETARDED

 

History Note:        Authority G.S. 131E-176(25); 131E-177(1); 131E-183(b);

Temporary Adoption Eff. January 1, 2002;

Eff. April 1, 2003;

Repealed Eff. April 1, 2012.

 

SECTION .0300 – PLANNING POLICIES AND NEED DETERMINATIONS FOR 2003

 

10A ncac 14B .0301       APPLICABILITY OF RULES RELATED TO THE 2003 STATE MEDICAL FACILITIES PLAN

10A ncac 14B .0302       CERTIFICATE OF NEED REVIEW SCHEDULE

10A ncac 14B .0303       MULTI-COUNTY GROUPINGS

10A ncac 14B .0304       SERVICE AREAS AND PLANNING AREAS

10a ncac 14b .0305       REALLOCATIONS AND ADJUSTMENTS

10A ncac 14B .0306       ACUTE CARE BED NEED DETERMINATION (REVIEW CATEGORY A)

10A ncac 14B .0307       INPATIENT REHABILITATION BED NEED DETERMINATION (REVIEW CATEGORY E)

10A ncac 14B .0308       OPERATING ROOM NEED DETERMINATIONS (REVIEW CATEGORY E)

10A ncac 14B .0309       OPEN HEART SURGERY SERVICES NEED DETERMINATION (REVIEW CATEGORY H)

10A ncac 14B .0310       HEART-LUNG BYPASS MACHINE NEED DETERMINATION (REVIEW CATEGORY H)

10A ncac 14B .0311       FIXED CARDIAC CATHETERIZATION/ANGIOPLASTY EQUIPMENT NEED DETERMINATIONS (REVIEW CATEGORY H)

10A ncac 14B .0312       SHARED FIXED CARDIAC CATHETERIZATION/ANGIOPLASTY EQUIPMENT NEED DETERMINATION (REVIEW CATEGORY H)

10A ncac 14B .0313       BURN INTENSIVE CARE SERVICES NEED DETERMINATION (REVIEW CATEGORY H)

10A ncac 14B .0314       BONE MARROW TRANSPLANTATION SERVICES NEED DETERMINATION (REVIEW CATEGORY H)

10A ncac 14B .0315       SOLID ORGAN TRANSPLANTATION SERVICES NEED DETERMINATION (REVIEW CATEGORY H)

10A ncac 14B .0316       LITHOTRIPTER NEED DETERMINATION (REVIEW CATEGORY H)

10A ncac 14B .0317       GAMMA KNIFE NEED DETERMINATION (REVIEW CATEGORY H)

10A ncac 14B .0318       RADIATION ONCOLOGY TREATMENT CENTER/LINEAR ACCELERATOR NEED DETERMINATIONS (REVIEW CATEGORY H)

10A ncac 14B .0319       FIXED DEDICATED POSITRON EMISSION TOMOGRAPHY (PET) SCANNERS NEED DETERMINATION (REVIEW CATEGORY H)

10A ncac 14B .0320       MOBILE DEDICATED POSITRON EMISSION TOMOGRAPHY (PET) SCANNER NEED DETERMINATION (REVIEW CATEGORY H)

10A ncac 14B .0321       FIXED MAGNETIC RESONANCE IMAGING (MRI) SCANNERS NEED DETERMINATION BASED ON FIXED MRI SCANNER UTILIZATION (REVIEW CATEGORY H)

10A ncac 14B .0322       FIXED MAGNETIC RESONANCE IMAGING (MRI) SCANNERS NEED DETERMINATION BASED ON MOBILE MRI SCANNER UTILIZATION (REVIEW CATEGORY H)

10A ncac 14B .0323       MOBILE MAGNETIC RESONANCE IMAGING (MRI) SCANNERS NEED DETERMINATION (REVIEW CATEGORY H)

10A ncac 14B .0324       NURSING CARE BED NEED DETERMINATIONS (REVIEW CATEGORY B)

10A ncac 14B .0325       ADULT CARE HOME BED NEED DETERMINATIONS (REVIEW CATEGORY B)

10A ncac 14B .0326       MEDICARE-CERTIFIED HOME HEALTH AGENCY OFFICE NEED DETERMINATION (REVIEW CATEGORY F)

10A ncac 14B .0327       HOSPICE HOME CARE NEED DETERMINATION (REVIEW CATEGORY F)

10A ncac 14B .0328       HOSPICE INPATIENT BED NEED DETERMINATION (REVIEW CATEGORY F)

10A ncac 14B .0329       DIALYSIS STATION NEED DETERMINATION METHODOLOGY FOR REVIEWS BEGINNING APRIL 1, 2003

10A ncac 14B .0330       DIALYSIS STATION NEED DETERMINATION METHODOLOGY FOR REVIEWS BEGINNING OCTOBER 1, 2003

10A ncac 14B .0331       PSYCHIATRIC BED NEED DETERMINATION (REVIEW CATEGORY C)

10A ncac 14B .0332       CHEMICAL DEPENDENCY (SUBSTANCE ABUSE) TREATMENT BED NEED DETERMINATION (REVIEW CATEGORY C)

10A ncac 14B .0333       INTERMEDIATE CARE FACILITY BEDS FOR THE MENTALLY RETARDED (ICF/MR) NEED DETERMINATION (REVIEW CATEGORY C)

 

History Note:        Authority G.S. 131E-176(25); 131E-177(1); 131E-183(b);

Temporary Adoption Eff. January 1, 2003;

Rule removed from the Code pursuant to G.S. 150B-2(8a)k.

 

10A NCAC 14B .0334       reserved for future codification

 

10A NCAC 14B .0335       reserved for future codification

 

10A ncac 14B .0336       EXEMPTION FROM PLAN PROVISIONS FOR CERTAIN ACADEMIC MEDICAL CENTER TEACHING HOSPITAL PROJECTS

10A ncac 14B .0337       POLICIES FOR GENERAL ACUTE CARE HOSPITALS

10A ncac 14B .0338       POLICIES FOR NURSING CARE FACILITIES

10A ncac 14B .0339       POLICY FOR PLAN EXEMPTION FOR CONTINUING CARE RETIREMENT COMMUNITIES - ADULT CARE HOME BEDS

10A ncac 14B .0340       POLICIES FOR MEDICARE-CERTIFIED HOME HEALTH SERVICES

10A ncac 14B .0341       POLICY FOR RELOCATION OF DIALYSIS STATIONS

10A ncac 14B .0342       POLICIES FOR PSYCHIATRIC INPATIENT FACILITIES

10A ncac 14B .0343       POLICY FOR CHEMICAL DEPENDENCY TREATMENT FACILITIES

10A ncac 14B .0344       POLICY FOR INTERMEDIATE CARE FACILITIES FOR MENTALLY RETARDED

 

History Note:        Authority G.S. 131E-176(25); 131E-177(1); 131E-183(b);

Temporary Adoption Eff. January 1, 2003;

Rule removed from the Code pursuant to G.S. 150B-2(8a)k.

 

 

 

SUBCHAPTER 14C – CERTIFICATE OF NEED REGULATIONS

 

SECTION .0100 - GENERAL

 

10a NCAC 14C .0101       DEFINITIONS

(a)  The definitions in G.S. 131E-176 shall apply to all the rules of this Subchapter.

(b)  "Home health agency office", as that phrase is used in G.S. 131E-176(9b) and G.S. 131E-176(16)o, means:

(1)           any site that is marketed or advertised as a place from which home health services are provided or for which a physical address or phone number for home health services is listed in the yellow or white pages of any telephone directory, any directory of home health agencies, any inventory of home health services, any promotional material, any agency letterhead, or any other documents distributed to the public; or

(2)           any site at which patients are accepted for home health services and regulatory responsibility and authority are assumed for organizing, implementing and evaluating a plan of care to meet the medical, nursing and social needs of the patient; or

(3)           any site at which staff are based to serve home health patients, excluding sites of a third party with which the home health agency subcontracts or private residences of employees; or

(4)           any site at which original client service records or patient medical records of current clients are maintained or stored.

(c)  "In use", as that phrase is used in G.S. 131E-176(16)s, means frequent, regular, periodic, or recurrent use of equipment and not occasional, sporadic, isolated, or incidental use of equipment.

 

History Note:        Authority G.S. 131E-177;

Eff. January 1, 1990;

Amended Eff. November 1, 1996.

10a NCAC 14C .0102       LOCATION OF THE AGENCY

As used in this Subchapter, the agency is the Certificate of Need Section in the Division of Health Service Regulation, North Carolina Department of Health and Human Services.  The location of the agency is 809 Ruggles Drive, Raleigh, North Carolina, 27603.  The mailing address of the agency is Certificate of Need Section, Division of Health Service Regulation, 2704 Mail Service Center, Raleigh, NC 27699-2704.  The telephone number of the agency is 919‑855-3873.

 

History Note:        Authority G.S. 131E‑177;

Eff. November 1, 1996;

Amended Eff. January 1, 2013; January 1, 2000.

 

10A NCAC 14C .0103       STATE MEDICAL FACILITIES PLAN

 

History Note:        Authority G.S. 131E‑176(25); 131E‑177(1); 131E‑183(1); 42 U.S.C. 300K‑2;

Eff. June 19, 1979;

Temporary Amendment Eff. January 1, 1983 for a Period of 120 Days to Expire on May 1, 1983;

Amended Eff. November 1, 1989; January 1, 1989; February 1, 1988; January 1, 1987;

Repealed Eff. October 1, 2016.

 

SECTION .0200 – APPLICATION AND REVIEW PROCESS

 

10A NCAC 14C .0201       LETTER OF INTENT

 

History Note:        Authority G.S. 131E‑177;

Eff. October 1, 1981;

Amended Eff. November 1, 1996; January 1, 1990; November 1, 1989;

Repealed Eff. October 1, 2016.

 

10A NCAC 14C .0202       DETERMINATION OF REVIEW

(a)  After receipt of a letter of intent, the agency shall determine whether the proposed project requires a certificate of need.

(b)  When any of the equipment listed in G.S. 131E-176(16)(f1) or (p) is acquired in parts or piecemeal fashion, the acquisition shall be determined to require a certificate of need on the date that the components are assembled.

(c)  If the agency determines that the project requires a certificate of need, the agency shall determine the appropriate review category or categories for the proposed project, the type or types of application forms to be submitted, the number of separate applications to be submitted, the applicable review period for each application, and the deadline date for submitting each application, as contained in this Subchapter.

(d)  Copies of the application forms may be obtained from the agency.

(e)  Proposals requiring review shall be reviewed according to the categories and schedule set forth in the duly adopted State Medical Facilities Plan in effect at the time the scheduled review period commences, as contained in this Subchapter.

(f)  Applications are competitive if they, in whole or in part, are for the same or similar services and the agency determines that the approval of one or more of the applications may result in the denial of another application reviewed in the same review period.

 

History Note:        Filed as a Temporary Amendment Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Authority G.S. 131E-177;

Eff. October 1, 1981;

Amended Eff. November 1, 1996; January 4, 1994; January 1, 1990; January 1, 1987;

Temporary Amendment Eff. January 1, 2000;

Amended Eff. April 1, 2001.

 

10A NCAC 14C .0203       FILING APPLICATIONS

(a)  A certificate of need application shall not be reviewed by the Certificate of Need Section until it is filed in accordance with this Rule.

(b)  An original and a copy of the application shall be file-stamped as received by the agency no later than 5:30 p.m. on the 15th day of the month preceding the scheduled review period.  In instances when the 15th of the month falls on a weekend or holiday, the filing deadline is 5:30 p.m. on the next business day.  An application shall not be included in a scheduled review if it is not received by the agency by this deadline.  Each applicant shall transmit, with the application, a fee to be determined according to the formula as stated in G.S. 131E-182(c).

(c)  After an application is filed, the agency shall determine whether it is complete for review.  An application shall not be considered complete if:

(1)           the requisite fee has not been received by the agency; or

(2)           a signed original and copy of the application have not been submitted to the agency on the appropriate application form.

(d)  If the agency determines the application is not complete for review, it shall mail notice of such determination to the applicant within five business days after the application is filed and shall specify what is necessary to complete the application.  If the agency determines the application is complete, it shall mail notice of such determination to the applicant prior to the beginning of the applicable review period.

(e)  Information requested by the agency to complete the application must be received by the agency no later than 5:30 p.m. on the last working day before the first day of the scheduled review period.  The review of an application shall commence in the next applicable review period that commences after the application has been determined to be complete.

 

History Note:        Authority G.S. 131E‑177; 131E‑182;

Eff. October 1, 1981;

Amended Eff. January 1, 1982;

Temporary Amendment Eff. July 15, 1983, for a Period of 118 Days, to Expire on November 10, 1983;

Amended Eff. November 1, 1990: January 1, 1990; December 1, 1989; January 1, 1987; October 1, 1984; November 10, 1983;

Temporary Amendment Eff. August 11, 1993, for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Amended Eff. January 4, 1994;

Temporary Amendment Eff. August 12, 1994, for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Amended Eff. December 1, 1994;

Temporary Amendment Eff. January 1, 2000;

Amended Eff. April 1, 2001;

Temporary Amendment Eff. February 16, 2004;

Amended Eff. August 1, 2004;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006;

Temporary Amendment Eff. January 1, 2008;

Amended Eff. July 1, 2008.

 

10A NCAC 14C .0204       AMENDMENTS TO APPLICATIONS

An applicant may not amend an application.  Responding to a request for additional information made by the agency after the review has commenced is not an amendment.

 

History Note:        Authority G.S. 131E‑177; 131E‑182;

Eff. October 1, 1981;

Amended Eff. January 1, 1990; January 1, 1987.

 

10A NCAC 14C .0205       REVIEW PERIOD

(a)  The review of an application for a certificate of need shall be completed within 90 days from the beginning date of the review period for the application, except as provided in Paragraph (b) of this Rule.

(b)  Except in the case of an expedited review, the period for review may be extended for up to 60 days by the agency if it determines that, for one or more of the following reasons, it cannot complete the review within 90 days:

(1)           the extension is necessary to consider conflicting, contradictory, or otherwise relevant matters;

(2)           the total number of applications assigned to the project analyst for review, including those in other review periods, preclude the project analyst from completing the review within 90 days;

(3)           the complexity of the application or applications to be reviewed make it necessary to extend the review period;

(4)           the review of an applicant's response to the agency's request for additional information has not been completed;

(5)           the timing of the public hearing which was held for the application or applications under review does not allow sufficient time to consider the information presented;

(6)           extension of previous reviews necessitated that the project analyst delay the commencement of the review; or

(7)           the unavailability of the project analyst due to illness, annual leave, litigation associated with other reviews, or other duties and responsibilities.

(c)  In the case of an expedited review, the review period may be extended only if the Agency has requested additional substantive information from the applicant in accordance with G.S. 131E-185(c).

(d)  Applicants will be provided written notice of the extension of the review period after the agency determines that an extension is necessary.  Failure to receive such notice prior to the last day of the scheduled review period, however, does not entitle an applicant to a certificate of need nor authorize an applicant to proceed with a project without one.

 

History Note:        Filed as a Temporary Amendment Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Authority G.S. 131E‑177; 131E‑185;

Eff. October 1, 1981;

Amended Eff. January 4, 1994; January 1, 1990; January 1, 1982.

 

10A NCAC 14C .0206       EXPEDITED REVIEW

(a)  An applicant which desires an expedited review shall submit a petition for an expedited review with the Certificate of Need Section when the application is submitted.

(b)  The Certificate of Need Section shall review the petition within 15 days from the beginning of the review and shall notify the applicant if the Agency has determined that a public hearing is in the public interest.

(c)  If the Certificate of Need Section decides that it is not in the public interest to hold a public hearing, a final determination on the request for an expedited review shall not be issued until after the thirty day written comment period has expired.

(d)  If a request for a public hearing is received by the Agency during the 30 day written comment period, which is defined in G.S. 131E-185, the request for an expedited review shall be denied.

(e)  After the thirty day written comment period, the Certificate of Need Section shall notify the applicant that its petition for an expedited review is approved or denied.

 

History Note:        Filed as a Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Authority G.S. 131E-177(1);

Eff. January 4, 1994.

 

10A NCAC 14C .0207       AGENCY DECISION

(a)  The agency shall determine whether a proposal is consistent with the review criteria set forth in G.S. 131E‑183 and the standards, plans, and criteria promulgated thereunder in effect at the time the review commences.  The agency shall determine which standards, plans, and criteria are applicable to the proposal.  If a proposal is consistent with all applicable standards, plans, and criteria, the agency decision shall be to issue the certificate of need.  If a proposal is not consistent with all applicable standards, plans, and criteria, the agency decision shall be to either not issue the certificate of need or issue one subject to those conditions necessary to insure that the proposal is consistent with applicable standards, plans, and criteria.  The agency may only impose conditions which relate directly to applicable standards, plans, and criteria.

(b)  The written agency decision shall include the following:

(1)           the basis for the decision;

(2)           the findings regarding the extent to which the proposal meets the criteria set forth in G.S. 131E‑183;

(3)           the time when the service or equipment is to be available or the project completed and the timetable to be followed; and

(4)           the approved capital expenditure for the project.

(c)  The agency decision and findings shall be sent to the applicant. The agency decision shall be sent to aggrieved persons as required under N.C.G.S. 150B‑23.  Any other person may obtain a copy of an agency decision and findings by requesting them from the agency, for which there will be a charge to cover the cost of reproducing the document.

 

History Note:        Authority G.S. 131E‑177; 131E‑189;

Eff. October 1, 1981;

Amended Eff. January 1, 1990.

 

10A NCAC 14C .0208       ISSUANCE OF A CERTIFICATE OF NEED

(a)  A certificate shall not be issued until 30 days after the date of the final decision under 10A NCAC 14C .0207.  If no request for a contested case hearing is received by the agency within that time, the agency shall issue the certificate.  If a request for a contested case hearing is received within that time, the certificate shall not be issued until the final agency decision from the contested case hearing has been issued.

(b)  The certificate, or attachments, shall specify:

(1)           the scope of the project;

(2)           the physical location of the project;

(3)           the person to whom the certificate was issued;

(4)           the maximum capital expenditure, if any, which may be obligated under the certificate;

(5)           the timetable to be followed in making the service or equipment available or in completing the project; and

(6)           when the first progress report under 10A NCAC 14C .0209 is due.

(c)  The effective date of the issuance of a certificate shall be the first day after the 30 day appeal period expires, the date the agency receives notice of withdrawal of the request for a contested case hearing, the date of the Department's final decision made in accordance with G.S. 131E‑188(a), or the date the agency determines that the conditions of approval are satisfied, whichever is latest.

 

History Note:        Authority G.S. 131E‑177;

Eff. October 1, 1981;

Amended Eff. January 1, 1990; February 1, 1986.

 

10A NCAC 14C .0209       PROGRESS REPORTS

(a)  The holder of a certificate of need shall submit a report on the progress made in making the service or equipment available or in completing the project.  These reports shall also include information as to the total dollar amount of capital expenditures which have been obligated under the certificate, and any changes in amounts of proposed or previously obligated capital expenditures.  These reports will be made on a form provided by the agency and will be due on the date or dates indicated by the agency on the Certificate of Need and in subsequent correspondence.

(b)  The agency may also request additional reports as often as necessary in order to determine:

(1)           if the timetable specified in the certificate is being met;

(2)           if the scope of the project is being completed as described on the certificate and in the application for the certificate of need;

(3)           if the amount of the capital expenditure or expenditures obligated under the certificate has exceeded or can be expected to exceed the maximum under the certificate; and

(4)           if the condition(s) of approval have been satisfactorily met.

 

History Note:        Authority G.S. 131E‑177; 131E‑189;

Eff. October 1, 1981;

Amended Eff. January 1, 1990; February 1, 1986.

 

section .0300 - exemptions

 

10A NCAC 14c .0301       RESEARCH ACTIVITY

(a)  Under G.S. 131E‑179 a health care facility may apply to the agency for an exemption from obtaining a certificate of need for any of the following if they are to be used solely for research:

(1)           acquisition of major medical equipment;

(2)           the offering of institutional health services; or

(3)           the incurring of the obligation of a capital expenditure.

If any of the foregoing is used to provide patient care on an occasional and irregular basis and not as a part of the research program, the agency will not deny any request for an exemption solely on that basis.

(b)  The exemption shall be granted if notice is filed in accordance with this Rule and if the notice shows that the proposed new institutional health service will not:

(1)           affect the charges of the health care facility for the provision of medical or other patient care services other than the services which are included in research;

(2)           substantially change the bed capacity of the facility; or

(3)           substantially change the medical or other patient care services of the facility.

(c)  The notice required by G.S. 131E‑179 shall be given on a form "Notice of Proposed Research Activity."  This form may be obtained by contacting the agency at the address and telephone number stated in 10A NCAC 14C .0102.

(d)  The notice must be completed and delivered to the agency before the new institutional health service is offered or developed.  The notice is not filed in accordance with this Rule until the notice is deemed complete.

(e)  The agency shall promptly acknowledge in writing receipt of the notice.  The notice shall be deemed complete unless the agency, within seven days after receipt, mails a letter to the person submitting the notice which states that the notice was incomplete and specifies what information is necessary to make it complete.  As soon as the requested information is delivered to the agency, the notice shall be deemed complete and filed in accordance with this Rule.

(f)  Within 30 days after receipt of a completed notice, the agency shall notify the health care facility submitting the notice whether the agency has granted the exemption.  If the exemption has been granted, the health care facility may proceed to offer and develop the new institutional health service.  If a certificate of need is required, the notice and review under this Rule shall be deemed to be in compliance with 10A NCAC 14C .0201.

(g)  Any affected person, as defined in G.S. 131E‑188(c), may obtain a contested case hearing on a decision of the agency under this Rule by following procedures set forth in G.S. 150B and G.S. 131E-188.

 

History Note:        Authority G.S. 131E‑177; 131E‑179;

Eff. January 1, 1982;

Amended Eff. February 1, 2000; January 1, 1990; November 1, 1989; February 1, 1986.

 

10A ncac 14c .0302       HEALTH MAINTENANCE ORGANIZATIONS

 

History Note:        Authority G.S. 131E‑177; 131E‑180;

Eff. January 1, 1982;

Amended Eff. November 1, 1996; January 1, 1990; November 1, 1989; February 1, 1986;

Temporary Amendment Eff. January 1, 2000;

Amended Eff. April 1, 2001;

Repealed Eff. January 1, 2013.

 

10A NCAC 14C .0303       REPLACEMENT EQUIPMENT

(a)  The purpose of this Rule is to define the terms used in the definition of "replacement equipment" set forth in G.S. 131E-176(22a).

(b)  "Activities essential to acquiring and making operational the replacement equipment" means those activities which are indispensable and requisite, absent which the replacement equipment could not be acquired or made operational.

(c)  "Comparable medical equipment" means equipment which is functionally similar and which is used for the same diagnostic or treatment purposes.

(d)  Replacement equipment is comparable to the equipment being replaced if:

(1)           it has the same technology as the equipment currently in use, although it may possess expanded capabilities due to technological improvements; and

(2)           it is functionally similar and is used for the same diagnostic or treatment purposes as the equipment currently in use and is not used to provide a new health service; and

(3)           the acquisition of the equipment does not result in more than a 10% increase in patient charges or per procedure operating expenses within the first twelve months after the replacement equipment is acquired.

(e)  Replacement equipment is not comparable to the equipment being replaced if:

(1)           the replacement equipment is new or reconditioned, the existing equipment was purchased second-hand, and the replacement equipment is purchased less than three years after the acquisition of the existing equipment; or

(2)           the replacement equipment is new, the existing equipment was reconditioned when purchased, and the replacement equipment is purchased less than three years after the acquisition of the existing equipment; or

(3)           the replacement equipment is capable of performing procedures that could result in the provision of a new health service or type of procedure that has not been provided with the existing equipment; or

(4)                 the replacement equipment is purchased and the existing equipment is leased, unless the lease is a capital lease; or

(5)                 the replacement equipment is a dedicated PET scanner and the existing equipment is:

(A)          a gamma camera with coincidence capability; or

(B)          nuclear medicine equipment that was designed, built, or modified to detect only the single photon emitted from nuclear events other than positron annihilation.

 

History Note:        Authority G.S. 131E-177(1);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Amended Eff. April 1, 1999; November 1, 1996;

Temporary Amendment Eff. June 3, 2002;

Amended Eff. April 1, 2003.

 

10A NCAC 14C .0304       PSYCHIATRIC BED CONVERSIONS

If psychiatric beds are established pursuant to G.S. 131E-184(c), those beds shall remain psychiatric beds only as long as the contract required in G.S. 131E-184(c) remains in effect. If that contract is terminated, then the facility shall:

(1)           obtain a certificate of need to convert the psychiatric beds back to acute care beds prior to termination of the contract, or

(2)           terminate the provision of psychiatric services in the beds.

 

History Note:        Authority G.S. 131E-177;

Eff. November 1, 1996.

 

SECTION .0400 – CERTIFICATE OF NEED APPEAL PROCESS

 

10A NCAC 14C .0401       PETITION FOR A HEARING

 

History Note:        Authority G.S. 131E‑177; 131E‑188;

Eff. October 1, 1981;

Amended Eff. January 1, 1990; November 1, 1989; February 1, 1986;

Repealed Eff. October 1, 2016.

 

10A NCAC 14C .0402       ISSUES

The correctness, adequacy, or appropriateness of criteria, plans, and standards shall not be an issue in a contested case hearing.

 

History Note:        Authority G.S. 131E‑177; 131E‑188;

Eff. October 1, 1981;

Amended Eff. February 1, 1986; October 1, 1984.

 

10A NCAC 14C .0403       CONTESTED CASE HEARINGS

 

History Note:        Authority G.S. 131E‑177; 131E‑188;

Eff. January 1, 1990;

Repealed Eff. October 1, 2016.

 

section .0500 – enforcement and sanctions

 

10A NCAC 14C .0501       ASSESSMENT OF CIVIL PENALTY

(a)  In determining the amount of a penalty assessed for a violation in accordance with G.S. 131E-190(f), the Agency may consider, but is not limited to, the following factors in evaluating the degree and extent of harm and the cost of rectifying the damage caused by the violation:

(1)           the amount of revenues derived as a consequence of offering the service; and

(2)           the amount of the unauthorized capital expenditure; and

(3)           the amount expended in excess of 115 percent of the approved capital expenditure of a certificate of need; and

(4)           the person's record of compliance with the Certificate of Need Law and with the terms and conditions of any other certificate of need issued to that person; and

(5)           the degree of completion of the project; and

(6)           the number of patients served as a consequence of the violation; and

(7)           the number of procedures performed or treatments offered as a consequence of the violation; and

(8)           the number of days a service is offered as a consequence of the violation; and

(9)           whether the violation duplicates an existing or approved health service capability or facility; and

(10)         whether the conduct violated any judicial or administrative order, injunction, decree, or decision; and

(11)         whether the person impeded or attempted to obstruct the Department's investigation of the current violation; and

(12)         whether the development ceased prior to the offering of a new institutional health service; and

(13)         whether the person voluntarily terminated the project prior to the Department's investigation of the violation; and

(14)         whether the person voluntarily and truthfully cooperated with the Department's investigation of the violation.

(b)  Payment of the penalty shall be due within 60 days from the date of notification of the penalty.

 

History Note:        Authority G.S. 131E-177(1); 131E-190(f);

Eff. November 1, 1996.

 

10A NCAC 14C .0502       WITHDRAWAL OF A CERTIFICATE

(a)  Before the agency withdraws a certificate of need, pursuant to G.S. 131E-189, it shall give the holder an opportunity to demonstrate why the certificate of need should not be withdrawn.

(b)  Ownership of a certificate of need is transferred when any person acquires a certificate from the holder by purchase, donation, lease, trade, or any comparable arrangement, except that ownership of a certificate of need is not transferred when:

(1)           the holder of the certificate is a corporation and the identity of the holder changes because of a corporate reorganization; or

(2)           the holder of the certificate is a partnership and the identity of the holder changes because the same partners reorganize as a new partnership.

(c)  Control of a certificate of need is transferred when any person acquires a majority interest in the facility, project or holder or any parent entity of the facility, project or holder.

(d)  "Parent entity" means any person that directly or indirectly controls the facility, project or holder of a certificate.

(e)  A transfer of ownership or control of a facility, project, or certificate shall not be grounds for the withdrawal of the certificate of need, pursuant to G.S. 131E-189, if the transfer occurs after the completion of the project or the operation of the facility.

 

History Note:        Filed as a Temporary Amendment Eff. October 10, 1990, for a Period of 142 Days to Expire on February 28, 1991;

Authority G.S. 131E-177; 131E-189;

Eff. October 1, 1981;

Amended Eff. November 1, 1996; March 1, 1991; January 1, 1990.

 

section .0600 – reserved for future codification

 

section .0700 – reserved for future codification

 

Section .0800 – reserved for future codification

 

section .0900 – reserved for future codification

 

section .1000 – reserved for future codification

 

SECTION .1100 – CRITERIA AND STANDARDS FOR NURSING FACILITY OR ADULT CARE HOME SERVICES

 

10A NCAC 14C .1101       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E-175; 131E-176; 131E‑177(1); 131E-183(b); S.L. 2001, c. 234;

Eff. November 1, 1996;

Temporary Amendment Eff. January 1, 2003; January 1, 2002;

Amended Eff. August 1, 2004; April 1, 2003;

Repealed Eff. February 1, 2016.

 

10A ncac 14C .1102       PERFORMANCE STANDARDS

(a)  An applicant proposing to add nursing facility beds to an existing facility, except an applicant proposing to transfer existing certified nursing facility beds from a State Psychiatric Hospital to a community facility, shall not be approved unless the average occupancy, over the nine months immediately preceding the submittal of the application, of the total number of licensed nursing facility beds within the facility in which the new beds are to be operated was at least 90 percent.

(b)  An applicant proposing to establish a new nursing facility or add nursing facility beds to an existing facility, except an applicant proposing to transfer existing certified nursing facility beds from a State Psychiatric Hospital to a community facility, shall not be approved unless occupancy is projected to be at least 90 percent for the total number of nursing facility beds proposed to be operated, no later than two years following the completion of the proposed project.  All assumptions, including the specific methodologies by which occupancies are projected, shall be clearly stated.

(c)  An applicant proposing to add adult care home beds to an existing facility shall not be approved unless the average occupancy, over the nine months immediately preceding the submittal of the application, of the total number of licensed adult care home beds within the facility in which the new beds are to be operated was at least 85 percent.

(d)  An applicant proposing to establish a new adult care home facility or add adult care home beds to an existing facility shall not be approved unless occupancy is projected to be at least 85 percent for the total number of adult care home beds proposed to be operated, no later than two years following the completion of the proposed project. All assumptions, including the specific methodologies by which occupancies are projected, shall be stated.

 

History Note:        Authority G.S. 131E-175; 131E-176; 131E-177(1); 131E-183(b); S.L. 2001, c. 234;

Eff. November 1, 1996;

Temporary Amendment Eff. January 1, 2002;

Amended Eff. April 1, 2003.

 

section .1200 – criteria and standards for intensive care services

 

10A NCAC 14C .1201       DEFINITIONS

The definitions in this Rule shall apply to all rules in this Section:

(1)           "Intensive care services" means those services provided by an acute care hospital to patients with a wide variety of illnesses of a life-threatening nature, including patients with highly unstable conditions which require sophisticated medical and surgical intervention and a high level of nursing care and those patients which require continuous, comprehensive observation.

(2)           "Intensive care unit" means a separate self-sufficient entity which has all supplies, equipment, and staff necessary to offer intensive care services twenty-four hours a day, seven days a week.  The term does not include post-operative recovery rooms, post-delivery rooms, or emergency observation units.

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Eff. January 4, 1994.

 

10A NCAC 14C .1202       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E-177(1); 131E-183;

Eff. January 4, 1994;

Amended Eff. November 1, 1996;

Temporary Amendment Eff. February 1, 2010;

Amended Eff. November 1, 2010;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .1203       PERFORMANCE STANDARDS

(a)  The applicant shall demonstrate that the proposed project is capable of meeting the following standards:

(1)           the overall average annual occupancy rate of all intensive care beds in the facility, excluding neonatal and pediatric intensive care beds, over the 12 months immediately preceding the submittal of the proposal, shall have been at least 70 percent for facilities with 20 or more intensive care beds, 65 percent for facilities with 10-19 intensive care beds, and 60 percent for facilities with 1-9 intensive care beds; and

(2)           the projected occupancy rate for all intensive care beds in the applicant's facility, exclusive of neonatal and pediatric intensive care beds, shall be at least 70 percent for facilities with 20 or more intensive care beds, 65 percent for facilities with 10-19 intensive care beds, and 60 percent for facilities with 1-9 intensive care beds, in the third operating year following the completion of the proposed project.

(b)  All assumptions and data supporting the methodology by which the occupancy rates are projected shall be provided.

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Eff. January 4, 1994.

 

10A NCAC 14C .1204       Support Services

10A NCAC 14C .1205       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E-177(1); 131E-183; 131E-183(b);

Eff. January 4, 1994;

Amended Eff. November 1, 1996;

Repealed Eff. February 1, 2016.

 

SECTION .1300 - CRITERIA AND STANDARDS FOR PEDIATRIC INTENSIVE CARE SERVICES

 

10A NCAC 14C .1301       DEFINITIONS

The definitions in this Rule shall apply to all rules in this Section:

(1)           "Pediatric intensive care service area" means a geographic area defined by the applicant from which the patients to be admitted to the unit will originate.

(2)           "Pediatric intensive care services" means those services provided by an acute care hospital to children with a wide variety of illnesses of a life-threatening nature, including children with highly unstable conditions requiring sophisticated medical and surgical intervention, children requiring a high level of nursing care and those children requiring continuous, comprehensive observation.

(3)           "Pediatric intensive care unit" means a separate self-sufficient entity that contains supplies and equipment essential to provide treatment on a 24-hour basis to children who need pediatric intensive care services.  It does not include post-operative recovery rooms, post-delivery rooms, or emergency observation units.

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Eff. January 4, 1994.

 

10A NCAC 14C .1302       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E-177(1); 131E-183;

Eff. January 4, 1994;

Amended Eff. November 1, 1996;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .1303       PERFORMANCE STANDARDS

(a)  An applicant proposing to develop a new pediatric intensive care unit or to add a bed to an existing pediatric intensive care unit shall demonstrate that the following standards are met:

(1)           the overall average annual occupancy rate of the number of beds in the applicant's existing pediatric intensive care unit for the twelve months immediately preceding the submittal of the application shall have been at least 70 percent in units with 20 or more pediatric intensive care beds, 65 percent in units with 10-19 pediatric intensive care beds, and 60 percent in units with 1-9 pediatric intensive care beds; and

(2)           the projected annual occupancy rate of the applicant's new or expanded pediatric intensive care unit in the third year of operation following completion of the proposed project shall be at least 70 percent in units with 20 or more pediatric intensive care beds, 65 percent in units with 10-19 pediatric intensive care beds, and 60 percent in units with 1-9 pediatric intensive care beds.

(b)  The applicant shall document all assumptions and provide data supporting the methodology used for each of the projections required in this Rule.

 

History Note:        Authority G.S. 131E-177(1); 131E-183;

Eff. January 4, 1994;

Amended Eff. November 1, 1996.

 

10A NCAC 14C .1304       Support Services

10A NCAC 14C .1305       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E-177(1); 131E-183;

Eff. January 4, 1994;

Amended Eff. November 1, 1996;

Repealed Eff. February 1, 2016.

 

section .1400 – criteria and standards for neonatal services

 

10A NCAC 14C .1401       DEFINITIONS

The definitions in this Rule shall apply to all rules in this Section:

(1)           "Approved neonatal service" means a neonatal service that was not operational prior to the beginning of the review period.

(2)           "Existing neonatal service" means a neonatal service in operation prior to the beginning of the review period.

(3)           "High-risk obstetric patients" means those patients requiring specialized services provided by an acute care hospital to the mother and fetus during pregnancy, labor, delivery and to the mother after delivery. The services are characterized by specialized facilities and staff for the intensive care and management of high-risk maternal and fetal patients before, during, and after delivery.

(4)           "Level I neonatal services" means services provided by an acute care hospital to full term and pre-term neonates that are stable, without complications, and may include neonates that are small for gestational age or large for gestational age.

(5)           "Level II neonatal service" means services provided by an acute care hospital in a licensed acute care bed to neonates and infants that are stable without complications but require special care and frequent feedings; infants of any weight who no longer require Level III or Level IV neonatal services, but still require more nursing hours than normal infants; and infants who require close observation in a licensed acute care bed.

(6)           "Level III neonatal service" means services provided by an acute care hospital in a licensed acute care bed to neonates or infants that are high-risk, small (approximately 32 and less than 36 completed weeks of gestational age) but otherwise healthy, or sick with a moderate degree of illness that are admitted from within the hospital or transferred from another facility requiring intermediate care services for sick infants, but not intensive care.  Level III neonates or infants require less constant nursing care than Level IV services, but care does not exclude respiratory support.

(7)           "Level IV neonatal service" means neonatal intensive care services provided by an acute care hospital in a licensed acute care bed to high-risk medically unstable or critically ill neonates (approximately under 32 weeks of gestational age) or infants requiring constant nursing care or supervision not limited to continuous cardiopulmonary or respiratory support, complicated surgical procedures, or other intensive supportive interventions.

(8)           "Neonatal bed" means a licensed acute care bed used to provide Level II, III or IV neonatal services.

(9)           "Neonatal intensive care services" shall have the same meaning as defined in G.S. 131E-176(15b).

(10)         "Neonatal service area" means a geographic area defined by the applicant from which the patients to be admitted to the service will originate.

(11)         "Neonatal services" means any of the Level I, Level II, Level III or Level IV services defined in this Rule.

(12)         "Obstetric services" means any normal or high-risk services provided by an acute care hospital to the mother and fetus during pregnancy, labor, delivery and to the mother after delivery.

(13)         "Perinatal services" means services provided during the period shortly before and after birth.

 

History Note:        Authority G.S. 131E-177(1); 131E-183;

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Amended Eff. November 1, 1996;

Temporary Amendment Eff. March 15, 2002;

Amended Eff. April 1, 2003.

 

10A NCAC 14C .1402       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E-177(1); 131E-183;

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Amended Eff. November 1, 1996;

Temporary Amendment Eff. March 15, 2002;

Amended Eff. April 1, 2003;

Temporary Amendment Eff. February 1, 2010;

Amended Eff. November 1, 2010;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .1403       PERFORMANCE STANDARDS

(a)  An applicant shall demonstrate that the proposed project is capable of meeting the following standards:

(1)           if an applicant is proposing to increase the total number of neonatal beds (i.e., the sum of Level II, Level III and Level IV beds), the overall average annual occupancy of the combined number of existing Level II, Level III and Level IV beds in the facility is at least 75 percent, over the 12 months immediately preceding the submittal of the proposal;

(2)           if an applicant is proposing to increase the total number of neonatal beds (i.e., the sum of Level II, Level III and Level IV beds), the projected overall average annual occupancy of the combined number of Level II, Level III and Level IV beds proposed to be operated during the third year of operation of the proposed project shall be at least 75 percent; and

(3)           The applicant shall document the assumptions and provide data supporting the methodology used for each projection in this rule.

(b)  If an applicant proposes to develop a new Level III or Level IV service, the applicant shall document that an unmet need exists in the applicant's defined neonatal service area, unless the State Medical Facilities Plan includes a need determination for neonatal beds in the service area.  The need for Level III and Level IV beds shall be computed for the applicant's neonatal service area by:

(1)           identifying the annual number of live births occurring at all hospitals within the proposed neonatal service area, using the latest available data compiled by the State Center for Health Statistics;

(2)           identifying the low birth weight rate (percent of live births below 2,500 grams) for the births identified in (1) of this Paragraph, using the latest available data compiled by the State Center for Health Statistics;

(3)           dividing the low birth weight rate identified in (2) of this Paragraph by .08 and subsequently multiplying the resulting quotient by four; and

(4)           determining the need for Level III and Level IV beds in the proposed neonatal service area as the product of:

(A)          the product derived in (3) of this Paragraph, and

(B)          the quotient resulting from the division of the number of live births in the initial year of the determination identified in (1) of this Paragraph by the number 1000.

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Temporary Amendment Eff. March 15, 2002;

Amended Eff. April 1, 2003;

Temporary Amendment Eff. February 1, 2009;

Amended Eff. November 1, 2009;

Temporary Amendment Eff. February 1, 2010;

Amended Eff. November 1, 2010.

 

10A NCAC 14C .1404       Support Services

10A NCAC 14C .1405       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Temporary Amendment Eff. March 15, 2002;

Amended Eff. April 1, 2003;

Repealed Eff. February 1, 2016.

 

section .1500 - CRITERIA AND STANDARDS FOR HOSPICES

 

10A NCAC 14C .1501       DEFINITIONS

The following definitions shall apply to all rules in this Section:

(1)           "Bereavement counseling" means counseling provided to a hospice patient's family or significant others to assist them in dealing with issues of grief and loss.

(2)           "Caregiver" means the person whom the patient designates to provide the patient with emotional support, physical care, or both.

(3)           "Care plan" means a plan as defined in 10A NCAC 13K .0102 of the Hospice Licensing Rules.

(4)           "Continuous care" means care as defined in 42 CFR 418.204, the Hospice Medicare Regulations.

(5)           "Homemaker services" means services provided to assist the patient with personal care, maintenance of a safe and healthy environment and implementation of the patient's care plan.

(6)           "Hospice" means any coordinated program of home care as defined in G.S. 131E-176(13a).

(7)           "Hospice inpatient facility" means a facility as defined in G.S. 131E-176(13b).

(8)           "Hospice services" means services as defined in G.S. 131E-201(5b).

(9)           "Hospice staff" means personnel as defined in 10A NCAC 13K .0102 of the Hospice Licensing Rules.

(10)         "Interdisciplinary team" means personnel as defined in G.S. 131E-201(6).

(11)         "Palliative care" means treatment as defined in G.S. 131E-201(8).

(12)         "Respite care" means care provided as defined in 42 CFR 418.98.

 

History Note:        Authority G.S. 131E-177(1);

Eff. July 1, 1994;

Temporary Amendment Eff. January 1, 2003;

Amended Eff. August 1, 2004;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006.

 

10A NCAC 14C .1502       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E-177(1); 131E-183;

Eff. July 1, 1994;

Amended Eff. November 1, 1996;

Temporary Amendment Eff. January 1, 2003;

Amended Eff. August 1, 2004;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .1503       PERFORMANCE STANDARDS

An applicant proposing to develop a hospice shall demonstrate that no less than 80 percent of the total combined number of days of hospice care furnished to Medicaid and Medicare patients will be provided in the patients' residences in accordance with 42 CFR 418.302(f)(2).

 

History Note:        Authority G.S. 131E-177(1);

Eff. July 1, 1994;

Temporary Amendment Eff. January 1, 1999;

Temporary Eff. January 1, 1999 Expired on October 12, 1999;

Temporary Amendment Eff. January 1, 2000;

Temporary Amendment effective January 1, 2000 amends and replaces a permanent rulemaking originally proposed to be effective August 2000;

Amended Eff. April 1, 2001;

Temporary Amendment Eff. January 1, 2003;

Amended Eff. August 1, 2004;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006.

 

10A NCAC 14C .1504       Support Services

10A NCAC 14C .1505       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E-177(1); 131E-183;

Eff. July 1, 1994;

Amended Eff. November 1, 1996;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006;

Repealed Eff. February 1, 2016.

 

section .1600 – criteria and standards for cardiac catheterization equipment and cardiac angioplasty equipment

 

10A ncac 14c .1601       DEFINITIONS

The following definitions shall apply to all rules in this Section:

(1)           "Approved" means the equipment was not in operation prior to the beginning of the review period and had been issued a certificate of need.

(2)           "Capacity" of an item of cardiac catheterization equipment means 1500 diagnostic‑equivalent procedures per year.  One therapeutic cardiac catheterization procedure is valued at 1.75 diagnostic‑equivalent procedures.  One cardiac catheterization procedure performed on a patient age 14 or under is valued at two diagnostic‑equivalent procedures.  All other procedures are valued at one diagnostic‑equivalent procedure.

(3)           "Cardiac catheterization equipment" shall have the same meaning as defined in G.S. 131E‑176(2f).

(4)           "Cardiac catheterization procedure," for the purpose of determining utilization in a certificate of need review, means a single episode of diagnostic or therapeutic catheterization which occurs during one visit to a cardiac catheterization room, whereby a flexible tube is inserted into the patient's body and advanced into the heart chambers to perform a hemodynamic or angiographic examination or therapeutic intervention of the left or right heart chamber, or coronary arteries.  A cardiac catheterization procedure does not include a simple right heart catheterization for monitoring purposes as might be done in an electrophysiology laboratory, pulmonary angiography procedure, cardiac pacing through a right electrode catheter, temporary pacemaker insertion, or procedures performed in dedicated angiography or electrophysiology rooms.

(5)           "Cardiac catheterization room" means a room or a mobile unit in which there is cardiac catheterization or cardiac angioplasty equipment for the performance of cardiac catheterization procedures.  Dedicated angiography rooms and electrophysiology rooms are not cardiac catheterization rooms.

(6)           "Cardiac catheterization service area" means a geographical area defined by the applicant, which has boundaries that are not farther than 90 road miles from the facility, if the facility has a comprehensive cardiac services program; and not farther than 45 road miles from the facility if the facility performs only diagnostic cardiac catheterization procedures; except that the cardiac catheterization service area of an academic medical center teaching hospital designated in 10A NCAC 14B shall not be limited to 90 road miles.

(7)           "Cardiac catheterization services" means the provision of diagnostic cardiac catheterization procedures or therapeutic cardiac catheterization procedures performed utilizing cardiac catheterization equipment in a cardiac catheterization room.

(8)           "Comprehensive cardiac services program" means a cardiac services program which provides the full range of clinical services associated with the treatment of cardiovascular disease including community outreach, emergency treatment of cardiovascular illnesses, non‑invasive diagnostic imaging modalities, diagnostic and therapeutic cardiac catheterization procedures, open heart surgery and cardiac rehabilitation services. Community outreach and cardiac rehabilitation services shall be provided by the applicant or through arrangements with other agencies and facilities located in the same city.  All other components of a comprehensive cardiac services program shall be provided within a single facility.

(9)           "Diagnostic cardiac catheterization procedure," for the purpose of determining utilization in a certificate of need review, means a cardiac catheterization procedure performed for the purpose of detecting and identifying defects or diseases in the coronary arteries or veins of the heart, or abnormalities in the heart structure, but not the pulmonary artery.

(10)         "Electrophysiology procedure" means a diagnostic or therapeutic procedure performed to study the electrical conduction activity of the heart and characterization of atrial ventricular arrhythmias.

(11)         "Existing" means the equipment was in operation prior to the beginning of the review period.

(12)         "High‑risk patient" means a person with reduced life expectancy because of left main or multi‑vessel coronary artery disease, often with impaired left ventricular function and with other characteristics as referenced in the American College of Cardiology/ Society for Cardiac Angiography and Interventions Clinical Expert Consensus Document on Cardiac Catheterization Laboratory Standards (June 2001) report.

(13)         "Mobile equipment" means cardiac catheterization equipment and transporting equipment which is moved to provide services at two or more host facilities.

(14)         "Percutaneous transluminal coronary angioplasty (PTCA)" is one type of therapeutic cardiac catheterization procedure used to treat coronary artery disease in which a balloon‑tipped catheter is placed in the diseased artery and then inflated to compress the plaque blocking the artery.

(15)         "Primary cardiac catheterization service area" means a geographical area defined by the applicant, which has boundaries that are not farther than 45 road miles from the facility, if the facility has a comprehensive cardiac services program; and not farther than 23 road miles from the facility if the facility performs only diagnostic cardiac catheterization procedures; except that the primary cardiac catheterization service area of an academic medical center teaching hospital designated in 10A NCAC 14B shall not be limited to 45 road miles.

(16)         "Therapeutic cardiac catheterization procedure," for the purpose of determining utilization in a certificate of need review, means a cardiac catheterization procedure performed for the purpose of treating or resolving anatomical or physiological conditions which have been determined to exist in the heart or coronary arteries or veins of the heart, but not the pulmonary artery.

 

History Note:        Authority G.S. 131E‑177(1); 131E‑183;

Eff. January 1, 1987;

Temporary Amendment Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Amended Eff. November 1, 1996; February 1, 1994;

Temporary Amendment Eff. January 1, 1999;

Temporary Eff. January 1, 1999 Expired on October 12, 1999;

Temporary Amendment Eff. January 1, 2000;

Temporary Amendment effective January 1, 2000 amends and replaces a permanent rulemaking originally proposed to be effective August 1, 2000;

Temporary Amendment Eff. January 1, 2001;

Temporary Amendment effective January 1, 2001 amends and replaces a permanent rulemaking originally proposed to be effective April 1, 2001;

Amended Eff. August 1, 2002;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006.

 

10A NCAC 14C .1602       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E‑177(1); 131E‑183;

Eff. January 1, 1987;

Temporary Amendment Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Amended Eff. November 1, 1996; February 1, 1994;

Temporary Amendment Eff. January 1, 2005;

Amended Eff. November 1, 2005;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006;

Repealed Eff. February 1, 2016.

 

10A ncac 14C .1603       PERFORMANCE STANDARDS

(a)  An applicant proposing to acquire cardiac catheterization equipment shall demonstrate that the project is capable of meeting the following standards:

(1)           each proposed item of cardiac catheterization equipment, including mobile equipment but excluding shared fixed cardiac catheterization equipment, shall be utilized at an annual rate of at least 60 percent of capacity excluding procedures not defined as cardiac catheterization procedures in 10A NCAC 14C .1601(5), measured during the fourth quarter of the third year following completion of the project;

(2)           if the applicant proposes to perform therapeutic cardiac catheterization procedures, each of the applicant's therapeutic cardiac catheterization teams shall be performing at an annual rate of at least 100 therapeutic cardiac catheterization procedures, during the third year of operation following completion of the project;

(3)           if the applicant proposes to perform diagnostic cardiac catheterization procedures, each diagnostic cardiac catheterization team shall be performing at an annual rate of at least 200 diagnostic‑equivalent cardiac catheterization procedures by the end of the third year following completion of the project;

(4)           at least 50 percent of the projected cardiac catheterization procedures shall be performed on patients residing within the primary cardiac catheterization service area;

(b)  An applicant proposing to acquire mobile cardiac catheterization equipment shall:

(1)           demonstrate that each existing item of cardiac catheterization equipment, excluding mobile equipment, located in the proposed primary cardiac catheterization service area of each host facility shall have been operated at a level of at least 80 percent of capacity during the 12 month period reflected in the most recent licensure form on file with the Division of Health Service Regulation;

(2)           demonstrate that the utilization of each existing or approved item of cardiac catheterization equipment, excluding mobile equipment, located in the proposed primary cardiac catheterization service area of each host facility shall not be expected to fall below 60 percent of capacity due to the acquisition of the proposed mobile cardiac catheterization equipment;

(3)           demonstrate that each item of existing mobile equipment operating in the proposed primary cardiac catheterization service area of each host facility shall have been performing at least an average of four diagnostic‑equivalent cardiac catheterization procedures per day per site in the proposed cardiac catheterization service area in the 12 month period preceding the submittal of the application;

(4)           demonstrate that each item of existing or approved mobile equipment to be operating in the proposed primary cardiac catheterization service area of each host facility shall be performing at least an average of four diagnostic‑equivalent cardiac catheterization procedures per day per site in the proposed cardiac catheterization service area in the applicant's third year of operation; and

(5)           provide documentation of all assumptions and data used in the development of the projections required in this Rule.

(c)  An applicant proposing to acquire cardiac catheterization equipment excluding shared fixed and mobile cardiac catheterization shall:

(1)           demonstrate that its existing items of cardiac catheterization equipment, except mobile equipment, located in the proposed cardiac catheterization service area operated at an average of at least 80 percent of capacity during the twelve month period reflected in the most recent licensure renewal application form on file with the Division of Health Service Regulation;

(2)           demonstrate that its existing items of cardiac catheterization equipment, except mobile equipment, shall be utilized at an average annual rate of at least 60 percent of capacity, measured during the fourth quarter of the third year following completion of the project; and

(3)           provide documentation of all assumptions and data used in the development of the projections required in this Rule.

(d)  An applicant proposing to acquire shared fixed cardiac catheterization equipment as defined in the applicable State Medical Facilities Plan shall:

(1)           demonstrate that each proposed item of shared fixed cardiac catheterization equipment shall perform a combined total of at least 225 cardiac catheterization and angiography procedures during the fourth quarter of the third year following completion of the project; and

(2)           provide documentation of all assumptions and data used in the development of the projections required in this Rule.

(e)  If the applicant proposes to perform cardiac catheterization procedures on patients age 14 and under, the applicant shall demonstrate that it meets the following additional criteria:

(1)           the facility has the capability to perform diagnostic and therapeutic cardiac catheterization procedures and open heart surgery services on patients age 14 and under; and

(2)           the proposed project shall be performing at an annual rate of at least 100 cardiac catheterization procedures on patients age 14 or under during the fourth quarter of the third year following initiation of the proposed cardiac catheterization procedures for patients age 14 and under.

 

History Note:        Authority G.S. 131E‑177(1); 131E‑183(b);

Eff. January 1, 1987;

Temporary Amendment Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Amended Eff. November 1, 1996; February 1, 1994;

Temporary Amendment Eff. January 1, 1999;

Temporary Eff. January 1, 1999 Expired on October 12, 1999;

Temporary Amendment Eff. January 1, 2000;

Temporary Amendment effective January 1, 2000 amends and replaces a permanent rulemaking originally proposed to be effective August 2000;

Temporary Amendment Eff. January 1, 2001;

Temporary Amendment effective January 1, 2001 amends and replaces a permanent rulemaking originally proposed to be effective April 1, 2001;

Temporary Amendment Eff. January 1, 2002;

Amended Eff. August 1, 2002;

Temporary Amendment effective January 1, 2002 amends and replaces the permanent rule effective August 1, 2002;

Amended Eff. April 1, 2003;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006.

 

10A NCAC 14C .1604       Support Services

10A NCAC 14C .1605       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E‑177(1); 131E‑183(b);

Eff. January 1, 1987;

Temporary Amendment Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Amended Eff. February 1, 1994;

Temporary Amendment Eff. February 2, 2001;

Temporary Amendment Eff. January 1, 2002;

Amended Eff. August 1, 2002;

Temporary Amendment effective January 1, 2002 amends and replaces the permanent rule effective

August 1, 2002;

Amended Eff. April 1, 2003;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006;

Repealed Eff. February 1, 2016.

 

SECTION .1700 - criteria and standards for open-heart surgery services and heart-lung bypass machines

 

10A NCAC 14C .1701       DEFINITIONS

The following definitions apply to all rules in this Section:

(1)           "Approved heart-lung bypass machine" means a heart-lung bypass machine that was not operational prior to the beginning of the review period.

(2)           "Capacity" of a heart-lung bypass machine means 400 adult-equivalent open heart surgical procedures per year.  One open heart surgical procedure on persons age 14 and under is valued at two adult open heart surgical procedures.  For purposes of determining capacity, one open heart surgical procedure is defined to be one visit or trip by a patient to an operating room for an open heart operation.

(3)           "Cardiac Surgical Intensive Care Unit" means an intensive care unit as defined in 10A NCAC 14C .1201(2) and that is for exclusive use by post-surgical open heart patients.

(4)           "Existing heart-lung bypass machine" means a heart-lung bypass machine in operation prior to the beginning of the review period.

(5)           "Heart-lung bypass machine" has the same meaning as defined in G.S. 131E-176(10a).

(6)           "Open heart surgery services" has the same meaning as defined in G.S. 131E-176(18b).

(7)           "Open heart surgical procedures" means specialized surgical procedures that:

(a)           utilize a heart-lung bypass machine (the "pump"); and

(b)           are designed to correct congenital or acquired cardiac and coronary disease by opening the chest for surgery on the heart muscle, valves, arteries, or other parts of the heart.

 

History Note:        Authority G.S. 131E-177(1); 131E-183;

Eff. January 1, 1987;

Amended Eff. November 1, 1989;

Temporary Amendment Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Amended Eff. November 1, 1996; January 4, 1994;

Temporary Amendment Eff. January 1, 1999;

Temporary Eff. January 1, 1999 Expired on October 12, 1999;

Temporary Amendment Eff. January 1, 2000 and shall expire on the date on which the permanent amendment to this Rule, approved by the Rules Review Commission on November 17, 1999, becomes effective;

Amended Eff. July 1, 2000;

Temporary Amendment Eff. March 1, 2010;

Amended Eff. January 1, 2013; November 1, 2010.

 

10A NCAC 14C .1702       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E‑177(1); 131E-183;

Eff. January 1, 1987;

Amended Eff. November 1, 1989;

Temporary Amendment Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Amended Eff. November 1, 1996; January 4, 1994;

Temporary Amendment January 1, 1999;

Temporary Eff. January 1, 1999 Expired on October 12, 1999;

Temporary Amendment Eff. January 1, 2000;

Temporary Amendment effective January 1, 2000 amends and replaces a permanent rulemaking originally proposed to be effective August 2000;

Amended Eff. January 1, 2013; April 1, 2001;

Repealed Eff. February 1, 2016.

 

10A ncac 14C .1703       PERFORMANCE STANDARDS

(a)  An applicant that proposes to develop open-heart surgery services shall:

(1)           demonstrate that the projected utilization and proposed staffing patterns are such that each open heart surgical team shall perform at least 150 open heart surgical procedures in the third year following completion of the project; and

(2)           document the assumptions and provide data supporting the methodology used to make these projections.

(b)  An applicant that proposes to acquire a heart-lung bypass machine shall demonstrate either:

(1)           that the applicant's projected annual utilization of its existing, approved, and proposed heart-lung bypass machines (other than a machine acquired pursuant to 10A NCAC 14C .1703(b)(3)) will be at least 200 open heart surgical procedures per machine during the third year following completion of the project;

(2)           that the projected annual utilization of its existing, approved, and proposed heart-lung bypass machines (other than a machine acquired pursuant to 10A NCAC 14C .1703(b)(3)), will be at least 900 hours per year during the third year following completion of the project, as measured in minutes used or staffed on standby for all procedures; or

(3)           that the proposed machine is needed to provide coverage for open-heart surgery emergencies and will not be scheduled for use at the same time as the applicant's equipment used to support scheduled open heart surgical procedures.

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Eff. January 1, 1987;

Amended Eff. November 1, 1989;

Temporary Amendment Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Amended Eff. January 4, 1994;

Temporary Amendment January 1, 1999;

Temporary Eff. January 1, 1999 expired October 12, 1999;

Temporary Amendment Eff. January 1, 2000 and shall expire on the date the permanent amendment to this rule, approved by the Rules Review Commission on November 17, 1999, becomes effective;

Amended Eff. July 1, 2000;

Temporary Amendment Eff. January 1, 2002;

Amended Eff. April 1, 2003;

Temporary Amendment Eff. February 1, 2010;

Amended Eff. January 1, 2013; November 1, 2010.

 

10A NCAC 14C .1704       Support Services

10A NCAC 14C .1705       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E‑177(1); 131E-183(b);

Eff. January 1, 1987;

Amended Eff. November 1, 1989;

Temporary Amendment Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Amended Eff. January 1, 2013; January 4, 1994;

Repealed Eff. February 1, 2016.

 

SECTION .1800 - CRITERIA AND STANDARDS FOR DIAGNOSTIC CENTERS

 

10A NCAC 14C .1801       PURPOSE AND SCOPE

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Repealed Eff. March 16, 2017.

 

10A NCAC 14C .1802       DEFINITIONS

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Amended Eff. November 1, 1996;

Repealed Eff. December 1, 2016.

 

10A NCAC 14C .1803       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E-177(1); 131E-183;

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Amended Eff. November 1, 1996;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .1804       PERFORMANCE STANDARDS

 

History Note:        Authority G.S. 131E-177(1); 131E-183;

Eff. November 1, 1996;

Repealed Eff. March 16, 2017.

 

10A NCAC 14C .1805       Support Services

10A NCAC 14C .1806       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Repealed Eff. February 1, 2016.

 

section .1900 – criteria and standards for radiation therapy equipment

 

10A ncac 14C .1901       DEFINITIONS

These definitions shall apply to all rules in this Section:

(1)           "Approved linear accelerator" means a linear accelerator which was not operational prior to the beginning of the review period.

(2)           "Complex Radiation treatment" is equal to 1.0 ESTV and means: treatment on three or more sites on the body; use of techniques such as tangential fields with wedges, rotational or arc techniques; or use of custom blocking.

(3)           "Equivalent Simple Treatment Visit [ESTV]" means one basic unit of radiation therapy which normally requires up to fifteen (15) minutes for the uncomplicated set-up and treatment of a patient on a megavoltage teletherapy unit including the time necessary for portal filming.

(4)           "Existing linear accelerator" means a linear accelerator in operation prior to the beginning of the review period.

(5)           "Intermediate Radiation treatment" means treatment on two separate sites on the body, three or more fields to a single treatment site or use of multiple blocking and is equal to 1.0 ESTV.

(6)           "Linear accelerator" shall have the same meaning as defined in G.S. 131E‑176(14g).

(7)           "Linear accelerator service area" means a single or multi-county area as used in the development of the need determination in the applicable State Medical Facilities Plan.

(8)           "Megavoltage unit" means MRT equipment which provides a form of teletherapy that involves the delivery of energy greater than, or equivalent to, one million volts by the emission of x-rays, gamma rays, electrons, or other radiation.

(9)           "Megavoltage radiation therapy (MRT)" means the use of ionizing radiation in excess of one million electron volts in the treatment of cancer.

(10)         "MRT equipment" means a machine or energy source used to provide megavoltage radiation therapy including linear accelerators and other particle accelerators.

(11)         "Radiation therapy equipment" means medical equipment which is used to provide radiation therapy services.

(12)         "Radiation therapy services" means those services which involve the delivery of controlled and monitored doses of radiation to a defined volume of tumor bearing tissue within a patient. Radiation may be delivered to the tumor region by the use of radioactive implants or by beams of ionizing radiation or it may be delivered to the tumor region systemically.

(13)         "Radiation therapy service area" means a single or multi-county area as used in the development of the need determination in the applicable State Medical Facilities Plan.

(14)         "Simple Radiation treatment" means treatment on a single site on the body, single treatment field or parallel opposed fields with no more than simple blocks and is equal to 1 ESTV.

(15)         "Simulator" shall have the same meaning as defined in G.S. 131E‑176(24b).

(16)         "Special technique" means radiation therapy treatments that may require increased time for each patient visit including:

(a)           total body irradiation (photons or electrons) which equals 2.5 ESTVs;

(b)           hemi-body irradiation which equals 2.0 ESTVs;

(c)           intraoperative radiation therapy which equals 10.0 ESTVs;

(d)           neutron and proton radiation therapy which equals 2.0 ESTVs;

(e)           intensity modulated radiation treatment (IMRT) which equals  1.0 ESTV;

(f)            limb salvage irradiation at lengthened SSD which equals 1.0 ESTV;

(g)           additional field check radiographs which equals .50 ESTV;

(h)           stereotactic radiosurgery treatment management with linear accelerator or gamma knife which equals 3.0. ESTVs; and

(i)            pediatric patient under anesthesia which equals  1.5 ESTVs.

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Amended Eff. November 1, 1996;

Temporary Amendment January 1, 1999;

Temporary Amendment Eff. January 1, 1999 expired October 12, 1999;

Temporary Amendment Eff. January 1, 2000;

Temporary Amendment effective January 1, 2000 amends and replaces a permanent rulemaking originally proposed to be effective August 2000;

Amended Eff. April 1, 2001;

Temporary Amendment Eff. January 1, 2002;

Amended Eff. April 1, 2003;

Temporary Amendment Eff. January 1, 2005;

Amended Eff. November 1, 2005;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006.

 

10A NCAC 14C .1902       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E-177; 131E-183; NC 2009 State Medical Facilities Plan, Chapter 9: Radiation Therapy Services – Linear Accelerator;

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Amended Eff. November 1, 1996;

Temporary Amendment Eff. January 1, 1999;

Temporary Amendment Eff. January 1, 1999 Expired on October 12, 1999;

Temporary Amendment Eff. January 1, 2000;

Temporary Amendment effective January 1, 2000 amends and replaces a permanent rulemaking originally proposed to be effective August 2000;

Amended Eff. April 1, 2001;

Temporary Amendment Eff. January 1, 2005;

Amended Eff. November 1, 2005;

Temporary Amendment Eff. February 1, 2009;

Amended Eff. November 1, 2009;

Temporary Amendment Eff. February 1, 2010;

Amended Eff. November 1, 2010;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .1903       PERFORMANCE STANDARDS

(a)  An applicant proposing to acquire a linear accelerator shall demonstrate that each of the following standards will be met:

(1)           an applicant's existing linear accelerators located in the proposed radiation therapy service area performed at least 6,750 ESTV treatments per machine or served at least 250 patients per machine in the twelve months prior to the date the application was submitted;

(2)           each proposed new linear accelerator will be utilized at an annual rate of 250 patients or 6,750 ESTV treatments during the third year of operation of the new equipment; and

(3)           an applicant's existing linear accelerators located in the proposed radiation therapy service area are projected to be utilized at an annual rate of 6,750 ESTV treatments or 250 patients per machine during the third year of operation of the new equipment.

(b)  A linear accelerator shall not be held to the standards in Paragraph (a) of this Rule if the applicant provides documentation that the linear accelerator has been or will be used exclusively for clinical research and teaching.

(c)  An applicant proposing to acquire radiation therapy equipment other than a linear accelerator shall provide the following information:

(1)           the number of patients who are projected to receive treatment from the proposed radiation therapy equipment, classified by type of equipment, diagnosis, treatment procedure, and county of residence; and

(2)           the maximum number and type of procedures that the proposed equipment is capable of performing.

(d)  The applicant shall document all assumptions and provide data supporting the methodology used to determine projected utilization as required in this Rule.

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Amended Eff. November 1, 1996

Temporary Amendment Eff. January 1, 1999;

Temporary Amendment effective January 1, 1999 expired October 12, 1999;

Temporary Amended Eff. January 1, 2000;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006.

Temporary Amendment effective January 1, 2000 amends and replaces a permanent rulemaking originally proposed to be effective August 2000;

Amended Eff. April 1, 2001;

Temporary Amendment Eff. March 15, 2002; January 1, 2002; Amended Eff. April 1, 2003;

Temporary Amendment Eff. February 1, 2008;

Amended Eff. November 1, 2008;

Temporary Amendment Eff. February 1, 2009;

Amended Eff. November 1, 2009.

 

10A NCAC 14C .1904       Support Services

10A NCAC 14C .1905       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E-177(1); 131E-183; 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Amended Eff. November 1, 1996;

Temporary Amendment Eff. February 1, 2009;

Amended Eff. November 1, 2009;

Repealed Eff. February 1, 2016.

 

section .2000 – criteria and standards for home health services

 

10A NCAC 14C .2001       DEFINITIONS

The following definitions in this Rule shall apply to all rules in this Section:

(1)           "Home Health Agency" shall have the same meaning as defined in G.S. 131E‑176(12).

(2)           "Home Health Services" shall have the same meaning as defined in G.S. 131E‑176(12).

 

History Note:        Authority G.S. 131E‑177(1); 131E‑183(b);

Eff. September 1, 1980;

Amended Eff. March 1, 1996; July 1, 1995; July 1, 1991; February 1, 1985; May 1, 1983.

 

10A NCAC 14C .2002       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E-177(1); 131E-183;

Eff. March 1, 1996;

Temporary Amendment Eff. February 1, 2009;

Amended Eff. November 1, 2009;

Repealed Eff. February 1, 2016.

 

10A ncac 14C .2003       PERFORMANCE STANDARDS

An applicant shall project, in the third year of operation, an annual unduplicated patient caseload for the county in which the facility will be located that meets or exceeds the minimum need used in the applicable State Medical Facilities Plan to justify the establishment of a new home health agency office in that county.  An applicant shall not be required to meet this performance standard if the home health agency office need determination in the applicable State Medical Facilities Plan was not based on application of the standard methodology for a Medicare-certified home health agency office.

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Eff. March 1, 1996;

Temporary Amendment Eff. January 1, 2002;

Amended Eff. April 1, 2003.

 

10A NCAC 14C .2004       reserved for future codification

 

10A NCAC 14C .2005       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E‑177(1); 131E-183;

Eff. March 1, 1996;

Repealed Eff. February 1, 2016.

 

section .2100 – criteria and standards for surgical services and operating rooms

 

10A ncac 14C .2101       DEFINITIONS

The following definitions apply to all rules in this Section:

(1)           "Ambulatory surgical facility" means a facility as defined in G.S. 131E-176(1b).

(2)           "Operating room" means a room as defined in G.S. 131E-176(18c), which includes an inpatient operating room, an outpatient or ambulatory surgical operating room, or a shared operating room.

(3)           "Ambulatory surgical program" means a program as defined in G.S. 131E-176(1c).

(4)           "Dedicated cesarean section operating room" means an operating room as defined in the applicable State Medical Facilities Plan.

(5)           "Existing operating rooms" means those operating rooms in ambulatory surgical facilities and hospitals which were reported in the License Application for Ambulatory Surgical Facilities and Programs and in Part III of Hospital Licensure Renewal Application Form submitted to the Acute and Home Care Licensure and Certification Section of the Division of Health Service Regulation and which were licensed and certified prior to the beginning of the review period.

(6)           "Approved operating rooms" means those operating rooms that were approved for a certificate of need by the Certificate of Need Section prior to the date on which the applicant's proposed project was submitted to the Agency but that have not been licensed.

(7)           "Multispecialty ambulatory surgical program" means a program as defined in G.S. 131E-176(15a).

(8)           "Outpatient or ambulatory surgical operating room" means an operating room used solely for the performance of surgical procedures which require local, regional or general anesthesia and a period of post-operative observation of less than 24 hours.

(9)           "Related entity" means the parent company of the applicant, a subsidiary company of the applicant (i.e., the applicant owns 50 percent or more of another company), a joint venture in which the applicant is a member, or a company that shares common ownership with the applicant (i.e., the applicant and another company are owned by some of the same persons).

(10)         "Service area" means the Operating Room Service Area as defined in the applicable State Medical Facilities Plan.

(11)         "Shared operating room" means an operating room that is used for the performance of both ambulatory and inpatient surgical procedures.

(12)         "Specialty area" means an area of medical practice in which there is an approved medical specialty certificate issued by a member board of the American Board of Medical Specialties and includes the following: gynecology, otolaryngology, plastic surgery, general surgery, ophthalmology, urology, orthopedics, and oral surgery.

(13)         "Specialty ambulatory surgical program" means a program as defined in G.S. 131E-176(24c).

(14)         "Surgical case" means an individual who receives one or more surgical procedures in an operating room during a single operative encounter.

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Eff. November 1, 1990;

Amended Eff. March 1, 1993;

Temporary Amendment Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Amended Eff. January 4, 1994;

Temporary Amendment Eff. January 1, 1999;

Temporary Eff. January 1, 1999 Expired on October 12, 1999;

Temporary Amendment Eff. January 1, 2000;

Temporary Amendment effective January 1, 2000 amends and replaces a permanent rulemaking originally proposed to be effective August 2000;

Amended Eff. April 1, 2001;

Temporary Amendment Eff. January 1, 2002; July 1, 2001;

Amended Eff. August 1, 2002;

Temporary Amendment effective January 1, 2002 amends and replaces the permanent rule effective August 1, 2002;

Amended Eff. April 1, 2003;

Temporary Amendment Eff. January 1, 2005;

Amended Eff. November 1, 2005;

Temporary Rule Eff. February 1, 2006;

Amended Eff. November 1, 2006;

Temporary Amendment Eff. February 1, 2008;

Amended Eff. November 1, 2008.

 

10A NCAC 14C .2102       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E-177; 131E-183(b);

Eff. November 1, 1990;

Temporary Amendment Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Amended Eff. January 4, 1994;

Temporary Amendment Eff. July 1, 2001;

Temporary Amendment Eff. January 1, 2002;

Amended Eff. August 1, 2002;

Temporary Amendment effective January 1, 2002 amends and replaces the permanent rule effective August 1, 2002;

Amended Eff. April 1, 2003;

Temporary Amendment Eff. February 1, 2008;

Amended Eff. November 1, 2008;

Temporary Amendment Eff. February 1, 2010;

Amended Eff. November 1, 2010;

Repealed Eff. February 1, 2016.

 

10A ncac 14C .2103       performance standards

(a)  In projecting utilization, the operating rooms shall be considered to be available for use five days per week and 52 weeks a year.

(b)  A proposal to establish a new ambulatory surgical facility, to establish a new campus of an existing facility, to establish a new hospital, to increase the number of operating rooms in an existing facility (excluding dedicated C-section operating rooms), to convert a specialty ambulatory surgical program to a multispecialty ambulatory surgical program or to add a specialty to a specialty ambulatory surgical program shall:

(1)           demonstrate the need for the number of proposed operating rooms in the facility which is proposed to be developed or expanded in the third operating year of the project based on the following formula: {[(Number of facility's projected inpatient cases, excluding trauma cases reported by Level I or II trauma centers, cases reported by designated burn intensive care units and cases performed in dedicated open heart and C-section rooms, times 3.0 hours) plus (Number of facility's projected outpatient cases times 1.5 hours)] divided by 1872 hours} minus the facility's total number of existing and approved operating rooms and operating rooms proposed in another pending application, excluding one operating room for Level I or II trauma centers, one operating room for facilities with designated burn intensive care units, and all dedicated open heart and C-section operating rooms or demonstrate conformance of the proposed project to Policy AC-3 in the State Medical Facilities Plan titled "Exemption From Plan Provisions for Certain Academic Medical Center Teaching Hospital Projects;" and

(2)           The number of rooms needed is determined as follows:

(A)          in a service area which has more than 10 operating rooms, if the difference is a positive number greater than or equal to 0.5, then the need is the next highest whole number for fractions of 0.5 or greater and the next lowest whole number for fractions less than 0.5; and if the difference is a negative number or a positive number less than 0.5, then the need is zero;

(B)          in a service area which has 6 to 10 operating rooms, if the difference is a positive number greater than or equal to 0.3, then the need is the next highest whole number for fractions of 0.3 or greater and the next lowest whole number for fractions less than 0.3, and if the difference is a negative number or a positive number less than 0.3, then the need is zero; and

(C)          in a service area which has five or fewer operating rooms, if the difference is a positive number greater than or equal to 0.2, then the need is the next highest whole number for fractions of 0.2 or greater and the next lowest whole number for fractions less than 0.2; and if the difference is a negative number or a positive number less than 0.2, then the need is zero.

(c)  A proposal to increase the number of operating rooms (excluding dedicated C-section operating rooms) in a service area shall:

(1)           demonstrate the need for the number of proposed operating rooms in addition to the rooms in all of the licensed facilities identified in response to 10A NCAC 14C .2102(b)(2) in the third operating year of the proposed project based on the following formula:  {[(Number of projected inpatient cases for all the applicant's or related entities' facilities, excluding trauma cases reported by Level I or II trauma centers, cases reported by designated burn intensive care units and cases performed in dedicated open heart and C-section rooms, times 3.0 hours) plus (Number of projected outpatient cases for all the applicant's or related entities' facilities times 1.5 hours)] divided by 1872 hours} minus the total number of existing and approved operating rooms and operating rooms proposed in another pending application, excluding one operating room for Level I or II trauma centers, one operating room for facilities with designated burn intensive care units, and all dedicated open heart and C-Section operating rooms in all of the applicant's or related entities' licensed facilities in the service area; and

(2)           The number of rooms needed is determined as follows:

(A)          in a service area which has more than 10 operating rooms, if the difference is a positive number greater than or equal to 0.5, then the need is the next highest whole number for fractions of 0.5 or greater and the next lowest whole number for fractions less than 0.5; and if the difference is a negative number or a positive number less than 0.5, then the need is zero;

(B)          in a service area which has 6 to 10 operating rooms, if the difference is a positive number greater than or equal to 0.3, then the need is the next highest whole number for fractions of 0.3 or greater and the next lowest whole number for fractions less than 0.3, and if the difference is a negative number or a positive number less than 0.3, then the need is zero; and

(C)          in a service area which has five or fewer operating rooms, if the difference is a positive number greater than or equal to 0.2, then the need is the next highest whole number for fractions of 0.2 or greater and the next lowest whole number for fractions less than 0.2; and if the difference is a negative number or a positive number less than 0.2, then the need is zero.

(d)  An applicant that has one or more existing or approved dedicated C-section operating rooms and is proposing to develop an additional dedicated C-section operating room in the same facility shall demonstrate that an average of at least 365 C-sections per room were performed in the facility's existing dedicated C-section operating rooms in the previous 12 months and are projected to be performed in the facility's existing, approved and proposed dedicated C-section rooms during the third year of operation following completion of the project.

(e)  An applicant proposing to convert a specialty ambulatory surgical program to a multispecialty ambulatory surgical program or to add a specialty to a specialty ambulatory surgical program shall:

(1)           provide documentation to show that each existing ambulatory surgery program in the service area that performs ambulatory surgery in the same specialty area as proposed in the application is currently utilized an average of at least 1,872 hours per operating room per year, excluding dedicated open heart and C-Section operating rooms. The hours utilized per operating room shall be calculated as follows:  [(Number of projected inpatient cases, excluding open heart and C-sections performed in dedicated rooms, times 3.0 hours) plus (Number of projected outpatient cases times 1.5 hours)] divided by the number of operating rooms, excluding dedicated open heart and C-Section operating rooms; and

(2)           demonstrate the need in the third operating year of the project based on the following formula:  [(Total number of projected outpatient cases for all ambulatory surgery programs in the service area times 1.5 hours) divided by 1872 hours] minus the total number of existing, approved and proposed outpatient or ambulatory surgical operating rooms and shared operating rooms in the service area.  The need is demonstrated if the difference is a positive number greater than or equal to one, after the number is rounded to the next highest number for fractions of 0.50 or greater.

(f)  The applicant shall document the assumptions and provide data supporting the methodology used for each projection in this Rule.

 

History Note:        Authority G.S. 131E-177; 131E-183(b);

Eff. November 1, 1990;

Amended Eff. March 1, 1993;

Temporary Amendment Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Amended Eff. January 4, 1994;

Temporary Amendment Eff. January 1, 2002; July 1, 2001;

Amended Eff. August 1, 2002;

Temporary Amendment effective January 1, 2002 amends and replaces the permanent rule effective August 1, 2002;

Amended Eff. April 1, 2003;

Temporary Amendment Eff. January 1, 2005;

Amended Eff. November 1, 2005;

Temporary Rule Eff. February 1, 2006;

Amended Eff. November 1, 2006;

Temporary Amendment Eff. February 1, 2008;

Amended Eff. November 1, 2008;

Temporary Amendment Eff. February 1, 2009;

Amended Eff. November 1, 2009;

Temporary Amendment Eff. February 1, 2010;

Amended Eff. November 1, 2010.

 

10A NCAC 14C .2104       Support Services

10A NCAC 14C .2105       STAFFING AND STAFF TRAINING

10A ncac 14C .2106       FACILITY

 

History Note:        Authority G.S. 131E-177; 131E-183(b);

Eff. November 1, 1990;

Temporary Amendment Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Amended Eff. January 4, 1994;

Temporary Amendment Eff. July 1, 2001;

Temporary Amendment Eff. January 1, 2002;

Amended Eff. August 1, 2002;

Temporary Amendment effective January 1, 2002 amends and replaces the permanent rule effective August 1, 2002;

Amended Eff. April 1, 2003;

Temporary Amendment Eff. February 1, 2008;

Amended Eff. November 1, 2008;

Temporary Amendment Eff. February 1, 2010;

Amended Eff. November 1, 2010;

Repealed Eff. February 1, 2016.

 

section .2200 – criteria and standards for end-stage renal disease services

 

10A NCAC 14C .2201       DEFINITIONS

The definitions in this Rule will apply to all rules in this Section:

(1)           "End stage renal disease (ESRD) services" means those dialysis or transplantation services necessary for the treatment of patients with end stage renal disease provided by transplantation centers, dialysis centers or dialysis facilities.

(2)           "Renal transplantation center" means a hospital unit which furnishes directly rental transplantation and other medical and surgical specialty services required for transplant candidates or patients.

(3)           "Renal dialysis center" is a hospital unit which furnishes the full spectrum of diagnostic, therapeutic, and rehabilitative services.

(4)           "Renal dialysis facility" is a unit, usually freestanding, which furnishes dialysis service to ESRD patients.

(5)           "Dialysis" means the artificially aided process of transferring body wastes from a person's blood to a dialysis fluid to permit discharge of the wastes from the body.

(6)           "Hemodialysis" means the form of dialysis in which the blood is circulated outside the body through an apparatus which permits transfer of waste through synthetic membranes.

(7)           "Peritoneal dialysis" means the form of dialysis in which a dialysis fluid is introduced into the person's peritoneal cavity and is subsequently withdrawn.

(8)           "Maintenance dialysis" is the term used to describe routine repetitive dialysis treatments necessary to sustain life of patients with ESRD.

(9)           "Self‑care dialysis or home dialysis training" means the systematic training of patients and their helpers in the techniques of self‑care dialysis.

(10)         "Self‑care dialysis" means the self administration of maintenance dialysis treatments in ESRD facility or elsewhere and may be assisted by an aide who is either a family member or a non‑family member assistant.

(11)         "Dialysis station" means a unit in an ESRD facility equipped with the apparatus for performing hemodialysis or peritoneal dialysis on a single patient.  Stations may designated for maintenance dialysis, self‑care dialysis, self‑care training, or isolation.

(12)         "Isolation station" means a dialysis station located apart from other maintenance dialysis stations to serve patients who either have or are suspected to have an infectious disease, i.e., hepatitis.

(13)         "Shift" means the scheduled time when a group of patients are provided their dialysis treatment.

(14)         "Transplantation" means a surgical procedure in which a functioning kidney is removed from a donor and implanted in the patient with ESRD.

(15)         "Organ procurement" means the process of acquiring kidneys for transplantation from potential donors.

(16)         "Histocompatability testing" means laboratory testing procedures which determine compatability between a potential donor organ and a potential organ transplant recipient.

 

History Note:        Authority G.S. 131E‑177(1); 131E-183(b);

Eff. September 1, 1980;

Amended Eff. November 1, 1989; November 1, 1983.

 

10A NCAC 14C .2202       INFORMATION REQUIRED Of APPLICANT

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Eff. March 1, 1989;

Temporary Amendment Eff. January 1, 2003;

Amended Eff. August 1, 2004;

Temporary Amendment Eff. January 1, 2005;

Amended Eff. November 1, 2005;

Temporary Amendment Eff. February 1, 2010;

Amended Eff. November 1, 2010;

Repealed Eff. February 1, 2016.

 

10A ncac 14C .2203       PERFORMANCE STANDARDS

(a)  An applicant proposing to establish a new End Stage Renal Disease facility shall document the need for at least 10 stations based on utilization of 3.2 patients per station per week as of the end of the first operating year of the facility, with the exception that the performance standard shall be waived for a need in the State Medical Facilities Plan that is based on an adjusted need determination.

(b)  An applicant proposing to increase the number of dialysis stations in an existing End Stage Renal Disease facility or one that was not operational prior to the beginning of the review period but which had been issued a certificate of need shall document the need for the additional stations based on utilization of 3.2 patients per station per week as of the end of the first operating year of the additional stations.

(c)  An applicant shall provide all assumptions, including the methodology by which patient utilization is projected.

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. January 1, 2003; January 1, 2002;

Eff. April 1, 2003;

Amended Eff. August 1, 2004;

Temporary Amendment Eff. January 1, 2005;

Amended Eff. November 1, 2005;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006;

Temporary Amendment Eff. February 1, 2010;

Amended Eff. November 1, 2010.

 

10A NCAC 14C .2204       Scope of Services

10A NCAC 14C .2205       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E‑177(1); 131E-183(b);

Eff. March 1, 1989;

Repealed Eff. February 1, 2016.

 

section .2300 – criteria and standards for computed tomography equipment

 

10A NCAC 14C .2301       DEFINITIONS

The following definitions shall apply to all rules in this Section:

(1)           "Approved computed tomography (CT) scanner" means a CT scanner which was not operational prior to the beginning of the review period but which had been issued a certificate of need.

(2)           "Computed tomography" means a technique whereby a sharply collimated X‑ray beam is passed through the human body from a source which rotates around the body in a specific arc.  As the beam passes through the body from its perimeter, its intensity is reduced.  The transmitted intensity of the beam varies in accordance with the density of the tissue it passes through and is measured by sensitive detectors and, from this information, two‑dimensional cross‑sectional pictures or other images may be generated.  A computer is used to generate the image from the measurements of X‑ray beam intensity.  Tissue images can be done with or without contrast agents.  Computed tomography services are rendered by CT scanners.

(3)           "Computed tomography (CT) scanner" means an imaging machine which combines the information generated by a scanning X‑ray source and detector system with a computer to reconstruct a cross‑sectional image of the full body, including the head.

(4)           "Computed tomography (CT) service area" means a geographical area defined by the applicant from which the applicant projects to serve patients.

(5)           "CT scan" means one discrete image of a patient produced by a CT scanner.

(6)           "Existing CT scanner" means a computed tomography scanner in operation prior to the beginning of the review period.

(7)           "Fixed CT scanner" means a CT scanner that is used at only one location or campus.

(8)           "HECT unit" means a unit that is equivalent to one CT scan which is derived by applying a weighted conversion factor to a CT scan in accordance with the Head Equivalent Computed Tomography studies formula developed by the National Electric Manufacturers, based on the "Leonard Methodology".

(9)           "Mobile CT scanner" means a CT scanner and transporting equipment which is moved to provide services at two or more host facilities.

(10)         "Related entity" means the parent company of the applicant, a subsidiary company of the applicant (i.e., the applicant owns 50 percent or more of another company), a joint venture in which the applicant is a member, or a company that shares common ownership with the applicant (i.e., the applicant and another company are owned by some of the same persons).

 

History Note:        Authority G.S. 131E‑177(1); 131E‑183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. February 1, 1994;

Amended Eff. February 1, 2008.

 

10A NCAC 14C .2302       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E‑177(1); 131E‑183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. February 1, 1994;

Amended Eff. February 1, 2008;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .2303       PERFORMANCE STANDARDS

An applicant proposing to acquire a CT scanner shall demonstrate each of the following:

(1)           each fixed or mobile CT scanner to be acquired shall be projected to perform 5,100 HECT units annually in the third year of operation of the proposed equipment;

(2)           each existing fixed or mobile CT scanner which the applicant or a related entity owns a controlling interest in and is located in the applicant's CT service area shall have performed at least 5,100 HECT units in the 12 month period prior to submittal of the application; and

(3)           each existing and approved fixed or mobile CT scanner which the applicant or a related entity owns a controlling interest in and is located in the applicant's CT service area shall be projected to perform 5,100 HECT units annually in the third year of operation of the proposed equipment.

 

History Note:        Authority G.S. 131E‑177(1); 131E‑183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. February 1, 1994;

Amended Eff. February 1, 2008.

 

10A NCAC 14C .2304       Support Services

10A NCAC 14C .2305       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E‑177(1); 131E‑183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. February 1, 1994;

Amended Eff. February 1, 2008;

Repealed Eff. February 1, 2016.

 

section .2400 – criteria and standards for intermediate care facility/mentally retarded (ICf/mr)

 

10A NCAC 14C .2401       DEFINITIONS

The definitions in this Rule shall apply to all rules in this Section:

(1)           "Intermediate care facility for the mentally retarded (ICF/MR)" shall have the same meaning as defined in G.S. 131E-176(14a).

(2)           "Active treatment" means:

(a)           regular participation in professionally developed and supervised activities, experiences, or therapies in accordance with an individual plan of care;

(b)           an individual plan of care which is a written plan that is based on individual choice and sets forth measurable goals or behaviorally stated objectives and prescribes an integrated program of individually designed activities, experiences or therapies necessary to achieve such goals or objectives;

(c)           an interdisciplinary professional evaluation consisting of complete medical, social, or psychological diagnosis and an evaluation of the individual's need for the facility's care, prior to admission but not to exceed three months before admission to the facility or, in the case of individuals who make application while in such facility, before requesting payment under the plan;

(d)           re‑evaluation medically, socially, and psychologically, at least annually by the staff involved in carrying out the resident's individual plan of care, including review of the individual's progress toward meeting the plan of care, assessment of continuing need for facility care, and consideration of alternate methods of care; and

(e)           an individual plan (as part of the individual's total plan of care) developed prior to discharge that is based on individual choice by a qualified developmental disabilities professional and other appropriate professionals, which includes the present residence, specifying the type of care and services that will be needed to enable the individual to function in a different environment and also includes provisions for protective supervision.

(3)           "Qualified Developmental Disabilities Professional" means a staff person in an ICF/MR facility designated to be responsible for supervising the implementation of each resident's individual plan of care, integrating the various aspects of the facility's program, recording each resident's progress and initiating periodic review of each individual plan of care. A Qualified Developmental Disabilities Professional shall meet the minimum qualifications for employment as defined in the 42 CFR 483.430 which is incorporated by reference including all subsequent amendments.

(4)           "Catchment area" means the geographic part of the State served by a specific area authority ("Area authority" means the Mental Health, Developmental Disabilities, and Substance Abuse Authority.)

 

History Note:        Authority G.S. 131E‑177(1), (5); 131E-183;

Eff. December 1, 1981;

Amended Eff. November 1, 1996; September 1, 1989.

 

10A NCAC 14C .2402       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E‑177(1), (5); 131E-183;

Eff. December 1, 1996;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .2403       PERFORMANCE STANDARDS

(a)  An applicant proposing to add ICF/MR beds to an existing facility shall not be approved unless the average occupancy, over the six months immediately preceding the submittal of the application, of the total number of ICF/MR beds within the facility in which the new beds are to be operated was at least 90 percent.

(b)  An applicant proposing to establish new ICF/MR beds shall not be approved unless occupancy is projected to be at least 90 percent for the total number of ICF/MR beds proposed to be operated in the entire facility, no later than one year following the completion of the proposed project.

(c)  An applicant proposing to establish new ICF/MR beds shall comply with one of the following models:

(1)           a residential community based freestanding facility with six beds or less, i.e., group home model;

(2)           a community‑based facility with 7 to 15 beds if documentation is provided that a facility of this size is necessary because adequate residential community based freestanding facilities are not available in the Area Authority catchment area to meet the needs of the population to be served; or

(3)           a facility with greater than 15 beds if the proposed new beds are to be established in response to an adjusted need determination contained in the 2003 State Medical Facilities Plan.

(d)  No more than three intermediate care facilities for the mentally retarded housing a combined total of 18 persons shall be developed on contiguous pieces of property, with the exception that this standard shall be waived for beds proposed to be established in response to an adjusted need determination contained in the 2003 State Medical Facilities Plan.

 

History Note:        Authority G.S. 131E-177(1), (5); 131E-183;

Eff. November 1, 1996;

Temporary Amendment Eff. January 1, 2003;

Amended Eff. August 1, 2004.

 

10A NCAC 14C .2404       reserved for future codification

 

10A NCAC 14C .2405       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E‑177(1), (5); 131E-183;

Eff. December 1, 1996;

Repealed Eff. February 1, 2016.

 

section .2500 – criteria and standards for substance abuse/chemical dependency treatment beds

 

10A ncac 14C .2501       DEFINITIONS

The following definitions shall apply to all rules in this Section:

(1)           "Chemical dependency treatment beds" shall have the same meaning as defined in G.S. 131E-176(5b).

(2)           "Detoxification beds" means chemical dependency treatment beds that are used during the period of time when the patient is withdrawing from psycho-active substances under medical direction.

(3)           "Intensive treatment beds" means chemical dependency treatment beds that are not detoxification beds.

(4)           "Clinical staff members" means the employees of a chemical dependency treatment program who provide treatment or rehabilitation services to a patient.

(5)           "Aftercare plan" means a component of a treatment plan which provides continued contact with the patient after completion of the structured treatment process in order to maintain or improve on the patient's recovery progress.

 

History Note:        Authority G.S. 131E‑177(1); 131E-183;

Eff. March 1, 1983;

Amended Eff. November 1, 1996; October 1, 1984.

Temporary Amendment Eff. January 1, 2001;

Amended Eff. August 1, 2002.

 

10A NCAC 14C .2502       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E‑177(1); 131E-183;

Eff. December 1, 1996;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .2503       PERFORMANCE STANDARDS

(a)  An applicant proposing additional intensive treatment beds shall not be approved unless the overall occupancy, over the nine months immediately preceding the submittal of the application, of the total number of intensive treatment beds within the facility in which the beds are to be located has been:

(1)           75 percent for facilities with a total of 1 through 15 intensive treatment beds; or

(2)           85 percent for facilities with a total of 16 or more intensive treatment beds.

(b)  An applicant shall not be approved unless the overall occupancy of the total number of intensive treatment beds to be operated in the facility is projected by the fourth quarter of the third year of operation following completion of the project, to be:

(1)           75 percent for facilities with a total of 1 through 15 intensive treatment beds; or

(2)           85 percent for facilities with a total of 16 or more intensive treatment beds.

(c)  The applicant shall document the specific methodology and assumptions by which occupancies are projected, including the average length of stay and anticipated recidivism rate.

 

History Note:        Authority G.S. 131E‑177(1); 131E-183(b);

Eff. November 1, 1996;

Temporary Amendment Eff. January 1, 2002;

Amended Eff. April 1, 2003;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. January 1, 2007.

 

10A NCAC 14C .2504       reserved for future codification

 

10A NCAC 14C .2505       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E‑177(1); 131E-183;

Eff. December 1, 1996;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006;

Repealed Eff. February 1, 2016.

 

section .2600 – criteria and standards for psychiatric beds

 

10A NCAC 14C .2601       DEFINITIONS

The definitions in this Rule apply to all rules in this Section:

(1)           "Psychiatric Beds" means beds in:

(a)           psychiatric units of general hospitals licensed under G.S. Chapter 131E-77, Article 5;

(b)           free-standing psychiatric hospitals licensed under G.S. Chapter 122C-23, Article 2.

(2)           "Involuntary Admissions" means those persons admitted under the involuntary commitment procedure defined in G.S. Chapter 122, Article 5, Part 7.

(3)           "Service Area" means the counties in the Mental Health Planning Area, as defined in the applicable State Medical Facilities Plan.

(4)           "Professional Staff" means any employee who provides treatment or habilitation services to a patient receiving psychiatric treatment in a general hospital, psychiatric hospital or inpatient unit of a community mental health center.  This includes, but is not necessarily limited to, physicians licensed to practice medicine in North Carolina, psychiatric nurses, practicing psychologists or psychiatric social workers.

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Eff. May 1, 1983;

Amended Eff. August 1, 2009; November 1, 1989.

 

10A NCAC 14C .2602       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E-177(1); 131E-183;

Eff. December 1, 1996;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. August 1, 2009; November 1, 2006;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .2603       PERFORMANCE STANDARDS

(a)  An applicant proposing to add psychiatric beds in an existing facility shall not be approved unless the average occupancy over the six months immediately preceding the submittal of the application of the total number of licensed psychiatric beds within the facility in which the beds are to be operated was at least 75 percent.

(b)  An applicant proposing to establish new psychiatric beds shall not be approved unless occupancy is projected to be 75% for the total number of licensed psychiatric beds proposed to be operated in the facility no later than the fourth quarter of the second operating year following completion of the project.

 

History Note:        Authority G.S. 131E‑177(1); 131E-183;

Eff. November 1, 1996.

 

10A NCAC 14C .2604       reserved for future codification

 

10A NCAC 14C .2605       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E‑177(1); 131E-183(b);

Eff. May 1, 1983;

Amended Eff. November 1, 1989;

Repealed Eff. February 1, 2016.

 

SECTION .2700 - CRITERIA AND STANDARDS FOR MAGNETIC RESONANCE IMAGING SCANNER

 

10A NCAC 14C .2701       DEFINITIONS

The following definitions apply to all rules in this Section:

(1)           "Approved MRI scanner" means an MRI scanner which was not operational prior to the beginning of the review period but which had been issued a certificate of need.

(2)           "Capacity of fixed MRI scanner" means 100 percent of the procedure volume that the MRI scanner is capable of completing in a year, given perfect scheduling, no machine or room downtime, no cancellations, no patient transportation problems, no staffing or physician delays and no MRI procedures outside the norm. Annual capacity of a fixed MRI scanner is 6,864 weighted MRI procedures, which assumes two weighted MRI procedures are performed per hour and the scanner is operated 66 hours per week, 52 weeks per year.

(3)           "Capacity of mobile MRI scanner" means 100 percent of the procedure volume that the MRI scanner is capable of completing in a year, given perfect scheduling, no machine or room downtime, no cancellations, no patient transportation problems, no staffing or physician delays and no MRI procedures outside the norm. Annual capacity of a mobile MRI scanner is 4,160 weighted MRI procedures, which assumes two weighted MRI procedures are performed per hour and the scanner is operated 40 hours per week, 52 weeks per year.

(4)           "Dedicated breast MRI scanner" means an MRI scanner that is configured to perform only breast MRI procedures and is not capable of performing other types of non-breast MRI procedures.

(5)           "Existing MRI scanner" means an MRI scanner in operation prior to the beginning of the review period.

(6)           "Extremity MRI scanner" means an MRI scanner that is utilized for the imaging of extremities and is of open design with a field of view no greater than 25 centimeters.

(7)           "Fixed MRI scanner" means an MRI scanner that is not a mobile MRI scanner.

(8)           "Magnetic Resonance Imaging" (MRI) means a non-invasive diagnostic modality in which electronic equipment is used to create tomographic images of body structure.  The MRI scanner exposes the target area to nonionizing magnetic energy and radio frequency fields, focusing on the nuclei of atoms such as hydrogen in the body tissue.  Response of selected nuclei to this stimulus is translated into images for evaluation by the physician.

(9)           "Magnetic resonance imaging scanner" (MRI Scanner) is defined in G.S. 131E-176(14m).

(10)         "Mobile MRI region" means either the eastern part of the State which includes the counties in Health Service Areas IV, V and VI (Eastern Mobile MRI Region), or the western part of the State which includes the counties in Health Service Areas I, II, and III (Western Mobile MRI Region).  The counties in each Health Service Area are identified in Appendix A of the State Medical Facilities Plan.

(11)         "Mobile MRI scanner" means an MRI scanner and transporting equipment which is moved at least weekly to provide services at two or more campuses or physical locations.

(12)         "MRI procedure" means a single discrete MRI study of one patient.

(13)         "MRI service area" means the Magnetic Resonance Imaging Planning Areas, as defined in the applicable State Medical Facilities Plan, except for proposed new mobile MRI scanners for which the service area is a mobile MRI region.

(14)         "MRI study" means one or more scans relative to a single diagnosis or symptom.

(15)         "Multi-position MRI scanner" means an MRI scanner as defined in the State Medical Facilities Plan, pursuant to a special need determination for a demonstration project.

(16)         "Related entity" means the parent company of the applicant, a subsidiary company of the applicant (i.e., the applicant owns 50 percent or more of another company), a joint venture in which the applicant is a member, or a company that shares common ownership with the applicant (i.e., the applicant and another company are owned by some of the same persons).

(17)         "Temporary MRI scanner" means an MRI scanner that the Certificate of Need Section has approved to be temporarily located in North Carolina at a facility that holds a certificate of need for a new fixed MRI scanner, but which is not operational because the project is not yet complete.

(18)         "Weighted MRI procedures" means MRI procedures which are adjusted to account for the length of time to complete the procedure, based on the following weights: one outpatient MRI procedure without contrast or sedation is valued at 1.0 weighted MRI procedure, one outpatient MRI procedure with contrast or sedation is valued at 1.4 weighted MRI procedures, one inpatient MRI procedure without contrast or sedation is valued at 1.4 weighted MRI procedures; and one inpatient MRI procedure with contrast or sedation is valued at 1.8 weighted MRI procedures.

(19)         "Weighted breast MRI procedures" means MRI procedures which are performed on a dedicated breast MRI scanner and are adjusted to account for the length of time to complete the procedure, based on the following weights: one diagnostic breast MRI procedure is valued at 1.0 weighted MRI procedure (based on an average of 60 minutes per procedure), one MRI-guided breast needle localization MRI procedure is valued at 1.1 weighted MRI procedure (based on an average of 66 minutes per procedure), and one MRI-guided breast biopsy procedure is valued at 1.6 weighted MRI procedures (based on an average of 96 minutes per procedure).

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. February 1, 1994;

Temporary Amendment Eff. January 1, 1999;

Temporary Amendment Eff. January 1, 1999 Expired on October 12, 1999;

Temporary Amendment Eff. January 1, 2000;

Temporary Amendment effective January 1, 2000 amends and replaces a permanent rulemaking originally proposed to be effective August 2000;

Temporary Amendment Eff. January 1, 2001;

Temporary Amendment effective January 1, 2001 amends and replaces a permanent rulemaking originally proposed to be effective April 1, 2001;

Temporary Amendment Eff. January 1, 2002;

Amended Eff. August 1, 2002;

Temporary Amendment effective January 1, 2002 amends and replaces the permanent rule effective August 1, 2002;

Temporary Amendment Eff. January 1, 2003;

Amended Eff. August 1, 2004; April 1, 2003;

Temporary Amendment Eff. January 1, 2005;

Amended Eff. November 1, 2005;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006;

Temporary Amendment Eff. February 1, 2008;

Amended Eff. November 1, 2008;

Temporary Amendment Eff. February 1, 2009;

Amended Eff. November 1, 2009;

Temporary Amendment Eff. February 1, 2010;

Amended Eff. November 1, 2010.

 

10A NCAC 14C .2702       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E‑177(1); 131E‑183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. February 1, 1994;

Temporary Amendment Eff. January 1, 2003; January 1, 2002;

Amended Eff. August 1, 2004; April 1, 2003;

Temporary Amendment Eff. January 1, 2005;

Amended Eff. November 1, 2005;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006;

Temporary Amendment Eff. February 1, 2008;

Amended Eff. November 1, 2008;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .2703       PERFORMANCE STANDARDS

(a)  An applicant proposing to acquire a mobile magnetic resonance imaging (MRI) scanner shall:

(1)           demonstrate that each existing mobile MRI scanner which the applicant or a related entity owns a controlling interest in and operates in the mobile MRI region in which the proposed equipment will be located, except temporary MRI scanners, performed 3,328 weighted MRI procedures in the most recent 12 month period for which the applicant has data [Note: This is not the average number of weighted MRI procedures performed on all of the applicant's mobile MRI scanners.]; with the exception that in the event an existing mobile MRI scanner has been in operation less than 12 months at the time the application is filed, the applicant shall demonstrate that this mobile MRI scanner performed an average of at least 277 weighted MRI procedures per month for the period in which it has been in operation;

(2)           demonstrate annual utilization in the third year of operation is reasonably projected to be at least 3328 weighted MRI procedures on each of the existing, approved and proposed mobile MRI scanners owned by the applicant or a related entity to be operated in the mobile MRI region in which the proposed equipment will be located [Note: This is not the average number of weighted MRI procedures performed on all of the applicant's mobile MRI scanners.]; and

(3)           document the assumptions and provide data supporting the methodology used for each projection required in this Rule.

(b)  An applicant proposing to acquire a fixed magnetic resonance imaging (MRI) scanner, except for fixed MRI scanners described in Paragraphs (c) and (d) of this Rule, shall:

(1)           demonstrate that the existing fixed MRI scanners which the applicant or a related entity owns a controlling interest in and locates in the proposed MRI service area performed an average of 3,328 weighted MRI procedures in the most recent 12 month period for which  the applicant has data;

(2)           demonstrate that each existing mobile MRI scanner which the applicant or a related entity owns a controlling interest in and operates in the proposed MRI service area except temporary MRI scanners, performed 3,328 weighted MRI procedures in the most recent 12 month period for which the applicant has data [Note: This is not the average number of weighted MRI procedures performed on all of the applicant's mobile MRI scanners.];

(3)           demonstrate that the average annual utilization of the existing, approved and proposed fixed MRI scanners which the applicant or a related entity owns a controlling interest in and locates in the proposed MRI service area are reasonably expected to perform the following number of weighted MRI procedures, whichever is applicable, in the third year of operation following completion of the proposed project:

(A)          1,716 weighted MRI procedures in MRI service areas in which the SMFP shows no fixed MRI scanners are located,

(B)          3,775 weighted MRI procedures in MRI service areas in which the SMFP shows one fixed MRI scanner is located,

(C)          4,118 weighted MRI procedures in MRI service areas in which the SMFP shows two fixed MRI scanners are located,

(D)          4,462 weighted MRI procedures in MRI service areas in which the SMFP shows three fixed MRI scanners are located, or

(E)           4,805 weighted MRI procedures in MRI service areas in which the SMFP shows four or more fixed MRI scanners are located;

(4)           if the proposed MRI scanner will be located at a different site from any of the existing or approved MRI scanners owned by the applicant or a related entity, demonstrate that the annual utilization of the proposed fixed MRI scanner is reasonably expected to perform the following number of weighted MRI procedures, whichever is applicable, in the third year of operation following completion of the proposed project:

(A)          1,716 weighted MRI procedures in MRI service areas in which the SMFP shows no fixed MRI scanners are located,

(B)          3,775 weighted MRI procedures in MRI service areas in which the SMFP shows one fixed MRI scanner is located,

(C)          4,118 weighted MRI procedures in MRI service areas in which the SMFP shows two fixed MRI scanners are located,

(D)          4,462 weighted MRI procedures in MRI service areas in which the SMFP shows three fixed MRI scanners are located, or

(E)           4,805 weighted MRI procedures in MRI service areas in which the SMFP shows four or more fixed MRI scanners are located;

(5)           demonstrate that annual utilization of each existing, approved and proposed mobile MRI scanner which the applicant or a related entity owns a controlling interest in and locates in the proposed MRI service area is reasonably expected to perform 3,328 weighted MRI procedures in the third year of operation following completion of the proposed project [Note: This is not the average number of weighted MRI procedures to be performed on all of the applicant's mobile MRI scanners.]; and

(6)           document the assumptions and provide data supporting the methodology used for each projection required in this Rule.

(c)  An applicant proposing to acquire a fixed dedicated breast magnetic resonance imaging (MRI) scanner for which the need determination in the State Medical Facilities Plan was based on an approved petition for an adjustment to the need determination shall:

(1)           demonstrate annual utilization of the proposed MRI scanner in the third year of operation is reasonably projected to be at least 1,664 weighted MRI procedures which is .80 times 1 procedure per hour times 40 hours per week times 52 weeks per year; and

(2)           document the assumptions and provide data supporting the methodology used for each projection required in this Rule.

(d)  An applicant proposing to acquire a fixed extremity MRI scanner for which the need determination in the State Medical Facilities Plan was based on an approved petition for an adjustment to the need determination shall:

(1)           demonstrate annual utilization of the proposed MRI scanner in the third year of operation is reasonably projected to be at least 80 percent of the capacity defined by the applicant in response to 10A NCAC 14C .2702(f)(7); and

(2)           document the assumptions and provide data supporting the methodology used for each projection required in this Rule.

(e)  An applicant proposing to acquire a fixed multi-position MRI scanner for which the need determination in the State Medical Facilities Plan was based on an approved petition for a demonstration project shall:

(1)           demonstrate annual utilization of the proposed multi-position MRI scanner in the third year of operation is reasonably projected to be at least 80 percent of the capacity defined by the applicant in response to 10A NCAC 14C .2702(g)(7); and

(2)           document the assumptions and provide data supporting the methodology used for each projection required in this Rule.

 

History Note:        Authority G.S. 131E‑177(1); 131E‑183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. February 1, 1994;

Temporary Amendment Eff. January 1, 1999;

Temporary Amendment Eff. January 1, 1999 Expired on October 12, 1999;

Temporary Amendment Eff. January 1, 2000;

Temporary Amendment effective January 1, 2000 amends and replaces a permanent rulemaking originally proposed to be effective August 2000;

Temporary Amendment Eff. January 1, 2001;

Temporary Amendment effective January 1, 2001 amends and replaces a permanent rulemaking originally proposed to be effective April 1, 2001;

Temporary Amendment Eff. January 1, 2002;

Temporary Amendment Eff. January 1, 2002 amends and replaces the   permanent rule effective, August 1, 2002;

Temporary Amendment Eff. January 1, 2003;

Amended Eff. August 1, 2004; April 1, 2003;

Temporary Amendment Eff. January 1, 2005;

Amended Eff. November 1, 2005;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006;

Temporary Amendment Eff. February 1, 2008;

Amended Eff. November 1, 2008.

 

10A NCAC 14C .2704       Support Services

10A NCAC 14C .2705       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E‑177(1); 131E‑183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. February 1, 1994;

Temporary Amendment Eff. January 1, 2002;

Amended Eff. April 1, 2003;

Temporary Amendment Eff. January 1, 2005;

Amended Eff. November 1, 2005;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006;

Repealed Eff. February 1, 2016.

 

SECTION .2800 ‑ CRITERIA AND STANDARDS FOR REHABILITATION SERVICES

 

10A NCAC 14C .2801       DEFINITIONS

The definitions in this Rule will apply to all rules in this Section.

(1)           "Rehabilitation Facility" means a facility as defined in G.S. 131E‑176.

(2)           "Rehabilitation" means the process to maintain, restore or increase the function of disabled individuals so that an individual can live in the least restrictive environment, consistent with his or her objective.

(3)           "Outpatient Rehabilitation Clinic" is defined as a program of coordinated and integrated outpatient services, evaluation, or treatment with emphasis on improving the functional level of the person in coordination with the patient's family.

(4)           "Rehabilitation Beds" means inpatient beds for which a need determination is set forth in the current State Medical Facilities Plan and which are located in a hospital licensed pursuant to G.S. 131E‑77.

(5)           "Traumatic Brain Injury" is defined as an insult to the brain that may produce a diminished or altered state of consciousness which results in impairment of cognitive abilities or physical functioning.  It can also result in the disturbance of behavioral or emotional functioning.  These impairments may be either temporary or permanent and cause partial or total functional disability or psychological maladjustment.

(6)           "Stroke" (cerebral infarction, hemorrhage) is defined as the sudden onset of a focal neurologic deficit due to a local disturbance in the blood supply to the brain.

(7)           "Spinal Cord Injury" is defined as an injury to the spinal cord that results in the loss of motor or sensory function.

(8)           "Pediatric Rehabilitation" is defined as inpatient rehabilitation services provided to persons 14 years of age or younger.

 

History Note:        Authority G.S. 131E‑177; 131E‑183(b);

Eff. May 1, 1991;

Amended Eff. February 1, 1993;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006.

 

10A NCAC 14C .2802       INFORMATION REQUIRED By APPLICANT

 

History Note:        Authority G.S. 131E‑177; 131E‑183(b);

Eff. May 1, 1991;

Amended Eff. November 1, 1996;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .2803       PERFORMANCE STANDARDS

(a)  An applicant proposing to establish new rehabilitation beds shall not be approved unless the average occupancy, over the nine months immediately preceding the submittal of the application, of the total number of licensed rehabilitation beds within the facility in which the new beds are to be operated was at least 80 percent.

(b)  An applicant proposing to establish new rehabilitation beds shall not be approved unless occupancy is projected to be 80 percent for the total number of rehabilitation beds to be operated in the facility no later than two years following completion of the proposed project.

 

History Note:        Authority G.S. 131E‑177; 131E‑183;

Eff. November 1, 1996.

 

10A NCAC 14C .2804       reserved for future codification

 

10A NCAC 14C .2805       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E‑177(1); 131E-183;

Eff. May 1, 1991;

Amended Eff. November 1, 1996;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .2806       QUALITY OF SERVICES

History Note:        Authority G.S. 131E‑177; 131E‑183(b);

Eff. May 1, 1991;

Temporary Repeal Eff. February 1, 2006;

Repealed Eff. November 1, 2006.

 

SECTION .2900 - CRITERIA AND STANDARDS FOR BONE MARROW TRANSPLANTATION SERVICES

 

10A NCAC 14C .2901       DEFINITIONS

The following definitions shall apply to all rules in this Section:

(1)           "Allogeneic bone marrow transplantation services" means the procedure by which the bone marrow of a person other than the patient is infused after treating the patient for disease.

(2)           "Approved bone marrow transplantation service" means an allogeneic or an autologous bone marrow transplantation service which was not operational prior to the beginning of the review period but which had been issued a certificate of need or had been developed and offered prior to March 18, 1993 in accordance with 1993 N.C. Sess. Laws c. 7, s. 12.

(3)           "Autologous bone marrow transplantation services" means the process of reinfusing the patient's own bone marrow after treating the patient for disease.

(4)           "Bone marrow transplantation service area" means a geographic area defined by the applicant from which patients to be admitted to the service will originate.

(5)           "Bone marrow transplantation services" is defined in G.S. 131E-176(2a).

(6)           "Cryopreservation" means the process of preserving tissue by freezing at very low temperatures.

(7)           "Existing bone marrow transplantation service" means an allogeneic or an autologous bone marrow transplantation service in operation prior to the beginning of the review period.

 

History Note:        Filed as a Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Authority G.S. 131E-177(1); 131E-183(b);

Eff. January 4, 1994.

 

10A NCAC 14C .2902       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Repealed Eff. February 1, 2016.

 

10a NCAC 14C .2903       PERFORMANCE STANDARDS

(a)  An applicant that proposes to provide new or expanded autologous or allogeneic bone marrow transplantation services shall demonstrate that:

(1)           all existing facilities within the applicant's bone marrow transplantation service area which have been offering bone marrow transplantation services for at least two years shall have performed at least 20 transplants during the most recent 12 month period;

(2)           all existing and approved facilities within the applicant's bone marrow transplantation service area will provide at least 20 transplants during the second year of operation following completion of the project; and

(3)           the projected utilization for the new or expanded bone marrow transplantation program shall perform at least 20 transplants during the second year of operation following completion of the project.

(b)  An applicant that proposes to provide new or expanded autologous or allogeneic bone marrow transplantation services shall describe all of the assumptions and methodologies used to calculate the projections requested in Subparagraphs (a)(2) and (3) of this Rule.

(c)  An applicant that proposes the use of bone marrow transplantation services for clinical use shall demonstrate that all equipment, supplies and pharmaceuticals proposed for the service have been certified for clinical use by the U.S. Food and Drug Administration or will be operated under an institutional review board whose membership is consistent with U.S. Department of Health and Human Services' regulations.

 

History Note:        Filed as a Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Authority G.S. 131E-177(1); 131E-183(b);

Eff. January 4, 1994.

 

10A NCAC 14C .2904       Support Services

10A NCAC 14C .2905       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Repealed Eff. February 1, 2016.

 

SECTION .3000 - CRITERIA AND STANDARDS FOR SOLID ORGAN TRANSPLANTATION SERVICES

 

10A NCAC 14C .3001       definitions

10A NCAC 14C .3002       INFORMATION REQUIRED OF APPLICANT

10A NCAC 14C .3003       SUPPORT SERVICES

10A NCAC 14C .3004       ADDITIONAL REQUIREMENTS FOR HEART, HEART/LUNG OR LUNG TRANSPLANTATION SERVICES

10A NCAC 14C .3005       ADDITIONAL REQUIREMENTS FOR LIVER TRANSPLANTATION SERVICES

10a NCAC 14C .3006       ADDITIONAL REQUIREMENTS FOR PANCREAS TRANSPLANTATION SERVICES

10A NCAC 14C .3007       ADDITIONAL REQUIREMENTS FOR KIDNEY TRANSPLANTATION SERVICES

10A NCAC 14C .3008       STAFFING AND STAFF TRAINING

10A NCAC 14C .3009       ACCESSIBILITY

 

History Note:        Authority G.S. 131E-177(1); 131E-183; 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Amended Eff. November 1, 1996;

Repealed Eff. February 1, 2016.

 

SECTION .3100 - CRITERIA AND STANDARDS FOR MAJOR MEDICAL EQUIPMENT

 

10A NCAC 14C .3101       PURPOSE AND SCOPE

10A NCAC 14C .3102       DEFINITIONS

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Repealed Eff. March 16, 2017.

 

10A NCAC 14C .3103       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E-177(1); 131E-183;

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Amended Eff. January 1, 1997; November 1, 1996;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .3104       NEED FOR SERVICES

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Repealed Eff. March 16, 2017.

 

10A NCAC 14C .3105       Support Services

10A NCAC 14C .3106       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Repealed Eff. February 1, 2016.

 

SECTION .3200 - CRITERIA AND STANDARDS FOR LITHOTRIPTOR EQUIPMENT

 

10A NCAC 14C .3201       DEFINITIONS

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Repealed Eff. October 1, 2016.

 

10A NCAC 14C .3202       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .3203       PERFORMANCE STANDARDS

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Repealed Eff. October 1, 2016.

 

10A NCAC 14C .3204       Support Services

10A NCAC 14C .3205       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Amended Eff. November 1, 1996;

Repealed Eff. February 1, 2016.

 

SECTION .3300 ‑ CRITERIA AND STANDARDS FOR AIR AMBULANCE

 

10A ncac 14C .3301       Definitions

10A NCAC 14C .3302       INFORMATION REQUIRED OF APPLICANT

10A NCAC 14C .3303       PERFORMANCE STANDARDS

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. February 1, 1994;

Temporary Amendment Eff. May 15, 2002;

Amended Eff. April 1, 2007; April 1, 2003;

Repealed Eff. January 1, 2013.

 

10A NCAC 14C .3304       reserved for future codification

 

10A NCAC 14C .3305       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E‑177(1); 131E‑183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. February 1, 1994;

Temporary Amendment Eff. May 15, 2002;

Amended Eff. April 1, 2003;

Repealed Eff. January 1, 2013.

 

SECTION .3400 - CRITERIA AND STANDARDS FOR BURN INTENSIVE CARE SERVICES

 

10A NCAC 14C .3401       DEFINITIONS

The following definitions shall apply to all rules in this Section:

(1)           "Approved burn intensive care unit" means a burn intensive care unit which was not operational prior to the beginning of the review period but which had been issued a certificate of need or had been developed prior to March 18, 1993 in accordance with 1993 N.C. Sess. Laws c. 7, s. 12.

(2)           "Burn care technician" means:

(a)           a licensed practical nurse;

(b)           an operating room technician;

(c)           an operating room corpsman; or

(d)           a high school graduate with basic nurse aide training who has received special education or experience in burn treatment care.

(3)           "Burn intensive care services" as defined in G.S. 131E-176(2b).

(4)           "Burn intensive care service area" means a geographic area defined by the applicant from which the patients to be admitted to the unit will originate.

(5)           "Burn intensive care unit" means a designated area within a hospital dedicated to the provision of burn intensive care services to severely burned patients.

(6)           "Burn specialist" means a registered nurse who possesses experience in general nursing and experience in or knowledge of intensive nursing care and burn treatment care.

(7)           "Existing burn intensive care unit" means a burn intensive care unit in operation prior to the beginning of the review period.

(8)           "Severely burned patient" means a patient that has burns covering more than 20 percent of the body area or that has burns which require intensive treatment, such as, but not limited to: inhalation injuries; chemical and electrical burns; burns with complications, such as fractures; burns to the face; full thickness burns to the hands and feet; burns on patients whose pre-burned health was known to be poor, such as patients with diabetes or heart disease; and, burns on patients who are under 5 and over 60 years of age.

 

History Note:        Filed as a Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Authority G.S. 131E-177(1); 131E-183;

Eff. January 4, 1994;

Amended Eff. November 1, 1996.

 

10A NCAC 14C .3402       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .3403       PERFORMANCE STANDARDS

(a)  An applicant proposing to develop a new burn intensive care unit or to add a bed to an existing or approved burn intensive care unit shall demonstrate that:

(1)           the existing burn intensive care units in the state had an overall average occupancy rate of at least 80 percent for the last year, which shall be calculated by dividing the total number of bed days utilized in the last year by severely burned patients in all facilities in the state that have burn intensive care units, by the total number of burn intensive care unit beds in all facilities in the state that have burn intensive care units multiplied by 365 days;

(2)           the average occupancy rate of the applicant's existing unit for the last year was at least 70% in units with 20 or more beds, 65% in units with 10 to 19 beds, and 60% in units with 1 to 9 beds;

(3)           the applicant's unit shall be utilized at an annual occupancy rate of at least 70% in units with 20 or more beds, 65% in units with 10 to 19 beds, and 60% in units with 1 to 9 beds, no later than 2 years following completion of the proposed project; and

(4)           each existing or approved burn intensive care unit shall be projected to be utilized at an annual occupancy rate of at least 70% in units with 20 or more beds, 65% in units with 10 to 19 beds, and 60% in units with 1 to 9 beds, no later than 2 years following completion of the applicant's proposed project.

(b)  The calculation of occupancy rates in this Rule shall be based only on severely burned patients.

(c)  The applicant shall document all assumptions and data supporting the methodology used for all occupancy rates projected in this Rule.

 

History Note:        Filed as a Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Authority G.S. 131E-177(1); 131E-183(b);

Eff. January 4, 1994.

 

10A NCAC 14C .3404       Support Services

10A NCAC 14C .3405       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Repealed Eff. February 1, 2016.

 

SECTION .3500 - CRITERIA AND STANDARDS FOR ONCOLOGY TREATMENT CENTERS

 

10A NCAC 14C .3501       DEFINITIONS

10A NCAC 14C .3502       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Filed as a Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Authority G.S. 131E-177(1); 131E-183(b);

Eff. January 4, 1994;

Temporary Repeal Eff. February 1, 2006;

Repealed Eff. November 1, 2006.

 

10A NCAC 14C .3503       reserved for future codification

 

10A NCAC 14C .3504       SUPPORT SERVICES

10A NCAC 14C .3505       STAFFING AND STAFF TRAINING

 

History Note:        Filed as a Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Authority G.S. 131E-177(1); 131E-183(b);

Eff. January 4, 1994;

Temporary Repeal Eff. February 1, 2006;

Repealed Eff. November 1, 2006.

 

SECTION .3600 - CRITERIA AND STANDARDS FOR GAMMA KNIFE

 

10A NCAC 14C .3601       DEFINITIONS

The following definitions shall apply to all rules in this Section:

(1)           "Approved gamma knife" means a gamma knife which was not operational prior to the beginning of the review period but which had been issued a certificate of need or had been acquired prior to March 18, 1993 in accordance with 1993 N.C. Sess. Laws c. 7, s. 12.

(2)           "Existing gamma knife" means a gamma knife in operation prior to the beginning of the review period.

(3)           "Gamma knife" is defined in G.S. 131E-176(7c).

(4)           "Gamma knife procedure" means a radiation dosage delivered in one treatment session.

(5)           "Gamma knife service area" means the geographic area defined by the applicant.

 

History Note:        Filed as a Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Authority G.S. 131E-177(1); 131E-183(b);

Eff. January 4, 1994.

 

10A NCAC 14C .3602       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .3603       PERFORMANCE STANDARDS

An applicant proposing to acquire a gamma knife shall:

 (1)          demonstrate that the gamma knife shall be utilized at an annual rate of at least 250 procedures per machine based on utilization in the fourth quarter of the third year of operation following completion of the project, multiplied by four, and shall provide all assumptions and data supporting the methodology used for the projections;

(2)           provide the number of procedures projected to be performed for clinical purposes and the number of procedures projected to be performed for research purposes in each of the first operating years of the proposed gamma knife.

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Temporary Amendment Eff. January 1, 2003;

Amended Eff. August 1, 2004.

 

10A NCAC 14C .3604       Support Services

10A NCAC 14C .3605       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Repealed Eff. February 1, 2016.

 

section .3700 - CRITERIA AND STANDARDS FOR POSITRON EMISSION TOMOGRAPHY SCANNER

 

10A NCAC 14C .3701       DEFINITIONS

The following definitions shall apply to all rules in this Section:

(1)           "Approved positron emission tomography (PET) scanner" means a PET scanner which was not operational prior to the beginning of the review period but which had been issued a certificate of need.

(2)           "Cyclotron" means an apparatus for accelerating protons or neutrons to high energies by means of a constant magnet and an oscillating electric field.

(3)           "Dedicated PET Scanner" means PET Scanners as defined in the applicable State Medical Facilities Plan.

(4)           "Existing PET scanner" means a PET scanner in operation prior to the beginning of the review period.

(5)           "Mobile PET Scanner" means a PET scanner and transporting equipment that is moved, at least weekly, to provide services at two or more host facilities.

(6)           "PET procedure" means a single discrete study of one patient involving one or more PET scans.

(7)           "PET scan" means an image-scanning sequence derived from a single administration of a PET radiopharmaceutical, equated with a single injection of the tracer.  One or more PET scans comprise a PET procedure.

(8)           "PET scanner service area" means the PET Scanner Service Area as defined in the applicable State Medical Facilities Plan.

(9)           "Positron emission tomographic scanner" (PET) is defined in G.S. 131E-176(19a).

(10)         "Radioisotope" means a radiochemical which directly traces biological processes when introduced into the body.

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Temporary Amendment Eff. January 1, 2001;

Temporary Amendment Eff. January 1, 2002;

Amended Eff. August 1, 2002;

Temporary Amendment effective January 1, 2002 amends and replaces the permanent rule effective August 1, 2002;

Temporary Amendment Eff. January 1, 2003;

Amended Eff. August 1, 2004; April 1, 2003.

 

10A NCAC 14C .3702       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Temporary Amendment Eff. January 1, 2002;

Temporary Amendment effective January 1, 2002 amends and replaces a permanent rulemaking originally proposed to be effective August 1, 2002;

Amended Eff. April 1, 2003;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006;

Temporary Amendment Eff. February 1, 2008;

Amended Eff. November 1, 2008;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .3703       PERFORMANCE STANDARDS

(a)  An applicant proposing to acquire a dedicated PET scanner, including a mobile dedicated PET scanner, shall demonstrate that:

(1)           the proposed dedicated PET scanner, including a proposed mobile dedicated PET scanner, shall be utilized at an annual rate of at least 2,080 PET procedures by the end of the third year following completion of the project;

(2)           if an applicant operates an existing dedicated PET scanner, its existing dedicated PET scanners, excluding those used exclusively for research, performed an average of at least 2,080 PET procedures per PET scanner in the last year; and

(3)           its existing and approved dedicated PET scanners shall perform an average of at least 2,080 PET procedures per PET scanner during the third year following completion of the project.

(b)  The applicant shall describe the assumptions and provide data to support and document the assumptions and methodology used for each projection required in this Rule.

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Temporary Amendment Eff. January 1, 2002; January 1, 2001;

Amended Eff. August 1, 2002;

Temporary Amendment effective January 1, 2002 amends and replaces the permanent rule effective August 1, 2002;

Temporary Amendment Eff. January 1, 2003;

Amended Eff. August 1, 2004; April 1, 2003;

Temporary Amendment Eff. January 1, 2005;

Amended Eff. November 1, 2005;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006.

 

10A NCAC 14C .3704       Support Services

10A NCAC 14C .3705       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. September 1, 1993 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Eff. January 4, 1994;

Temporary Amendment Eff. January 1, 2002;

Amended Eff. April 1, 2003;

Temporary Amendment Eff. February 1, 2006;

Amended Eff. November 1, 2006;

Repealed Eff. February 1, 2016.

 

section .3800 - criteria and standards for ACUTE CARE BEDS

 

10A NCAC 14C .3801       DEFINITIONS

The following definitions shall apply to all Rules in this Section:

(1)           "Acute care beds" means acute care beds licensed by the Division of Health Service Regulation in accordance with standards in 10A NCAC 13B .6200, and located in hospitals licensed pursuant to G.S. 131E-79.

(2)           "Average daily census" means the number of days of inpatient acute care provided in licensed acute care beds in a given year divided by 365 days.

(3)           "Campus" shall have the same meaning as defined in G.S. 131E-176(2c).

(4)           "Service Area" means the single or multi-county area as used in the development of the acute care bed need determination in the applicable State Medical Facilities Plan.

 

History Note:        Authority G.S. 131E‑177(1); 131E-183;

Temporary Adoption Eff. January 1, 2004;

Eff. August 1, 2004.

 

10A NCAC 14C .3802       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E‑177(1); 131E-183;

Temporary Adoption Eff. January 1, 2004;

Eff. August 1, 2004;

Temporary Amendment Eff. January 1, 2005;

Amended Eff. November 1, 2005;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .3803       PERFORMANCE STANDARDS

(a)  An applicant proposing to develop new acute care beds shall demonstrate that the projected average daily census (ADC) of the total number of licensed acute care beds proposed to be licensed within the service area, under common ownership with the applicant, divided by the total number of those licensed acute care beds is reasonably projected to be at least 66.7 percent when the projected ADC is less than 100 patients, 71.4 percent when the projected ADC is 100 to 200 patients, and 75.2 percent when the projected ADC is greater than 200 patients, in the third operating year following completion of the proposed project or in the year for which the need determination is identified in the State Medical Facilities Plan, whichever is later.

(b)  An applicant proposing to develop new acute care beds shall provide all assumptions and data used to develop the projections required in this rule and demonstrate that they support the projected inpatient utilization and average daily census.

 

History Note:        Authority G.S. 131E‑177(1); 131E-183;

Temporary Adoption Eff. January 1, 2004;

Eff. August 1, 2004.

 

10A NCAC 14C .3804       Support Services

10A NCAC 14C .3805       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E‑177(1); 131E-183;

Temporary Adoption Eff. January 1, 2004;

Eff. August 1, 2004;

Repealed Eff. February 1, 2016.

 

SECTION .3900 - CRITERIA AND STANDARDS FOR GASTROINTESTINAL ENDOSCOPY PROCEDURE ROOMS IN LICENSED HEALTH SERVICE FACILTIES

 

10A ncac 14C .3901       DEFINITIONS

The following definitions shall apply to all rules in this Section:

(1)           "Ambulatory surgical facility" means a facility as defined in G.S. 131E-176(1b).

(2)           "Gastrointestinal (GI) endoscopy room" means a room as defined in G.S. 131E-176(7d) that is used to perform one or more GI endoscopy procedures.

(3)           "Gastrointestinal (GI) endoscopy procedure" means a single procedure, identified by CPT code or ICD-9-CM procedure code, performed on a patient during a single visit to the facility for diagnostic or therapeutic purposes.

(4)           "Operating room" means a room as defined in G.S. 131E-176(18c). )

(5)           "Related entity" means the parent company of the applicant, a subsidiary company of the applicant (i.e., the applicant owns 50 percent or more of another company), a joint venture in which the applicant is a member, or a company that shares common ownership with the applicant (i.e., the applicant and another company are owned by some of the same persons).

(6)           "Service area" means the geographical area, as defined by the applicant using county lines, from which the applicant projects to serve patients.

 

History Note:        Authority G.S. 131E-177(1); 131E-183(b);

Temporary Adoption Eff. February 1, 2006;

Eff. November 1, 2006.

 

10A NCAC 14C .3902       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E‑177; 131E-183(b);

Temporary Adoption Eff. February 1, 2006;

Eff. November 1, 2006;

Repealed Eff. February 1, 2016.

 

10A ncac 14C .3903       performance standards

(a)  In providing projections for operating rooms, as required in this rule, the operating rooms shall be considered to be available for use 250 days per year, which is five days per week, 52 weeks per year, excluding ten days for holidays.

(b)  An applicant proposing to establish a new licensed ambulatory surgical facility for performance of GI endoscopy procedures or develop a GI endoscopy room in an existing licensed health service facility shall reasonably project to perform an average of at least 1,500 GI endoscopy procedures only per GI endoscopy room in each licensed facility the applicant or a related entity owns in the proposed service area, during the second year of operation following completion of the project.

(c)  An applicant proposing to establish a new licensed ambulatory surgical facility for performance of GI endoscopy procedures or develop a GI endoscopy room in an existing licensed health service facility shall demonstrate that at least the following types of GI endoscopy procedures will be provided in the proposed facility or GI endoscopy room: upper endoscopy procedures, esophagoscopy procedures, and colonoscopy procedures.

(d)  If an applicant, which proposes to establish a new licensed ambulatory surgical facility for performance of GI endoscopy procedures or develop a GI endoscopy room in an existing licensed health service facility, or a related entity to the applicant owns operating rooms located in the proposed service area, the applicant shall meet one of the following criteria:

(1)           if the applicant or a related entity performs GI endoscopy procedures in any of its surgical operating rooms in the proposed service area, reasonably project that during the second operating year of the project the average number of surgical and GI endoscopy cases per operating room, for each category of operating room in which these cases will be performed, shall be at least: 4.8 cases per day for each facility for the outpatient or ambulatory surgical operating rooms and 3.2 cases per day for each facility for the shared operating rooms; or

(2)           demonstrate that GI endoscopy procedures were not performed in the applicant's or related entity's inpatient operating rooms, outpatient operating rooms, or shared operating rooms in the last 12 months and will not be performed in those rooms in the future.

(e)  An applicant proposing to establish a new licensed ambulatory surgical facility for performance of GI endoscopy procedures or develop an additional GI endoscopy room in an existing licensed health service facility shall describe all assumptions and the methodology used for each projection in this Rule.

 

History Note:        Authority G.S. 131E‑177; 131E-183(b);

Temporary Adoption Eff. February 1, 2006;

Eff. November 1, 2006.

 

10A NCAC 14C .3904       Support Services

10A NCAC 14C .3905       STAFFING AND STAFF TRAINING

10A ncac 14C .3906       FACILITY

 

History Note:        Authority G.S. 131E‑177; 131E-183(b);

Temporary Adoption Eff. February 1, 2006;

Eff. November 1, 2006;

Repealed Eff. February 1, 2016.

 

section .4000 - CRITERIA AND STANDARDS FOR HOSPICE INPATIENT FACILITIES AND HOSPICE RESIDENTIAL CARE FACILITIES

 

10A NCAC 14C .4001       DEFINITIONS

The following definitions shall apply to all rules in this Section:

(1)           "Bereavement counseling" means counseling provided to a hospice patient's family or significant others to assist them in dealing with issues of grief and loss.

(2)           "Caregiver" means the person whom the patient designates to provide the patient with emotional support, physical care, or both.

(3)           "Care plan" means a plan as defined in 10A NCAC 13K .0102 of the Hospice Licensing Rules.

(4)           "Home-like" means furnishings of a hospice inpatient facility or a hospice residential care facility as defined in 10A NCAC 13K .1110 or .1204 of the Hospice Licensing Rules.

(5)           "Hospice" means any coordinated program of home care as defined in G.S. 131E-176(13a).

(6)           "Hospice inpatient facility" means a facility as defined in G.S. 131E-176(13b).

(7)           "Hospice residential care facility" means a facility as defined in G.S. 131E-176(13c).

(8)           "Hospice service area" means for residential care facilities, the county in which the hospice residential care facility will be located and the contiguous counties for which the hospice residential care facility will provide services.

(9)           "Hospice services" means services as defined in G.S. 131E-201(5b).

(10)         "Hospice staff" means personnel as defined in 10A NCAC 13K .0102 of the Hospice Licensing Rules.

 

History Note:        Authority G.S. 131E-177(1);

Temporary Adoption Eff. February 1, 2006;

Eff. November 1, 2006.

 

10A NCAC 14C .4002       INFORMATION REQUIRED OF APPLICANT

 

History Note:        Authority G.S. 131E-177(1); 131E-183;

Temporary Adoption Eff. February 1, 2006;

Eff. November 1, 2006;

Temporary Amendment Eff. February 1, 2008;

Amended Eff. November 1, 2008;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .4003       PERFORMANCE STANDARDS

(a)  An applicant proposing to develop hospice inpatient facility beds or hospice residential care facility beds shall demonstrate that:

(1)           the average occupancy rate of the licensed hospice beds, for each level of care, in the facility is projected to be at least 50 percent for the last six months of the first operating year following completion of the project;

 (2)          the average occupancy rate for the licensed hospice beds, for each level of care, in the facility is projected to be at least 65 percent for the second operating year following completion of the project; and

(3)           if the application is submitted to address the need for hospice residential care beds, each existing hospice residential care facility which is located in the hospice service area operated at an occupancy rate of at least 65 percent for the 12 month period reported on that facility's most recent Licensure Renewal Application Form.

(b)  An applicant proposing to add hospice inpatient facility beds to an existing hospice inpatient facility shall document that the average occupancy of the licensed hospice inpatient facility beds in its existing facility was at least 65 percent for the nine months immediately preceding the submittal of the proposal.

(c)  An applicant proposing to add residential care beds to an existing hospice residential care facility shall document that the average occupancy of the licensed hospice residential care beds in its existing facility was at least 65 percent for the nine months immediately preceding the submittal of the proposal.

 

History Note:        Authority G.S. 131E-177(1);

Temporary Adoption Eff. February 1, 2006;

Eff. November 1, 2006;

Temporary Amendment Eff. February 1, 2008;

Amended Eff. November 1, 2008.

 

10A NCAC 14C .4004       Support Services

10A NCAC 14C .4005       STAFFING AND STAFF TRAINING

 

History Note:        Authority G.S. 131E-177(1); 131E-183;

Temporary Adoption Eff. February 1, 2006;

Eff. November 1, 2006;

Repealed Eff. February 1, 2016.

 

10A NCAC 14C .4006       facility

 

History Note:        Authority G.S. 131E-177(1); 131E-183;

Temporary Adoption Eff. February 1, 2008;

Eff. November 1, 2008;

Repealed Eff. February 1, 2016.

 

 

 

SUBCHAPTER 14D - OVERNIGHT RESPITE IN CERTIFIED ADULT DAY CARE PROGRAMS

 

SECTION .0100 – SCOPE AND DEFINITIONS

 

10A NCAC 14D .0101       SCOPE

 

History Note:        Authority S.L. 2011-104; S.L. 2015-52;

Temporary Adoption Eff. January 1, 2012;

Eff. October 1, 2012;

Repealed Eff. November 1, 2015.

SUBCHAPTER 14D - OVERNIGHT RESPITE IN CERTIFIED ADULT DAY CARE PROGRAMS

 

SECTION .0100 – SCOPE AND DEFINITIONS

 

10A NCAC 14D .0102       Definitions

 

History Note:        Authority S.L. 2011-104; S.L. 2015-52;

Temporary Adoption Eff. January 1, 2012;

Eff. October 1, 2012;

Repealed Eff. July 1, 2017.

 

SECTION .0200 – PHYSICAL PLANT RULES

 

10A NCAC 14D .0201       SUBMISSION OF INFORMATION TO THE DIVISION OF HEALTH SERVICE REGULATION CONSTRUCTION SECTION

10A NCAC 14D .0202       CAPACITY

10A NCAC 14D .0203       DESIGN AND CONSTRUCTION

10A NCAC 14D .0204       LOCATION

10A NCAC 14D .0205       LIVING ARRANGEMENT

10A NCAC 14D .0206       LIVING ROOM

10A NCAC 14D .0207       DINING ROOM

10A NCAC 14D .0208       KITCHEN

10A NCAC 14D .0209       BEDROOMS

10A NCAC 14D .0210       BATHROOM

10A NCAC 14D .0211       STORAGE AREAS

10A NCAC 14D .0212       CORRIDOR

10A NCAC 14D .0213       OUTSIDE ENTRANCE AND EXITS

10A NCAC 14D .0214       LAUNDRY ROOM

10A NCAC 14D .0215       FLOORS

10A NCAC 14D .0216       HOUSEKEEPING AND FURNISHINGS

10A NCAC 14D .0217       FIRE SAFETY and Disaster Plan

10A NCAC 14D .0218       BUILDING SERVICE EQUIPMENT

10A NCAC 14D .0219       OUTSIDE PREMISES

 

History Note:        Authority S.L. 2011-104; S.L. 2015-52;

Temporary Adoption Eff. January 1, 2012;

Eff. October 1, 2012;

Repealed Eff. July 1, 2017.

 

SECTION .0300 - program management

 

10A NCAC 14D .0301       PLANNING PROGRAM ACTIVITIES

10A NCAC 14D .0302       Administrator

10A NCAC 14D .0303       Supervisor In Charge

 

History Note:        Authority S.L. 2011-104; S.L. 2015-52;

Temporary Adoption Eff. January 1, 2012;

Eff. October 1, 2012;

Repealed Eff. July 1, 2017.

 

SECTION .0400 – enrollment to overnight respite services

 

10A NCAC 14D .0401       enrollment of residents

10A NCAC 14D .0402       Planning Services for Individual residents

 

History Note:        Authority S.L. 2011-104; S.L. 2015-52;

Temporary Adoption Eff. January 1, 2012;

Eff. October 1, 2012;

Repealed Eff. July 1, 2017.

 

SECTION .0500 – staffing

 

10A NCAC 14D .0501       Staffing

10A NCAC 14D .0502       staff

 

History Note:        Authority S.L. 2011-104; S.L. 2015-52;

Temporary Adoption Eff. January 1, 2012;

Eff. October 1, 2012;

Repealed Eff. July 1, 2017.

 

SECTION .0600 - medication Administration

 

10A NCAC 14D .0601       Medication Administration

10A NCAC 14D .0602       Medication Administration Competency Evaluation

10A NCAC 14D .0603       Medication Administration POLICIES AND PROCEDURES

 

History Note:        Authority S.L. 2011-104; S.L. 2015-52;

Temporary Adoption Eff. January 1, 2012;

Eff. October 1, 2012;

Repealed Eff. July 1, 2017.

 

SECTION .0700 – Nutrition and food service

 

10A NCAC 14D .0701       Food procurement and safety

10A NCAC 14D .0702       Food preparation and service

10A NCAC 14D .0703       Menus

10A NCAC 14D .0704       food requirements

10A NCAC 14D .0705       therapeutic diets

10A NCAC 14D .0706       feeding assistance

10A NCAC 14D .0707       accommodation of resident needs and preferences

 

History Note:        Authority S.L. 2011-104; S.L. 2015-52;

Temporary Adoption Eff. January 1, 2012;

Eff. October 1, 2012;

Repealed Eff. July 1, 2017.

 

SECTION .0800 - Program Activities

 

10A NCAC 14D .0801       ACTIVITIES PROGRAM

 

History Note:        Authority S.L. 2011-104; S.L. 2015-52;

Temporary Adoption Eff. January 1, 2012;

Eff. October 1, 2012;

Repealed Eff. July 1, 2017.

 

 

 

SUBCHAPTER 14E - CERTIFICATIONS OF CLINICS FOR ABORTION

 

SECTION .0100 - CERTIFICATION PROCEDURE

 

10A NCAC 14E .0101       DEFINITIONS

The following definitions will apply throughout this Subchapter:

(1)           "Abortion" means the termination of a pregnancy as defined in G.S. 90-21.81(1).

(2)           "Clinic" means a freestanding facility (a facility neither physically attached nor operated by a licensed hospital) for the performance of abortions completed during the first 20 weeks of pregnancy.

(3)           "Complication" includes but is not limited to hemorrhage, infection, uterine perforation, cervical laceration, or retained products of conception.

(4)           "Division" means the Division of Health Service Regulation of the North Carolina Department of Health and Human Services.

(5)           "Gestational age" means the length of pregnancy as indicated by the date of the first day of the last normal monthly menstrual period, if known, or as determined by ultrasound.

(6)           "Governing authority" means the individual, agency, group, or corporation appointed, elected or otherwise designated, in which the ultimate responsibility and authority for the conduct of the abortion clinic is vested pursuant to Rule .0302 of this Subchapter.

(7)           "Health Screening" means an evaluation of an employee or contractual employee, including tuberculosis testing, to identify any underlying conditions that may affect the person's ability to work in the clinic.

(8)           "New clinic" means one that is not certified as an abortion clinic by the Division as of July 1, 2014, and has not been certified within the previous six months of the application for certification.

(9)           "Qualified Physician" means a licensed physician who advises, procures, or causes a miscarriage or abortion as defined in G.S. 14-45.1(g).

(10)         "Registered Nurse" means a person who holds a valid license issued by the North Carolina Board of Nursing to practice professional nursing in accordance with the Nursing Practice Act, G.S. 90, Article 9A.

 

History Note:        Authority G.S. 14‑45.1(a); 14-45.1(g); 143B-10; S.L. 2013-366, s. 4(c);

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. October 1, 2015; July 1, 1994; December 1, 1989; June 30, 1980.

10A NCAC 14E .0102       CONFERENCE

Before proceeding with construction and operational plans, a potential sponsor or owner of a freestanding abortion clinic shall discuss with the staff of the Division of Health Service Regulation the scope of the proposed facility.  This will provide an opportunity for the owner and the Division's staff to discuss certification requirements.

 

History Note:        Authority G.S. 14‑45.1(a); 143B‑10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977.

 

10A NCAC 14E .0103       CHANGES

All stages of the plans from schematics through working drawings shall be reviewed by the Division's staff each time a change is made.

 

History Note:        Authority G.S. 14‑45.1(a); 143B‑10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977.

 

10A NCAC 14E .0104       PLANS

Prior to issuance of a certificate pursuant to Rule .0107 of this Section, a clinic shall submit two copies of the building plans to the Division for certification purposes when the clinic requires a review by the Division and the Department of Insurance, according to the North Carolina Administration and Enforcement Requirements Code, 2012 edition, including subsequent amendments and editions.  Copies of the North Carolina Administration Code are available from the International Code Council at http://www.ecodes.biz/ecodes_support/Free_Resources/2012NorthCarolina/12NorthCarolina_main.html at no cost.  When the local jurisdiction has authority from the North Carolina Building Code Council to review the plans, the clinic shall submit only one copy of the plans to the Division.  In that case, the clinic shall submit an additional set of plans directly to the local jurisdiction.

 

History Note:        Authority G.S. 14‑45.1(a); 143B‑10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. October 1, 2015.

 

10A NCAC 14E .0105       APPROVAL

Approval from the Division of Health Service Regulation, the Division of Environmental Health, and the Department of Insurance should be obtained before construction is commenced.

 

History Note:        Authority G.S. 14‑45.1(a); 143B‑10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. December 1, 1989.

 

10A NCAC 14E .0106       APPLICATION

(a)  Prior to the admission of patients, an application from the clinic for certification shall be submitted to and approved by the Division.

(b)  Application forms may be obtained by contacting the Division.

(c)  The application form shall set forth the ownership, staffing patterns, clinical services to be rendered, professional staff in charge of services, and general information that would be helpful to the Division's understanding of the clinic's operating program.

(d)  After construction requirements in Section .0200 of this Subchapter have been met and the application for certification has been received and approved, the Division shall conduct an on-site, certification survey.

(e)  Each certificate must be renewed at the beginning of each calendar year.  The governing authority shall file an application for renewal of certification with the Division at least 30 days prior to the date of expiration on forms furnished by the Division.  Failure to file a renewal application shall result in expiration of the certificate to operate.

 

History Note:        Authority G.S. 14‑45.1(a);

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. July 1, 1994.

 

10A NCAC 14E .0107       ISSUANCE OF CERTIFICATE

(a)  The Division shall issue a certificate if it finds the facility can:

(1)           Comply with all requirements described in this Subchapter; and

(2)           Assure that, in the event that complications arise from the abortion procedure, an OB-GYN board certified or board eligible physician shall be available.

(b)  Each certificate shall be issued only for the premises and persons or organizations named in the application and shall not be transferable.

(c)  The governing authority shall notify the Division in writing, within 10 working days, of any change in the name of the facility or change in the name of the administrator.

(d)  The facility shall report to the Division all incidents, within 10 working days, of vandalism to the facility such as fires, explosions or other action causing disruption of services.

 

History Note:        Authority G.S. 14‑45.1(a);

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. July 1, 1994.

 

10A NCAC 14E .0108       POSTING

Certificates shall be posted in a conspicuous place on the premises.

 

History Note:        Authority G.S. 14‑45.1(a); 143B‑10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977.

 

10A NCAC 14E .0109       RENEWAL

Each certificate, unless previously suspended or revoked, pursuant to the applicable rules and statutes shall be renewable annually upon the filing of an application, payment of the non-refundable renewal fee as defined in G.S. 131E-269, and approval by the Division.

 

History Note:        Authority G.S. 14‑45.1(a); 131E-269; 143B‑10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. October 1, 2015.

 

10A NCAC 14E .0110       REVOCATION

The Department shall deny, suspend, or revoke a certificate in any case where it finds that substantial failure to comply with these regulations renders the facility unsuitable for the performance of abortions.

 

History Note:        Authority G.S. 14‑45.1(a); 143B‑10; 150B;

Eff. February 1, 1976;

Amended Eff. December 1, 1989.

 

10A NCAC 14E .0111       INSPECTIONS

(a)  Any clinic certified by the Division to perform abortions shall be inspected by representatives of the Division annually and as it may deem necessary as a condition of holding such license.  An inspection shall be conducted whenever the purpose of the inspection is to determine whether the clinic complies with the rules of this Subchapter or whenever there is reason to believe that some condition exists which is not in compliance with the rules of this Subchapter.

(b)  The Division shall have authority to investigate any complaint relative to the care, treatment, or complication of any patient.

(c)  Representatives of the Division shall make their identities known to the person in charge prior to inspection of the clinic.

(d)  Representatives of the Division may review any records in any medium necessary to determine compliance with the rules of this Subchapter, while maintaining the confidentiality of the complainant and the patient, unless otherwise required by law.

(e)  The clinic shall allow the Division to have immediate access to its premises and the records necessary to conduct an inspection and determine compliance with the rules of this Subchapter. 

(f)  A clinic shall file a plan of correction for cited deficiencies within 10 business days of receipt of the report of the survey.  The Division shall review and respond to a written plan of correction within 10 business days of receipt of the corrective action plan.

 

History Note:        Authority G.S. 14‑45.1(a); 14-45.1(a1); 143B-10; S.L. 2013-366, s. 4(c);

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. October 1, 2015; July 1, 1994.

 

10A NCAC 14E .0112       ALTERATIONS

Any certificate holder or prospective applicant desiring to make specified types of alteration or addition to a clinic or to construct a new clinic, before commencing such alteration, addition or new construction shall submit plans and specifications therefor to the Division for preliminary inspection and approval or recommendations with respect to compliance with the regulations and standards herein authorized.

 

History Note:        Authority G.S. 14‑45.1(a); 143B‑10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. December 1, 1989.

 

SECTION .0200 - MINIMUM STANDARDS FOR CONSTRUCTION AND EQUIPMENT

 

10A NCAC 14E .0201       BUILDING CODE REQUIREMENTS

(a)  The physical plant for a clinic shall meet or exceed minimum requirements of the North Carolina State Building Code for Group B occupancy (business office facilities) which is incorporated herein by reference including subsequent amendments and editions.  Copies of the Code can be obtained from the International Code Council online at http://shop.iccsafe.org/north-carolina-doi.discounts?ref=NC for a cost of five hundred twenty-seven dollars ($527.00), or accessed electronically free of charge at http://www.ecodes.biz.

(b)  The requirements contained in this Section shall apply to new clinics and to any alterations, repairs, rehabilitation work, or additions which are made to a previously certified facility.

 

History Note:        Authority G.S. 14‑45.1(a); 143B-10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. October 1, 2015; July 1, 1994; December 1, 1989.

 

10A NCAC 14E .0202       SANITATION

Clinics that are certified by the Division to perform abortions shall comply with the Rules governing the sanitation of hospitals, nursing homes, adult care homes, and other institutions, contained in 15A NCAC 18A .1300 which is hereby incorporated by reference including subsequent amendments and editions.  Copies of 15A NCAC 18A .1300 may be obtained at no charge from the Division of Public Health, Environmental Health Section, 1632 Mail Service Center, Raleigh, NC 27699-1632, or accessed electronically free of charge from the Office of Administrative Hearings at http://www.ncoah.com.

 

History Note:        Authority G.S. 14‑45.1(a); 143B-10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. October 1, 2015; July 1, 1994.

 

10A NCAC 14E .0203       ELEVATOR

(a)  In multi‑story buildings, at least one elevator for patient use shall be provided.

(b)  At least one dimension of the elevator cab shall be six and one‑half feet to accommodate stretcher patients.

(c)  The elevator door shall have an opening of no less than three feet in width, which is minimum for stretcher use.

 

History Note:        Authority G.S. 14‑45.1(a); 143B‑10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977.

 

10A NCAC 14E .0204       CORRIDORS

The width of corridors shall be sufficient to allow for patient evacuation by stretcher, but in no case shall patient-use corridors be less than 60 inches.

 

History Note:        Authority G.S. 14‑45.1(a);

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. July 1, 1994.

 

10A NCAC 14E .0205       DOORS

Minimum width of doors to all rooms needing access for stretchers shall be three feet.  No door shall swing into corridors in a manner that might obstruct traffic flow or reduce the required corridor width except doors to spaces such as small closets not subject to occupancy.

 

History Note:        Authority G.S. 14‑45.1(a);

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. July 1, 1994.

 

10A NCAC 14E .0206       ELEMENTS AND EQUIPMENT

The physical plant shall provide equipment to carry out the functions of the clinic with the following minimum requirements:

(1)           Mechanical requirements.

(a)           Temperatures and humidities:

(i)            The mechanical systems shall be designed to provide the temperature and humidities shown in this Sub-Item:

Area                       Temperature                         Relative Humidity

Procedure              70-76 degrees F.                   50-60%

Recovery               75-80 degrees F.                   30-60%

(b)           All air supply and exhaust systems for the procedure suite and recovery area shall be mechanically operated.  All fans serving exhaust systems shall be located at the discharge end of the system.  The ventilation rates shown herein shall be considered as minimum acceptable rates.

(i)            The ventilation system shall be designed and balanced to provide the pressure relationships detailed in Sub-Item (b)(vii) of this Rule.

(ii)           All air supplied to procedure rooms shall be delivered at or near the ceiling of the room and all exhaust or return from the area shall be removed near the floor level at not less than three inches above the floor.

(iii)          Corridors shall not be used to supply air to or exhaust air from any procedure or recovery room except to maintain required pressure relationships.

(iv)          All ventilation or air conditioning systems serving procedure rooms shall have a minimum of one filter bed with a minimum filter efficiency of 80 percent.

(v)           Ventilation systems serving the procedure or recovery rooms shall not be tied in with the soiled holding or work rooms, janitors' closets or locker rooms if the air is to be recirculated in any manner.

(vi)          Air handling duct systems shall not have duct linings.

(vii)         The following general air pressure relationships to adjacent areas and ventilation rates shall apply:

Area                       Pressure Relationship          Minimum Air

Changes/Hour

Procedure                              P                                              6

Recovery                               P                                              6

Soiled work,

Janitor's closet,

Toilets,

Soiled holding                       N                                             10

Clean work or

Clean holding                       P                                              4

(P = positive pressure  N = negative pressure)

(2)           Plumbing And Other Piping Systems.

(a)           Medical Gas and Vacuum Systems

(i)            Piped-in medical gas and vacuum systems, if installed, shall meet the requirements of NFPA-99-2012, type one system, which is hereby incorporated by reference including subsequent amendments and editions.  Copies of NFPA-99-2012 may be purchased from the National Fire Protection Association, 1 Batterymarch Park, P.O. Box 9101, Quincy, MA 02269-9101, or accessed electronically free of charge at http://www.nfpa.org.

(ii)           If inhalation anesthesia is used in any concentration, the facility must meet the requirements of NFPA 70-2011 and NFPA 99-2012, current editions relating to inhalation anesthesia, which are hereby incorporated by reference including subsequent amendments and editions.  Copies of NFPA 70-2011 and NFPA 99-2012 may be purchased from the National Fire Protection Association, 1 Batterymarch Park, P.O. Box 9101, Quincy, MA 02269-9101, or accessed electronically free of charge at http://www.nfpa.org.

(b)           Lavatories and sinks for use by medical personnel shall have the water supply spout mounted so that its discharge point is a minimum distance of five inches above the rim of the fixture with mixing type fixture valves that can be operated without the use of the hands.

(c)           Hot water distribution systems shall provide hot water at hand washing and bathing facilities at a minimum temperature of 100 degrees F. and a maximum temperature of 116 degrees F.

(d)           Floor drains shall not be installed in procedure rooms.

(e)           Building drainage and waste systems shall be designed to avoid installations in the ceiling directly above procedure rooms.

(3)           Electrical Requirements.

(a)           Procedure and recovery rooms, and paths of egress from these rooms to the outside shall have at a minimum, listed battery backup lighting units of one and one-half hour capability that will automatically provide at least five foot candles of illumination at the floor in the event needed for a utility or local lighting circuit failure.

(b)           Electrically operated medical equipment necessary for the safety of the patient shall have, at a minimum, battery backup.

(c)           Receptacles located within six feet of sinks or lavatories shall be ground-fault protected.

(d)           At least one wired-in, ionization-type smoke detector shall be within 15 feet of each procedure or recovery room entrance.

(4)           Buildings systems and medical equipment shall have preventative maintenance conducted as recommended by the equipment manufacturers' or installers' literature to assure operation in compliance with manufacturer's instructions.

 

History Note:        Authority G.S. 14‑45.1(a); 143B-10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. October 1, 2015; July 1, 1994; December 1, 1989.

 

10A NCAC 14E .0207       AREA REQUIREMENTS

The following areas shall comply with Rule .0206 of this Section, and are considered minimum requirements for clinics that are certified by the Division to perform abortions:

(1)           receiving area;

(2)           examining room;

(3)           preoperative preparation and holding room;

(4)           individual patient locker facilities or equivalent;

(5)           procedure room;

(6)           recovery room;

(7)           clean workroom;

(8)           soiled workroom;

(9)           medicine room may be defined as area in the clean workroom if a self‑contained secure cabinet complying with security requirements of state and federal laws is provided;

(10)         separate and distinct areas for storage and handling clean and soiled linen;

(11)         patient toilet;

(12)         personnel lockers and toilet facilities;

(13)         laboratory;

(14)         nourishment station with storage and preparation area for serving meals or in‑between meal snacks;

(15)         janitor's closets;

(16)         adequate space and equipment for assembling, sterilizing and storing medical and surgical supplies;

(17)         storage space for medical records; and

(18)         office space for nurses' charting, doctors' charting, communications, counseling, and business functions.

 

History Note:        Authority G.S. 14‑45.1(a); 143B‑10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. October 1, 2015; December 24, 1979.

 

10A NCAC 14E .0208       SHARED SERVICES

When there is written indication that services are to be shared or purchased, appropriate modifications or deletions in space requirements may be anticipated.

 

History Note:        Authority G.S. 14‑45.1(a); 143B‑10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977.

 

SECTION .0300 ‑ ADMINISTRATION

 

10A NCAC 14E .0301       OWNERSHIP

The ownership of the abortion clinic shall be fully disclosed to the Division.

 

History Note:        Authority G.S. 14‑45.1(a); 143B‑10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977.

 

SECTION .0300 – governing AUTHORITY

 

10A NCAC 14E .0302       governing authority

(a)  The governing authority, as defined in Rule .0101(6) of this Subchapter, shall appoint a chief executive officer or a designee of the clinic to represent the governing authority and shall define his or her authority and duties in writing.  This person shall be responsible for the management of the clinic, implementation of the policies of the governing authority and authorized and empowered to carry out the provisions of these Rules.

(b)  The chief executive officer or designee shall designate, in writing, a person to act on his or her behalf during his or her absence.  In the absence of the chief executive officer or designee, the person on the grounds of the clinic who is designated by the chief executive officer or designee to be in charge of the clinic shall have access to all areas in the clinic related to patient care and to the operation of the physical plant.

(c)  When there is a planned change in ownership or in the chief executive officer, the governing authority of the clinic shall notify the Division in writing of the change.

(d)  The clinic's governing authority shall adopt operating policies and procedures that shall:

(1)           specify the individual to whom responsibility for operation and maintenance of the clinic is delegated and methods established by the governing authority for holding such individuals responsible;

(2)           provide for at least annual meetings of the governing authority, for which minutes shall be maintained; and

(3)           maintain a policies and procedures manual designed to ensure professional and safe care for the patients which shall be reviewed, and revised when necessary, at least annually, and shall include provisions for administration and use of the clinic, compliance, personnel quality assurance, procurement of outside services and consultations, patient care policies, and services offered.

(e)  When the clinic contracts with outside vendors to provide services such as laundry, or therapy services, the governing authority shall be responsible to assure the supplier meets the same local and state standards the clinic would have to meet if it were providing those services itself using its own staff.

(f)  The governing authority shall provide for the selection and appointment of the professional staff and the granting of clinical privileges and shall be responsible for the professional conduct of these persons.

(g)  The governing authority shall be responsible for ensuring the availability of supporting personnel to meet patient needs and to provide safe patient care.

 

History Note:        Authority G.S. 14‑45.1(a); 143B‑10; S.L. 2013-366, s. 4(c);

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. October 1, 2015; December 1, 1989.

 

10A NCAC 14E .0303       POLICIES AND PROCEDURES and administrative records

(a)  The following essential documents and references shall be on file in the administrative office of the clinic:

(1)           documents evidencing control and ownerships, such as deeds, leases, or incorporation or partnership papers;

(2)           policies and procedures of the governing authority, as required by Rule .0302 of this Section;

(3)           minutes of the governing authority meetings;

(4)           minutes of the clinic's professional and administrative staff meetings;

(5)           a current copy of the rules of this Subchapter;

(6)           reports of inspections, reviews, and corrective actions taken related to licensure; and

(7)           contracts and agreements related to licensure to which the clinic is a party.

(b)  All operating licenses, permits, and certificates shall be displayed on the licensed premises.

(c)  The governing authority shall prepare a manual of clinic policies and procedures for use by employees, medical staff, and contractual physicians to assist them in understanding their responsibilities within the organizational framework of the clinic.  These shall include:

(1)           patient selection and exclusion criteria; and clinical discharge criteria;

(2)           policy and procedure for validating the full and true name of the patient;

(3)           policy and procedure for each type of abortion procedure performed at the clinic;

(4)           policy and procedure for the provision of patient privacy in the recovery area of the clinic;

(5)           protocol for determining gestational age as defined in Rule .0101(5) of this Subchapter;

(6)           protocol for referral of patients for whom services have been declined; and

(7)           protocol for discharge instructions that informs patients who to contact for post-procedural problems and questions.

 

History Note:        Authority G.S. 14‑45.1(a); 143B-10; S.L. 2013-366 s. 4(c);

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. October 1, 2015; July 1, 1994.

 

10A NCAC 14E .0304       ADMISSION AND DISCHARGE

(a)  There shall be on the premises throughout all hours of operation an employee authorized to receive patients and to make administrative decisions on their disposition.

(b)  All patients shall be admitted only under the care of a physician who is currently licensed to practice medicine in North Carolina.

(c)  Any patient not discharged within 12 hours following the abortion procedure shall be transferred to a general hospital.

(d)  Following admission and prior to obtaining the consent for the procedure, representatives of the clinic's management shall provide to each patient the following information:

(1)           a fee schedule and any extra charges routinely applied;

(2)           the name of the attending physician(s) and hospital admitting privileges, if any. In the absence of admitting privileges a statement to that effect shall be included;

(3)           instructions for post-procedure problems and questions as outlined in Rule .0313(d) of this Section;

(4)           grievance procedures a patient may follow if dissatisfied with the care and services rendered; and

(5)           the telephone number for Complaint Intake of the Division.

 

History Note:        Authority G.S. 14‑45.1(a); 143B-10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. October 1, 2015; July 1, 1995; July 1, 1994; December 1, 1989.

 

10A NCAC 14E .0305       MEDICAL RECORDS

(a)  A complete and permanent record shall be maintained for all patients including:

(1)           the date and time of admission and discharge;

(2)           the patient's full and true name;

(3)           the patient's address;

(4)           the patient's date of birth;

(5)           the patient's emergency contact information;

(6)           the patient's diagnoses;

(7)           the patient's duration of pregnancy;

(8)           the patient's condition on admission and discharge;

(9)           a voluntarily-signed consent for each surgery or procedure and signature of the physician performing the procedure witnessed by a family member, other patient representative, or facility staff member;

(10)         the patient's history and physical examination including identification of pre-existing or current illnesses, drug sensitivities or other idiosyncrasies having a bearing on the procedure or anesthetic to be administered; and

(11)         documentation that indicates all items listed in Rule .0304(d) of this Section were provided to the patient.

(b)  All other pertinent information such as pre- and post-procedure instructions, laboratory report, drugs administered, report of abortion procedure, and follow-up instruction, including family planning advice, shall be recorded and authenticated by signature, date, and time.

(c)  If Rh is negative, the significance shall be explained to the patient and so recorded.  The patient in writing may reject Rh immunoglobulin.  A written record of the patient's decision shall be a permanent part of her medical record.

(d)  An ultrasound examination shall be performed and the results, including gestational age, placed in the patient's medical record for any patient who is scheduled for an abortion procedure.

(e)  The clinic shall maintain a daily procedure log of all patients receiving abortion services.  This log shall contain at least the following:

(1)           the patient name;

(2)           the estimated length of gestation;

(3)           the type of procedure;

(4)           the name of physician:

(5)           the name of Registered Nurse on duty; and

(6)           the date and time of procedure.

(f)  Medical records shall be the property of the clinic and shall be preserved or retained in the State of North Carolina for a period of not less than 10 years from the date of the most recent discharge, unless the client is a minor, in which case the record must be retained until three years after the client's 18th birthday, regardless of change of clinic ownership or administration.  Such medical records shall be made available to the Division upon request and shall not be removed from the premises where they are retained except by subpoena or court order.

(g)  The clinic shall have a written plan for destruction of medical records to identify information to be retained and the manner of destruction to ensure confidentiality of all material.

(h)  Should a clinic cease operation, arrangements shall be made for preservation of records for at least 10 years.  The clinic shall send written notification to the Division of these arrangements.

 

History Note:        Authority G.S. 14‑45.1(a); 143B-10; S.L. 2013-366, s. 4(c);

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. October 1, 2015; July 1, 1994; December 1, 1989.

 

10A NCAC 14E .0306       PERSONNEL RECORDS

(a)  Personnel Records:

(1)           A record of each employee shall be maintained that includes the following:

(A)          employee's identification;

(B)          application for employment that includes education, training, experience and references;

(C)          resume of education and work experience;

(D)          verification of valid license (if required), education, training, and prior employment experience; and

(E)           verification of references.

(2)           Personnel records shall be confidential.

(3)           Notwithstanding the requirement found in Subparagraph (b)(2) of this Rule, representatives of the Division conducting an inspection of the clinic shall have the right to inspect personnel records.

(b)  Job Descriptions:

(1)           The clinic shall have a written description that describes the duties of every position.

(2)           Each job description shall include position title, authority, specific responsibilities, and minimum qualifications.  Qualifications shall include education, training, experience, special abilities, and valid license or certification required.

(3)           The clinic shall review annually and, if needed, update all job descriptions. The clinic shall provide the updated job description to each employee or contractual employee assigned to the position.

(c)  All persons having direct responsibility for patient care shall be at least 18 years of age.

(d)  The clinic shall provide an orientation program to familiarize each new employee or contractual employee with the clinic, its policies, and the employee's job responsibilities.

(e)  The governing authority shall be responsible for implementing health standards for employees, as well as contractual employees, which are consistent with recognized professional practices for the prevention and transmission of communicable diseases.

(f)  Employee and contractual employee records for health screening as defined in Rule .0101(7) of this Subchapter, education, training, and verification of professional certification shall be available for review by the Division.

 

History Note:        Authority G.S. 14‑45.1(a); 14-45.1(a1); 143B-10; S.L. 2013-366, s. 4(c);

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. October 1, 2015; July 1, 1994.

 

10A NCAC 14E .0307       NURSING SERVICE

(a)  The clinic shall have an organized nursing staff under the supervision of a nursing supervisor who is currently licensed as a Registered Nurse and who has responsibility and accountability for all nursing services.

(b)  The nursing supervisor shall be responsible and accountable to the chief executive officer or designee for:

(1)           provision of nursing services to patients; and

(2)           developing a nursing policy and procedure manual and written job descriptions for nursing personnel.

(c)  The clinic shall have the number of licensed and ancillary nursing personnel on duty to assure that staffing levels meet the total nursing needs of patients based on the number of patients in the clinic and their individual nursing care needs.

(d)  There shall be at least one Registered Nurse with experience in post‑operative or post‑partum care who is currently licensed to practice professional nursing in North Carolina on duty in the clinic at all times patients are in the clinic.

 

History Note:        Authority G.S. 14‑45.1(a); 143B‑10; S.L. 2013-366, s. 4(c);

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. October 1, 2015; December 1, 1989.

 

10A NCAC 14E .0308       QUALITY ASSURANCE

(a)  The governing authority shall establish a quality assurance program for the purpose of providing standards of care for the clinic.  The program shall include the establishment of a committee that shall evaluate compliance with clinic procedures and policies.

(b)  The committee shall determine corrective action, if necessary.

(c)  The committee shall consist of at least one physician who is not an owner, the chief executive officer or designee, and other health professionals.  The committee shall meet at least once per quarter.

(d)  The functions of the committee shall include development of policies for selection of patients, approval for adoption of policies, review of credentials for staff privileges, peer review, tissue inspection, establishment of infection control procedures, and approval of additional procedures to be performed in the clinic.

(e)  Records shall be kept of the activities of the committee for a period not less than 10 years.  These records shall include:

(1)           reports made to the governing authority;

(2)           minutes of committee meetings including date, time, persons attending, description and results of cases reviewed, and recommendations made by the committee; and

(3)           information on any corrective action taken.

(f)  Orientation, training, or education programs shall be conducted to correct deficiencies that are uncovered as a result of the quality assurance program.

 

History Note:        Authority G.S. 14‑45.1(a); 143B-10; S.L. 2013-366, s. 4(c);

Eff. October 1, 2015.

 

10A NCAC 14E .0309       LABORATORY SERVICES

(a)  Each clinic shall have the capability to provide or obtain laboratory tests required in connection with the procedure to be performed.

(b)  The governing authority shall establish written policies requiring examination by a pathologist of all surgical specimens except for those types of specimens that the governing authority has determined do not require examination.

(c)  Each patient shall have the following performed and a record of the results placed in the patient's medical record prior to the abortion:

(1)           pregnancy testing, except when a positive diagnosis of pregnancy has been established by ultrasound;

(2)           anemia testing (hemoglobin or hematocrit); and

(3)           Rh factor testing.

(d)  Patients requiring the administration of blood shall be transferred to a local hospital having blood bank facilities.

(e)  The clinic shall maintain a manual in a location accessible by employees, that includes the procedures, instructions, and manufacturer's instructions for each test procedure performed, including:

(1)           sources of reagents, standard and calibration procedures, and quality control procedures; and

(2)           information concerning the basis for the listed "normal" ranges.

(f)  The clinic shall perform and document, at least quarterly, calibration of equipment and validation of test results.

 

History Note:        Authority G.S. 14‑45.1(a); 143B-10; S.L. 2013-366, s. 4(c);

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. October 1, 2015; July 1, 1994; December 1, 1989; October 28, 1981.

 

10a NCAC 14E .0310       EMERGENCY BACK‑UP SERVICES

(a)  Each clinic shall have a written plan for the transfer of emergency cases from the clinic to a nearby hospital when hospitalization becomes necessary.

(b)  The clinic shall have procedures, personnel, and suitable equipment to handle medical emergencies which may arise in connection with services provided by the clinic.

(c)  The clinic shall have a written agreement between the clinic and a hospital to facilitate the transfer of patients who are in need of emergency care.  A clinic that has documentation of its efforts to establish such a transfer agreement with a hospital that provides emergency services and has been unable to secure such an agreement shall be considered to be in compliance with this Rule.

(d)  The clinic shall provide intervention for emergency situations.  These provisions shall include:

(1)           basic cardio-pulmonary life support;

(2)           emergency protocols for:

(A)          administration of intravenous fluids;

(B)          establishing and maintaining airway support;

(C)          oxygen administration;

(D)          utilizing a bag-valve-mask resuscitator with oxygen reservoir;

(E)           utilizing a suction machine; and

(F)           utilizing an automated external defibrillator;

(3)           emergency lighting available in the procedure room as set forth in Rule .0206 of this Subchapter; and

(4)           ultrasound equipment.

 

History Note:        Authority G.S. 14‑45.1(a); 143B-10; S.L. 2013-366, s. 4(c);

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. October 1, 2015; July 1, 1994; December 24, 1979.

 

10A NCAC 14E .0311       SURGICAL SERVICES

(a)  The procedure room shall be maintained exclusively for surgical procedures and shall be so designed and maintained to provide an atmosphere free of contamination by pathogenic organisms.  The clinic shall establish procedures for infection control and universal precautions.

(b)  Tissue Examination:

(1)           The physician performing the abortion is responsible for examination of all products of conception (P.O.C.) prior to patient discharge.  Such examination shall note specifically the presence or absence of chorionic villi and fetal parts, or the amniotic sac.  The results of the examination shall be recorded in the patient's medical record.

(2)           If adequate tissue is not obtained based on the gestational age, ectopic pregnancy or an incomplete procedure shall be considered and evaluated by the physician performing the procedure.

(3)           The clinic shall establish procedures for obtaining, identifying, storing, and transporting specimens.

 

History Note:        Authority G.S. 14‑45.1(a); 143B-10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. October 1, 2015; July 1, 1994; December 1, 1989; November 1, 1984; September 1, 1984.

 

10A NCAC 14E .0312       MEDICATIONS AND ANESTHESIA

(a)  Medication

(1)           No medication or treatment shall be given except on written order of a physician.

(2)           Medications must be administered in accordance with the Nurse Practice Act of the State of North Carolina, and must be recorded in the patient's permanent record.

(b)  Anesthesia

(1)           The anesthesia must be administered only under the direct supervision of a licensed physician.

(2)           Flammable anesthetics shall be prohibited except when construction, storage and equipment meet the standards of the National Fire Protection Association (N.F.P.A.) incorporated in Bulletin No. 56, "Code for Use of Flammable Anesthetics."

 

History Note:        Authority G.S. 14‑45.1(a); 143B‑10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977.

 

10A NCAC 14E .0313       POST‑OPERATIVE CARE

(a)  A patient whose pregnancy is terminated on an ambulatory basis shall be observed in the clinic to ensure that no post‑operative complications are present.  Thereafter, patients may be discharged according to a physician's order and the clinic's protocols.

(b)  Any patient having an adverse condition or complication known or suspected to have occurred during or after the performance of the abortion shall be transferred to a hospital for evaluation or admission.

(c)  The following criteria shall be documented prior to discharge:

(1)           the patient shall be ambulatory with a stable blood pressure and pulse; and

(2)           bleeding and pain shall be controlled.

(d)  Written instructions shall be issued to all patients in accordance with the orders of the physician in charge of the abortion procedure and shall include the following:

(1)           symptoms and complications to be looked for; and

(2)           a dedicated telephone number to be used by the patients should any complication occur or question arise.  This number shall be answered by a person 24 hours a day, seven days a week. 

(e)  The clinic shall have a defined protocol for triaging post-operative calls and complications.  This protocol shall establish a pathway for physician contact to ensure ongoing care of complications that the operating physician is incapable of managing.

 

History Note:        Authority G.S. 14‑45.1(a); 143B‑10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. October 1, 2015; December 24, 1979.

 

10A NCAC 14E .0314       CLEANING OF MATERIALS AND EQUIPMENT

(a)  All supplies and equipment used in patient care shall be properly cleaned or sterilized between use for different patients.

(b)  Methods of cleaning, handling, and storing all supplies and equipment shall be such as to prevent the transmission of infection through their use.

 

History Note:        Authority G.S. 14‑45.1(a); 143B‑10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977.

 

10A NCAC 14E .0315       HOUSEKEEPING

Clinics that are certified by the Division to perform abortions shall meet the standards for sanitation as required by the Division of Public Health, Environmental Health Section, in the rules and regulations governing the sanitation of hospitals, nursing homes, adult care homes, and other institutions, set forth in 15A NCAC 18A .1300, including subsequent amendments and editions, with special emphasis on the following:

(1)           the floors, walls, woodwork and windows must be cleaned, and accumulated waste material must be removed at least daily;

(2)           the premises must be kept free from rodents and insect infestation;

(3)           bath and toilet facilities must be maintained in a clean and sanitary condition at all times; and

(4)           linen that comes directly in contact with the patient shall be provided for each individual patient.  No such linen shall be interchangeable from one patient to another before being cleaned, sterilized, or laundered.

Copies of 15A NCAC 18A .1300 may be obtained at no charge from the Division of Public Health, Environmental Health Section, 1632 Mail Service Center, Raleigh, NC, 27699-1632, or accessed electronically free of charge from the Office of Administrative Hearings at http://www.ncoah.com.

 

History Note:        Authority G.S. 14‑45.1(a); 143B‑10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. October 1, 2015; December 1, 1989.

 

10A NCAC 14E .0316       FOOD SERVICE

(a)  Nourishments shall be available and offered to all patients.

(b)  Sanitary conditions shall be maintained in accordance with regulations of the North Carolina Sanitation Code administered by the Division of Environmental Health.

 

History Note:        Authority G.S. 14‑45.1(a); 143B‑10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977;

Amended Eff. January 1, 1990.

 

SECTION .0400 ‑ MEDICAL STAFF

 

10A NCAC 14E .0401       QUALIFICATIONS

Every person admitted to practice in the clinic shall qualify by submitting a signed application in writing which shall contain the following data:  age, year and school of graduation, date of licensure, statement of postgraduate work, and experience.

 

History Note:        Authority G.S. 14‑45.1(a); 143B‑10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977.

 

10A NCAC 14E .0402       FILE

An individual file for each physician practicing in the clinic shall be maintained.  Each file shall contain the information outlined in Rule .0401 of this Section.

 

History Note:        Authority G.S. 14‑45.1(a); 143B‑10;

Eff. February 1, 1976;

Readopted Eff. December 19, 1977.

 

 

 

subchapter 14F- certification of cardiac rehabilitation programs

 

section .0100 – reserved for future codificaiton

section .0200 – reserved for future codification

 

section .0300 – reserved for future codification

 

section .0400 – reserved for future codification

 

section .0500 – reserved for future codification

 

section .0600 – reserved for future codification

 

section .0700 – reserved for future codification

 

section .0800 – reserved for future codification

 

section .0900 – reserved for future codification

 

section .1000 – reserved for future codification

 

SECTION .1100 – GENERAL INFORMATION: DEFINITIONS

 

10A NCAC 14F .1101        DEFINITIONS

The following definitions shall apply throughout this Subchapter:

(1)           "ACLS-trained" means training that is current in Advanced Cardiac Life Support, by the American Heart Association and who has appropriate licensure to administer advanced cardiac life support.

(2)           "ACSM" means the American College of Sports Medicine.

(3)           "Article" means Article 8 of G.S. 131E.

(4)           "Cardiac Rehabilitation Program" has the same meaning as the definition in the Article.

(5)           "Certification" has the same meaning as the definition in the Article.

(6)           "DVRS" means the Division of Vocational Rehabilitation Services, North Carolina Department of Health and Human Services.

(7)           "Department" means the North Carolina Department of Health and Human Services.

(8)           "Division" means the Division of Health Service Regulation, North Carolina Department of Health and Human Services.

(9)           "ECG" means electrocardiogram.

(10)         "Graded exercise test" (GXT) means a multistage test that determines a person's physiological response to different intensities of exercise or the person's peak aerobic capacity.

(11)         "Maximal oxygen consumption" means the highest rate of oxygen transport and oxygen use that can be achieved at a person's maximal physical exertion, or functional capacity.  This is usually expressed in METs.

(12)         "MET" means "metabolic equivalent," a measure of functional capacity, or maximal oxygen consumption.  One MET represents the approximate rate of oxygen consumption by a seated individual at rest: approximately 3.5 ml/kg/min.  METs during exercise are determined by dividing metabolic rate during exercise by the metabolic rate at rest.

(13)         "Nurse Practitioner" means a currently licensed registered nurse approved by the NC Board of Nursing and NC Medical Board to practice medicine as a nurse practitioner under the supervision of a physician licensed by the Board.

(14)         "Owner" means the legal owner of the certified cardiac rehabilitation program.

(15)         "Physician" means an individual who is licensed according to G.S. 90, Article 1, by the NC Medical Board to practice medicine.

(16)         "Physician Assistant" means an individual who is licensed and registered according to G.S. 90, Article 1, by the NC Medical Board to practice medicine under the supervision of a physician licensed by the Board.

(17)         "Premises" means "site."

(18)         "Program" means "Cardiac Rehabilitation Program."

(19)         "Risk stratification model" means a method of categorizing patients according to their risk of acute cardiovascular complications during exercise as well as their overall prognosis.  Risk status is related primarily to the type and severity of cardiovascular disease.  This rating takes into account how well the heart pumps, the presence of heart pain symptoms and/or changes in the electrocardiogram during exercise.  Guidelines concerning medical supervision of patients in cardiac rehabilitation programs which are based on risk stratification models are provided by: the American College of Cardiology, the American College of Physicians, the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the North Carolina Cardiopulmonary Rehabilitation Association.

(20)         "Simple spirometry" means an analysis of air flow which provides information as to the degree and severity of airway obstruction, and serves as an index of dynamic lung function.  It must include, at a minimum, Forced Vital Capacity and Forced Expiratory Volume in 1 second.

(21)         "Site" means the facility in which the cardiac rehabilitation program is held.

(22)         "Supervising physician" means a physician who is on-site during the operation of the cardiac rehabilitation program.

(23)         "Symptom-limited heart rate reserve" means the difference between the symptom-limited maximal heart rate and the resting heart rate.

(24)         "Vocational Questionnaire" means the document used for vocational assessment.

(25)         "Vocational Rehabilitation Counselor" means an individual who provides vocational rehabilitation counseling services.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

SECTION .1200 – CERTIFICATION

 

10A NCAC 14F .1201        CERTIFICATE

The named person(s) and the street address of the named premises shall appear on the certificate.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

10A ncac 14F .1202        CERTIFICATION PROCESS

(a)  To initiate the certification process, an application for certification shall be filed with the Department by the owner of the cardiac rehabilitation services.

(b)  Application forms shall be available from the Department, and each application shall contain at least the following information:

(1)           legal identity of the owner-applicant;

(2)           name or names under which the facility or services are advertised or presented to the public;

(3)           program mailing address;

(4)           program exercise site;

(5)           program telephone number;

(6)           ownership disclosure;

(7)           name of program director;

(8)           name of medical director; and

(9)           program hours of operation.

(c)  No applicant shall offer any cardiac rehabilitation services described or represented as a "Certified Cardiac Rehabilitation Program," unless the services have been certified in accordance with the provisions of this Subchapter.

(d)  Except as otherwise provided in this Section, the Department shall inspect and evaluate the program and premises identified in the application and shall thereafter issue a certificate upon its determination that the applicant has substantially complied with, and the program and the services at the premises substantially met, the provisions of the Article and this Subchapter.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

10A NCAC 14F .1203        CERTIFICATE RENEWAL

(a)  A certificate issued pursuant to the Article and this Subchapter shall expire two years after the effective date but can be renewed upon the successful re-evaluation of the program.  To initiate the renewal process, an application for certification shall be filed with the Department by the owner of the program.

(b)  Determination of compliance with the provisions of the Article and this Subchapter for purposes of certificate renewal may, at the discretion of the Department, be based upon an inspection or upon review of requested information submitted by a program to the Department.

 

History Note:        Authority G.S. 131E-167; 131E-169;

Eff. July 1, 2000.

 

10A NCAC 14F .1204        CERTIFICATION FOLLOWING PROGRAM CHANGES

(a)  The Department shall be notified, in writing, at least 30 days prior to the effective date, of any expected occurrences of the following:

(1)           change in program ownership;

(2)           change in program name;

(3)           change of the premises in which a program is conducted; and

(4)           the replacement or termination of employment of the program director.

(b)  If a 30-day advanced written notification of any occurrence enumerated in Paragraph (a) of this Rule is not possible, the Department shall be notified immediately, by any reasonably reliable means of notification, of such expected or completed occurrence, and written notification shall follow immediately thereafter.

(c)  Upon the occurrences enumerated in Subparagraphs (a)(1), (2), and (3) of this Rule, the owner of the program shall file with the Department an application for certification, which, at a minimum, shall contain the information specified in Rule .1202(b) of this Subchapter, and shall provide such other documentation and information as requested by the Department.

(d)  The revised program shall be evaluated for compliance with the provisions of the Article and this Section.  Evaluation may be based upon inspection of the program or upon review of requested information submitted by a program to the Department.  After a determination by the Department that the program substantially complies with the provisions of the Article and this Subchapter, a new certificate shall be issued.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

10A NCAC 14F .1205        INSPECTIONS

(a)  In accordance with G.S. 131E-167(c), inspection(s) shall be made by the Department before a program is issued its initial certification as a program defined in the Article.

(b)  The Department shall make or cause to be made such other inspections of a program as it deems necessary in accordance with the Article.  Circumstances which may be deemed to necessitate an inspection include, but are not limited to:

(1)           change in program ownership;

(2)           change in program name;

(3)           change of the premises in which a program is conducted;

(4)           the replacement or termination of employment of the program director; and

(5)           investigation of complaints.

(c)  Inspections shall be announced or unannounced and may be conducted any time during program business hours.  The purpose of any inspection shall be discussed with the Program Director or designee during an entrance conference.

(d)  Information deemed necessary by the Department to evaluate compliance with the Article and this Subchapter, shall be made available for inspection.  The information may include medical records, personnel files, policies and procedures, program records, interviews with program staff, interviews with patients, observation of the program in operation, and any other information necessary to determine compliance.

(e)  Following completion of an inspection, an exit conference shall be conducted with one or more representatives of the program's management.  An oral summary of the findings shall be presented at the exit conference.  The Department shall provide the program with a written report of the findings.  The program shall have 10 working days from the receipt of the report to respond with a plan of correction which describes the corrective actions planned and taken to correct any cited deficiency(ies), the date each deficiency was or will be corrected, and the date the program expects to be in compliance with the provisions of the Article and this Subchapter.

 

History Note:        Authority G.S. 131E-169; 131E-170;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

10A NCAC 14f .1206        ADVERSE ACTION

(a)  Upon a determination that there has been a substantial failure to comply with the provisions of the Article or the rules contained in this Subchapter, the Department may, at its discretion, deny a new or renewal certificate, suspend or revoke an existing certificate, or, as enumerated in Paragraph (c) of this Rule, issue a provisional certificate.

(b)  Substantial noncompliance which has endangered, or has a potential to endanger the health, safety, or welfare of any patient, shall be cause for the denial, revocation, or suspension of a certificate.

(c)  Substantial noncompliance which does not endanger the health, safety, or welfare of the patients being served may, at the discretion of the Department, result in the issuance of a provisional certificate for a period not to exceed six months.

 

History Note:        Authority G.S. 131E-168; 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

SECTION .1300 – ADMINISTRATION

 

10A NCAC 14F .1301        STAFF REQUIREMENTS AND RESPONSIBILITIES

(a)  Each program shall be conducted utilizing an interdisciplinary team composed of a program director, medical director, nurse, exercise specialist, mental health professional, dietician or nutritionist, supervising physician, physician assistant or nurse practitioner, and a DVRS or other vocational rehabilitation counselor.  The program may employ, full-time or part-time, or contract for the services of team members. Program staff shall be available to patients as needed to perform initial assessments and to implement each patient's cardiac rehabilitation care plan.

(b)  Individuals may perform multiple team functions, if qualified for each function, as stated in this Rule:

(1)           Program Director - supervises program staff and directs all facets of the program.

(2)           Medical Director B physician who provides medical assessments and is responsible for supervising all clinical aspects of the program and for assuring the adequacy of emergency procedures and equipment, testing equipment, and personnel.

(3)           Nurse - provides nursing assessments and services.

(4)           Exercise Specialist - provides an exercise assessment, in consultation with the medical director, plans and evaluates exercise therapies.

(5)           Mental Health Professional - provides directly or assists program staff in completion of the mental health screening and referral, if indicated, for further mental health services.

(6)           Dietitian or Nutritionist - provides directly or assists program staff in completion of the nutrition assessment and referral, if indicated, for further nutrition services.

(7)           Supervising Physician, Physician Assistant, or Nurse Practitioner - medical person who is on-site during the operation of programs that are not located within a hospital.

(8)           DVRS or other Vocational Rehabilitation Counselor - screens patients who may be eligible for and interested in vocational rehabilitation services, develops assessment and intervention strategies, and provides other services as needed to meet the vocational goal(s) of patients who may be eligible for and interested in services.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000.

 

10A NCAC 14F .1302        POLICIES AND PROCEDURES

The program director shall assure that written policies and procedures are adopted by the program, approved by the medical director, and available to and implemented by staff.  At a minimum, these policies and procedures shall include the following areas:

(1)           admission of patients and orientation to the program;

(2)           patient assessment, care planning, and implementation of therapies;

(3)           patient follow-up evaluations, including progress toward cardiac rehabilitation goals;

(4)           patient discharge;

(5)           medical records, in accordance with Rule .2002 of this Subchapter;

(6)           orientation of all program personnel;

(7)           maintenance of personnel records which include job descriptions, verification of credentials, continuing education and current competencies;

(8)           use and orientation of volunteers;

(9)           communication with patient's referral and personal physicians;

(10)         provisions for reporting and investigating complaints and accidental events regarding patients, visitors and personnel (incidents) and corrective action taken;

(11)         emergency procedures;

(12)         a preventative maintenance program to assure all equipment is maintained in safe and proper working order and in accordance with the manufacturer's recommendations; and

(13)         quality improvement program.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

10a NCAC 14F .1303        CONTINUOUS QUALITY IMPROVEMENT

(a)  The cardiac rehabilitation program shall have an ongoing Continuous Quality Improvement (CQI) program which identifies quality deficiencies and addresses them with corrective plans of action, as indicated.

(b)  The CQI program shall evaluate the appropriateness, effectiveness, and quality of the cardiac rehabilitation program, with findings used to verify policy implementation, to identify problems, and to establish problem resolution and policy revision as necessary.

(c)  The CQI program shall consist of an overall policy and administration review, including admission and discharge policies, emergency care, patient records, personnel qualifications and program evaluation.  Data to be assessed shall include, at a minimum, the following:

(1)           number of patients in the program;

(2)           average length (weeks) patients are in the program;

(3)           patient clinical outcomes;

(4)           adequacy of staff to meet program/patient needs;

(5)           reasons for discharge; and

(6)           untoward events.

(d)  A sample of active and closed records shall be reviewed at least semi-annually to assure program policies are followed and the program is in compliance with the Article and the rules contained in this Subchapter.

(e)  Documentation of the CQI program shall include the criteria and methods used to collect and analyze data, identification of quality deficiencies, and any action(s) taken by the cardiac rehabilitation program as a result of CQI findings.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

SECTION .1400 – PATIENT RIGHTS

 

10A NCAC 14F .1401        PATIENT RIGHTS

(a)  Prior to or at the time of admission, the program shall provide each patient with a written notice of the patient's rights and responsibilities.  The program shall maintain documentation showing that all patients have been informed of their rights and responsibilities.

(b)  Each patient's rights shall include, at a minimum, the right to:

(1)           be informed and participate in developing the patient's plan of care;

(2)           voice grievances about the care provided, and not be subjected to discrimination or reprisal for doing so;

(3)           confidentiality of the patient's records;

(4)           be informed of the patient's liability for payment for services;

(5)           be informed of the process for acceptance and continuation of service and eligibility determination;

(6)           accept or refuse services; and

(7)           be advised of the program's procedures for discharge.

(c)  The program shall provide all patients with a telephone number for information, questions or complaints about services provided by the program.  The program shall also provide the Division Complaints Hotline number or the Department of Health and Human Services Careline number or both.

(d)  The program shall investigate, within seven days, complaints made to the program by the patient, the patient's family, or significant other, and must document both the existence of the complaint and the resolution of the complaint.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

SECTION .1500 – ADMISSION AND DISCHARGE

 

10A NCAC 14F .1501        ADMISSION AND DISCHARGE

(a)  All patients admitted to the program shall have a referral from a physician.

(b)  Prior to discharging a patient, the interdisciplinary team shall develop a discharge plan. At a minimum, the discharge plan shall include instructions as to how to achieve or maintain the goals established in the cardiac rehabilitation care plan.

(c)  Upon discharge from the program, a discharge summary as outlined in Rule .2002(a)(10) of this Subchapter, shall be sent to the personal or referring physician.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

SECTION .1600 – PATIENT ASSESSMENT

 

10a NCAC 14F .1601        PATIENT ASSESSMENT

(a)  Within five weeks of a patient's admission to the program, the interdisciplinary team shall complete and document a cardiac rehabilitation assessment.  At a minimum, the assessment shall include the components specified in this Rule.

(b)  Medical Assessment shall include:

(1)           cardiovascular evaluation as to present diagnosis, therapy, and a discharge summary of the patient=s last hospitalization; or

(2)           statement by referring physician as to present diagnosis, and therapy;

(3)           resting 12-lead ECG;

(4)           medical record documentation prior to or during the first exercise session of ECG, hemodynamic data, and the presence or absence of symptoms, preferably determined by a graded exercise test.  A graded exercise test shall not be required when deemed unnecessary by the patient's attending or personal physician or the program's medical director;

(5)           fasting blood chemistry, as indicated, to include total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, triglycerides, and other comparable measures; and

(6)           simple spirometry, if clinically indicated.

(c)  Physical Assessment shall include:

(1)           functional capacity as determined by measured or predicted equivalents (METs);

(2)           height, weight, or other anthropometric measures (i.e., body mass index, percent body fat, waist-to-hip ratio, girth measurements);

(3)           current and past exercise history; and

(4)           physical limitations and disabilities that may impact rehabilitation.

(d)  Nursing Assessment shall include:

(1)           coronary risk profile;

(2)           current symptoms such as angina or dyspnea, and recovery from recent cardiac events;

(3)           presence of comorbidities;

(4)           assessment of medications; and

(5)           educational needs.

(e)  Nutrition Assessment shall include:

(1)           review of medical history;

(2)           eating patterns as measured by a food diary or food frequency questionnaire;

(3)           fasting blood chemistries as described in Subparagraph (b)(5) of this Rule;

(4)           anthropometric measures as described in Subparagraph (c)(2) of this Rule;

(5)           behavioral patterns; and

(6)           identification of nutritional goals.

(f)  Mental Health Assessment shall include:

(1)           past history of mental illness including depression, anxiety, or hostility or anger; and

(2)           present mental health functioning and need for referral to a mental health professional.

(g)  Vocational Assessment shall include:

(1)           vocational questionnaire to determine current vocational status, description of physical requirements of job, working conditions, psychological demands as perceived by the patient; and

(2)           the need for vocational rehabilitation services.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

SECTION .1700 – CARE PLANNING AND FOLLOW-UP EVALUATION

 

10A NCAC 14F .1701        CARE PLANNING

(a)  Within five weeks of a patient's admission to the program, the interdisciplinary team shall develop a cardiac rehabilitation care plan for the patient based upon assessments completed as required under Section .1600 of this Subchapter.

(b)  The cardiac rehabilitation care plan, at a minimum, shall include:

(1)           the patient's exercise therapy;

(2)           nutrition services, if indicated;

(3)           mental health services, if indicated;

(4)           vocational services if, indicated;

(5)           educational counseling;

(6)           cardiac rehabilitation goals; and

(7)           discharge planning.

(c)  Within six weeks of the patient's admission to the program, a copy of the cardiac rehabilitation care plan shall be sent to the patient's personal and referring physicians.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

10A NCAC 14f .1702        FOLLOW-UP EVALUATION

(a)  The interdisciplinary team members shall attend monthly meetings for follow-up evaluation of patients' progress toward cardiac rehabilitation goals. Changes to each patient's cardiac rehabilitation care plan shall be made as needed based on continued evaluations. Any changes made in the patient's cardiac rehabilitation care plan shall be recorded in the medical record and sent to the patient's personal and referring physician(s).

(b)  If any staff member cannot attend, the reason for the absence and the means of communicating information prior to and after the meeting shall be documented.

(c)  The personal and referring physician(s) shall be informed of any complication or change in patient status while in the program.

(d)  Progress notes shall be recorded in the patient's medical record evaluating progress toward goals established from the plan of care.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

SECTION .1800 – PROVISION OF SERVICES

 

10A NCAC 14F .1801        PERSONNEL

(a)  At least one ACLS trained and one other staff member shall be present at the site during all program hours.

(b)  For cardiac rehabilitation programs that are not located within a hospital or a hospital emergency resuscitation team is not available to respond in an emergency, a supervising physician, physician assistant, or nurse practitioner shall be on-site during all program hours.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

10A NCAC 14F .1802        EXERCISE THERAPY

(a)  The medical director, in consultation with program staff, shall establish staff to patient ratios for exercise therapy sessions based on medical acuity, utilizing an acceptable risk stratification model.

(b)  If any patient has not had a graded exercise test prior to the first exercise session, the patient's first exercise session must include objective assessment of hemodynamic data, ECG, and symptom response data.

(c)  Unless contraindicated by medical and laboratory assessments or the cardiac rehabilitation care plan, each patient's exercise therapy shall include:

(1)           mode of exercise therapy including, but not limited to: walk/jog, aquatic activity, cycle ergometry, arm ergometry, resistance training, stair climbing, rowing, aerobics;

(2)           intensity:

(A)          up to 85 percent of symptom-limited heart rate reserve;

(B)          up to 80 percent of measured maximal oxygen consumption;

(C)          rating of perceived exertion (RPE) of 11 to 13 if a graded exercise test is not performed; or

(D)          for myocardial infarction patients: heart rate not to exceed 20 beats per minute above standing resting heart rate if a graded exercise test is not performed; and for post coronary artery by-pass graft patients: heart rate not to exceed 30 beats per minute above standing resting heart rate if a graded exercise test is not performed;

(3)           duration: up to 60 minutes, as tolerated, including a minimum of five minutes each for warm-up and cool-down; and

(4)           frequency: minimum of three days per week.

(d)  The patient shall be monitored through the use of electrocardiography during each exercise therapy session.  The frequency of the monitoring continuous or intermittent shall be based on medical acuity and risk stratification.

(e)  At two week intervals, the patient's adherence to the cardiac rehabilitation care plan and progress toward goals shall be monitored by an examination of exercise therapy records and documented.

(f)  The exercise specialist shall be responsible for consultation with the medical director or the patient's personal physician concerning changes in the exercise therapy, results of graded exercise tests, as needed or anticipated (e.g. regular follow-up intervals, graded exercise test conducted, or medication changes). Feedback concerning changes in the exercise therapy shall be discussed with the patient and documented.

(g)  Diabetic patients who are taking insulin or oral hypoglycemic agents for control of diabetes shall have blood sugars monitored for at least the first week of cardiac therapy sessions in order to establish the patient's level of control and subsequent response to exercise.  Cardiac rehabilitation staff shall record blood sugar measurements pre- and post-exercise.  Patients whose blood sugar values are considered abnormal for the particular patient shall be monitored.  A carbohydrate food source or serving shall be available.  Snacks shall be available in case of a hypoglycemic response.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000.

 

10A NCAC 14F .1803        NUTRITION SERVICES

If indicated, based on the nutrition assessment and cardiac rehabilitation care plan, each patient's program shall include the following nutrition services:

(1)           interpretation and feedback on the patient's eating patterns, blood chemistries, anthropometrics, and behavioral patterns;

(2)           identification of a therapeutic diet plan to determine, at a minimum, a reasonable body weight, caloric, and fat intake;

(3)           patient counseling or behavior modification based on the therapeutic diet plan and goals.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

10A NCAC 14F .1804        MENTAL HEALTH SERVICES

If indicated, based on the mental health assessment and cardiac rehabilitation care plan, each patient's program shall include the following mental health services:

(1)           feedback from mental health assessment to the patient; and  

(2)           present mental health functioning and need for referral to a mental health professional for evaluation or treatment.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

10A NCAC 14F .1805        VOCATIONAL REHABILITATION COUNSELING AND SERVICES

(a)  The cardiac rehabilitation program shall have a written agreement, with the local DVRS office or other vocational rehabilitation counselor/services, which specifies the following:

(1)           The program shall administer a Vocational Questionnaire to patients.

(2)           After administering the Vocational Questionnaire, the program shall refer to the DVRS or other vocational rehabilitation counselor/services patients who may be eligible for and desire services.

(3)           The DVRS or other vocational rehabilitation counselor shall provide feedback to the cardiac rehabilitation program regarding the eligibility for DVRS or other vocational services of referred patients.

(4)           The DVRS or other vocational rehabilitation counselor shall provide progress reports for patients who are receiving DVRS or other vocational rehabilitation services.

(5)           The DVRS or other vocational rehabilitation counselor shall attend monthly staff meetings in which eligible vocational rehabilitation clients are discussed.  If the counselor cannot attend, the reason for the absence and the means of communicating information prior to and after the meeting shall be documented and attached to the staffing report.

(b)  The cardiac rehabilitation program must have written documentation that feedback as described in Subparagraph (a)(3) of this Rule and progress reports as described in Subparagraph (a)(4) of this Rule have been communicated to the cardiac rehabilitation program by the DVRS or other counselor and, if not, the reason(s) why.

(c)  If the program is not able to complete a written agreement with the local office of DVRS or other vocational rehabilitation counselor as outlined in Paragraph (a) of this Rule, the program shall have documentation that specifies why such an agreement was not completed.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

10A NCAC 14F .1806        PATIENT EDUCATION

(a)  Each patient's cardiac rehabilitation care plan shall include participation in the program's basic education plan.  At a minimum, the education plan shall include the following topics:

(1)           basic anatomy, physiology, and pathophysiology of the cardiovascular system;

(2)           risk factor reductions, including smoking cessation and management of blood pressure, lipids, diabetes, and obesity;

(3)           principles of behavior modification including nutrition, exercise, stress management and other lifestyle changes;

(4)           relaxation training offered at least once per week by staff trained in relaxation techniques;

(5)           cardiovascular medications including compliance, interactions, and side effects;

(6)           basic principles of exercise physiology, guidelines for safe and effective exercise therapy, and guidelines for vocational/recreational exertional activities;

(7)           recognition of cardiovascular signs, symptoms and management; and

(8)           environmental considerations such as exercise in hot or cold climates.

(b)  The educational program shall include individual or group sessions utilizing written, audio, or visual educational materials as deemed appropriate and necessary by program staff.

(c)  Each session shall be documented and presented on a rotating basis such that each patient has access to all materials and classes offered.

(d)  Documentation shall be included in each patient's medical record to indicate which educational programs the patient attended.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

SECTION .1900 – EMERGENCIES

 

10A NCAC 14F .1901        EMERGENCY PLAN

A written plan approved and signed by the medical director shall be established to handle any emergencies occurring on site while cardiac rehabilitation services are being provided.  All areas of the premises pertinent to program operation shall be included.  The plan shall address the assignment of personnel and availability of equipment required in an emergency.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000.

 

10A NCAC 14F .1902        EMERGENCY EQUIPMENT

The following equipment and supplies must be available and operable in the event of an emergency and must be maintained according to manufacturer's recommendations:

(1)           suction equipment (portable);

(2)           defibrillator (portable);

(3)           intubation equipment;

(4)           medications;

(5)           oxygen tank supply;

(6)           regulator and mask for nasal cannula; and

(7)           communication system to access emergency medical services.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

10A NCAC 14F .1903        EMERGENCY DRILLS

(a)  At least six patient emergency drills shall be conducted each year and shall be documented.

(b)  Drill sites shall be rotated through all locations used by patients while participating in program activities.

(c)  The drill documentation and effectiveness of emergency drills shall be reviewed and signed by the medical director or supervising physician.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000.

 

SECTION .2000 – MEDICAL RECORDS

 

10A NCAC 14F .2001        POLICIES AND PROCEDURES FOR MEDICAL RECORDS

The program shall develop and implement policies and procedures to include at least the following:

(1)           maintenance of a complete, accurate, and organized medical record for each patient admitted to the program;

(2)           confidentiality of records;

(3)           accessibility of medical record information to the patient, program staff, and non-employees; and

(4)           authentication of entries in medical records including hard copy records and those kept in electronic medium such as computerized records.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

10A NCAC 14F .2002        CONTENT OF MEDICAL RECORDS

(a)  The medical record shall contain at least the following information:

(1)           patient identification data;

(2)           medical history and, when applicable, hospital discharge summary;

(3)           graded exercise data, if available;

(4)           resting 12-lead ECG;

(5)           signed physician referral;

(6)           records of blood chemistry analyses;

(7)           signed informed consent to participate in the program;

(8)           progress notes and response to the cardiac rehabilitation care plan;

(9)           all records of each discipline's participation in the patient's cardiac rehabilitation care plan;

(10)         a discharge summary which describes the patient's progress while in the program, reason(s) for discharge, the post-discharge plan, and follow-up as indicated;

(11)         miscellaneous clinical records developed pursuant to the patient's course of treatment.

(b)  In the case of hard copy medical records, the following shall apply:

(1)           the patient's name must be recorded on each page of the record;

(2)           all entries in the records shall be legible and authenticated with a signature, title, and date by the individual making the entry; and

(3)           faxed entries, including orders, are acceptable as long as a hard copy is incorporated in the medical record (note: thermal paper faxes are not acceptable).

(c)  At its option, the program may maintain all or part of its medical records in a form other than hard copy, such as electronic medium.  Entries in such a record shall be authenticated according to program policies and may include authentication measures such as personal computer entry codes or electronic signatures.  However, when requested by the Division or other State officials, the program must be able to produce a hard copy printout of the record.

(d)  Medical record information may be stored, such as when records are thinned or patients are discharged, in a form other than hard copy, but the program must be able to produce a hard copy printout of the record if requested by the Division or other State officials.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

SECTION .2100 – FACILITIES AND EQUIPMENT

 

10A NCAC 14F .2101        PHYSICAL ENVIRONMENT AND EQUIPMENT

(a)  The program shall provide a clean and safe environment.

(b)  Equipment and furnishings shall be cleaned not less than weekly.

(c)  All areas of the facility shall be orderly and free of debris and with clear traffic areas.

(d)  A written and documented preventative maintenance program shall be established to ensure that all equipment is calibrated and maintained in safe and proper working order in accordance with manufacturers' recommendations.

(e)  There shall be emergency access to all areas a patient may enter, and floor space must allow easy access of personnel and equipment.

(f)  Exit signs and an evacuation plan shall be posted and clearly visible.  The evacuation plan shall detail evacuation routes for patients, staff, and visitors in case of fire or other emergency.

(g)  No smoking shall be permitted in patient care or treatment areas.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000.

 

10A NCAC 14F .2102        GRADED EXERCISE TESTING LABORATORY

If the program performs graded exercise testing, the following facilities and equipment shall be available:

(1)           space for physical examination which allows for visual privacy;

(2)           adequate space and temperature and humidity controls for exercise as described under Rule .2101 of this Subchapter;

(3)           12-lead ECG equipment for recording the ECG during exercise testing;

(4)           oscilloscope for ECG monitoring or continuous recording;

(5)           treadmill, bicycle ergometer, or arm crank ergometer;

(6)           blood pressure cuff and stethoscope;

(7)           emergency procedures, equipment, and supplies as described in Section .1900 of this Subchapter; and

(8)           access to spirometer for pulmonary function testing.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

10A NCAC 14F .2103        EXERCISE THERAPY

The following equipment shall be available and operable for the provision of exercise assessment and therapy:

(1)           ECG and oscilloscope;

(2)           blood pressure cuff and stethoscope;

(3)           large clock with sweep second hand;

(4)           blood glucose testing equipment; and

(5)           equipment for the performance of anthropometric measurements such as skinfold caliper, stadiometer, tape measure, and physician's scale.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

10A NCAC 14F .2104        NUTRITION SERVICES

If provided on site, the following facilities and equipment shall be available for the provision of nutrition services:

(1)           space that allows for confidential interviewing and counseling;

(2)           nutrition guidelines and means of nutrient analysis; and

(3)           educational materials, as deemed appropriate by the program's dietitian/nutritionist, for patient distribution and use during nutrition therapy counseling.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

10A NCAC 14F .2105        MENTAL HEALTH SERVICES

If provided on site, space shall be available for the provision of the mental health services to allow for confidential interviewing and counseling.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

10A NCAC 14F .2106        VOCATIONAL REHABILITATION SERVICES

If provided on site, space shall be available for the provision of vocational rehabilitation services to allow for confidential interviewing and counseling.

 

History Note:        Authority G.S. 131E-169;

Eff. July 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. December 6, 2016.

 

 

 

SUBCHAPTER 14G - EXEMPTIONS FROM PROHIBITIONS OF SELF-REFERRALS BY HEALTH CARE PROVIDERS FOR UNDERSERVED AREAS

 

SECTION .0100 – GENERAL INFORMATION

 

10A NCAC 14G .0101       DEFINITIONS

(a)  The terms defined in G.S. 90-405 shall have the same meaning in this Subchapter.

(b)  As used in this Subchapter "Commercial lender" means commercial banks, savings banks, and savings and loan organizations and all branches of any of those three categories.

(c)  As used in this Subchapter "Regional daily newspaper" shall mean the newspaper from the following list which has the primary circulation for the area in which the entity is located or proposed to be located:

(1)           Asheville Citizen-Times,

(2)           Charlotte Observer,

(3)           Winston-Salem Journal,

(4)           Greensboro News and Record,

(5)           Raleigh News and Observer,

(6)           Fayetteville Observer,

(7)           The Daily Reflector (Greenville),

(8)           Wilmington Star.

 

History Note:        Authority G.S. 90-408;

Eff. April 1, 1995.

10A NCAC 14G .0102       APPLICATION

(a)  An application must be submitted to the Department by any health care provider wishing to be exempt from G.S. 90-406.

(b)  The application shall include the following information:

(1)           the name, address, and telephone number of the health care provider applicant;

(2)           the name, address, and telephone number of the manager of the entity to which the health care provider wishes to be able to make referrals;

(3)           an explanation of the ownership of the entity to which referrals would be made including the names and ownership interests of all individuals or entities having an investment interest in the entity;

(4)           a description of the designated health care services provided or to be provided by the entity;

(5)           an analysis of the need for the health care service in the area sufficient to allow the Department to determine that the area is an underserved area for the particular service to be provided; and

(6)           documentation of attempts made to obtain alternative financing to develop the entity in which the health care provider has an interest and an explanation as to why any proposed alternative was not reasonable.

(c)  Applications shall be sent to the Director's Office, Division of Health Service Regulation, North Carolina Department of Human Resources, 701 Barbour Drive, P.O. Box 29530, Raleigh, N.C. 27626-0530, and shall indicate the purpose of the application.

 

History Note:        Authority G.S. 90-408;

Eff. April 1, 1995.

 

10A NCAC 14G .0103       CRITERIA FOR AN UNDERSERVED AREA EXEMPTION - NEW ENTITY

(a)  In order for the Department to determine that there is a demonstrated need in the county where the entity is proposed to be located for the designated health care services to be offered by the entity the Department must conclude that:

(1)           the service or services proposed are not provided in the county within 15 miles of the proposed site of the entity; or

(2)           any existing provider of the same service or services proposed by the new entity, located in the county or within 10 miles of the proposed site of the entity, is not able to provide services to all who require the service and is unwilling or unable to expand services in order to accommodate those in need of the service.  The application shall provide written confirmation from the existing provider acknowledging unmet need and unwillingness or inability to accommodate it.

(b)  In order for the Department to determine that alternative financing is not available for a proposed new entity the applicant shall provide all of the following:

(1)           when an applicant health care provider is proposing to invest in an entity which includes non-health care providers, documentation that the non-health care providers have applied for financing from at least three commercial lenders located in the county, except that if the county does not have three commercial lenders one or more of the three may be from outside the county, and that the commercial lenders have considered and rejected the application to finance the proposed new entity; and

(2)           documentation that the plan of finance proposed to include the applicant health care provider in an entity which includes non-health care providers has the applicant health care provider participating on essentially the same terms as those proposed to the commercial lenders referenced in Subparagraph (b)(1) of this Rule; and

(3)           documentation that any non health care providers who are proposed to be parties to the financing, are proposed to be participating under the same terms and conditions as that proposed for the health care providers; and

(4)           documentation that an advertisement at least 3 inches wide and 3 inches long has been placed in four successive Sunday editions of a regional daily newspaper by any proposed non-health care provider owners under the heading "Investment Opportunity" describing the type of investment available, and that no responses have been received within 30 days of the fourth advertisement or that interested parties have been unable or unwilling to provide financing under the same terms and conditions that are proposed for the health care provider investor.

 

History Note:        Authority G.S. 90-408;

Eff. April 1, 1995.

 

10A NCAC 14g .0104       CRITERIA FOR AN UNDERSERVED AREA EXEMPTION - EXISTING ENTITY

(a)  In order for the Department to determine that there is a demonstrated need in the county where the entity is located for the designated health care services offered by the entity, the Department must conclude that:

(1)           No other entity is providing the service or services in the county within 15 miles of the existing entity; or

(2)           Any other entity located in the county within 15 miles of the existing entity which offers the same service or services provided by the existing entity is not able to provide services to all who require the service and is unwilling or unable to expand services in order to accommodate those in need of the service.  The application shall provide written confirmation from the existing provider acknowledging unmet need and unwillingness or inability to accommodate it.

(b)  In order for the Department to determine that alternative financing is not available for an existing entity the applicant shall provide with its application each of the following:

(1)           documentation that an appraisal of the entity has been made and that the portion of the entity owned by the applicant has been offered for sale to other current and potential investors at a price represented by the proportionate share of the appraised value owned by the applicant seeking an exemption and that the offer has been rejected within 30 days of the date the application was submitted; and

(2)           documentation that the portion of the entity owned by the applicant seeking an exemption has been publicly offered for sale at a price represented by its appraised value plus the cost of the appraisal, including affidavits of publication that an advertisement at least 3 inches wide and 3 inches long has appeared in four successive Sunday editions of a regional daily newspaper under the heading "Investment Opportunity" describing the type of investment available, and that no responses have been received within 30 days of the fourth advertisement or that interested parties have been unable or unwilling to purchase the portion of the entity owned by the applicant.

 

History Note:        Authority G.S. 90-408;

Eff. April 1, 1995.

 

 

 

subchapter 14h – certification of statewide data processors

 

SECTION .0100 ‑ CERTIFICATION OF STATEWIDE DATA PROCESSOR

 

10A NCAC 14H .0101       PURPOSE

This Section sets forth the process and requirements for obtaining certification as a statewide data processor.

 

History Note:        Filed as a Temporary Adoption effective October 1, 1995 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Authority G.S. 131E‑214.1(6);

Eff. February 1, 1996.

10A NCAC 14H .0102       DEFINITIONS

(a)  The definitions set forth in G.S. 131E‑214.1 shall apply to this Section.

(b)  As used in this Section:

(1)           "Applicant" means a party applying to the Division for certification as a statewide data processor.

(2)           "HCFA" means the Health Care Financing Administration of the U.S. Department of Health and Human Services, or any successor agency.

(c)  All references in this Section to the "HCFA 1500" and "HCFA 1450" claim forms, include references to their successor forms that are developed pursuant to federal law under the auspices of HCFA, the National Uniform Billing Committee, or the North Carolina State Uniform Billing Committee.

 

History Note:        Filed as a Temporary Adoption effective October 1, 1995 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Authority G.S. 131E‑214.1(6);

Eff. February 1, 1996.

 

10A NCAC 14H .0103       REQUIREMENTS FOR CERTIFICATION

A party desiring to be certified as a statewide data processor shall make a written application to the Division that complies with the following requirements:

(1)           The applicant must make a satisfactory showing that it is capable of making available annually to the Division, at no charge, a report which compares the 35 most frequently reported charges of the hospitals and freestanding ambulatory surgical facilities reporting patient data to the applicant during the calendar year.  Each annual report shall be due to the Division within 180 days after the end of the calendar year.

(2)           The applicant must make a satisfactory showing that it is capable of receiving from hospitals and freestanding ambulatory surgical facilities throughout the State the patient data elements specified in Items (3) through (5) of this Rule.

(3)           With regard to patient data concerning inpatients discharged by hospitals, the applicant must make a satisfactory showing that is capable of compiling and maintaining a uniform set of data from the patient data which shall include the following HCFA 1450 (UB‑92) data elements for every inpatient discharged regardless of payor:

 

 

DATA ELEMENT

DESCRIPTION

(1)

Patient Control Number

Form Locator 3 - As stated in the North Carolina HCFA 1450 Manual

(2)

Bill Type

Form Location 4 - As Stated in the North Carolina HCFA 1450 Manual

(3)

Provider Identification

 

(A)

 

Medicaid Base Provider Number

The number assigned to the provider by Medicaid or as assigned by the certified statewide data processor (for batching only)

(B)

Federal Tax Number

Form Locator 5 - As stated in the North Carolina HCFA 1450 Manual

(4)

 

Zip Code of Patient Address

Form Locator 13 - Only the zip code portion of this field is required.  Code as stated in the North Carolina HCFA 1450 Manual

(5)

 

Patient Birth Date

 

Form Locator 14 - As stated in the North Carolina HCFA 1450 Manual

(6)

Patient Sex

Form Locator 15 - As stated in the North Carolina HCFA 1450 Manual

(7)

Admission Date

Form Locator 17 - As stated in the North Carolina HCFA 1450 Manual

(8)

Admission Type

Form Locator 19 - As stated in the North Carolina HCFA 1450 Manual

(9)

Source of Admission

Form Locator 20 - As stated in the North Carolina HCFA 1450 Manual

(10)

Patient Status

Form Locator 22 - As stated in the North Carolina HCFA 1450 Manual

(11)

Discharge Date (Statement Covers Period)

Form Locator 6 - As stated in the North Carolina HCFA 1450 Manual

(12)

All Revenue Codes and Associate Charges

Forms Locators 42 and 47 - As stated in the North Carolina HCFA 1450 Manual

(13)

 

Payer Identification

Form Locator 50a - Classifications code and specific carrier identification code for primary payer

(14)

 

Certificate/Social Security/Health

Form Locator 60a - As stated in the Insurance Claim/Identification Number North Carolina HCFA 1450 Manual

(15)

Insurance Group Number

Form Locator 62a - As stated in the North Carolina HCFA 1450 Manual

(16)

Principal Diagnosis

Form Locator 67 - As stated in the North Carolina HCFA 1450 Manual

(17)

Other Diagnoses 8

Form Locators 68-75 - As stated in the North Carolina HCFA 1450 Manual

(18)

 

External Cause of Injury Code (E Code)

Form Locator 77 - As stated in the North Carolina HCFA 1450 Manual/whenever the principal diagnosis is an injury, poisoning or adverse effect

(19)

Principal Procedure and Date

Form Locator 80 - As stated in the North Carolina HCFA 1450 Manual

(20)

Other Procedures and Dates

Form Locator 81a-e - As stated in the North Carolina HCFA 1450 Manual

(21)

 

Attending Physician Identification

Form Locator 82 - Only the UPIN is required.  Code as stated in the North Carolina HCFA 1450 Manual

(22)

 

Other Physician Identification

Form Locator 83 - Only the UPIN is required.  Code as stated in the North Carolina HCFA 1450 Manual

 

(4)           With regard to patient data concerning ambulatory surgery patients released from hospitals and freestanding ambulatory surgical facilities, the applicant must make a satisfactory showing that it is capable of compiling and maintaining a uniform set of data from the patient data which shall include the following HCFA 1450 (UB‑92) data elements for every ambulatory surgical patient released regardless of payor:

 

 

DATA ELEMENT

DESCRIPTION

(1)

Patient Control Number

Form Locator 3 - As stated in the North Carolina HCFA 1450 Manual

(2)

Bill Type

Form Locator 4 - As stated in the North Carolina HCFA 1450 Manual

(3)

Provider Identification

 

(A)

 

Medicaid Base Provider Number

The number assigned to the provider by Medicaid or as assigned by the certified statewide data processor (for batching only)

(B)

Federal Tax Number

Form Locator 5 - As stated in the North Carolina HCFA 1450 Manual

(4)

 

Zip Code of Patient Address

Form Locator 13 - Only the zip code portion of this field is required.  Code as stated in the North Carolina HCFA 1450 Manual

(5)

Patient Birth Date

Form Locator 14 - As stated in the North Carolina HCFA 1450 Manual

(6)

Patient Sex

Form Locator 15 - As stated in the North Carolina HCFA 1450 Manual

(7)

Admission Date

Form Locator 17 - As stated in the North Carolina HCFA 1450 Manual

(8)

Admission Type

Form Locator 19 - As stated in the North Carolina HCFA 1450 Manual

(9)

Source of Admission

Form Locator 20 - As stated in the North Carolina HCFA 1450 Manual

(10)

Patient Status

Form Locator 22 - As stated in the North Carolina HCFA 1450 Manual

(11)

Discharge Date (Statement Covers Period)

Form Locator 6 - As stated in the North Carolina HCFA 1450 Manual

(12)

All Revenue Codes and Associated Charges

Form Locators 42 and 47 - As stated in the North Carolina HCFA 1450 Manual

(13)

Payer Identification

Form Locator 50a - Classification code and specific carrier identification

(14)

 

Certificate/Social Security/Health

Form Locator 60a - As stated in the Insurance Claim/Identification Number North Carolina HCFA 1450 Manual

(15)

Insurance Group Number

Form Locator 62a - As stated in the North Carolina HCFA 1450 Manual

(16)

Principal Diagnosis

Form Locator 67 - As stated in the North Carolina HCFA 1450 Manual

(17)

Other Diagnoses

8 Form Locators 68-75 - As stated in the North Carolina HCFA 1450 Manual

(18)

 

External Cause of Injury Code (E‑Code)

Form Locator 77 - As stated in the North Carolina HCFA 1450 Manual/whenever the principal diagnosis is an injury, poisoning or adverse effect

(19)

Principal Procedure and Date

Form Locator 80 - As stated in the North Carolina HCFA 1450 Manual

(20)

Other Procedures and Dates

Form Locators 81a-e - As stated in the North Carolina HCFA 1450 Manual

(21)

 

Attending Physician Identification

Form Locator 82 - Only the UPIN is required.  (Code as stated in the North Carolina HCFA 1450 Manual

(22)

 

Other Physician Identification

Form Locator 83 - Only the UPIN is required.  Code as stated in the North Carolina HCFA 1450 Manual

 

(5)           With regard to patient data concerning ambulatory surgery patients released from hospitals and freestanding ambulatory surgical facilities, the application must make a satisfactory showing that it is capable of compiling and maintaining a uniform set of data from the patient data which shall include the following HCFA 1500 data elements for every ambulatory surgical patient released regardless of payor:

 

(1)

Payer Identification

(2)

Insured's ID Number

(3)

Patient's Date of Birth

(4)

Gender of Patient

(5)

Zip Code of Patient Address

(6)

Diagnosis or Nature of Illness or Injury (1-4)

(7)

Dates of Service

(8)

Place of Service

(9)

Type of Service

(10)

Procedures, Services, and Supplies (including modifiers if applicable)

(11)

Charges

(12)

Days or Units

(13)

Federal Tax ID

(14)

Patient's Account Number

(15)

Total Charge

(16)

Attending Physician's UPIN Number

(17)

Medicaid Base Provider Number or Number Assigned by Certified Statewide Data Processor

 

(6)           The applicant must make a satisfactory showing that it is capable of examining the patient data it receives for accuracy, informing the hospital or freestanding ambulatory surgical facility submitting the patient data of all potential errors in the patient data which are discovered as a result of the examination for accuracy, and correcting the patient data as directed by the hospital or freestanding ambulatory surgical facility.  An applicant shall be deemed to have satisfactorily shown that it is capable of examining patient data for accuracy if the applicant has made a satisfactory showing that it is capable of designating a record as an error record when:

(a)           A record reported on a HCFA 1450 (UB‑92) form contains an invalid or all‑blank field for any of the following HCFA 1450 (UB‑92) data elements:  Patient Control Number, Bill Type, Federal Tax I.D., Zip Code, Date of Birth, Sex, Admission Date, Admission Type, Source of Admission, Patient Status, Statement Covers Period, Revenue Codes and Charges, Primary Payer, Principal Diagnosis, Attending Physician Identification.

(b)           A record reported on a HCFA 1500 form contains an invalid or all‑blank field for any of the following HCFA 1500 data elements:  Payor Identification, Insured's I.D. Number, Federal Tax I.D., Zip Code, Date of Birth, Sex, Dates of Service, Place of Service, Type of Service, Procedures Defined with CPT‑HCPCS Code with Modifiers, Principal Diagnosis Codes, Principal and Secondary Surgical Procedure, Patient's Account Number, Attending Physician Identification.

(c)           The sum indicated by the data element concerning total charges does not equal the sum of all other charges reported on the record.

(d)           An inpatient record reported on a HCFA 1450 (UB‑92) contains any of the following data elements which contain an invalid code:  Other Diagnoses, Principal Procedure Code and Date, Other Procedure Codes and Dates, External Cause of Injury Code, Other Physician Identification (if a procedure was performed).

(e)           An ambulatory surgical patient record reported on a HCFA 1450 (UB‑92) form contains any of the following data elements which contain an invalid code:  Other Diagnoses, Other Procedure Codes and Dates, External Cause of Injury Code.

(7)           The applicant shall make satisfactory showing that it is capable of:

(a)           compiling reports from patient data which shall further the purposes of the Medical Care Data Act, as set forth in G.S. 131E‑214(b), such as reports enabling a review and comparison of charges, utilization patterns, and quality of medical services;

(b)           producing such reports at least on a calendar quarter basis, with reports concerning patients discharged or released during a specific calendar quarter being published at least within 180 days after the end of said calendar quarter;

(c)           making such reports available upon request to all interested persons at a reasonable charge.

(8)           The applicant shall make a satisfactory showing that it is capable of ensuring that adequate measures will be taken to provide system security for all data and information received from hospitals and freestanding ambulatory surgical facilities.

(9)           The applicant shall make a satisfactory showing that it is capable of protecting the confidentiality of patient records and complying with applicable laws and regulations concerning patient confidentiality, including the confidentiality of patient‑identifying information, and that it shall not disclose patient‑identifying information unless:

(a)           the information was originally submitted by the party requesting disclosure; or

(b)           the State Health Director requests specific individual records for the purpose of protecting and promoting the public health under G.S. 130A, and the disclosure is not otherwise prohibited by federal law or regulation.

The applicant shall also make a satisfactory showing that it shall make such records available to the State Heath Director at a reasonable charge.

 

History Note:        Filed as a Temporary Adoption effective October 1, 1995 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Authority G.S. 131E‑214.1(6);

Eff. February 1, 1996.

 

10A NCAC 14H .0104       APPLICATION REVIEW

The Division shall notify each applicant of the Division's decision concerning the applicant's request for certification as a statewide data processor within 90 days after the Division has received the applicant's written application unless the Division notifies the applicant that the review has been extended.  If any portion of an application lacks certain information or is unclear, the Division may request additional information or clarification from the applicant during the review period; provided, however, that the Division is not required to request such additional information or clarification, and the Division may deny certification on the basis that the application lacks information or is unclear.

 

History Note:        Filed as a Temporary Adoption effective October 1, 1995 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Authority G.S. 131E‑214.1(6);

Eff. February 1, 1996.

 

10A NCAC 14H .0105       PERIOD OF CERTIFICATION

An applicant who demonstrates through its application that it presently is performing each of the requirements specified in 10A NCAC 14H .0103 (with the exception of the requirement of making annual reports to the Division found in 10A NCAC 14H .0103(1), and the requirement of disclosing data to the State Health Director found in 10A NCAC 14H .0103(9), for which requirements the applicant needs only to make a satisfactory showing that it is capable of performing the requirements), shall be certified as a statewide data processor for a period of three years.  An applicant who demonstrates through its application that it is capable of performing each of the requirements specified in 10A NCAC 14H .0103 but who presently is not performing each of the requirements specified in 10A NCAC 14H .0103(2)‑(9) (excluding the requirement in 10A NCAC 14H .0103(9) to disclose data to the State Health Director), shall be granted a certificate for a one year period.  If within that one year period the applicant makes a satisfactory showing to the Division by written application that it then is performing all of the requirements specified in 10A NCAC 14H .0103, the applicant shall be granted certification as a statewide data processor for an additional two year period.

 

History Note:        Filed as a Temporary Adoption effective October 1, 1995 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Authority G.S. 131E‑214.1(6);

Eff. February 1, 1996.

 

10A NCAC 14H .0106       STANDARDS FOR REFUSAL, SUSPENSION OR REVOCATION OF CERTIFICATION

A certificate applied for or issued under this Chapter may be refused, suspended, or revoked by the Division if the Division determines that the applicant or statewide data processor cannot or does not perform the requirements specified in 10A NCAC 14H .0103 and G.S. 131E‑214.4.

 

History Note:        Filed as a Temporary Adoption effective October 1, 1995 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Authority G.S. 131E‑214.1(6);

Eff. February 1, 1996.

 

10A NCAC 14H .0107       FAILURE TO TIMELY RENEW

A certificate issued under this Chapter shall be automatically suspended by the Division after a failure to renew the certificate for a period of more than three months after the renewal date.

 

History Note:        Filed as a Temporary Adoption effective October 1, 1995 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Authority G.S. 131E‑214.1(6);

Eff. February 1, 1996.

 

10A NCAC 14H .0108       PROCEDURE

Except as otherwise provided in this Chapter, the procedure for revocation, suspension, or refusal of certification shall be in accordance with the provisions of G.S. 150B.

 

History Note:        Filed as a Temporary Adoption effective October 1, 1995 for a period of 180 days or until the permanent rule becomes effective, whichever is sooner;

Authority G.S. 131E‑214.1(6);

Eff. February 1, 1996.

 

 

 

subchapter 14i - certificate of public advantage

 

section .0100 – certificate of public advantage program

 

10A NCAC 14I .0101         CERTIFICATE OF PUBLIC ADVANTAGE

10A NCAC 14I .0102         APPLICATION FILING FEE

10A NCAC 14I .0103         FILING FEE – PERIODIC REPORTS

10A NCAC 14I .0104         PUBLIC HEARING

 

History Note:        Authority G.S. 131E-192.11;

Temporary Adoption Eff. October 25, 1993 for a Period of 180 days or until the Permanent Rule becomes effective, whichever is sooner;

Eff. March 1, 1994;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest eff. March 22, 2015;

Repealed Eff. September 30, 2016 pursuant to G.S. 150B-21.7.

 

 

subchapter 14J – jails, local confinement facilities

 

SECTION .0100 ‑ DEFINITIONS AND APPLICABILITY FOR JAILS

 

10A NCAC 14J .0101        DEFINITIONS

The following definitions shall apply in 10A NCAC 14J .0101 through .1300:

(1)           "Addition" is an extension or increase in floor area or height of a building or structure.

(2)           "Alteration" is any change or modification in construction or use.

(3)           "Booking area" is a secure area where a person is admitted to a jail and procedures such as searching, fingerprinting, photographing, health screening, and collecting personal history data occur.

(4)           "Section" is the Jail and Detention Section of the Division of Health Service Regulation, Department of Health and Human Services.

(5)           "Cell" is any confinement unit except a dormitory.

(6)           "Cellblock" is a separate and identifiable grouping of cells.

(7)           "Communicable disease or condition" is an illness or condition as defined in G.S. 130A‑133 which is hereby adopted by reference pursuant to G.S. 150B‑14(c).

(8)           "Confinement unit" is a single segregation cell, a single cell, a multiple occupancy cell or a dormitory.

(9)           "Contraband" is any item that a person is not authorized to possess in the jail because it is a violation of law or a violation of rules.

(10)         "Dayroom" is an area accessible to a single cell or a multiple occupancy cell, with controlled access from the cell and to which inmates may be admitted for activities such as dining, showers, physical exercise and recreation.

(11)         "Department", unless otherwise specified, is the North Carolina Department of Health and Human Services.

(12)         "Division", unless otherwise specified, is the Division of Health Service Regulation of the North Carolina Department of Health and Human Services.

(13)         "Dormitory" is an area designed to house up to 40 inmates and that combines dayroom space with sleeping space.

(14)         "Emergency medical problem" is a serious medical need, including severe bleeding, unconsciousness, serious breathing difficulties, head injury, severe pain, suicidal behavior or severe burns, that requires immediate medical attention and that cannot be deferred until the next scheduled sick call or clinic.

(15)         "Footcandle" is the amount of light thrown on a surface one foot away from the light source.  It is a unit for measuring the intensity of illumination.

(16)         "Governing body" refers to the governing body of a county or the policy‑making body for a district confinement facility.

(17)         "Health screening" is a procedure for each newly‑admitted inmate that combines visual observation with an interview to obtain relevant information about the inmate's physical and mental health.

(18)         "Holding area" is a place where inmates are temporarily held while awaiting processing, booking, court appearance, discharge, or transfer to a regular confinement unit.

(19)         "Holdover facility" is a facility as defined in G.S. 7A‑517(16) which is hereby adopted by reference pursuant to G.S. 150B‑14(c).

(20)         "Inmate" is any person, whether pretrial, unsentenced, or sentenced, who is confined in a jail or a county satellite jail/work release unit.

(21)         "Inmate processing area" is a secure area through which inmates enter and exit, and it may be combined with the booking area.

(22)         "Institutional‑Restrained" is a Building Code occupancy classification used for buildings in which persons are restrained under lock and key or other security measures which render them incapable of self‑preservation due to the security measures not being under their direct control.

(23)         "Jail" is a building or part of a building operated by a county or group of counties for the confinement of inmates, including county jails, district confinement facilities and jail annexes.  It shall not include a county satellite jail/work release unit governed by Part 3 of Article 10 of Chapter 153A of the General Statutes.

(24)         "Jail annex" is a building or a designated portion of a building designed, staffed and used primarily to house inmates who do not present reasonably identifiable security risks.

(25)         "Medical record" is a record of medical problems, examinations, diagnoses and treatments.

(26)         "Multiple occupancy cell" is a cell designed to house up to four inmates.

(27)         "Officer" is a person, whether sworn or unsworn, who is involved in the supervision, control, or custody of inmates.

(28)         "Operations manual" is a set of written policies and procedures for the operation of a jail in compliance with state and federal law and the minimum standards for the operation of jails.

(29)         "Qualified medical personnel" are persons who provide medical services to inmates and who are licensed, certified, registered, or approved, in accordance with state law.  It includes persons who provide limited medical services under supervision as permitted by law.

(30)         "Registered dietitian" is a specialist in the field of nutrition, dietetics and food system management who maintains current registration with the Commission on Dietetic Registration of the American Dietetic Association.

(31)         "Repair" is reconstruction or renewal of any part of an existing building for the purpose of its maintenance.

(32)         "Residential" is a Building Code occupancy classification used for buildings which provide sleeping accommodations for the occupants and in which the egress doors are unlocked at all times thereby providing free movement to the building exterior from occupied areas.

(33)         "Sally port" is an enclosed entry and exit area used either for vehicular or pedestrian traffic with gates or doors at both ends, only one of which opens at a time.

(34)         "Satellite jail/work release unit" is a unit as defined in G.S. 153A‑230.1.

(35)         "Secretary", unless otherwise specified, is the Secretary of the Department of Health and Human Services.

(36)         "Security perimeter" is the outer portion of a jail that provides for the secure confinement of inmates and that prevents the entry of unauthorized persons or contraband.

(37)         "Security vestibule" is a defined space that provides security by using two or more doors, with each door able to operate independently, and that permits an officer to observe those who pass through the space.

(38)         "Single cell" is a cell designed to house one inmate.

(39)         "Single segregation cell" is a cell designed to house one inmate who has been removed from the general inmate population for administrative segregation, disciplinary segregation, or protective custody.

(40)         "Tamper resistant" means designed to prevent damage, destruction or interference by inmates.

(41)         "View panel" is a transparent panel.

(42)         "Visitation area" is a designated area where inmates are permitted to receive visitors according to the policies and procedures that govern visitation.

(43)         "Work release" refers to the release of a convicted inmate for employment in the community, returning to custody during nonworking hours.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990.

10A NCAC 14J .0102        APPLICABILITY ‑ OPERATIONS AND ENFORCEMENT

The operations and enforcement standards established in Section .0100 through .1100 and Section .1300 shall apply to all jails.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990.

 

10A NCAC 14J .0103        APPLICABILITY ‑ CONSTRUCTION

(a)  North Carolina State Building Code ‑ Jails must meet the requirements of the North Carolina State Building Code in effect at the time of construction, additions, alterations or repairs.

(b)  New Jails ‑ The construction standards established in Section .1200 shall apply to all jail construction for which the final working drawings are approved by the Section after the effective date of this Rule.

(c)  Existing Jails ‑ Existing jails shall continue to be governed by the existing construction standards which are now in Section .1500, and the same standards shall apply to new jails which have had final working drawings approved by the Section prior to the effective date of this Rule.  Existing jails or new jails which have had final working drawings approved by the Section prior to the effective date of this Rule may choose to comply with any of the new construction standards in Section .1200 as a substitute for existing standards on the same subject in Section .3700.

(d)  Additions ‑ The construction standards established in Section .1200 shall apply to any construction that adds square footage to the building and for which the final working drawings are approved after the effective date of this Rule.

(e)  Alterations or Repairs ‑ When alterations or repairs are made to an existing jail building which affect its structural strength, exits, fire hazards, electrical systems, mechanical systems, or sanitary conditions, such alterations or repairs shall comply with the standards for new construction established in Section .1200.  Unaltered portions of the building shall only be required to comply with the new construction standards indicated in Section .1200 under the circumstances specified in Paragraphs (f)‑(h) of this Rule.

(f)  Extensive Annual Alterations or Repairs ‑ If, within any 12 month period, alterations or repairs costing in excess of 50 percent of the then physical value of the building are made to an existing jail, the entire jail shall conform to the construction standards for new jails established in Section .1200.

(g)  Reconstruction After Damage ‑ If an existing jail is damaged by fire or otherwise in excess of 50 percent of the then physical value of the building at the time of damage, the jail shall be reconstructed in conformance with the construction standards for new jails established in Section .1200.

(h)  Physical Value ‑ For the purpose of this Rule, the physical value of the jail building shall be determined by the local building inspection department.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990.

 

SECTION .0200 ‑ OPERATIONS MANUAL FOR JAILS

 

10A NCAC 14J .0201        REQUIREMENT FOR OPERATIONS MANUAL

Effective January 1, 1992, the sheriff or the administrator of a regional jail shall develop an operations manual that meets the requirements of this Section.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. June 1, 1991.

 

10A NCAC 14J .0202        PURPOSE OF OPERATIONS MANUAL

The purpose of the operations manual is to ensure the smooth and efficient operation of the jail, and therefore it shall be detailed enough to guide officers in completing their assigned duties.  The operations manual shall be available to all officers, and each officer shall be familiar with the manual.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .0203        CONTENTS OF OPERATIONS MANUAL

(a)  The operations manual shall include written policies and procedures that address the following areas:

(1)           administration and management;

(2)           admissions, transportation and release;

(3)           classification;

(4)           security and supervision;

(5)           inmate rules and discipline;

(6)           management of special inmates;

(7)           legal rights of inmates;

(8)           health, mental health, mental retardation and substance abuse services;

(9)           food services;

(10)         program services;

(11)         work release;

(12)         opportunities for exercise;

(13)         access to legal assistance or legal materials;

(14)         grievance procedures;

(15)         visitation and mail policies;

(16)         religious activities;

(17)         sanitation;

(18)         emergency plans.

(b)  The most recent editions of the following references are available as guides for developing policies and procedures:

(1)           Appalachian State University, Model Policies and Procedures Manual for North Carolina Jails;

(2)           American Correctional Association, Standards for Adult Local Detention Facilities;

(3)           American Correctional Association, Standards for Small Jails;

(4)           National Commission on Correctional Health Care, Standards for Health Services in Jails.

These references shall be available for inspection or loan from the Section.  Consultation and technical assistance shall be available from the Section.  The Section can also provide information regarding outside agencies with additional resources for developing policies and procedures.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990.

 

10A NCAC 14J .0204        REVIEW OF MANUAL

The operations manual shall be reviewed and updated at least once each year by the sheriff or the administrator of a regional jail.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990.

 

SECTION .0300 ‑ CLASSIFICATION AND HOUSING

 

10A NCAC 14J .0301        CLASSIFICATION SYSTEM

Each jail shall have a written classification procedure for the placement and housing of inmates.  Within the limitations imposed by the design and capacity of the jail, the procedure shall assign inmates to confinement units that best meet their individual needs and that reasonably protect the inmate, other inmates, the jail staff, and the public.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990.

 

10A NCAC 14J .0302        FEMALE INMATES

Male and female inmates shall not be placed in the same confinement unit, dayroom or other living area and, in addition, female inmates shall be housed out of sight of male inmates.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. December 1, 1991.

 

10A NCAC 14J .0303        CONFINEMENT OF MALES UNDER 18 YEARS OF AGE

Male inmates under 18 years of age shall be confined in separate cells from adult inmates during sleeping hours.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990.

 

10A NCAC 14J .0304        CONFINEMENT OF JUVENILES UNDER AGE 16

Any juvenile under age 16 who is transferred to superior court for trial as an adult and who is ordered held in the jail pursuant to G.S. 7A‑611 shall be confined in a holdover facility where the juvenile cannot converse with, see, or be seen by the adult inmates.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .0305        DISCRIMINATION IN HOUSING ASSIGNMENTS

Housing assignments shall not be made on the basis of race, color, creed, national origin, or political belief.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

SECTION .0400 ‑ FIRE SAFETY

 

10A NCAC 14J .0401        EXITS

Each jail shall have readily accessible emergency exits in compliance with the North Carolina State Building Code in order to permit the prompt evacuation of inmates and staff during an emergency.  Egress doors in jails which are classified as "Residential Occupancy" by the North Carolina State Building Code shall remain unlocked at all times thereby permitting free movement to the building exterior from occupied areas.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .0402        FIRE EQUIPMENT

Each jail shall provide the following emergency fire equipment:

(1)           fire extinguishers that meet all of the requirements in National Fire Protection Association pamphlet number 10 which is hereby incorporated by reference including subsequent amendments and editions of the referenced materials [a copy can be obtained from the National Fire Protection Association, 1 Battery March Park, Post Office Box 9101, Quincy, Massachusetts 02269‑9959 at a cost of seventeen dollars and fifty cents ($17.50)]; and

(2)           smoke detection equipment that meets the requirements of the North Carolina State Building Code.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. December 1, 1991.

 

10A NCAC 14J .0403        FIRE PLAN

(a)  Each jail shall have a written plan for the evacuation and control of inmates in the event of a fire.  The plan shall include at least quarterly fire drills, and records shall be made of the fire drills and retained.  The actual movement of inmates to other areas or outside the building is not required.

(b)  Evacuation routes shall be posted or otherwise clearly marked throughout the jail.

(c)  The sheriff or the regional jail administrator shall request in writing that the local fire department or fire marshall inspect the jail and review the fire plan at least once each year.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990.

 

10A NCAC 14J .0404        MATTRESSES

Mattresses shall be of fire resistive and nontoxic construction.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990.

 

10A NCAC 14J .0405        KEYS

Each jail that is required to meet the "Institutional Occupancy ‑ Restrained" requirements of the North Carolina State Building Code shall have a key control system that includes the following elements:

(1)           a key control center that is secure and inaccessible to unauthorized persons at all times;

(2)           a set of duplicate keys to be stored in a safe place that is inaccessible to unauthorized persons at all times;

(3)           an accounting procedure for issuing and returning keys; and

(4)           a system of keys and matching locks that are color‑coded and marked for identification by touch.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990.

 

SECTION .0500 ‑ SECURITY

 

10A NCAC 14J .0501        GENERAL SECURITY REQUIREMENTS

Each jail shall meet the following security requirements:

(1)           provide for the secure confinement of inmates from the time of their passage through the security perimeter until release;

(2)           provide for the locked storage of firearms before persons enter the security perimeter;

(3)           prevent the passage of contraband;

(4)           prevent unauthorized contact between inmates and persons from outside the jail;

(5)           provide a ground‑level perimeter exterior that is well lighted; and

(6)           provide a communications link with outside agencies for use in emergencies.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. December 1, 1991.

 

SECTION .0600 ‑ SUPERVISION

 

10A NCAC 14J .0601        SUPERVISION

(a)  Officers shall make supervision rounds and directly observe each inmate in person at least twice per hour on an irregular basis.  The supervision rounds shall be documented.  If remote electronic monitoring is used to supplement supervision, it shall not be substituted for supervision rounds and direct visual observation.

(b)  In addition to the supervision rounds required in Paragraphs (a) and (c) of this Rule, each jail shall utilize one or both of the following methods of supervision:

(1)           Direct or remote two‑way voice communication with all confinement units.

(2)           Visual contact either through direct observation or by means of electronic surveillance with all confinement units.

(c)  Officers shall directly observe, at least four times per hour, inmates who display the following behavior:

(1)           physically hitting or trying to hit an officer; or

(2)           being verbally abusive; or

(3)           stating he will do harm to himself; or

(4)           intoxicated, as determined by a score of .15 on a breathalyzer or displaying slurred speech or smelling of alcohol or inability to control body movement; or

(5)           displaying erratic behavior such as screaming, crying, laughing uncontrollably, or refusing to talk at all.

In addition to displayed behavior, a previous record of a suicide attempt or a previous record of mental illness shall warrant observation at least four times per hour.

(d)  Officers shall remain awake at all times.

(e)  Officers shall not be assigned other duties that would interfere with the continuous supervision, custody or control of inmates.

(f)  Female officers shall be on duty when female inmates are confined.

(g)  The sheriff or the administrator of the regional jail shall develop a contingency plan for the supervision and control of inmates during an emergency, and that plan shall provide for the ready availability of extra personnel.

(h)  Inmates shall not be allowed to supervise or assume any control over other inmates.

 

History Note:        Authority G.S. 153A‑221;

Eff. October 1, 1990;

Amended Eff. June 1, 1992.

 

SECTION .0700 ‑ SANITATION AND PERSONAL HYGIENE

 

10A NCAC 14J .0701        SANITATION

Each jail shall comply with the North Carolina Commission for Public Health rules governing sanitation as codified in Title 15A Chapter 18A Section .1500 and which are hereby adopted by reference pursuant to G.S. 150B‑14(c).

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .0702        MATTRESSES AND BEDDING

Mattresses, sheets, and blankets that are clean and in good repair shall be supplied to all inmates except those not housed overnight.  Clean sheets shall be issued at least once a week.  Mattresses shall meet the following requirements:

(1)           Mattresses shall comply with Commission for Public Health rules on sanitation, Title 15A Chapter 18B .0201 ‑ .0215 and G.S. Chapter 130A‑273 which are adopted by reference pursuant to G.S. 150B‑14(c).

(2)           Mattresses shall not be less than four inches thick and shall be the same length and width as the jail bunks.

(3)           Mattresses shall not have any metal, plastic, or other rigid framing component.

(4)           Mattress ticking shall be durable and water repellent.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990.

 

10A NCAC 14J .0703        SHAVING

Each inmate detained over 24 hours shall be provided with individual shaving supplies, except when security considerations dictate otherwise, and inmates shall not be allowed to share razors.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .0704        SHOWERS AND TOILETS

Inmates shall have access to showers a minimum of three times per week.  Inmates on work release shall have daily access to showers.  Bath towels and soap shall be provided.  Inmates shall have unrestricted access to toilets while confined.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. March 1, 1992; December 1, 1991;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .0705        PERSONAL HYGIENE ITEMS

Every inmate detained over 24 hours shall be issued without charge the following items as appropriate:

(1)           Toothbrush;

(2)           Toothpaste or powder;

(3)           Comb; and

(4)           Feminine hygiene products.

After a newly admitted inmate has exhausted his or her initial supply of personal hygiene items, each jail shall make the listed items available either for purchase or without charge.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. January 1, 1992.

 

SECTION .0800 ‑ COMMISSARY OR CANTEEN SERVICES

 

10A NCAC 14J .0801        AVAILABILITY OF SERVICES

Each jail shall make commissary or canteen items, including snacks and personal care products, available for purchase by inmates.  The items shall be available either directly from officers or through contract vending.  The price of these items shall be no higher than local retail prices.  Snacks and personal care products do not have to be made available for purchase if they are provided without charge.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. December 1, 1991;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

SECTION .0900 ‑ FOOD

 

10A NCAC 14J .0901        FOOD SERVICE

(a)  In jails that purchase meals from an outside provider, a written contract shall require the provider to meet the applicable standards in this Section.

(b)  Inmates who assist with the preparation or service of any meal shall be supervised at all times.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .0902        MEAL SERVICE

(a)  Each jail shall provide at least three meals for inmates, two of which must be hot, at regular times during each 24‑hour period.  There shall be not more than 14 hours between the evening meal and breakfast.

(b)  Food shall be served to inmates on individual serving trays. Eating utensils, consistent with security considerations, and condiments shall be provided.

(c)  While food is being transported, either from inside or outside the jail it shall be covered to prevent contamination.  Food must be maintained at appropriate serving temperatures as specified in Commission for Public Health Rule 15 NCAC 18A .1522.

(d)  Food shall never be used as a reward or punishment.

(e)  Each jail shall keep a daily record of the number of meals served.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. December 1, 1991;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .0903        FOOD AND NUTRIENT REQUIREMENTS

(a)  The average nutrient content of weekly menus shall meet the Recommended Dietary Allowances of the National Academy of Sciences which are hereby adopted by reference pursuant to G.S. 150B‑14(c).

(b)  Daily menus shall include the following:

(1)           Milk Group:  Two servings;

(2)           Fruit Group:  Two servings, one of which shall be citrus;

(3)           Vegetable Group:  Three servings;

(4)           Meat or Protein Group:  Two servings;

(5)           Cereal or Bread Group:  Four servings of whole grain or enriched products; and

(6)           Calories:  2,100 ‑ 2,500.

(c)  For all pregnant women and inmates under age 18, the milk group shall include four servings per day.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .0904        MENUS

(a)  Menus shall be prepared in consultation with a registered dietitian.

(b)  Menus shall be written and portion sizes shall be specified.

(c)  Menus shall be dated and posted one week in advance.

(d)  Menus shall be served as written to inmates in the jail.  Any necessary substitutions shall be of comparable nutritional value, and a written record of substitutions shall be kept.

(e)  The same menu shall not be served at lunch and dinner on the same day.

(f)  Dated menus and records of any substitutions shall be retained for three years.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990.

 

10a NCAC 14J .0905        MODIFIED DIETS

(a)  Modified diets shall be provided if prescribed by appropriate medical or dental personnel.

(b)  Modified diets shall be provided when reasonably possible to accommodate the sincerely held religious beliefs of an inmate.

(c)  Written menus for modified diets shall be prepared in consultation with a registered dietitian.

(d)  Modified diets shall be served as written.  Any necessary substitutions shall be of comparable nutritional value, and a written record of substitutions shall be kept.  Dated menus of modified diets and records of any substitutions shall be retained for three years.

(e)  Each jail shall maintain a current list of inmates requiring modified diets, and it shall be posted for use by staff.

(f)  Each jail shall record the number of modified diets served at each meal, along with the name of each inmate and the type of modified diet that he or she received.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

SECTION .1000 ‑ HEALTH CARE OF INMATES AND EXERCISE

 

10A NCAC 14J .1001        MEDICAL PLAN

(a)  A written medical plan shall be developed in compliance with G.S. 153A‑225 and it shall be available for ready reference by jail personnel.  The medical plan shall include a description of the health services available to inmates.

(b)  The written plan shall include policies and procedures that address the following areas:

(1)           Health screening of inmates upon admission;

(2)           Handling routine medical care;

(3)           The handling of inmates with chronic illnesses or known communicable diseases or conditions;

(4)           Administration, dispensing and control of prescription and non‑prescription medications;

(5)           Handling emergency medical problems, including but not limited to emergencies involving dental care, chemical dependency, pregnancy and mental health;

(6)           Maintenance and confidentiality of medical records; and

(7)           Privacy during medical examinations and conferences with qualified medical personnel.

(c)  Inmates must be provided an opportunity each day to communicate their health complaints to a health professional or to an officer.  Qualified medical personnel shall be available to evaluate the medical needs of inmates.  A written record shall be maintained of the request for medical care and the action taken.

(d)  Inmates shall not perform any medical functions in the jail.

(e)  The medical plan shall be reviewed annually.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. December 1, 1991.

 

10A NCAC 14J .1002        HEALTH SCREENING FORM

The health screening form completed upon admission by an officer shall be available to jail officers, and a copy of the form shall be kept in any medical file that is maintained for inmates.  The form shall be reviewed for the presence of confidential information which can not be made available to jail officers.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. December 1, 1991.

 

10A NCAC 14J .1003        MEDICAL ISOLATION

Each jail shall separate inmates who require medical isolation from other inmates, either by housing them in a separate area of the jail or by transferring them to another facility.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1004        EXERCISE

After the fourteenth consecutive day of confinement, each inmate shall be provided opportunities for physical exercise at least three days weekly for a period of one hour each of the days.  Physical exercise shall take place either in the confinement unit if it provides adequate space or in a separate area of the jail that provides adequate space.  The opportunity for physical exercise shall be documented.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. December 1, 1991;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

SECTION .1100 ‑ REPORTS

 

10A NCAC 14J .1101        MONTHLY REPORT FOR JAILS

The sheriff or the administrator of a regional jail shall complete a monthly report on Form DHR‑JDS‑1 and send it to the Section no later than the tenth day of the following month.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1102        REPORT OF DEATH

The report of an inmate death required by G.S. 153A‑225 shall be submitted to the Section within five days.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. June 1, 1993;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

SECTION .1200 ‑ STANDARDS FOR NEW JAIL DESIGN AND CONSTRUCTION

 

10A NCAC 14J .1201        APPLICABILITY ‑ CONSTRUCTION

(a)  North Carolina State Building Code ‑ Jails must meet the requirements of the North Carolina State Building Code in effect at the time of construction, additions, alterations or repairs.

(b)  New Jails ‑ The construction standards established in Section .1200 shall apply to all jail construction for which the final working drawings have been approved by the Branch after the effective date of this Rule.  The operational standards in Sections .0100 through .1000 of this Subchapter will affect design options and shall be reviewed prior to submittal of working drawings.

(c)  Existing Jails ‑ Existing jails shall continue to be governed by the existing construction standards which are now in Section .1500 and the same standards shall apply to new jails which have had final working drawings approved by the Section prior to the effective date of this Rule.  Existing jails or new jails which have had final working drawings approved by the Section prior to the effective date of this Rule may choose to comply with any of the new construction standards in Section .1200 as a substitute for existing standards on the same subject in Section .1500.

(d)  Additions ‑ The construction standards established in Section .1200 shall apply to any construction that adds square footage to the building and for which the final working drawings are approved after the effective date of this Rule.

(e)  Alterations or Repairs ‑ When alterations or repairs are made to an existing jail building such alterations or repairs shall comply with the standards for new construction established in Section .1200.  Unaltered portions of the building shall be required to comply with the new construction standards indicated in Section .1200 only under the circumstances specified in Paragraphs (f)‑(h) of this Rule.

(f)  Extensive Annual Alterations or Repairs ‑ If, within any 12 month period, alterations or repairs costing in excess of 50 percent of the then physical value of the building are made to an existing jail, the entire jail shall conform to the construction standards for new jails established in Section .1200.

(g)  Reconstruction After Damage ‑ If an existing jail is damaged by fire or otherwise in excess of 50 percent of the then physical value of the building at the time of damage, the jail shall be reconstructed in conformance with the construction standards for new jails established in Section .1200.

(h)  Physical Value ‑ For the purpose of this Rule, the physical value of the jail building shall be determined by the local building inspection department.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. June 1, 1992.

 

10A NCAC 14J .1202        CONSULTATION AND TECHNICAL ASSISTANCE

Consultation and technical assistance in planning a new jail shall be available through the Section.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990.

 

10A NCAC 14J .1203        COMPLIANCE REVIEW AND APPROVAL

(a)  The governing body shall submit copies of the following to the Branch before it begins construction of a new jail and before it makes additions or alterations to an existing jail as defined by the North Carolina State Building Code:

(1)           three sets of schematic drawings and outline specifications;

(2)           three sets of preliminary working drawings or design development drawings and outline specifications; and

(3)           three sets of completed final working drawings and specifications.

(b)  Upon receipt of the drawings and specifications at each stage, the Section shall send one set each to the following for their review and approval:  the Department of Insurance to insure compliance with the North Carolina State Building Code, and the Division of Environmental Health in the Department of Environment and Natural Resources to insure compliance with the rules governing sanitation as codified in 15A NCAC 18A, Section .1500 and which are hereby incorporated by reference including subsequent amendments and editions of the referenced materials.  A copy of this material can be obtained free of charge from the State Division of Health Services, Environmental Health Section, Post Office Box 27687, Raleigh, North Carolina 27611‑7687.  The Section shall keep one set for its own review and approval to insure compliance with the minimum standards for the operation and construction of jails as contained in this Subchapter.  Review and comment on the drawings and specifications at each stage shall be made no later than 30 days after their receipt by the Section.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. June 1, 1992.

 

10A NCAC 14J .1204        SPECIFIC CONSTRUCTION REQUIREMENTS

(a)  Jails that restrain inmates under lock and key within a building shall meet the requirements of the North Carolina State Building Code for "Institutional Occupancy ‑ Restrained" and the additional security requirements imposed by Rule .1220.

(b)  Jails that do not restrain inmates within a building by lock and key shall meet the requirements of the North Carolina State Building Code for "Residential Occupancy".

(c)  The construction materials in all jails shall be sufficient to provide the degree of security required for the area in which they are used.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1205        reserved for future codification

 

10A NCAC 14J .1206        ELEVATORS

Elevators that open into the jail shall be secure and shall be under the control and observation of officers.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1207        INMATE PROCESSING AREA

Each jail that performs a booking and release function shall have an inmate processing area that includes the following:

(1)           a separate inmate entrance;

(2)           a holding area with seating and access to a commode, lavatory, drinking fountain, and a shower;

(3)           a booking area that includes space for photographing and fingerprinting inmates and a telephone for making local and collect long‑distance calls; and

(4)           a sobriety testing area.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990.

 

10A NCAC 14J .1208        VISITATION AREAS

(a)  Each jail shall provide an area for visitation.

(b)  If provided, noncontact visitation areas shall:

(1)           provide seating for the inmate and visitors;

(2)           provide a view panel with minimum dimensions of 1' x 1' between the inmate and visitors;

(3)           provide a telephone communication system or equivalent audio link between the inmate and visitors;

(4)           permit visual and auditory observation by officers; and

(5)           prevent the passage of contraband.

(c)  If provided, contact visitation areas shall:

(1)           provide seating for the inmate and visitors; and

(2)           permit visual and auditory observation by officers.

(d)  Confidential attorney visitation areas shall:

(1)           permit contact between the inmate and attorney;

(2)           be separate and distinct from the general visitation area;

(3)           provide seating and a writing table for the inmate and attorney;

(4)           permit only visual monitoring by the officers;

(5)           provide a way for the attorney to contact officers if needed; and

(6)           provide a minimum of 30 footcandles of artificial light.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1209        MEDICAL AREA

(a)  Each jail shall have a medical area that provides the following:

(1)           a door that may be locked;

(2)           locked storage for equipment, supplies, medications and medical records;

(3)           an examination table and a handicapped‑accessible sink, toilet and shower;

(4)           a work station for the doctor and nurse;

(5)           a telephone; and

(6)           direct voice contact with officers.

(b)  If a county or a region has more than one jail, it shall be required to provide only one medical area if that area meets the medical needs of the inmates in all of the jails.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1210        OTHER AREAS

(a)  Each jail that does not contract for meals shall have a kitchen. If a county or a region has more than one jail, it shall be required to provide only one kitchen if it meets the needs of the inmates in all of the jails.

(b)  Each jail that does not contract for laundry services shall have a laundry.  If a county or a regional jail has more than one jail, it shall be required to provide only one laundry if it meets the needs of the inmates in all of the jails.

(c)  Each jail shall have an area or areas specifically designated for physical exercise.

(d)  Each jail shall provide areas with shelves that meet its storage needs.  Each jail shall provide a separate area for the secure storage of inmate personal property.

(e)  Each jail shall have a cleaning area that is equipped with a sink and that provides for the secure storage of cleaning supplies and equipment.

(f)  Each jail shall provide adequate secure storage for those inmates who are placed on work release.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990.

 

10A NCAC 14J .1211        ADMINISTRATIVE FACILITIES

Each jail shall provide space at some location for the following administrative activities:

(1)           Secretarial support;

(2)           Record storage;

(3)           Training materials and resources;

(4)           Mailboxes and bulletin boards for officers;

(5)           In‑service training;

(6)           Office space for jail supervisors.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1212        FLOORS, CEILINGS, AND WALLS

All ceilings, walls, and floors in confinement units shall have a finished surface that is easily cleaned, nontoxic, and predominantly of light colors.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. December 1, 1991.

 

10A NCAC 14J .1213        SHOWERS AND PLUMBING FIXTURES

(a)  Each jail shall provide at least one shower for every eight inmates.

(b)  Showers shall have drains that prevent water from draining outside the shower, and the shower fixtures and drains shall be tamper‑resistant if necessary for security.

(c)  Plumbing fixtures shall be made of stainless steel or other materials as necessary for security.

(d)  Drinking fountains shall be equipped with mouth guards.

(e)  All privacy partitions in showers and bathrooms shall be high enough to allow limited privacy for the inmates while still allowing adequate supervision by officers.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990.

 

10A NCAC 14J .1214        WINDOWS AND GLAZING

(a)  Windows and window framing, including glazing, shall be made of materials necessary to provide the degree of security required for the area in which they are used.

(b)  Glazing shall be diffused or obscured if it affords a view into confinement units from outside the jail.

(c)  View panels shall be made of materials necessary to provide the degree of security required for the area in which they are used, and those used for confinement units shall have an area that permits observation of the entire unit.

(d)  Natural light shall be admitted into all confinement units either directly or indirectly.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. December 1, 1991.

 

10A NCAC 14J .1215        DOORS, BUNKS AND LOCKS

(a)  Doors, locks and detention hardware shall be made of materials necessary to provide the degree of security required for the area in which they are used.

(b)  Doors to all confinement units shall have view panels.

(c)  Doors shall operate independently of each other, and the cell doors in a cellblock shall be capable of simultaneous release during an emergency.

(d)  Doors and locks that are electronically controlled shall be equipped with manual override.

(e)  Food passes, if used, shall have openings large enough to permit the passage of a food tray.

(f)  Bunks shall have dimensions necessary to accommodate a standard detention mattress and they shall be securely anchored at least 15 inches above the floor.  When one bunk is placed above another, the lower bunk shall be approximately 15 inches and the upper bunk approximately 50 inches above the floor.

(g)  Doors, locks, detention hardware and bunks shall be designed to inhibit their use for an attempted suicide.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990.

 

10A NCAC 14J .1216        SAFETY EQUIPMENT

In each jail the safety equipment, including intercoms, fire extinguishers, smoke detectors, and sprinkler heads, shall be tamper‑resistant if necessary for security.  Two‑way voice communications shall comply with Rule .0601 of this Subchapter.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. June 1, 1992;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1217        MECHANICAL SYSTEMS

(a)  Each jail shall have heating, ventilation, and air conditioning systems that are capable of maintaining temperatures in confinement units at not less than 68 degrees Fahrenheit during the heating season and not more than 85 degrees Fahrenheit during the cooling season.

(b)  The master controls for the system shall be located outside the confinement units and shall be accessible to officers during an emergency.

(c)  The ducts for the systems shall be designed to prevent the escape of inmates and the passage of contraband, and they shall be designed to inhibit their use for attempted suicide.

(d)  The ventilation system shall provide a minimum of ten cubic feet per minute of fresh or purified air for each inmate.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1218        PLUMBING SYSTEMS

(a)  Each jail shall have a plumbing system that complies with the Commission for Public Health Rules 15A NCAC 18A, Section .1500 and the North Carolina State Building Code, Plumbing Code, both of which are hereby incorporated by reference including subsequent amendments and editions of the referenced materials.  A copy of 15A NCAC 18A, Section .1500 can be obtained free of charge from the State Division of Health Services, Environmental Health Section, Post Office Box 27687, Raleigh, North Carolina 27611‑7687.  A copy of the North Carolina State Building Code, Plumbing Code (Volume II of the North Carolina State Building Code) can be obtained for twenty‑five dollars ($25.00) from the North Carolina Department of Insurance, Post Office Box 26387, Raleigh, North Carolina 27611.

(b)  Each jail shall have a hot water supply for lavatories and showers designed to meet the usual needs of the number of inmates confined in the jail.

(c)  The master control valves for the plumbing system shall be located outside the confinement units and shall be accessible to officers during an emergency.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. June 1, 1992.

 

10A NCAC 14J .1219        ELECTRICAL SYSTEMS

(a)  Each jail shall have an electrical system that provides artificial lighting in the confinement units of at least 30 footcandles and that can be reduced during sleeping hours.

(b)  Artificial lighting in the corridors shall be at least 20 footcandles.

(c)  Lighting fixtures shall be made of materials necessary to provide the degree of security required for the area in which they are used.

(d)  Each jail shall provide electrical and antenna or cable connections for a television in its dayroom areas.

(e)  The master controls and circuit breakers shall be located outside the confinement units and shall be accessible to officers during an emergency.

(f)  Each jail shall have an auxiliary emergency power supply for each electrical system.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990.

 

10A NCAC 14J .1220        ADDITIONAL SECURITY REQ/ "INSTITUTIONAL OCCUPANCY‑RESTRAINED" JAILS

Each jail that is required to meet the "Institutional Occupancy ‑ Restrained" requirements of the North Carolina State Building Code shall also meet the following security requirements:

(1)           Each jail shall have a separate entrance for inmates, and all entrances to the jail shall be controlled and visually and audibly monitored.

(2)           Each jail shall have security perimeter walls that are provided with a separate and complete security vestibule, sally port, security window, security door, or other security device at each wall opening.

(3)           Clothing or towel hooks shall not be used.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. June 1, 1993;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1221        CONFINEMENT UNITS

The governing body shall decide what confinement unit or combination of confinement units it will include in its jail:  single segregation cells, single cells, multiple occupancy cells, or dormitories provided each county or region has the means to protect or isolate an inmate, when necessary, in a cell with a toilet, a sink, a drinking fountain and a security mirror.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. December 1, 1991;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1222        STANDARDS FOR SINGLE SEGREGATION CELLS

Each single cell used for segregation shall have:

(1)           a shower or access to a shower;

(2)           a telephone jack or other telephone arrangement;

(3)           a food pass;

(4)           a minimum floor space of 70 square feet, a minimum floor dimension of 7 feet, a toilet, a sink, a drinking fountain and a security mirror.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10a NCAC 14J .1223        STANDARDS FOR SINGLE CELLS

Each single cell shall have:

(1)           a minimum floor space of 50 square feet;

(2)           a minimum floor dimension of 7 feet;

(3)           a toilet, a sink, a drinking fountain and a security mirror; and

(4)           access to a dayroom.

The requirements of Paragraph (3) of this Rule shall be satisfied if inmates have unrestricted access, except during emergencies, to a dayroom that includes one toilet per eight inmates, one sink with a security mirror per eight inmates and one water fountain.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. December 1, 1991;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1224        STANDARDS FOR MULTIPLE OCCUPANCY CELLS

Each multiple occupancy cell shall house no more than four inmates and shall have:

(1)           a minimum floor space of 50 square feet for the first inmate and 35 square feet of floor space for each additional inmate;

(2)           a minimum floor dimension of seven feet;

(3)           a toilet, a sink, a drinking fountain and a security mirror; and

(4)           access to a dayroom.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1225        STANDARDS FOR DAYROOMS

Each dayroom shall have:

(1)           a separate and complete security vestibule at its entrance;

(2)           a minimum floor space of 105 square feet or 35 square feet per inmate, whichever is greater;

(3)           sufficient seating for the capacity of the unit;

(4)           sufficient table space for the capacity of the unit unless each inmate has unrestricted access to a cell with a table and chair, in which case the dayroom shall have sufficient table space for 70 percent of the capacity of the unit;

(5)           a telephone jack or other telephone arrangement provided within the dayroom;

(6)           a way for officers to observe the entire area; and

(7)           one toilet per eight inmates unless the inmates have unrestricted access to a cell with a toilet, sink, drinking fountain and security mirror.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. June 1, 1993; December 1, 1991.

 

10A NCAC 14J .1226        STANDARDS FOR DORMITORIES

Each dormitory shall house no more than 40 inmates and shall have:

(1)           a minimum floor space of 70 square feet per inmate including both the sleeping and dayroom area;

(2)           one shower per eight inmates, one toilet per eight inmates, one sink with a security mirror per eight inmates, and one water fountain;

(3)           a telephone jack or other telephone arrangement provided within the dormitory;

(4)           space designed to allow a variety of activities;

(5)           sufficient seating and tables for all inmates; and

(6)           a way for officers to observe the entire area from the entrance.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. December 1, 1991.

 

SECTION .1300 ‑ INSPECTION AND ENFORCEMENT OF MINIMUM STANDARDS

 

10A NCAC 14J .1301        INSPECTIONS

All jails shall be visited and inspected at least twice each year, but a jail shall be inspected more frequently if the Department considers it necessary or if it is required by an agreement of correction pursuant to 10A NCAC 14 .1304.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1302        REPORT OF INSPECTION

(a)  The procedures contained in G.S. 153A‑222 shall govern all inspections except those that find noncompliance with one or more of the provisions listed in Paragraph (b) of this Rule.

(b)  The inspector shall forward a copy of the inspection report to the Secretary within ten days after the inspection if there are findings of noncompliance with any of the following standards contained in 10A NCAC 14J or the following statutes:

(1)           Classification; Section .0300;

(2)           Fire Safety; Section .0400;

(3)           Supervision; Section .0600;

(4)           Sanitation and Personal Hygiene; Section .0700;

(5)           Food; Section .0900;

(6)           Medical Care of Inmates; Section .1000;

(7)           G.S. 153A‑224, Supervision of Jails; or

(8)           G.S. 153A‑226(b), Disapproval for Public Health Purposes.

(c)  The inspector at the same time shall submit to the Secretary a written description of the conditions that caused noncompliance and a preliminary determination of whether those conditions jeopardize the safe custody, safety, health or welfare of the inmates confined in the jail.

(d)  The inspection report shall be submitted to the local officials responsible for the jail within 30 days after the inspection as required by G.S. 153A‑222, and it shall include a notice that the facility was not in compliance with one or more of the provisions listed in Paragraph (b) of this Rule.  The notice shall state that the report has been submitted to the Secretary on a designated date for a final determination of whether conditions at the jail jeopardize the safe custody, safety, health or welfare of its inmates.  The notice shall state that local officials will be mailed a final determination within 45 days of the designated date.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Amended Eff. October 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1303        DETERMINATION THAT CONDITIONS JEOPARDIZE INMATES

(a)  The Secretary shall determine whether conditions in the jail jeopardize the safe custody, safety, health or welfare of its inmates within 30 days after receipt of the inspection report and the supporting materials.

(b)  The Secretary may determine that noncompliance with any of the provisions listed in 10A NCAC 14 .1302(b) jeopardizes the safe custody, safety, health or welfare of inmates confined in the jail.

(c)  Although noncompliance with other specific standards or statutes may be found to jeopardize inmate or staff safe custody, safety, health or welfare, the Secretary shall determine that noncompliance with any of the following provisions contained in 10A NCAC 14J jeopardizes the safe custody, safety, health or welfare of inmates confined in the jail:

(1)           Mattress flame retardant requirements; Rule .0404;

(2)           Emergency exits; Rule .0401;

(3)           Fire plan; Rule .0403;

(4)           Fire equipment; Rule .0402;

(5)           Separation of male and female inmates; Rule .0302;

(6)           Separation of males under age 18; Rule .0303;

(7)           Medical plan; Rule .1001;

(8)           Disapproval for public health purposes; G.S. 153A‑226(b).

(d)  The Secretary shall notify the local officials responsible for the jail within 15 days of his final determination if he concludes that the conditions in the jail jeopardize the safe custody, safety, health or welfare of the inmates.  The Secretary shall order corrective action, order the jail closed, or enter into an agreement of correction with local officials pursuant to 10A NCAC 14J .1304.

(e)  The Secretary shall notify the local officials responsible for the jail within 15 days of his final determination if he concludes that the conditions in the jail do not jeopardize the safe custody, safety, health or welfare of the inmates.  The notice shall direct local officials to consider the inspection report and initiate corrective action pursuant to the provisions of G.S. 153A‑222.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1304        AGREEMENT OF CORRECTION

(a)  Before ordering corrective action or ordering the jail closed, the Secretary may direct the governing body to enter into an agreement of correction.  If the Secretary chooses this option, he shall require the governing body to enter into a written agreement within 30 days after it receives notice that conditions in the jail jeopardize the safe custody, safety, health or welfare of the inmates.

(b)  The agreement of correction at a minimum shall indicate the specific areas of noncompliance with the standards or statutes, the governing body's intent to remedy noncompliance, a plan for remedying the noncompliance, a definite and reasonable number of days within which the jail will be brought into compliance, and a schedule of inspections to monitor compliance.

(c)  The agreement of correction may be extended once for a period not to exceed 60 days if the time period in the initial agreement expires before the jail is brought into compliance, but only if the governing body is making a good faith effort to achieve compliance.

(d)  If the jail is not brought into compliance within the time period required by Paragraph (c) of this Rule, the Secretary shall order corrective action or order the jail closed.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1305        ORDER OF CORRECTIVE ACTION OR ORDER OF CLOSURE

If the Secretary determines that an agreement of correction is not appropriate, or if he determines that a jail is not brought into compliance within the time period required by an agreement of correction, the Secretary shall order corrective action or order the jail closed. Notice of the action taken shall be given to local officials responsible for the jail as provided by G.S. 153A‑223(1).  Local officials may contest the Secretary's order according to the procedures outlined in G.S. 153A‑223.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1306        DESIGNATION BY SECRETARY

The Secretary may designate a person to act for him with respect to matters covered by this Section.  The designation shall be in writing and it shall be on file with the Section.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

SECTION .1400 ‑ SATELLITE JAIL/WORK RELEASE UNITS

 

10A NCAC 14J .1401        APPLICABILITY

The standards for definitions, operations, construction and enforcement contained in Sections .0100 ‑ .1300 that apply to jails shall also apply to satellite jail/work release units.

 

History Note:        Authority G.S. 153A‑230.4;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

SECTION .1500 ‑ CONSTRUCTION STANDARDS FOR EXISTING FACILITIES

 

10A NCAC 14J .1501        DEFINITIONS

The following definitions shall apply in 10A NCAC 14J .1500:

(1)           "County jail" is a detention facility designated for the confinement of persons for varying periods of time including persons awaiting adjudication and short‑term sentences as well as persons serving sentences while on work release.  The facility is authorized, maintained and administered by officials at the county level.

(2)           "Municipal jail" is a facility designated for the confinement of persons for periods not to exceed 24 hours, pending release or transfer to county jail.  The facility is authorized, maintained and administered by officials at the municipal level.

(3)           "Local lock‑up" is a facility designated for the temporary confinement of persons not to exceed six hours pending either release or transfer to a county jail.  The facility is authorized, maintained and administered by officials at the municipal level.

(4)           "Regional or district jail" is a facility designated for the identical purpose as a county jail except authorization, maintenance and administration is under the control of a joint governing body comprised of authorized representatives for the participating counties.

(5)           Because of current changes from the traditional in terminology associated with the confinement setting, the following comparison of a limited number of terms is included:

(a)           "Terminology used in standards" is the same as "traditional or approximate synonym".

(b)           "Single sleeping room" is the same as "single cell".

(c)           "Multiple sleeping room" is the same as "multiple (four‑man) cell".

(d)           "Isolation room" is the same as "solitary cell".

(e)           "Dayroom" is the same as "cell run‑around".

(f)            "Confinement unit" is the same as "cell‑block".

(g)           "Holding area" is the same as "bull pen".

(h)           "Sally port" is the same as "yard gate" (for vehicles).

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1502        BUILDING MATERIALS AND CONSTRUCTION REQUIREMENTS

(a)  The walls and roof shall be made of:

(1)           reinforced concrete that complies with the North Carolina State Building Code, or

(2)           masonry that complies with approved plans and specifications, or

(3)           other materials that comply with the North Carolina State Building Code.

(b)  The interior walls in security areas shall be made of:

(1)           reinforced concrete that is at least four inches thick and finished smooth, or

(2)           cement masonry (CMU) and brick that is at least eight inches thick, or

(3)           approved steel as specified in Rule .1513 of this Section.

(c)  Interior floors shall be made of concrete that is finished smooth, terrazzo, quarry tile, or other approved material.

(d)  Interior ceilings shall be made of:

(1)           reinforced concrete that is finished smooth, or

(2)           approved steel as specified in Rule .1513 of this Section, or

(3)           other approved material.

(e)  Grating fronts and grating doors for single and multiple rooms shall be made of tool‑resisting steel, as specified in Rule .1513(1)(a) of this Section, unless enclosed in a tool resisting perimeter.

(f)  Safety vestibule grating and interior grating doors shall be made of tool‑resisting steel, as specified in Rule .1513(1)(a) of this Section.

(g)  Materials shall be non‑combustible and shall have fire‑resistive ratings if required by the North Carolina State Building Code.

(h)  A local confinement facility shall not be located in or attached to buildings with less than fire‑resistive construction, unless the confinement area is separated by an approved masonry firewall.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1503        DOORS

(a)  All doors that open into booking or control areas of jails shall be security doors as specified in Rules .1514 and .1515 of this Section, unless other exterior security is provided, including either a sally port, a controlled gate, or fencing.

(b)  Exit doors shall be security type doors and they shall be keyed to both sides.

(c)  The number of exits, the width and location of exit doors, and the swing of exit doors shall comply with North Carolina State Building Code.

(d)  Sally port doors shall be of the security type and shall be installed in accordance with approved plans and specifications.

(e)  Swinging plate doors of approved type as specified in Rule .1515(a) to (c) of this Section shall be provided with a speaking panel and an observation port when employed on safety vestibules and in other locations as may be approved in plans and specifications.

(f)  Swinging plate doors with a prison type lock or hollow metal doors of approved types with an observation port shall be used at entrances to inspection corridors.  Hollow metal doors shall have heavy‑duty lock with multiple tumblers.

(g)  An approved grill, a hollow metal security door, or a plate security door shall be used at all entrances to security areas (see Rule .1515 of this Section).

(h)  Grill doors to individual rooms shall be made of open hearth steel only if it is enclosed in a tool‑resisting perimeter.

(i)  Pipe chase access doors or plates shall be made of approved security‑type plate or hollow metal (Rule .1516 of this Section) according to approved plans and specifications.

(j)  Access doors in all inmate occupied areas shall be equipped with observation ports and food passes according to approved plans and specifications.

(k)  In all areas occupied by female inmates, observation ports shall be equipped with an operating hatch that may be closed from the outside and secured to provide privacy.

(l)  If electro‑mechanical capability is used in a security door installation within the confinement area, the control box shall provide a mechanical over‑ride in the event of power failure.

(m)  All door‑locking mechanisms shall be of the approved type (see Rule .1517 of this Section) and installed according to approved plans and specifications.

(n)  Elevator doors opening into jail areas shall be secure and located so as to be under observation and control of officers.

(o)  The controls for sally port doors shall be located within the booking control area to provide constant surveillance by supervisory personnel.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1504        WINDOWS AND SECURITY SCREENING

(a)  All windows shall open and close to provide ventilation unless mechanical cooling or forced air circulation is provided.

(b)  Windows shall be constructed of such material to contain persons within the enclosed area and to provide security from without.

(c)  Windows in inspection corridors shall be designed to maximum security specifications using tool‑resistant steel bars or members (equivalent to Bayley AN‑1, SG‑1, or SN‑1, or Southern Steel Co. Type AST or SST) unless the confinement unit has a tool‑resisting steel grating enclosure.

(d)  Windows in the inspection corridor shall be designed to moderate security detention using mild steel bars and members (equivalent to Bayley SG‑1, AN‑2 or SN‑2) if the confinement unit has a tool‑resisting grating enclosure.

(e)  Local lockups are the only exception to (c) and (d) if the windows are fixed, inaccessible, or they otherwise present no threat to safety or security.

(f)  Windows shall have protective or security screening to prevent the passing of contraband except where approved exterior fencing is provided.

(g)  Security screening shall be of a type to protect glass from damage and prevent the passage of contraband if inmates have access to windows (see Rule .1529 and .1530 of this Section).

(h)  Windows shall be glazed with diffused or obscured glass or an approved synthetic material which admits light to all confinement areas if they afford a view into the confinement area from outside.

(i)  Skylights shall meet the same requirements for light transmission and security windows, except that skylights need not be ventilating units.

(j)  Windows in the booking area shall be of an approved type and construction to provide security and protection for the area.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1505        SINGLE ROOM REQUIREMENTS

(a)  Single room areas shall be a minimum of five feet by seven feet by eight feet.

(b)  The room shall have a combination lavatory, commode and drinking fountain (see Rule .1534 of this Section).

(c)  Isolation rooms shall have hot and cold water.

(d)  Except for local lockups, a shower with hot water shall be provided for each area of isolation rooms.

(e)  An approved mirror shall be installed (see Rule .1521 of this Section).

(f)  No more than one approved stationary steel bunk shall be installed in the room (see Rule .1522 of this Section).

(g)  Natural light shall be admitted to the room in compliance with the North Carolina State Building Code.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1506        MULTIPLE ROOM REQUIREMENTS

(a)  The capacity of multi‑room units shall not exceed four inmates.

(b)  The minimum room area shall be nine feet by seven feet by eight feet.

(c)  The room shall have a combination lavatory, commode and drinking fountain (see Rule .1534 of this Section).

(d)  The room shall have hot and cold water unless it is contained in a confinement unit with a dayroom that has hot and cold water.

(e)  Except for local lockups, each room shall have a shower with hot and cold water.

(f)  An approved mirror shall be installed (see Rule .1521 of this Section).

(g)  No more than four approved stationary steel bunks shall be installed within each room.

(h)  Natural light shall be admitted to the room in compliance with the North Carolina State Building Code.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10a NCAC 14J .1507        DORMITORY AREA REQUIREMENTS IN JAILS

(a)  The capacity of dormitories shall not exceed 16.

(b)  The minimum room area for each inmate shall be 50 square feet and 400 cubic feet per inmate.

(c)  Each dormitory shall have one combination commode, drinking fountain, and lavatory with hot and cold water for every eight inmates.

(d)  Each dormitory shall have one shower.

(e)  Each dormitory shall have an approved mirror for every eight inmates (see Rule .1521 of this Section).

(f)  Each dormitory shall have a table and bench (see Rule .1523 of this Section).

(g)  Natural light shall be admitted to the dormitory in compliance with North Carolina State Building Code.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1508        DORMITORY AREA REQUIREMENTS IN COUNTY JAIL ANNEXES

Dormitory areas in county jail annexes must not exceed the rated capacity as approved by the Section.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1509        DAYROOM AND SAFETY VESTIBULE REQUIREMENTS: COUNTY JAIL

(a)  Confinement units with a capacity of over four persons, except for dormitories, shall provide a dayroom of equal area to the sleeping areas.

(b)  The dayroom area shall have an approved shower with hot and cold water for every 16 inmates (see Rule .1524 of this Section), and it shall have a commode, drinking fountain, and lavatory with hot and cold water.

(c)  Each dayroom shall have an approved steel bench and table (see Rule .1523 of this Section) that will accommodate all of the inmates in the confinement unit.

(d)  Confinement units with a capacity of over four persons, except for dormitories, shall have a safety vestibule that permits one door to be locked before the other is opened.

(e)  A combination of single rooms and four‑man rooms may share a common dayroom, but the capacity of a dayroom shall not exceed 24 inmates.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1510        HOLDING AREAS

(a)  Each facility with a capacity of 30 or more inmates shall have a secure holding area adjacent to the booking area where inmates can be held pending their commitment.

(b)  The holding area shall be under observation by administrative jail personnel.

(c)  The holding area shall be constructed of approved grill steel.

(d)  The holding area shall have an approved bench and combination lavatory, commode, and drinking fountain.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1511        OTHER AREAS

(a)  Each facility shall have sufficient storage space.

(b)  Each county jail shall have a medical examining room that at least is equipped with an examining table and a lavatory.

(c)  Each jail with a capacity of more than 20 inmates shall have secure conference areas, and the areas shall not have recording or listening devices.

(d)  All confinement areas shall have adequate floor drains in accordance with approved plans and specifications (see Rule .1535 of this Section).

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1512        LIGHTING AND VENTILATION

(a)  Lighting fixtures in sleeping rooms and dayrooms shall provide at least 30 footcandles of artificial light, and they shall have diffusers designed to illuminate a horizontal area from a ceiling or wall position.

(b)  Artificial lighting in the inspection and control corridors shall be at least 20 footcandles.

(c)  The artificial lighting at night in the sleeping rooms shall not exceed two footcandles.

(d)  The lighting levels in the non‑domiciliary portions of the jail shall be within ranges recommended by the I.E.S. (Illumination Engineering Society) for the particular activity.

(e)  Lighting fixtures in the inmate‑occupied areas shall be of the security type, and the wiring controls and fixtures shall be inaccessible to inmates (see Rule .1527 of this Section).

(f)  Confinement areas shall be heated within a range of not less than 70 degrees nor more than 75 degrees.  Confinement areas shall not have a heater or furnace that burns liquid or solid fuel.

(g)  Wiring, temperature controls, and heat distribution equipment shall be inaccessible to inmates.

(h)  Each facility shall provide adequate air circulation and ventilation of confinement areas in compliance with the North Carolina State Building Code.

(i)  Confinement areas shall be cooled within a range of not less than 75 degrees nor more than 85 degrees.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1513        WALLS

Walls and partitions shall be made of either reinforced concrete or masonry or the following materials:

(1)           Steel grating of either tool‑resisting steel or open hearth steel as specified in the plans:

(a)           Tool‑resisting steel grating shall meet the following construction requirements:

(i)            Seven‑eighths of an inch or one inch diameter vertical double‑ribbed round bars spaced not over four inches on center, passing through and interlocking at each intersection with 3/8 inch x 2‑1/4 inches or 3/8 inch x 2‑1/2 inches tool‑resisting flat bars spaced on 12 inch centers for 7/8 inch bars and on 18 inch centers for one inch bars;

(ii)           Vertical framing bars shall be 3/8 inch x 2‑1/4 inches or 3/8 inch x 2‑1/2 inches tool‑resisting flat bars.

(b)           Open hearth steel grating shall meet the following construction requirements:

(i)            Seven‑eighths of an inch or one inch diameter vertical double‑ribbed round bars spaced not over four inches on center, passing through and interlocking at each intersection with 3/8 inch x 2‑1/4 inches or 3/8 inch x 2‑1/2 inches horizontal flat bars spaced on 12 inch centers for 7/8 inch bars and on 18 inch centers for one inch bars;

(ii)           Vertical framing bars shall be 3/8 inch x 2‑1/4 inches or 3/8 inch x 2‑1/2 inches open hearth flat bars.

(2)           Steel plate used in a wall or ceiling shall meet the following construction requirements:

(a)           not less than 3/16 inch open hearth steel, or

(b)           not less than 1/4 inch tool‑resisting steel.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1514        SLIDING DOORS

(a)  Sliding doors shall be made of the same weight and quality of grating or plate as the confinement area fronts or wall in which they are installed.

(b)  Sliding doors shall be approximately two feet x six feet, three inches, and shall be hung from the top by a plate door carriage.

(c)  The door carriage shall have two hardened steel spindles on which will be mounted two needle‑bearing or two S.K.F. or approved equal ball‑bearing solid steel machined wheels.

(d)  The door carriage shall be enclosed in a covered box of the prescribed type.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1515        SWINGING DOORS

(a)  Plate doors installed in plate walls shall be made of steel that is at least the same quality and thickness as specified for the wall in which the door opening is installed.

(b)  Plate doors installed in concrete or masonry walls shall be made of material not lighter than 3/16 inch thick open hearth steel plate framed and stiffened with angles, bars, or other shapes and securely hung to door frames made of structural or bent plate channel at least 3/16 inch thick.

(c)  The depth of plate door frame shall equal the thickness of the wall.

(d)  Grating doors installed either in grating, plate walls, or concrete or masonry walls shall be constructed of tool‑resisting steel or open‑hearth steel as specified by the plans.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1516        ACCESS DOORS AND PANELS

(a)  Swinging access doors to pipe and utility spaces shall be at least one foot, eight inches x four feet in size and made of 3/16 inch steel plate.

(b)  Removable access panels shall be made of 3/16 inch open‑hearth steel plate and shall be large enough to permit entrance.

(c)  Access panels shall be secured to the wall either by 3/8 inch hex‑head screws tapped into the panel opening frame and spaced not more than eight inches on center, or they shall be secured by metal lugs at the bottom of the panel and a deadlock at the top, both of which shall be mounted at the back side of the panel to provide further security.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1517        PRISON KEY‑OPERATED LOCKS

(a)  Locking swinging doors shall use prison deadlocks with heavy multiple tumblers.  The lock mechanism shall be housed in a lock case made of forged steel not less than 5‑1/2 inches x 1‑3/8 inches in size.

(b)  Manually‑operated sliding doors shall be locked by a heavy multiple tumbler that uses a snap and automatic deadlock.  The lock mechanism shall be housed in a lock case made either of strong steel or malleable iron or steel not less than 10 inches x 3‑1/2 inches x 1‑3/8 inches in size.

(c)  Food passes and shutters, where specified, shall be locked by a heavy multiple tumbler that uses a prison type snap or spring.  The food pass lock shall be mounted to prevent food or other matter from coming in contact with the lock.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1518        HINGES

Swinging doors shall be hung on hinges designed for jail use.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1519        OBSERVATION AND SPEAKING PANELS

(a)  Observation and speaking panels shall be mounted in plate or masonry walls where shown on plans, and they shall be designed to prevent the passage of contraband.

(b)  Observation and speaking panels shall be made either of polished stainless steel, chromium plated steel, brass, or aluminum.

(c)  Glass in observation panels shall be bullet‑proof and at least 7/8 inch thick.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1520        FOOD PASSES

(a)  The food pass in plate walls shall be approximately 12 inches wide x 4‑1/2 inches high.  Hinged food pass shutters shall be about 13 inches wide and six inches high and they shall be made of 3/16 inch open‑hearth steel plate.  The shutter shall form a shelf when in open position and it shall overlap the opening around the edges.

(b)  The food pass in grating walls shall be approximately 12 inches wide x 4‑1/2 inches high, and a shelf 5 inches x 12 inches shall be riveted or welded to the bottom of the opening to facilitate the passage of food.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1521        MIRRORS

(a)  Mirrors shall be approximately 8 inches x 9‑1/2 inches in size when provided.

(b)  Mirrors shall be highly polished stainless steel or chrome plated steel, and they shall be attached securely to the wall.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1522        BUNKS

(a)  Bunks shall be six feet, three inches long and not less than two feet, one inch nor more than two feet, three inches wide.

(b)  The bottoms of bunks shall be 16‑gauge sheet steel perforated with one inch to two inch holes for ventilation.

(c)  Bunks shall be framed on the long side by angles not less than 1‑1/2 inches x 2 inches x 3/16 inch in size and on the ends by 3/16 inch bent plate brackets.

(d)  The required parts shall be welded together to form a one‑piece bunk assembly with end brackets.

(e)  The bunk brackets shall be securely fastened to cell walls.

(f)  When one bunk is placed above another, the lower bunk shall be approximately 15 inches and the upper bunk approximately 50 inches above the floor.

(g)  In dormitories, double bunks with approved bottoms and frames shall be securely attached either to the floor or the wall.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1523        TABLES, BENCHES AND SEATS

(a)  One‑piece bench and table units shall be installed as shown on the plans, and they shall be welded securely to an adjacent steel wall and anchored securely to the floor.

(b)  The tops of tables and benches shall be made of at least 10‑gauge sheet steel neatly flanged around the edges.

(c)  Table legs and other supports shall be made of properly designed and reinforced materials.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1524        SHOWER STALLS

(a)  The dimensions of showers shall be at least 30 inches x 30 inches x 7 feet.

(b)  Shower stalls shall be constructed of either concrete, masonry, at least 1/8 inch galvanized steel plate, heavy gauge aluminum plate, or heavy gauge stainless steel according to approved plans and specifications.

(c)  The shower stall shall be attached to the wall of the dayroom.

(d)  The floor of the shower stall shall be approximately eight inches above floor level and it shall slope to the floor shower drain.

(e)  A curb that is approximately four inches above the shower floor shall extend across the front of the shower stall.  The top of the curb shall have a smooth edge.

(f)  The shower head and the push‑button valve assembly shall be vandal proof, and the metering valve and temperature balance mechanism shall be concealed.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1525        REMOTE CONTROL LOCKING MECHANISMS

(a)  Remote control locking and operating mechanisms for fully selective sliding doors shall be electric, electrical‑mechanical, mechanical, or gang locking.

(b)  Remote control locking mechanisms shall be designed and manufactured specifically for corrections use and shall be installed according to plans.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1526        MATERIAL TESTS

(a)  Tool‑resisting materials that are included in jail equipment shall withstand the following tests:

(1)           A load test of not less than 6,000 lbs. applied at the midpoint of heat‑treated 7/8 inch or one inch diameter double‑ribbed round tool‑resisting bar resting horizontally on two supports spaced 12 inches apart.  The load shall be applied with a blunt‑end rounded to a radius of approximately 1/4 inch on the edge which is in contact with the tested bar.  The bar shall not assume a permanent set in excess of 1/4 inch and it shall not break under the load.

(2)           Tool‑resisting 7/8 inch or one inch steel bars shall not be severed within six hours by using six hacksaw blades, and it shall not be pierced by using six 1/8 inch bits, used either in a hand‑operated or motor‑driven drill.  The hacksaw blades and bits in this test shall be the standard type found in institutions.

(b)  Open‑hearth steel shall be the type produced for corrections use and it shall have a chemical composition that is within the limits adopted by the Association of American Steel Manufacturers for open‑hearth bars and shapes.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1527        PROTECTION EQUIPMENT FOR ELECTRICAL LIGHTS

(a)  Each facility shall adequately protect electric lights in cells from damage by inmates.

(b)  Fittings shall be either covered with 3/8 inch tempered lenses for diffusing light or protected with steel wire.

(c)  Steel plate brackets shall be provided for mounting light receptacles.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1528        DOOR PULLS

(a)  Swinging plate security doors shall have at least six inch loop pulls of polished aluminum alloy, polished bronze or chrome plated bronze.

(b)  Door pulls shall be secured to doors by security‑type patch head screws, spanner screws, or hexagon nuts.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1529        WIRE WINDOW GUARDS

(a)  Wire window guards shall cover windows as called for in the plans.

(b)  Window guards shall be made of 11‑gauge steel mesh, woven three mesh to the inch, and they shall be framed with flat steel bars.

(c)  Hinges, padlocks, hasps, and staples shall be furnished for window guards.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1530        SECURITY SCREENS

Security screens shall be installed as indicated on the construction plans, and they shall be made of steel, stainless steel, or extruded aluminum.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1531        INSECT SCREENS AND DOORS

Insect screens and doors shall be provided as indicated on the plans, and they shall be made of extruded aluminum, stainless steel, bronze, or steel.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1532        KEY CABINET

(a)  A secure key cabinet shall be provided as shown on the plans, and it shall be made of not less than 10‑gauge open‑hearth steel plate.

(b)  The door to the key cabinet shall be hung securely on two steel pin hinges and locked with a heavy multiple tumbler security‑type deadlock.

(c)  The key cabinet shall have shelves, gun racks, and key hooks as required.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1533        PLUMBING

All plumbing shall be in accordance with the North Carolina State Plumbing Code and the approved plans in effect at time of construction.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1534        PLUMBING FIXTURES

(a)  Plumbing fixtures shall be furnished and installed as specified on the approved plans.

(b)  The plumbing construction shall withstand damage attempted without tools, and the plumbing materials shall offer maximum resistance to wear while providing sanitation in the area used.

(c)  Vitreous china lavatories shall have an integral spout and drinking nozzle with a mouth guard.

(d)  Lavatories shall have an integral soap dish and outlet.

(e)  Lavatories shall have self‑closing operating buttons.

(f)  Vitreous china water closets shall be floor mounted and shall have an integral seat and base with a 1‑1/2 inch back spud.

(g)  The flush valve shall be tamper proof and self‑closing, and siphon jet action shall be used.

(h)  Commode, lavatory and drinking fountain combination units shall be made of welded stainless steel or cast aluminum except that galvanized steel shall be allowed for cabinet reinforcement.

(i)  The fixture shall have tamper‑proof, chrome‑plated self‑closing valves and a combination filler, drinking bubbler with a mouth guard and vacuum flow control.

(j)  The water closet bowl shall have an integral seat and back outlet.

(k)  The lavatory top, bowl, and closet bowl in the stainless steel fixture shall be 16‑gauge or heavier with an 11‑gauge or heavier liner.

(l)  Surfaces in the stainless steel unit shall be satin finish, except the bowl shall have a high luster finish.

(m)  The fixture shall be anchored through the wall with concealed bolts.

(n)  A vacuum breaker shall be incorporated and a water shutoff shall be installed outside the room or dayroom.

(o)  The fountain bubbler shall produce a water flow on a jet angle and the protector shall be above the water outlet to prevent the mouth from touching it.  The protector shall be strong enough that the average person cannot change its configuration without tools.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1535        FLOOR DRAINS

Floor drains that are accessible to inmates shall be fitted with tamper‑resistant covers.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1536        GENERAL PROVISIONS REGARDING EQUIPMENT INSTALLATION

(a)  All steel equipment, except tool‑resisting bars embedded in concrete floors and other such parts that are enameled or plated, shall have a prime coat applied in the fabricating shop.

(b)  Paint shall be of good metallic grade.

(c)  All riveting and welding connected with the installation of security equipment shall meet specifications indicated by the architect.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

SECTION .1600 ‑ CONSTRUCTION STANDARDS FOR EXISTING STATE‑FUNDED SATELLITE JAIL/WORK RELEASE UNITS

 

10A NCAC 14J .1601        APPLICABILITY

Existing state‑funded satellite jail/work release units shall continue to be governed by the existing construction standards which are now in this Section.  These same standards shall apply to new satellite jail/work release units which have had final working drawings approved by the Section prior to the effective date of this Rule.  Existing state‑funded satellite jail/work release units or new state‑funded satellite jail/work release units which have had final working drawings approved by the Section prior to the effective date of this Rule may choose to comply with any of the new construction standards in Section .1200 as a substitute for existing standards on the same subject in Section .1500.

 

History Note:        Authority G.S. 153A‑230.4;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1602        CONFINEMENT UNIT

Each satellite jail/work release unit shall include:

(1)           No more than 24 inmates per sleeping area;

(2)           No less than 35 square feet per inmate devoted to sleeping area only;

(3)           One shower per 10 inmates, one water closet per six inmates, one sink per six inmates and one water fountain per 10 inmates.  Showers and toilet facilities shall be designed to provide maximum privacy (line of sight) while not interfering with the capability of the jail staff to complete supervision rounds;

(4)           A telephone hookup or other arrangements provided within the area;

(5)           A dayroom/activity room for each unit separated from the sleeping area and of a size to provide a minimum of 15 square feet per inmate;

(6)           A dayroom/activity room designed to allow a variety of activities to take place and have:

(a)           sufficient seating and tables for each inmate in each confinement unit;

(b)           natural light;

(c)           artificial lighting at 30 footcandles in reading areas which may be reduced during sleeping hours;

(d)           access to toilet, sink with hot and cold water, and drinking fountain;

(e)           visual control by staff to observe entire area from point of entrance;

(f)            direct voice contact with continuously staffed post or central control center.

(7)           Single occupancy sleeping areas when called for in the design.  Each single occupancy area shall have:

(a)           a minimum of 35 square feet of floor space;

(b)           a minimum floor dimension of seven feet;

(c)           a toilet, sink, and drinking fountain;

(d)           a bed frame;

(e)           artificial lighting of 30 footcandles which can be reduced during sleeping hours;

(f)            natural light provided by window with exterior exposure;

(g)           direct voice contact with staff post or central control center.

 

History Note:        Authority G.S. 153A‑230.4;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1603        PROGRAMMING AREAS

Each satellite jail/work release unit, when located in a separate facility from a maximum confinement unit shall have:

(1)           A general visitation area with:

(a)           a public entrance to the facility;

(b)           an entry located to permit direct observation and control by staff;

(c)           storage facilities for visitors' coats and packages;

(d)           a sufficient number of stations to accommodate visitation needs;

(e)           seating for both inmates and visitors.

(2)           A confidential attorney visitation area that:

(a)           is separate and distinct from the general visitation area;

(b)           permits passage of papers and documents;

(c)           provides seating with a table or desk for writing for visitors and inmates;

(d)           provides artificial lighting of 30 footcandles;

(e)           permits contact visiting;

(f)            provides for visual monitoring, but not hearing by staff;

(g)           provides for visitors to contact staff if needed.

(3)           If the facility is not a "work release" only facility, a medical area designed:

(a)           to prohibit access by unauthorized personnel;

(b)           to have locked storage for equipment, supplies, medications, and records;

(c)           for equipment approved by the jail physician including a sink, toilet, shower, examining table, nurses and physicians work station, telephone, and direct contact with the central control area.

(4)           A food service that meets the sanitation requirements of the Commission for Public Health Title 15A Chapter 18A Section .1500, with adequate storage and food preparation areas.

(5)           A laundry service (either contracted for or on premises).

(6)           In a facility which is not a "work release" only facility, recreational facilities with:

(a)           an area designed for vigorous physical activities, such as volleyball, basketball, etc.;

(b)           equipment storage area;

(c)           staff observation post for all areas;

(d)           access to areas controlled by staff.

(7)           A commissary through contract services or built on premises.

 

History Note:        Authority G.S. 153A‑230.4;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1604        ADMINISTRATION AREA

Each satellite jail/work release unit shall have an administrative area which shall provide:

(1)           adequate space for administrative offices accessible to the public;

(2)           clerical support areas;

(3)           record storage areas;

(4)           space for information resources, report writing, and training materials;

(5)           conference or training area;

(6)           space for unit administrator and support staff personnel.

 

History Note:        Authority G.S. 153A‑230.4;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1605        CONSTRUCTION MATERIALS FOR SATELLITE JAIL/WORK RELEASE UNITS

Traditional building materials may be used where safety will not be jeopardized, taking into consideration the type and level of security described in the operations program developed by the local authorities.

 

History Note:        Authority G.S. 153A‑230.4;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1606        MECHANICAL SYSTEMS

Mechanical systems shall:

(1)           Provide heating, ventilation, and air conditioning to meet the requirements of the N.C. Building Code;

(2)           Have master controls for electrical, plumbing, heating, and air conditioning, that are inaccessible to inmates;

(3)           Have master cutoff controls for electrical and water supplies to each confinement area (either single cells or dormitory type areas);

(4)           Have capability of maintaining temperatures in the confinement areas within 68 degrees Fahrenheit minimum in the heating season and a maximum of 85 degrees Fahrenheit during the non‑heating season.

 

History Note:        Authority G.S. 153A‑230.4;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1607        GENERAL REQUIREMENTS

In addition to the rules in this Section, the minimum secure unit shall be designed to:

(1)           allow access for emergency equipment (e.g., fire hoses, stretchers) provided at appropriate entrances;

(2)           have auxiliary power and emergency lighting available;

(3)           have vehicle parking for both public and facility staff and be so designed to prevent unauthorized persons from entering the security perimeter.

 

History Note:        Authority G.S. 153A‑230.3; 153A‑230.4;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

SECTION .1700 ‑ MUNICIPAL LOCKUPS

 

10A NCAC 14J .1701        DEFINITIONS

The following definitions shall apply in 10A NCAC 14J .1700:

(1)           "Addition" is an extension or increase in floor area or height of a building or structure.

(2)           "Alteration" is any change or modification in construction or use.

(3)           "Booking area" is a secure area where a person is admitted to a jail and procedures such as searching, fingerprinting, photographing, health screening, and collecting personal history data occur.

(4)           "Section" is the Jail and Detention Section of the Division of Health Service Regulation, Department of Health and Human Services.

(5)           "Cell" is any confinement unit.

(6)           "Cellblock" is a separate and identifiable grouping of cells.

(7)           "Communicable disease or condition" is an illness or condition as defined in G.S. 130A‑133 which is hereby adopted by reference pursuant to G.S. 150B‑14(c).

(8)           "Confinement unit" is a single segregation cell, a single cell, a multiple occupancy cell or a dormitory.

(9)           "Contraband" is any item that a person is not authorized to possess in the lockup because it is a violation of law or a violation of rules.

(10)         "Department", unless otherwise specified, is the North Carolina Department of Health and Human Services.

(11)         "Division", unless otherwise specified, is the Division of Health Service Regulation of the North Carolina Department of Health and Human Services.

(12)         "Emergency medical problem" is a serious medical need, including severe bleeding, unconsciousness, serious breathing difficulties, head injury, severe pain, suicidal behavior or severe burns, that requires immediate medical attention and that cannot be deferred until the next scheduled sick call or clinic.

(13)         "Footcandle" is the amount of light thrown on a surface one foot away from the light source.  It is a unit for measuring the intensity of illumination.

(14)         "Governing body" refers to the governing body of a municipal government.

(15)         "Health screening" is a procedure for each newly‑admitted inmate that combines visual observation with an interview to obtain relevant information about the inmate's physical and mental health.

(16)         "Inmate" is any person, whether pretrial, unsentenced, or sentenced, who is confined in a lockup.

(17)         "Inmate processing area" is a secure area through which inmates enter and exit, and it may be combined with the booking area.

(18)         "Institutional‑Restrained" is a Building Code occupancy classification used for buildings in which persons are restrained under lock and key or other security measures which render them incapable of self‑preservation due to the security measures not being under their direct control.

(19)         "Medical record" is a record of medical problems, examinations, diagnoses and treatments.

(20)         "Multiple occupancy cell" is a cell designed to house up to four inmates.

(21)         "Municipal lockup" is a facility designated for the confinement of persons for periods not to exceed 24 hours, pending release or transfer to the county jail.  The facility is authorized, maintained, and administered by municipal officials.

(22)         "Officer" is a person, whether sworn or unsworn, who is involved in the supervision, control, or custody of inmates.

(23)         "Operations manual" is a set of written policies and procedures for the operation of a lockup in compliance with state and federal law and the minimum standards for the operation of municipal lockups.

(24)         "Qualified medical personnel" are persons who provide medical services to inmates and who are licensed, certified, registered, or approved, in accordance with state law.  It includes persons who provide limited medical services under supervision as permitted by law.

(25)         "Registered dietitian" is a specialist in the field of nutrition, dietetics and food system management who maintains current registration with the Commission on Dietetic Registration of the American Dietetic Association.

(26)         "Repair" is reconstruction or renewal of any part of an existing building for the purpose of its maintenance.

(27)         "Residential" is a Building Code occupancy classification used for buildings which provide sleeping accommodations for the occupants and in which the egress doors are unlocked at all times thereby providing free movement to the building exterior from occupied areas.

(28)         "Sally port" is an enclosed entry and exit area used either for vehicular or pedestrian traffic with gates or doors at both ends, only one of which opens at a time.

(29)         "Secretary", unless otherwise specified, is the Secretary of Department of Health and Human Services.

(30)         "Security perimeter" is the outer portion of a lockup that provides for the secure confinement of inmates and that prevents the entry of unauthorized persons or contraband.

(31)         "Security vestibule" is a defined space that provides security by using two or more doors, with each door able to operate independently, and that permits an officer to observe those who pass through the space.

(32)         "Single cell" is a cell designed to house one inmate.

(33)         "Tamper resistant" means designed to prevent damage, destruction or interference by inmates.

(34)         "View panel" is a transparent panel.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1702        APPLICABILITY ‑ CONSTRUCTION

(a)  New Municipal Lockups ‑ The construction standards established in this Section shall apply to all municipal lockup construction for which the final working drawings are approved by the Branch after the effective date of this Rule.

(b)  Existing Municipal Lockups ‑ Existing municipal lockups shall continue to be governed by the existing construction standards which are now in Section .1500 of this Subchapter and the same standards shall apply to new municipal lockups which have had final working drawings approved by the Section prior to the effective date of this Rule.  Existing municipal lockups or new municipal lockups which have had final drawings approved by the Section prior to the effective date of this Rule may choose to comply with any of the new construction standards in Section .1200 as a substitute for existing standards on the same subject in Section .1500.

(c)  Additions ‑ The construction standards established in this Section shall apply to any construction that adds square footage to the building and for which the final working drawings are approved after the effective date of this Rule.

(d)  Alterations or Repairs ‑ When alterations or repairs are made to an existing municipal lockup building which affect its structural strength, exits, fire hazards, electrical systems, mechanical systems, or sanitary conditions, such alterations or repairs shall comply with the standards for new construction established in this Section.  Unaltered portions of the building shall be required to comply with the new construction standards indicated in this Section only under the circumstances specified in Paragraphs (e) ‑ (g) of this Rule.

(e)  Extensive Annual Alterations or Repairs ‑ If, within any 12 month period, alterations or repairs costing in excess of 50 percent of the then physical value of the building are made to an existing municipal lockup, the entire municipal lockup shall conform to the construction standards for new municipal lockups established in this Section.

(f)  Reconstruction After Damage ‑ If an existing municipal lockup is damaged by fire or otherwise in excess of 50 percent of the then physical value of the building at the time of damage, the municipal lockup shall be reconstructed in conformance with the construction standards for new municipal lockups established in this Section.

(g)  Physical Value ‑ For the purpose of this Rule, the physical value of the municipal lockup building shall be determined by the local building inspection department.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1703        REQUIREMENT FOR OPERATIONS MANUAL

Within 12 months after the effective date of this Rule, the chief of police or his designee responsible for operating the municipal lockup shall develop written policies and procedures that describe how the lockup will be operated.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1704        PURPOSE OF OPERATIONS MANUAL

The purpose of the operations manual is to ensure the smooth and efficient operation of the municipal lockup, and therefore it shall be detailed enough to guide officers in completing their assigned duties.  The operations manual shall be available to all officers, and each officer shall be familiar with the manual.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1705        CONTENTS OF OPERATIONS MANUAL

(a)  The operations manual shall include written policies and procedures that address the following areas:

(1)           administration and management;

(2)           admissions, transportation and release;

(3)           classification;

(4)           security and supervision;

(5)           inmate rules and discipline;

(6)           management of special inmates;

(7)           legal rights of inmates;

(8)           health, mental health, mental retardation and substance abuse services;

(9)           food services;

(10)         access to legal representation;

(11)         sanitation; and

(12)         emergency plans.

(b)  The most recent editions of the following references are available as guides for developing policies and procedures:

(1)           Appalachian State University, Model Policies and Procedures Manual for North Carolina Jails;

(2)           American Correctional Association, Standards for Adult Local Detention Facilities;

(3)           American Correctional Association, Standards for Small Jails;

(4)           National Commission on Correctional Health Care, Standards for Health Services in Jails.

These references shall be available for inspection or loan from the Section. Consultation and technical assistance shall be available from the Section. The Section can also provide information regarding outside agencies with additional resources for developing policies and procedures.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1706        REVIEW OF MANUAL

The operations manual shall be reviewed and updated at least once each year by the police chief.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1707        CLASSIFICATION SYSTEM

Each municipal lockup shall have a written classification procedure for the placement and housing of inmates.  Within the limitations imposed by the design and capacity of the lockup, the procedure shall assign inmates to confinement units that best meet their individual needs and that reasonably protect the inmate, other inmates, the jail staff, and the public.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1708        FEMALE INMATES

Male and female inmates shall not be placed in the same confinement unit, dayroom or other living area and, in addition, female inmates shall be housed out of sight of male inmates.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. December 1, 1991;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1709        CONFINEMENT OF MALES UNDER 18 YEARS OF AGE

Male inmates under 18 years of age shall be confined in separate cells from adult inmates during sleeping hours.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1710        DISCRIMINATION IN HOUSING ASSIGNMENTS

Housing assignments shall not be made on the basis of race, color, creed, national origin, or political belief.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1711        EXITS

Each municipal lockup shall have readily accessible emergency exits in compliance with the North Carolina State Building Code in order to permit the prompt evacuation of inmates and staff during an emergency.  Egress doors in jails which are classified as "Residential Occupancy" by the N.C. State Building Code shall remain unlocked at all times thereby permitting free movement to the building exterior from occupied areas.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1712        FIRE EQUIPMENT

Each municipal lockup shall provide the following emergency fire equipment:

(1)           fire extinguishers that meet all of the requirements in National Fire Prevention Association pamphlet number 10 which is hereby adopted by reference pursuant to G.S. 150B‑14(c), and

(2)           smoke detection equipment that meets the requirements of the North Carolina State Building Code.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1713        FIRE PLAN

(a)  Each municipal lockup shall have a written plan for the evacuation and control of inmates in the event of a fire.  The plan shall include at least quarterly fire drills, and records shall be made of the fire drills and retained.  The actual movement of inmates to other areas or outside the building is not required.

(b)  Evacuation routes shall be posted or otherwise clearly marked throughout the municipal lockup.

(c)  The police chief shall request in writing that the local fire department or fire marshall inspect the municipal lockup and review the fire plan at least once each year.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1714        MATTRESSES

Mattresses shall be of fire resistive and nontoxic construction.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1715        KEYS

Each municipal lockup shall have a key control system that includes the following elements:

(1)           a key control center that is secure and inaccessible to unauthorized persons at all times;

(2)           a set of duplicate keys to be stored in a safe place that is inaccessible to unauthorized persons at all times;

(3)           an accounting procedure for issuing and returning keys; and

(4)           a system of keys and matching locks that are color‑coded and marked for identification by touch.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1716        GENERAL SECURITY REQUIREMENTS

Each municipal lockup shall meet the following security requirements:

(1)           provide for the secure confinement of inmates from the time of their passage through the security perimeter until release;

(2)           prevent the passage of contraband;

(3)           prevent unauthorized contact between inmates and person from outside the lockup;

(4)           provide a ground‑level perimeter exterior that is well lighted; and

(5)           provide a communications link with outside agencies for use in emergencies.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1717        SUPERVISION

(a)  Officers shall make supervision rounds and directly observe each inmate in person at least twice per hour on an irregular basis.  The supervision rounds shall be documented.  If remote electronic monitoring is used to supplement supervision, it shall not be substituted for supervision rounds and direct visual observation.

(b)  Officers shall maintain voice or visual contact with all inmates at all times, and it shall be through either direct observation or by means of electronic surveillance.

(c)  Their shall be more frequent observation of inmates who are assaultive, suicidal, intoxicated, mentally ill or who have other special needs or problems.

(d)  Officers shall remain awake at all times.

(e)  Officers shall not be assigned other duties that would interfere with the continuous supervision, custody or control of inmates.

(f)  Female officers shall be on duty when female inmates are confined.

(g)  The police chief shall develop a contingency plan for the supervision and control of inmates during an emergency, and it shall provide for the ready availability of extra personnel.

(h)  Inmates shall not be allowed to supervise or assume any control over other inmates.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1718        SANITATION AND TOILETS

Each municipal lockup shall comply with the North Carolina Commission for Public Health rules governing sanitation as codified in Title 15A Chapter 18A Section .1500 and which are hereby adopted incorporated by reference, including subsequent amendments and editions of the reference materials.  A copy of this material can be obtained free of charge from the State Division of Health Services, Environmental Health Section, Post Office Box 27687, Raleigh, North Carolina 27611‑7687.  Inmates shall have unrestricted access to toilets.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. December 1, 1991;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1719        MATTRESSES AND BEDDING

Mattresses, sheets, and blankets that are clean and in good repair shall be supplied to all inmates except those not housed overnight.  Sheets shall be exchanged at least once a week.  Mattresses shall meet the following requirements:

(1)           Mattresses shall comply with Commission for Public Health rules on sanitation, Title 15A Chapter 18B .0201 ‑ .0215 and G.S. Chapter 130A‑273 which are hereby adopted by reference pursuant to G.S. 150B‑14(c).

(2)           Mattresses shall not be less than four inches thick and shall be the same length and width as the lockup bunks.

(3)           Mattresses shall not have any metal, plastic, or other rigid framing component.

(4)           Mattress ticking shall be durable and water repellent.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1720        FOOD SERVICE

(a)  In municipal lockups that purchase meals from an outside provider, a written contract shall require the provider to meet the applicable standards in this Section.

(b)  Inmates shall not be used as the sole source of personnel for the preparation or service of any meal.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1721        MEAL SERVICE

(a)  Each municipal lockup shall provide at least three meals for inmates, two of which must be hot, at regular times during each 24‑hour period.  There shall be not more than 14 hours between the evening meal and breakfast.  An inmate shall be provided a meal if he is in the municipal lockup during a normal meal hour.

(b)  Food shall be served to inmates on individual serving trays. Eating utensils, consistent with security considerations, and condiments shall be provided.

(c)  While food is being transported, either from inside or outside the jail, it shall be covered to prevent contamination.  Food must be maintained at appropriate serving temperatures as specified in Commission for Health Service Rule 15A NCAC 18A .1522.

(d)  Food shall never be used as a reward or punishment.

(e)  Each municipal lockup shall keep a daily record of the number of meals served.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. December 1, 1991;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1722        FOOD AND NUTRIENT REQUIREMENTS

(a)  The average nutrient content of weekly menus shall meet the Recommended Dietary Allowances of the National Academy of Sciences which are hereby adopted by reference pursuant to G.S. 150B‑14(c).

(b)  Daily menus shall include the following:

(1)           Milk Group:  Two servings;

(2)           Fruit Group:  Two servings, one of which shall be citrus;

(3)           Vegetable Group:  Three servings;

(4)           Meat or Protein Group:  Two servings;

(5)           Cereal or Bread Group:  Four servings of whole grain or enriched products; and

(6)           Calories:  2,100 ‑ 2,500.

(c)  For all pregnant women and inmates under age 18, the milk group shall include four servings per day.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1723        MENUS

(a)  Menus shall be prepared in consultation with a registered dietitian.

(b)  Menus shall be written and portion sizes shall be specified.

(c)  Menus shall be dated and posted one week in advance.

(d)  Menus shall be served as written to inmates in the municipal lockup.  Any necessary substitutions shall be of comparable nutritional value, and a written record of substitutions shall be kept.

(e)  The same menu shall not be served at lunch and dinner on the same day.

(f)  Dated menus and records of any substitutions shall be retained for three years.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1724        MODIFIED DIETS

(a)  Modified diets shall be provided if prescribed by appropriate medical or dental personnel.

(b)  Modified diets shall be provided when reasonably possible to accommodate the sincerely held religious beliefs of an inmate.

(c)  Written menus for modified diets shall be prepared in consultation with a registered dietitian.

(d)  Modified diets shall be served as written.  Any necessary substitutions shall be of comparable nutritional value, and a written record of substitutions shall be kept.  Dated menus of modified diets and records of any substitutions shall be retained for three years.

(e)  Each municipal lockup shall maintain a current list of inmates requiring modified diets, and it shall be posted for use by staff.

(f)  Each municipal lockup shall record the number of modified diets served at each meal, along with the name of each inmate and the type of modified diet that he or she received.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1725        MEDICAL PLAN

(a)  A written medical plan shall be developed in compliance with G.S. 153A‑225 and it shall be available for ready reference by municipal lockup personnel.  The medical plan shall include a description of the health services available to inmates.

(b)  The written plan shall include policies and procedures that address the following areas:

(1)           Health screening of inmates upon admission;

(2)           Routine medical care;

(3)           The handling of inmates with chronic illnesses or known communicable diseases or conditions;

(4)           Administration, dispensing and control of prescription and non‑prescription medications;

(5)           Handling emergency medical problems, including but not limited to emergencies involving dental care, chemical dependency, pregnancy and mental health;

(6)           Maintenance and confidentiality of medical records; and

(7)           Privacy during medical examinations and conferences with qualified medical personnel.

(c)  Inmates must be provided an opportunity each day to communicate their health complaints to a health professional or to an officer.  Qualified medical personnel shall be available to evaluate the medical needs of inmates.  A written record shall be maintained of the request for medical care and the action taken.

(d)  Inmates shall not perform any medical functions in the lockup.

(e)  The medical plan shall be reviewed annually.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. December 1, 1991;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1726        HEALTH SCREENING FORM

The health screening form completed upon admission by an officer shall be available to municipal lock‑up officers, and a copy of the form shall be kept in any medical file that is maintained for inmates.  The form shall be reviewed for the presence of confidential information which cannot be made available to municipal lock‑up officers.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. December 1, 1991;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1727        LOGS OF ADMISSIONS AND RELEASES

Municipal lockups shall keep a log that contains at least the following information on each inmate admitted:

(1)           Inmate name,

(2)           Date and time inmate is admitted and released,

(3)           Charge,

(4)           Condition of release, and

(5)           If not released, place to which inmate was transferred.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1728        MONTHLY REPORT OF MUNICIPAL LOCKUPS

The police chief shall complete a monthly report on Form DHR‑JDS‑1 and send it to the Section no later than the tenth day of the following month.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1729        REPORT OF DEATH

The report of an inmate death required by G.S. 153A‑225 shall be submitted to the Section.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1730        CONSULTATION AND TECHNICAL ASSISTANCE

Consultation and technical assistance in planning a new municipal lockup shall be available through the Section.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1731        COMPLIANCE REVIEW AND APPROVAL

(a)  The governing body shall submit copies of the following to the Section before it begins construction of a new municipal lockup and before it makes additions or alterations to an existing municipal lockup as defined by the North Carolina State Building Code:

(1)           three sets of schematic drawings and outline specifications;

(2)           three sets of preliminary working drawings or design development drawings and outline specifications;

(3)           three sets of completed final working drawings and specifications.

(b)  Upon receipt of the drawings and specifications at each stage, the Section shall send one set each to the following for their review and approval:  the Department of Insurance to insure compliance with the North Carolina State Building Code, and the Division of Environmental Health in the Department of Environment and Natural Resources to insure compliance with the rules governing sanitation as codified in Title 15A Chapter 18A Section .1500 and which are hereby adopted by reference pursuant to G.S. 150B‑14(c).  The Section shall keep one set for its own review and approval to insure compliance with the minimum standards for the operation and construction of municipal lockups as contained in this Subchapter.  Review and comment on the drawings and specifications at each stage shall be made no later than 30 days after receipt by the Section.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1732        SPECIFIC CONSTRUCTION REQUIREMENTS

(a)  Municipal lockups restrain inmates under lock and key within a building and therefore shall meet the requirements of the North Carolina State Building Code for "Institutional Occupancy ‑ Restrained".

(b)  The construction materials in all municipal lockups shall be sufficient to provide the degree of security required for the area in which they are used.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1733        CENTRAL CONTROL STATION

In municipal lockups that have a central control station, the station shall:

(1)           be strategically located and equipped to regulate and monitor the movement of inmates and officers;

(2)           have a security vestibule at its entrance;

(3)           have direct two‑way voice communication with all confinement units;

(4)           have direct two‑way voice communication with all officers as needed to maintain safety and security;

(5)           be equipped with a release mechanism to open all confinement unit doors in an emergency;

(6)           have a toilet and sink.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1734        ELEVATORS

Elevators that open into the municipal lockup shall be secure and shall be under the control and observation of officers.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1735        INMATE PROCESSING AREA

Each municipal lockup that performs a booking and release function shall have an inmate processing area with access to the following:

(1)           a booking area that includes space for photographing and fingerprinting inmates and a telephone for making local and collect long‑distance calls; and

(2)           a sobriety testing area.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1736        VISITATION AREAS

Each municipal lockup shall provide a confidential attorney visitation area that shall:

(1)           permit contact between the inmate and attorney;

(2)           provide seating and a writing table for the inmate and attorney;

(3)           permit only visual monitoring by the officers;

(4)           provide a way for the attorney to contact officers if needed; and

(5)           provide a minimum of 30 footcandles of artificial light.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1737        OTHER AREAS

Each municipal lockup that does not contract for meals shall have a kitchen.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1738        FLOORS, CEILINGS, AND WALLS

All ceilings, walls, and floors in confinement units shall have a finished surface that is easily cleaned, nontoxic, and predominantly of light colors.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. December 1, 1991;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1739        SHOWERS AND PLUMBING FIXTURES

(a)  If provided, each municipal lockup shall have at least one shower for every eight inmates.

(b)  If provided, showers shall have drains that prevent water from draining outside the shower, and the shower fixtures and drains shall be tamper‑resistant if necessary for security.

(c)  Plumbing fixtures shall be made of stainless steel or other suitable materials as necessary for security.

(d)  Drinking fountains shall be equipped with mouth guards.

(e)  All privacy partitions in showers and bathrooms shall be high enough to allow limited privacy for the inmates while still allowing adequate supervision by officers.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1740        WINDOWS AND GLAZING

(a)  Windows and window framing, including glazing, shall be made of materials necessary to provide the degree of security required for the area in which they are used.

(b)  Glazing shall be diffused or obscured if it affords a view into confinement units from outside the municipal lockup.

(c)  View panels shall be made of materials necessary to provide the degree of security required for the area in which they are used, and those used for confinement units shall have a minimum area of 180 square inches and permit observation of the entire unit.

(d)  Natural light shall be admitted into all confinement units either directly or indirectly.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Amended Eff. December 1, 1991;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1741        DOORS, BUNKS AND LOCKS

(a)  Doors, locks and detention hardware shall be made of materials necessary to provide the degree of security required for the area in which they are used.

(b)  Doors to all confinement units shall have view panels.

(c)  Doors shall operate independently of each other, and the cell doors in a cellblock shall be capable of simultaneous release during an emergency.

(d)  Doors and locks that are electronically controlled shall be equipped with manual override.

(e)  Food passes, if used, shall have openings large enough to permit the passage of a food tray.

(f)  Bunks shall have dimensions necessary to accommodate a standard detention mattress and they shall be securely anchored at least 15 inches above the floor.  When one bunk is placed above another, the lower bunk shall be approximately 15 inches and the upper bunk approximately 50 inches above the floor.

(g)  Doors, locks, detention hardware and bunks shall be designed to inhibit their use for an attempted suicide.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1742        SAFETY EQUIPMENT

In each municipal lockup the safety equipment, including intercoms, fire extinguishers, smoke detectors, and sprinkler heads, shall be tamper‑resistant if necessary for security.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1743        MECHANICAL SYSTEMS

(a)  Each municipal lockup shall have heating, ventilation, and air conditioning systems that are capable of maintaining temperatures in confinement units not less than 68 degrees Fahrenheit during the heating season and not more than 85 degrees Fahrenheit during the cooling season.

(b)  The master controls for the system shall be located outside the confinement units and shall be accessible to officers during an emergency.

(c)  The ducts for the systems shall be designed to prevent the escape of inmates and the passage of contraband, and they shall be designed to inhibit their use for attempted suicide.

(d)  The ventilation system shall provide a minimum of ten cubic feet per minute of fresh or purified air for each inmate.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1744        PLUMBING SYSTEMS

(a)  Each municipal lockup shall have a plumbing system that complies with the Commission for Public Health Rules Title 15A Chapter 18A and the North Carolina State Plumbing Code, both of which are hereby adopted by reference pursuant to G.S. 150B‑14(c).

(b)  Each municipal lockup shall have a hot water supply for inmate lavatories, if provided, and showers designed to meet the usual needs of the number of inmates confined in the municipal lockup.

(c)  The master control valves for the plumbing system shall be located outside the confinement units and shall be accessible to officers during an emergency.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1745        ELECTRICAL SYSTEMS

(a)  Each municipal lockup shall have an electrical system that provides artificial lighting in the confinement units of at least 30 foot‑candles and that can be reduced during sleeping hours.

(b)  Artificial lighting in the corridors shall be at least 20 footcandles.

(c)  Lighting fixtures shall be made of materials necessary to provide the degree of security required for the area in which they are used.

(d)  The master controls and circuit breakers shall be located outside the confinement units and shall be accessible to officers during an emergency.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1746        CLOTHING AND TOWEL HOOKS

Clothing and towel hooks shall not be used.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1747        CONFINEMENT UNITS

The governing body shall decide what confinement unit or combination of confinement units it will include in its municipal lockup:  single cells and multiple occupancy cells.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1748        STANDARDS FOR SINGLE CELLS

Each single cell shall have:

(1)           a minimum floor space of 50 square feet;

(2)           a minimum floor dimension of seven feet;

(3)           a toilet, a sink and a drinking fountain.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1749        STANDARDS FOR MULTIPLE OCCUPANCY CELLS

Each multiple occupancy cell shall house no more than four inmates and shall have:

(1)           a minimum floor space of 50 square feet for the first inmate and 35 square feet of floor space for each additional inmate;

(2)           a minimum floor dimension of seven feet;

(3)           a toilet, a sink and a drinking fountain.

 

History Note:        Authority G.S. 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1750        INSPECTIONS

All municipal lockups shall be visited and inspected at least twice each year, but a lockup shall be inspected more frequently if the Department considers it necessary or if it is required by an agreement of correction pursuant to Rule .1753 of this Subchapter.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1751        REPORT OF INSPECTION

(a)  The procedures contained in G.S. 153A‑222 shall govern all inspections except those that find noncompliance with one or more of the provisions listed in Paragraph (b) of this Rule.

(b)  The inspector shall forward a copy of the inspection report to the Secretary within ten days after the inspection if there are findings of noncompliance with any of the following standards contained in 10A NCAC 14J or the following statutes:

(1)           Classification; Rules .1707‑.1709;

(2)           Fire Safety; Rules .1711‑.1715;

(3)           Supervision; Rule .1717;

(4)           Sanitation and Personal Hygiene; Rules .1718‑.1719;

(5)           Food; Rules .1720‑.1724;

(6)           Medical Care of Inmates; Rules .1725‑.1726;

(7)           G.S. 153A‑224, Supervision of Lockups; or

(8)           G.S. 153A‑226(b), Disapproval for Public Health Purposes.

(c)  The inspector at the same time shall submit to the Secretary a written description of the conditions that caused noncompliance and a preliminary determination of whether those conditions jeopardize the safe custody, safety, health or welfare of the inmates confined in the municipal lockup.

(d)  The inspection report shall be submitted to the local officials responsible for the municipal lockup within 30 days after the inspection as required by G.S. 153A‑222, and it shall include a notice that the facility was not in compliance with one or more of the provisions listed in Paragraph (b) of this Rule.  The notice shall state that the report has been submitted to the Secretary on a designated date for a final determination of whether conditions at the municipal lockup jeopardize the safe custody, safety, health or welfare of its inmates.  The notice shall state that local officials will be mailed a final determination within 45 days of the designated date.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1752        DETERMINATION THAT CONDITIONS JEOPARDIZE INMATES

(a)  The Secretary shall determine whether conditions in the municipal lockup jeopardize the safe custody, safety, health or welfare of its inmates within 30 days after receipt of the inspection report and the supporting materials.

(b)  The Secretary may determine that noncompliance with any of the provisions listed in 10A NCAC 14J .1751(b) jeopardizes the safe custody, safety, health or welfare of inmates confined in the lockup.

(c)  Although noncompliance with other specific standards or statutes may be found to jeopardize inmate or staff safe custody, safety, health or welfare, the Secretary shall determine that noncompliance with any of the following provisions contained in 10A NCAC 14J jeopardizes the safe custody, safety, health or welfare of inmates confined in the lockup:

(1)           Mattress flame retardant requirements; Rule .1711;

(2)           Emergency exits; Rule .1713;

(3)           Fire plan; Rule .1713;

(4)           Fire equipment; Rule .1712;

(5)           Separation of male and female inmates; Rule .1708;

(6)           Separation of males under age 18; Rule .1709;

(7)           Medical plan; Rule .1725;

(8)           Disapproval for public health purposes; G.S. 153A‑226(b).

(d)  The Secretary shall notify the local officials responsible for the municipal lockup within 15 days of his final determination if he concludes that the conditions in the lockup jeopardize the safe custody, safety, health or welfare of the inmates.  The Secretary shall order corrective action, order the municipal lockup closed, or enter into an agreement of correction with local officials pursuant to 10A NCAC 14J .1753.

(e)  The Secretary shall notify the local officials responsible for the lockup within 15 days of his final determination if he concludes that the conditions in the lockup do not jeopardize the safe custody, safety, health or welfare of the inmates.  The notice shall direct local officials to consider the inspection report and initiate corrective action pursuant to the provisions of G.S. 153A‑222.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1753        AGREEMENT OF CORRECTION

(a)  Before ordering corrective action or ordering the lockup closed, the Secretary may direct the governing body to enter into an agreement of correction.  If the Secretary chooses this option, he shall require the governing body to enter into a written agreement within 30 days after it receives notice that conditions in the lockup jeopardize the safe custody, safety, health or welfare of the inmates.

(b)  The agreement of correction at a minimum shall indicate the specific areas of noncompliance with the standards or statutes, the governing body's intent to remedy noncompliance, a plan for remedying the noncompliance, a definite and reasonable number of days within which the lockup will be brought into compliance, and a schedule of inspections to monitor compliance.

(c)  The agreement of correction may be extended once for a period not to exceed 60 days if the time period in the initial agreement expires before the lockup is brought into compliance, but only if the governing body is making a good faith effort to achieve compliance.

(d)  If the lockup is not brought into compliance within the time period required by Paragraph (c) of this Rule, the Secretary shall order corrective action or order the lockup closed.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1754        ORDER OF CORRECTIVE ACTION OR ORDER OF CLOSURE

If the Secretary determines that an agreement of correction is not appropriate, or if he determines that a lockup is not brought into compliance within the time period required by an agreement of correction, the Secretary shall order corrective action or order the lockup closed. Notice of the action taken shall be given to local officials responsible for the lockup as provided by G.S. 153A‑223(1).  Local officials may contest the Secretary's order according to the procedures outlined in G.S. 153A‑223.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

10A NCAC 14J .1755        DESIGNATION BY SECRETARY

The Secretary may designate a person to act for him with respect to matters covered by this Section.  The designation shall be in writing and it shall be on file with the Section.

 

History Note:        Authority G.S. 153A‑220; 153A‑221;

Eff. June 1, 1990;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. January 5, 2016.

 

 

 

SUBCHAPTER 14k - PREADMISSION SCREENING FOR ADULT CARE HOME RESIDENTS

 

SECTION .0100 - PREADMISSION SCREENING FOR ADULT CARE HOME RESIDENTS

 

10A NCAC 14K .0101       PREADMISSION SCREENING

 

History Note:        Authority S.L. 2012-142;

Temporary Adoption Eff. March 1, 2013;

Temporary Adoption expired November 26, 2013.

 

 

SUBCHAPTER 14L – STROKE CENTER DESIGNATION

 

SECTION .0100 – DEFINITIONS

 

10a ncac 14L .0101       DEFINITIONS

The following definitions apply throughout this Subchapter:

(1)           "Acute Stroke Care" means the process for the assessment and treatment of patients experiencing an acute cerebrovascular accident.

(2)           "Acute Stroke Ready" means a hospital that has satisfied all requirements for certification as an acute stroke ready hospital from a nationally recognized hospital accrediting organization.

(3)           "Catchment Area" means the geographical area from which a hospital's patients are drawn.

(4)           "Comprehensive Stroke Care" means care provided by hospitals that meet or exceed the requirements put forward by nationally-recognized hospital accrediting organizations and have developed the infrastructure, staff, and training necessary to receive and treat patients with the most complex stroke cases, including advanced imaging capabilities, 24 hours per day, seven days per week, with availability of specialized treatments, and staff with the unique education and competencies to care for complex stroke patients through the certification process required by accrediting organizations.

(5)           "Comprehensive Stroke Center" means a hospital that has satisfied all requirements for certification from a nationally recognized hospital certifying organization for the provision of comprehensive stroke care.

(6)           "Conditional Designation" means a hospital that is pursuing certification but has not satisfied all certification requirements of the national accrediting body to qualify for Comprehensive Stroke Center or Primary Stroke Center or Acute Stroke Ready Hospital designation.

(7)           "Department" means the Department of Health and Human Services.

(8)           "Designated Stroke Center" means a hospital that has presented evidence to the Department of current certification by a national accrediting organization as a Comprehensive Stroke Center or Primary Stroke Center or Acute Stroke Ready Hospital.

(9)           "Designation" means the recognition by the Department of a hospital's certification by a nationally recognized hospital certifying organization for the provision of stroke care as set forth in Items (2), (5), and (13) of this Rule.

(10)         "EMS System" means those entities that are approved by the Department in accordance with 10A NCAC 13P .0201 of the EMS and Trauma rules.

(11)         "EMS Provider" means those entities defined in G.S. 131E-155(13a) that hold a current license issued by the Department pursuant to G.S. 131E-155.1.

(12)         "Office of Emergency Medical Services (OEMS)" means a section of the Division of Health Service Regulation of the North Carolina Department of Health and Human Services located at 1201 Umstead Drive, Raleigh, North Carolina 27603.

(13)         "Primary Stroke Center" means a hospital that has satisfied all requirements for certification from a nationally recognized hospital accrediting organization for the provision of acute stroke care.

 

History Note:        Authority G.S. 143B-10; 131E-78.5;

Eff. February 1, 2015.

SECTION .0200 –STROKE CENTER DESIGNATION

 

10a ncac 14L .0201       stRoke center designation REQUIREMENTS

(a)  The Department shall designate hospitals licensed by the Division of Health Service Regulation pursuant to G.S. 131E-78.5 as certified "Designated Stroke Centers," as defined in Rule .0101(8) of this Subchapter, upon receipt of evidence provided by the hospital as defined in Paragraph (b) of this Rule that the hospital has received Primary Stroke Center or Comprehensive Stroke Center or Acute Stroke Ready certification by any of the following:

(1)           "The Joint Commission" (TJC), "American Heart Association" (AHA), and "American Stroke Association" (ASA) Comprehensive Stroke Center, Disease Specific Certification Program;

(2)           "Healthcare Facilities Accreditation Program" (HFAP);

(3)           "Det Norske Veritas" (DNV); or

(4)           other nationally recognized accrediting body that requires conformance to best practices for stroke care.

(b)  Hospitals designated as a Primary Stroke Center or Comprehensive Stroke Center or Acute Stroke Ready Hospital shall notify the Office of Emergency Medical Services of the following information within 90 days of certification:

(1)           the name of the accrediting organization issuing certification to the hospital;

(2)           the date of certification;

(3)           the level of certification (Primary, Comprehensive or Acute Stroke Ready);

(4)           the date of renewal of the certification; and

(5)           the name and phone number of the primary contact person at the hospital who is responsible for obtaining the certification.

(c)  The Department shall maintain a list of all Primary Stroke Centers, Comprehensive Stroke Centers and Acute Stroke Ready Hospitals on its website at http://www.ncdhhs.gov.

(d)  Each designated Primary Stroke Center or Comprehensive Stroke Center or Acute Stroke Ready Hospital shall coordinate the provision of acute stroke care with other hospitals in their catchment area through written agreements that address the following minimum requirements:

(1)           transportation of acute stroke patients to the designated Primary Stroke Center or Comprehensive Stroke Center or Acute Stroke Ready Hospital; and

(2)           acceptance of patients initially treated at hospitals incapable of providing management of the acute stroke patient.

(e)  The Office of Emergency Medical Services shall provide written notification annually through email to the medical directors of each EMS system and EMS provider a list of all Primary Stroke Centers, Comprehensive Stroke Centers and Acute Stroke Ready Hospitals contained on the Department's website.

(f)  Hospitals shall notify the Office of Emergency Medical Services in writing within 30 days of any change to the hospital's Primary Stroke Center or Comprehensive Stroke Center or Acute Stroke Ready certification.

(g)  Hospitals that have received a conditional certification are ineligible for designation by the Department as a Primary Stroke Center or Comprehensive Stroke Center or Acute Stroke Ready Hospital until the hospital receives Primary Stroke Center or Comprehensive Stroke Center or Acute Stroke Ready certification by the accrediting body issuing the certification.

(h)  Hospitals that fail to maintain certification shall be removed from the Department's website by the Office of Emergency Medical Services within 30 days following receipt of written notification from the affected hospital.

(i)  Non-certified hospitals shall not advertise or utilize signage representing the hospital as a Primary Stroke Center or Comprehensive Stroke Center or Acute Stroke Ready Hospital if the hospital has not received that designation by the Department.

 

History Note:        Authority G.S. 143B-10; 131E-78.5;

Eff. February 1, 2015.