Section 51 Hospitals, institutions for unwed mothers, or clinics; licensing
Section 51. The department shall issue for a term of two years, and shall renew for like terms, a license, subject to revocation by it for cause, to any person, city, town, or county it deems responsible and suitable to establish or maintain a hospital, an institution for the care of unwed mothers or a clinic, which meets the requirements of the department established in accordance with its rules and regulations. In the case of the transfer of ownership of a hospital, an institution for the care of unwed mothers or a clinic, the application of the new owner for a license, when filed with the department on the date of transfer of ownership, shall have the effect of a license for a period of three months. If a license has not been issued by the department upon the expiration of said three months period, all the patients shall be transferred or discharged from such hospital or such institution for unwed mothers, and the hospital, institution for unwed mothers, or clinic, as the case may be, shall cease operating.
No original license shall be issued to establish or maintain a hospital, an institution for the care of unwed mothers or a clinic providing ambulatory surgery as defined by section twenty-five B, unless there is determination by the department that there is need for such a facility at the designated location; provided, however, that no such determination shall be required with respect to original licensure of any hospital or clinic which, pursuant to the provisions of section twenty-five C1/2, is exempt from the provisions of section twenty-five C; and provided further, that no license shall be issued or renewed to any applicant to establish or maintain an acute hospital as defined pursuant to chapter six B if the department has been notified by the division of health care policy and finance that such applicant or such hospital owes an outstanding obligation to the Uncompensated Care Trust Fund pursuant to section 18 of chapter 118G.
Each hospital shall give the department an annual written statement containing a licensure adjustment calculated pursuant to this section as of the first day of such hospital’s fiscal year, and the department shall adjust the hospital’s total licensed bed capacity accordingly. As of such date, each hospital’s number of licensed acute-care medical-surgical beds, excluding all critical care beds, shall be adjusted to equal the lesser of: (a) the number of such licensed beds as reported for the prior year on division of health care finance and policy form 403, schedule III, column 4, line 1; or (b) a number equal to the average daily census for such prior year divided by seventy-five hundredths; provided, however, that no such adjustment shall be made on or after October first, nineteen hundred and ninety-three, if such adjustment would result in the loss of the hospital’s eligibility for an additional payment amount pursuant to section 1886 (d) (5) (F) of the Social Security Act if at any time during the prior fiscal year said hospital serves a disproportionate number of low income patients as defined in section 1886 (d) (5) (F) (v) of said Social Security Act. Such average daily census shall be calculated by dividing the number reported in division of health care finance and policy form 403, schedule III, column 6, line 1, by three hundred and sixty-five. If a hospital experiences eighty-five per cent average occupancy for its adult medical-surgical beds excluding all critical care beds for three consecutive months, it may, by letter application documenting such occupancy, increase its licensed number of such beds to a number equal to the average daily census of adult medical-surgical beds excluding all critical care beds, divided by seventy-five hundredths, or to a number equal to its number of licensed beds for the preceding fiscal year, whichever is less. The department shall approve or disapprove such application within ten days after filing, on the basis of a review limited to the sole issue of whether such hospital is in fact experiencing such occupancy. If such application has not been acted upon by the department within such time limit, the application shall be deemed approved. Notwithstanding the foregoing, the department may permit a hospital to increase its licensed bed capacity by the number of beds for which such hospital qualifies according to a determination of need by the department pursuant to sections twenty-five B to twenty-five G, inclusive and provided further, that the department may retrospectively and prospectively waive the automatic bed delicensure provisions imposed pursuant to this paragraph to assist financially troubled hospitals for the purpose of qualifying for medicare disproportionate share reimbursement, and for other reasonable purposes.
Each licensee shall maintain its licensed bed capacity at all times in accordance with the provisions of this chapter and all applicable rules and regulations promulgated by the department.
No original license shall be issued to establish a hospital, except a college and school infirmary, unless it complies with the construction standards of the state building code and is of at least type 1-B fireproof construction.
In the case of new construction of a hospital, an institution for unwed mothers or a clinic, or in the case of alterations or additions to an existing hospital, an institution for unwed mothers or a clinic, preliminary architectural plans and final architectural plans and specifications shall be submitted to the division of hospital facilities of the department. Written approval of the final architectural plans and specifications shall be obtained from said division prior to said new construction or alterations or additions.
No original license shall be issued nor shall a license be renewed hereunder unless there shall be first submitted to the department by the authorities in charge of the hospital, the institution for unwed mothers or the clinic, with respect to each building occupied by patients, (1) a certificate of inspection of the egresses, the means of preventing the spread of fire and the apparatus for extinguishing fire, issued by an inspector of the division of inspection of the department of public safety, and (2) a certificate of inspection issued by the head of the local fire department certifying compliance with the local ordinances.
Any applicant for an original or renewal license who is aggrieved by a written disapproval of a certificate of inspection by the head of the local fire department or by the division of inspection of the department of public safety, may, within thirty days from such disapproval, appeal in writing, to the department of public safety. Failure to either approve or disapprove within thirty days, after a written request by an applicant, shall be deemed a disapproval.
If the department of public safety approves the issuance of a certificate of inspection, it shall forthwith be issued by the agency that failed to approve. If said department disapproves, the applicant may appeal therefrom to the superior court. Failure of the department of public safety to either approve or disapprove the issuance of a certificate of inspection within thirty days after receipt of an appeal shall be deemed a disapproval. No original license shall be issued and no license shall be renewed by the department of public health until issuance of an approved certificate of inspection, as required in this section.
Upon a written request by an applicant who is aggrieved by the revocation of a license or the refusal of the department to renew a license, the commissioner and the council shall hold a public hearing, after due notice, and thereafter they may modify, affirm or reverse the action of the department. In no case shall the revocation of such a license take effect in less than thirty days after written notification by the department to the hospital, the institution for unwed mothers or the clinic. There shall be no new admissions to such hospital, an institution for unwed mothers or a clinic during the thirty day period herein referred to; and upon the expiration of said thirty days all the patients shall be transferred or discharged therefrom and the hospital or the institution for unwed mothers or the clinic shall cease operating.
The fee for the issue or renewal of each license shall be determined annually by the commissioner of administration under the provision of section three B of chapter seven for a hospital or an institution for unwed mothers and for all clinics. The license shall not be transferable and shall be issued only for the premises described in the application.
No hospital licensed pursuant to this section shall permit early discharge, defined as less than forty-eight hours for a vaginal delivery and ninety-six hours for a caesarean delivery except in accordance with rules and regulations established by the department of public health.
The department of public health shall promulgate rules and regulations as required under section seventeen C of chapter thirty-two A, section ten A of chapter one hundred and eighteen E, section forty-seven F of chapter one hundred and seventy-five, section eight H of chapter one hundred and seventy-six A and section four H of chapter one hundred and seventy-six B; provided, however, that the standards shall be consistent with the most current guidelines established by the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics.