Rules and Regulations of the State of Georgia
 

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  1. In the address bar, type about:config and press Enter.
  2. Click "I'll be careful, I promise" if a warning message appears.
  3. In the search box, search for javascript.enabled
  4. Toggle the "javascript.enabled" preference (right-click and select "Toggle" or double-click the preference) to change the value from "false" to "true".
  5. Click on the "Reload current page" button of the web browser to refresh the page.
  • 1. In the address bar, type about:config and press Enter.
  • 2. Click "I'll be careful, I promise" if a warning message appears.
  • 3. In the search box, search for javascript.enabled
  • 4. Toggle the "javascript.enabled" preference (right-click and select "Toggle" or double-click the preference) to change the value from "false" to "true".
  • 5. Click on the "Reload current page" button of the web browser to refresh the page.




ie Internet Explorer

  1. On web browser menu click "Tools" icon and select "Internet Options".
  2. In the "Internet Options" window select the "Security" tab.
  3. On the "Security" tab click on the "Custom level..." button.
  4. When the "Security Settings - Internet Zone" dialog window opens, look for the "Scripting" section.
  5. In the "Active Scripting" item select "Enable".
  6. When the "Warning!" window pops out asking "Are you sure you want to change the settings for this zone?" select "Yes".
  7. In the "Internet Options" window click on the "OK" button to close it.
  8. Click on the "Refresh" button of the web browser to refresh the page.
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 Internet Explorer < 9
  1. On web browser menu click "Tools" and select "Internet Options"
  2. In the "Internet Options" window select the "Security" tab.
  3. On the "Security" tab click on the "Custom level..." button.
  4. When the "Security Settings - Internet Zone" dialog window opens, look for the "Scripting" section.
  5. In the "Active Scripting" item select "Enable".
  6. When the "Warning!" window pops out asking "Are you sure you want to change the settings for this zone?" select "Yes".
  7. In the "Internet Options" window click on the "OK" button to close it.
  8. Click on the "Refresh" button of the web browser to refresh the page.
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chrome Google Chrome

  1. On the web browser menu click on the "Customize and control Google Chrome" and select "Settings".
  2. In the "Settings" section click on the "Show advanced settings..."
  3. Under the the "Privacy" click on the "Content settings...".
  4. When the dialog window opens, look for the "JavaScript" section and select "Allow all sites to run JavaScript (recommended)".
  5. Click on the "OK" button to close it.
  6. Close the "Settings" tab.
  7. Click on the "Reload this page" button of the web browser to refresh the page.
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opera Opera

  • 1. a) Click on "Menu", hover mouse on the "Settings" then hover mouse on the "Quick preferences" and mark the "Enable Javascript" checkbox.
  • 1. b) If "Menu bar" is shown click on the "Tools", hover mouse on the "Quick preferences" and mark the "Enable Javascript" checkbox.
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safari Apple Safari

  1. On the web browser menu click on the "Edit" and select "Preferences".
  2. In the "Preferences" window select the "Security" tab.
  3. In the "Security" tab section "Web content" mark the "Enable JavaScript" checkbox.
  4. Click on the "Reload the current page" button of the web browser to refresh the page.
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<xmp>.</xmp> <form name="form1" method="post" action="111-8-4?urlRedirected=yes&amp;data=admin&amp;lookingfor=111-8-4" id="form1"> <input type="hidden" name="__VIEWSTATE" id="__VIEWSTATE" value="/wEPDwUKLTY5ODkwOTM2Nw8WAh4Ec3BhbQIJFgJmD2QWAgIFDw8WAh4EVGV4dAUFOCArIDFkZGSadPLz/6Xkzv1MhiZSVqtlrkP5Rg==" /> <input type="hidden" name="__VIEWSTATEGENERATOR" id="__VIEWSTATEGENERATOR" value="EEBB6393" /> <input type="hidden" name="__EVENTVALIDATION" id="__EVENTVALIDATION" value="/wEWCALGx6z+AQLniKOhBALV5cpNAoa5iIEFAoznisYGAsrv5u0MAsrv4u0MAsrv3u0MuaSMHKGwF4X9vMpnHG1ozQ6LF5M=" /> <div class='popup'> <div class='cnt223'> <div style="margin-bottom:6px;"> <img alt="Rules and Regulations of the State of Georgia" src="/images/new.gif"/> </div> <div class="header"> Terms and Conditions of Agreement for Access to Rules and Regulations of the State of Georgia Website </div> <div class="scroll"> <p>(Note: certain features of this site have been disabled for the general public to prevent digital piracy. If you are an entitled government entity pursuant the Georgia Administrative Procedures Act, <a target="_new" href="http://links.casemakerlegal.com/states/GA/books/Code_of_Georgia/browse?ci=25id=gasos&amp;codesec=50-13-7&amp;title=50&amp;#50-13-7(d)">O.C.G.A.§ 50-13-7(d)</a> contact the State of Georgia's Administrative Procedures Division at 678-364-3785 to enable these features for your location.)</p> <p>To access this website, you must agree to the following: </p> <p> These terms of use are a contract between you and/or your employer (if any), and Lawriter, LLC. </p> <p> You agree that you will not copy, print, or download anything from this website for any commercial use. </p> <p> You agree not to use any web crawler, scraper, or other robot or automated program or device to obtain data from the website.</p> <p> You agree that you will not sell, will not license, and will not otherwise make available in exchange for anything of value, anything that you download, print, or copy from this site.</p> <p> You agree that you will not copy, print, or download any portion of the regulations posted on this site exceeding a single chapter of regulations for sale, license, or other transfer to a third party, except that you may quote a reasonable portion of the regulations in the course of rendering professional advice.</p> <p> If you violate this agreement, or if you access or use this website in violation of this agreement, you agree that Lawriter will suffer damages of at least $20,000. </p> <p> THIS WEBSITE AND ITS CONTENT ARE PROVIDED "AS IS." THE STATE OF GEORGIA AND LAWRITER EXPRESSLY DISCLAIM ALL WARRANTIES, INCLUDING THE WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, AND NON-INFRINGEMENT AND ARE NOT LIABLE TO ANY PERSON FOR ANY ERRORS IN INACCURACIES CONTAINED IN THIS WEBSITE. </p> <p> If you accept these terms enter the information below and click “I AGREE”.</p> </div> <table border="0" style="width: 810px"> <tr> </tr> <tr> <td style="vertical-align: text-top; width: 243px;"> Full Name:</td> <td style="width: 532px; vertical-align:super;"> <input name="firstName" type="text" id="firstName" class="txt" /> <span id="lbl_fname"><font color="Red"></font></span> </td> </tr> <tr><td style="width: 243px"> Human verification: <b> <span id="lblStopSpam">8 + 1</span>&nbsp;= </b></td><td style="width: 532px"> <input name="captcha" type="text" id="captcha" class="txt" /> <span id="lbl_captcha"><font color="Red"></font></span> &nbsp; <input name="sum" type="hidden" id="sum" value="9" /> </td></tr> </table> <input type="submit" name="Button1" value="I AGREE" id="Button1" disabled="disabled" /> <span id="alrtmsg"><font color="Red"></font></span> <input name="v1" type="hidden" id="v1" /> <input name="v2" type="hidden" id="v2" /> <input name="v3" type="hidden" id="v3" /> <p>Privacy Policy: the above information is for internal use only as related to this agreement and will not be sold or distributed.</p> </div> </div> </form> <html> <head runat="server"> <title>GA - GAC</title> <link href="_files/main.css" media="all" rel="Stylesheet" type="text/css" /> <link href="_files/treeview_old.css" media="all" rel="Stylesheet" type="text/css" /> <link href="/_files/popup.css" media="all" rel="stylesheet" type="text/css" /> <script type="text/javascript" src="/_files/treeview.js"></script> <script type="text/javascript" src="/_files/jquery-1.8.0.min.js"></script> <script type="text/javascript" src="/_files/jquery-1.10.2.js"></script> <script type="text/javascript" src="/_files/popup.js"></script> <script type="text/javascript" src="http://code.jquery.com/jquery-1.8.2.js"></script> <script type="text/javascript" src="https://ajax.googleapis.com/ajax/libs/jquery/1.8/jquery.min.js" /> <script type="text/javascript" src="/_files/jquery.popup.js"></script> <script type="text/javascript" src="/_files/jquery.popup.min.js"></script> <script type="text/javascript" src="/_files/ValidateForm.js"></script> <script src="https://code.jquery.com/jquery-1.11.3.js"></script> <link href="/_files/enablejs.css" rel="Stylesheet" type="text/css" /> <link href="/_files/forJavascript.css" rel="Stylesheet" type="text/css" /> <style type="text/css"> .collapse{background-image:url('/images/expcoll_right.png');} .expand{background-image:url('/images/expcoll_down.png');} </style> <script type="text/javascript"> $(document).ready(function(){ $("#History-parent").click(function(){ $("#History-Childs").toggle(); if ($('#History-parent img').hasClass('expand')) { $('#History-parent img').addClass('collapse'); $('#History-parent img').removeClass('expand'); $('#History-parent img').attr('src', '/images/expcoll_right.png'); } else { $('#History-parent img').removeClass('collapse'); $('#History-parent img').addClass('expand'); $('#History-parent img').attr('src', '/images/expcoll_down.png'); } }); $("#History-Childs").hide(); var tocnode=document.getElementById('toc-children'); if (tocnode != null) { if(tocnode.childNodes.length != 0) { document.getElementById("doc-content").style.width="72%"; document.getElementById("toc").style.width="21%"; document.getElementById("toc").style.padding="10px"; } else { document.getElementById('toc').style.display="none"; } } }); function fnsetRDVal(id) { if (id=="y") { document.getElementById("y").value="yes" document.getElementById("n").value="" } else { document.getElementById("n").value="no" document.getElementById("y").value="" } } </script> <script type="text/javascript"> function TermsCon() { var overlay = $('<div id="overlay"></div>'); overlay.show(); overlay.appendTo(document.body); $('.popup2').show(); $('#btnAgree').click(function () { $('.popup2').hide(); $("#overlay").hide(); overlay.appendTo(document.body).remove(); }); $("#btnprint").click(function () { var contents = $("#popupterms").html(); var frame1 = $('<iframe />'); frame1[0].name = "frame1"; frame1.css({ "position": "absolute", "top": "-1000000px" }); $("body").append(frame1); var frameDoc = frame1[0].contentWindow ? 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If you are an entitled government entity pursuant the Georgia Administrative Procedures Act, <a target="_new" href="http://links.casemakerlegal.com/states/GA/books/Code_of_Georgia/browse?ci=25id=gasos&amp;codesec=50-13-7&amp;title=50&amp;#50-13-7(d)">O.C.G.A.§ 50-13-7(d)</a> contact the State of Georgia's Administrative Procedures Division at 678-364-3785 to enable these features for your location.)</p> <p>To access this website, you must agree to the following: </p> <p> These terms of use are a contract between you and/or your employer (if any), and Lawriter, LLC. </p> <p> You agree not to use any web crawler, scraper, or other robot or automated program or device to obtain data from the website. </p> <p> You agree that you will not sell or license anything that you download, print, or copy from this website.</p> <p> THIS WEBSITE AND ITS CONTENT ARE PROVIDED "AS IS." THE STATE OF GEORGIA AND LAWRITER EXPRESSLY DISCLAIM ALL WARRANTIES, INCLUDING THE WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, AND NON-INFRINGEMENT AND ARE NOT LIABLE TO ANY PERSON FOR ANY ERRORS IN INACCURACIES CONTAINED IN THIS WEBSITE. </p> <p> By accessing and/or using this website, you agree to the terms and conditions above. If you do not agree to the terms and conditions above, you must cease accessing and/or using this website and destroy all material obtained from this website without your agreement. </p> </div> </div> <div class="modal-footer"> <input type="button" name="btnAgree" value="Close" id="btnAgree" class="btn-blue noprint" /> <input type="button" name="btnprint" value="Print" id="btnprint" class="btn-blue noprint" /> </div> </div> </div> <div id="main" class="noprint"> <!--class="noprint"--> <div id="header" class="noprint"> <div class="container"> <div class="terms"> <!--NOTICE OF TERMS OF USE OF THIS WEBSITE. 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charset=UTF-16"> </HEAD> <div id="infobar"><a href="javascript:;" accesskey="r" Name="Route" title="Route" class="quickkey"><em class="mnemonic">R</em>oute </a>:<div class="searchtips" style="float:right;margin-right:10px;color: rgb(47, 79, 79);"> <a style="text-decoration:none;color: rgb(47, 79, 79);" title="search tips" name="searchtip" href="../help.aspx#searching" target="_blank"><em class="mnemonic">S</em>earch tips</a></div><ul class="breadcrumb"> <li><a href="/GAC" name="GAC" title="GAC">GA R&amp;R</a></li> <li>&raquo; <a href="/GAC/111" title="111">Department 111</a></li> <li>&raquo; <a href="/GAC/111-8" title="111-8">Chapter 111-8</a></li> <li>&raquo; Subject 111-8-4</li> </ul> </div> </div><div id="doc" class="container"> <div id="doc-content" class="content"> <h1><nllsubject>Subject 111-8-4 AMBULATORY SURGICAL TREATMENT CENTERS</nllsubject></h1> <h2><a href="/GAC/111-8-4-.01" name="111-8-4-.01" title="111-8-4-.01">Rule 111-8-4-.01 Definitions</a></h2> <P>Unless a different meaning is required by the context, the following terms as used in these rules and regulations shall have the meaning hereinafter respectively ascribed to them:</P> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Ambulatory Surgical Treatment Centers" means any institution, building, or facility, or part thereof, devoted primarily to the provision of surgical treatment to patients not requiring hospitalization, as provided under provisions of O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=31-7-1&amp;title=31#31-7-1(4)(c)" target="_newtab">31-7-1(4)(c)</a>. Such facilities do not admit patients for treatment which normally requires overnight stay, nor provide accommodations for treatment of patients for period of twenty-four (24) hours or longer;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Governing Body" and/or "Management" means the Board of Directors and/or Trustees, the partnership, the corporation, the association, or the person or group of persons who maintain and control the operation of the ambulatory surgical treatment center and who are legally responsible for its operation;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Center" means an ambulatory surgical treatment center as defined in these rules and regulations;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Board," unless otherwise indicated, shall mean the Georgia Board of Community Health;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Commissioner" means the Commissioner of the Georgia Department of Community Health or his designee;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(f)">(f)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Department" means the Georgia Department of Community Health;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(g)">(g)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "General Anesthesia" means any drug, element or other material administered to eliminate all sensation and which, when administered, is accompanied by a state of unconsciousness;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(h)">(h)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Licensee" means the person or body to whom the license or permit is issued and who is held responsible for compliance with all required rules, regulations, and minimum standards;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(i)">(i)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Permit" or "license" means an authorization granted by the Department to an applicant to operate an ambulatory surgical treatment center providing one or more types or classifications of services;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(j)">(j)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Provisional Permit" means an authorization granted by the Department to an applicant to operate an ambulatory surgical treatment center on a conditional basis to allow a newly established center a reasonable but limited period of time to demonstrate that operational procedures are in satisfactory compliance with these rules and regulations, or to allow an established and operating center a specified length of time to comply with these rules and regulations, provided said center shall first present a plan of improvement which is acceptable to the Department;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(k)">(k)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Plan of Improvement" means a written plan submitted to the Department by the person or persons responsible for the center, and acceptable to the Department. The plan shall identify the existing areas of noncompliance of the facility, together with the proposed procedures, methods and period of time to correct the areas of noncompliance;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(l)">(l)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Professional Staff" means the group of persons or body appointed by the Governing Body to provide patient services, and who require special licensure or registration. Normally, the professional staff will be restricted to currently licensed medical, dental, and podiatrist practitioners. Other personnel, for example, registered nurses, may be appointed to the professional staff to assist the practitioners in the development, interpretation, and enforcement of patient care policies;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(m)">(m)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Practitioner" means a physician, dentist, or podiatrist;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(n)">(n)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Physician" means an individual who is currently licensed to practice medicine, surgery or osteopathy in the State of Georgia, under the Georgia Medical Practice Act, O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=43-34-20&amp;title=43&amp;getbrowsepage=yes#" target="_newtab">43-34-20</a><I>et seq.</I>;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(o)">(o)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Dentist" means any person who is currently licensed to practice dentistry in the State of Georgia, under provisions of the Georgia Dentist and Dental Hygienists Act, O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=43-11-1&amp;title=43&amp;getbrowsepage=yes#" target="_newtab">43-11-1</a><I>et seq.</I>;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(p)">(p)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Podiatrist" (Chiropodist) means any person who is currently licensed to practice podiatry (chiropody) in the State of Georgia, under provisions of the Georgia Podiatry Act, O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=43-35-1&amp;title=43&amp;getbrowsepage=yes#" target="_newtab">43-35-1</a><I>et seq.</I>;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(q)">(q)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Registered Nurse," "Registered Professional Nurse," or "R.N." means a person who is currently licensed to practice as a licensed registered nurse under provisions of O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=43-26-1&amp;title=43&amp;getbrowsepage=yes#" target="_newtab">43-26-1</a><I>et seq.</I>; </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(r)">(r)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Licensed Practical Nurse" or "L.P.N." means a person currently licensed to practice as a licensed practical nurse under provisions of O.C.G.A.§ <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=43-26-30&amp;title=43&amp;getbrowsepage=yes#" target="_newtab">43-26-30</a><I>et seq.</I>;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(s)">(s)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Private Office(s)," "Office(s)," and/or "Treatment Rooms" means any area or place established and maintained by a currently licensed individual practitioner, professional association, or group practice of such practitioners, in his/her/their private individual or private group practice, in which he/she/they primarily see(s), consult(s) with, examine(s), and/or treats private patients on a regular and on-going basis, and in the operation of which such currently licensed practitioners have full control of all financial, administrative, and professional arrangements with said patients;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(t)">(t)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Hospital" means any facility which meets the requirements of and is currently licensed as a hospital under Georgia Laws and rules and regulations pertaining thereto;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(u)">(u)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Procedure Room" means any room or area of the ambulatory surgical treatment center in which surgical procedures are performed;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(v)">(v)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Patient" means any individual who receives medical/surgical treatment in facilities governed by these regulations;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.01(w)">(w)</a></td> <td valign="top" style="text-align:left" class="leftalign"> "Qualified Counselor" means a person who assists the professional staff by talking with and informing patients regarding expectations and probable outcomes associated with services in an ambulatory surgical treatment center, and who possesses the following minimum qualifications: at least a bachelor's degree from an accredited college or university in nursing, psychology or social work, or in some related field, or who has special training in counseling which is deemed acceptable by the Department; provided, however, that any such counselor shall function only under the direct supervision of the responsible practitioner.</td> </tr> </table> <h2><a href="/GAC/111-8-4-.02" name="111-8-4-.02" title="111-8-4-.02">Rule 111-8-4-.02 Exemptions</a></h2> <P>The following types of health care facilities are exempt from the requirements of these regulations:</P> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.02(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> currently licensed hospitals, or a facility as specified in <a title="111-8-4-.03(12)" href="111-8-4-.03#111-8-4-.03(12)">111-8-4-.03(12)</a>;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.02(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> a practitioner's private offices or treatment rooms in which a practitioner primarily sees, consults with, and treats patients;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.02(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> facilities owned and operated by the Federal Government.</td> </tr> </table> <h2><a href="/GAC/111-8-4-.03" name="111-8-4-.03" title="111-8-4-.03">Rule 111-8-4-.03 Organization and Administration</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.03(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each ambulatory surgical treatment center shall be organized with an identifiable governing body that establishes the objectives, sets the policies and assumes full legal responsibilities for the overall conduct of the center and for compliance with all applicable laws and regulations pertaining to the center. The membership of the governing body shall be identified in the application to the Department for licensure.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.03(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The ownership of the center shall be fully disclosed in the application to the Department. This disclosure shall include the names and addresses of all corporate officers and any person(s) having a five percent (5.0%) or more financial interest.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.03(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The governing body of the center shall be responsible for appointing the professional staff and shall establish effective mechanisms for quality assurance and to ensure the accountability of the center's medical and/or dental staff and other professional personnel.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.03(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The organizational objectives of the ambulatory surgical treatment center shall be clearly stated in the procedures and policies of the governing body and on the application for licensure.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.03(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The governing body shall inform the Department of the name(s) of the administrator(s) to whom the responsibility for the day-to-day management of the center is delegated, including the implementation of rules and policies adopted by the governing body.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.03(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each center shall be at all times under the immediate personal and daily supervision and control of the administrator or his designated representative, whose authority, duties and responsibilities shall be defined in writing and which shall be available to the Department upon request.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.03(7)">(7)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The Department shall be notified with a new application, or written amendment to the current application, when there are changes in location, ownership, management or operational objectives.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.03(8)">(8)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Individual patients shall be discharged within twenty-four (24) hours of admission, in an ambulatory condition which will not endanger their continued well-being, or shall be transferred to a licensed hospital or other treatment facility. There shall be written procedures and assigned responsibilities for implementing such procedures, including provisions for transportation. Patients requiring emergency services shall be accompanied by a member of the professional staff of the center.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.03(9)">(9)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each center shall have an organized professional staff which is responsible for the development of patient care policies and procedures and for maintaining the level of professional performance through a continuing program of staff education, review and evaluation of patient care.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.03(10)">(10)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each center shall at all times have a professional director designated by the governing body, who shall be responsible for the direction and coordination of all professional aspects of the center programs.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.03(11)">(11)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The practitioners applying for staff privileges shall be required to sign an agreement to abide by the staff bylaws and required State laws and rules and regulations.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.03(12)">(12)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Nothing in these rules and regulations shall prevent a licensed hospital from organizing and providing an ambulatory surgical treatment service as a part of a licensed hospital under the controlling authority of a hospital board, so long as all hospital licensure standards are met and the provided services are included in the application under which the hospital license is granted.</td> </tr> </table> <h2><a href="/GAC/111-8-4-.04" name="111-8-4-.04" title="111-8-4-.04">Rule 111-8-4-.04 Classification of Services</a></h2> <P>Each ambulatory surgical center, when applying for a permit shall designate the type(s) or classification(s) of services to be provided in or by the center. These classifications may include, but are not necessarily limited to the following: general surgery; eye, ear, nose, and throat; plastic surgery; oral and maxillofacial; obstetrical-gynecological; oncological; ophthamological; and urological. Provided, however, that any facility providing labor and delivery services must meet the requirements of Rules and Regulations for Hospitals, Maternity and Obstetrical and Newborn Services, Rule <a title="111-8-40-.34" href="111-8-40-.34">111-8-40-.34</a> or as later revised. The permit for a single ambulatory surgical treatment center may cover one or more types of services. Each ambulatory surgical treatment center shall provide only those services listed on the face of its permit.</P> <h2><a href="/GAC/111-8-4-.05" name="111-8-4-.05" title="111-8-4-.05">Rule 111-8-4-.05 Application for Permits</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.05(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Any person or persons responsible for the operation of an ambulatory surgical treatment center as defined and classified in these regulations, or who may hereafter propose to establish and operate such an institution, shall submit an application to the Department for a permit to operate said institution using forms provided by the Department. No such institution shall be operated in Georgia without a valid permit which shall be displayed in a conspicuous place within the center. </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.05(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The applicant for a permit to operate an ambulatory surgical treatment center shall submit a completed application with character references and a certification that the applicant is able and willing to comply with the minimum standards for an ambulatory surgical treatment center and with the rules and regulations lawfully promulgated. Each application shall be accompanied by a statement from the local (city or county) fire safety authority stating that an inspection has been made of the premises and that state and local fire safety requirements have been met.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.05(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The application shall include full and complete information concerning the name and address of the applicant and the classification(s) of services to be provided; the ownership of the property and operation; in case a center is organized as a corporation, the names and addresses of each officer and director of the corporation; in case the center is organized as a partnership, the names and addresses of each partner; the identity of the professional director of the facility; the days and hours the center is normally operated; and any other information which the Department may require.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.05(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Ambulatory surgical treatment centers are subject to review by the Department, pursuant to the Georgia Certificate of Need Law. Evidence of completion of this review shall be made a part of the application for a permit.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.05(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Plans for ambulatory surgical treatment centers shall be submitted to the Department for review and approved in three stages of development: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.05(5)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> schematic drawings; </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.05(5)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> design-development drawings; and </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.05(5)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> final working drawings and specifications. </td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.05(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A permit shall be issued to the person or persons named only for the premises listed on the application for licensure. </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.05(7)">(7)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Permits are not transferable or assignable.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.05(8)">(8)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Changes in ownership shall be subject to notice requirements as specified in O.C.G.A.§ <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=31-6-40.1&amp;title=31#" target="_newtab">31-6-40.1</a>. Each planned change of ownership or lease shall be reported to the Department thirty (30) days prior to such change with an application being submitted from the proposed new owners for a new permit.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.05(9)">(9)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Separate applications and permits are required for centers maintained in separate premises, even though they are owned or operated by the same person(s), business or corporation, and may be doing business under the same title.</td> </tr> </table> <h2><a href="/GAC/111-8-4-.06" name="111-8-4-.06" title="111-8-4-.06">Rule 111-8-4-.06 Permits</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.06(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Following inspection and classification of the institution for which application for a permit has been made, the Department may issue a permit or a provisional permit or refuse to reissue or continue a permit or provisional permit. Each permit or provisional permit shall indicate the classifications of services to be provided and patient capacity of the center.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.06(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Permits issued shall mean that the Department grants authorization to the governing body of the applicant institution to operate an ambulatory surgical treatment center and signifies compliance with these rules and regulations. Permits issued shall remain in force and effect until revoked or suspended.</td> </tr> </table> <h2><a href="/GAC/111-8-4-.07" name="111-8-4-.07" title="111-8-4-.07">Rule 111-8-4-.07 Provisional Permits</a></h2> <P>Provisional permits may be issued for a limited period specified by the Department based on an acceptable written plan for correcting one or more deficiencies (plan of correction) found during an inspection; provisional permits issued shall remain in force and effect for such limited period of time as specified by the Department, unless earlier revoked due to prevailing circumstances which are not acceptable to the Department. Centers which are established and operating prior to adoption of these rules and regulations may be considered for extension of a provisional permit when needed to meet physical plant standards. If the Department's decision is that a deficiency is of such nature that it would jeopardize the life of a patient, a provisional permit will not be issued.</P> <h2><a href="/GAC/111-8-4-.08" name="111-8-4-.08" title="111-8-4-.08">Rule 111-8-4-.08 Inspections</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.08(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The ambulatory surgical treatment center shall be available at all reasonable and/or scheduled operating hours for observation and examination by properly identified representative of the Department.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.08(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The governing body shall notify the Department of the anticipated opening date of a newly constructed center in order that a preopening licensure inspection of the center may be conducted to determine compliance with these rules and regulations.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.08(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The administrator or his representative shall accompany the Department representative on all tours of inspection and shall sign the completed checklist.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.08(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each center shall be periodically inspected to determine whether the center is continuing to meet these requirements or is making satisfactory progress on approved plans of correction.</td> </tr> </table> <h2><a href="/GAC/111-8-4-.09" name="111-8-4-.09" title="111-8-4-.09">Rule 111-8-4-.09 Professional Services</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.09(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All services provided by or in the center shall be provided by persons who are currently licensed to perform the services they render when such services require licensure or registration under the laws of the State of Georgia. There shall be a sufficient number of qualified staff members to adequately provide for patient needs based on services provided and the number of patients served.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.09(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each center shall have a professional director who shall be a practitioner currently licensed in Georgia, and who shall be responsible for the direction and coordination of all medical aspects of the center program.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.09(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> General anesthesia shall be administered by an anesthesiologist, a physician anesthetist, an oral surgeon, or a certified R.N. anesthetist under the direction and responsibility of a currently licensed physician with training and experience in anesthesia, as specified in Georgia Code 84-10A. After administration of a general anesthetic, patients shall be constantly attended (at bedside) by a person qualified as above or by an R.N. until reactive and able to summon aid.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.09(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All nursing services shall be under the supervision of a registered nurse (R.N.). Each center shall have a sufficient number of currently licensed nurses present and on duty to attend to patients at all times patients are receiving treatment or recovering from treatment up to and including the time of discharge. Additional staff shall be on duty and available to assist the professional staff to adequately handle routine and emergency patient needs.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.09(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each center shall establish written procedures for emergency services which will insure that a professional staff member who has been trained in emergency resuscitation procedures shall be on duty at all times when there is a patient receiving treatment or recovering from treatment, up to and including the time of discharge.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.09(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The written procedures shall provide that an appropriate practitioner be designated on call and available to provide timely response to emergencies which may occur with any patient in the center.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.09(7)">(7)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each center shall have a hospital affiliation agreement and/or the medical staff must have admitting privileges or other acceptable documented arrangements to insure the necessary backup for medical complications. The center must have the capability to transfer a patient immediately to a hospital with adequate emergency room services.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.09(8)">(8)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each center will have effective policies and procedures for handling infection control and for recording complications which occur during or after surgery, which includes a reporting mechanism for patients who develop infections or postoperative complications after discharge.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.09(9)">(9)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Either prior to, or at the time of admission, each patient who is admitted to the center without an appointment with a specified practitioner shall be provided (in writing) with the name, address and phone number of the practitioner who is serving him/her. The practitioner or a qualified counselor designated by the practitioner, shall explain the surgical and medical procedures, its potential complications, and postoperative complications and other alternatives to surgery; this shall be confirmed by the patient who shall sign an informed consent form as provided under O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=31-9-1&amp;title=31&amp;getbrowsepage=yes#" target="_newtab">31-9-1</a><I>et seq.</I> Prior to dismissal, each patient shall be provided with both verbal and written instructions for posttreatment care and procedures for obtaining emergency care, if needed during the period of recuperation.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.09(10)">(10)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All ancillary supportive health or medical services such as radiological services, pharmaceutical services, or clinical laboratory services provided in or by the center shall be in accordance with applicable rules and regulations of the State of Georgia.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.09(11)">(11)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each center shall establish policies for patient care and procedures for maintaining these policies.</td> </tr> </table> <h2><a href="/GAC/111-8-4-.10" name="111-8-4-.10" title="111-8-4-.10">Rule 111-8-4-.10 Physical Plant and Operational Standards</a></h2> <P>The following minimum physical plant and operational standards shall be met by an applicant or licensee as a prerequisite for the issuance and continuance of a permit to operate an ambulatory surgical treatment center. The failure of any licensee to comply with the minimum standards may result at any time in the denial, revocation, or suspension of licensure to operate an ambulatory surgical treatment center, pursuant to provisions of O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=31-2-8&amp;title=31#" target="_newtab">31-2-8</a>, and these rules and regulations.</P> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Rooms and/or areas shall be planned and provided with sufficient space and equipment to provide for patient and visitor waiting area; presurgical examination and treatment; procedure rooms; patient recovery; and staff and administrative areas.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The physical plant of the center shall meet all Federal, State and local laws, codes, ordinances, and regulations which apply to its location, construction, maintenance and operation.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Equipment, electrical appliances, wiring, elevators, heating and cooling systems, surgery rooms and special service areas shall be constructed so as to assure the safety of all occupants. It shall be the responsibility of the governing body to assure that the center is in a safe condition at all times and that a fire inspection record is maintained on equipment, systems, and areas that may present a hazard to occupants.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Except where additional requirements are specified herein, or are required by State or local ordinances or regulations, the construction of an ambulatory surgical treatment center shall meet the requirements for Health Care or Business Occupancies as specified in Chapter 10 and/or Chapter 13, as applicable, of the 1976 Life Safety Code, as currently adopted and amended by regulations of the Georgia Safety Fire Commissioner, Chapter 120-3-3, March 1, 1979, and subsequent revisions thereto.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Entrances for patients shall be connected to the public right-of-way by a hardsurfaced, unobstructed walkway in good repair. Handicapped patients confined to a wheel chair or otherwise impaired shall be able to access the center building without climbing any stairs or steps. A ramp with handrails over existing stairs or steps may be utilized in meeting this requirement. A hard-surfaced, unobstructed road or driveway for use by ambulances or other emergency fire or police vehicles shall run from at least one entrance of the building to the public right-of-way. The doorway of such entrance shall be immediately adjacent to the road or driveway.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(f)">(f)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Ambulatory surgical services provided in multistory buildings shall be accessible by an elevator of adequate size to accommodate date a standard wheeled litter patient and two attendants. A stairway or ramp of adequate dimensions shall be available for transfer of a patient in case of power failure.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(g)">(g)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All procedure rooms shall be constructed, equipped, and maintained to assure the safety of patients and personnel. The following requirements shall apply within the patient treatment/procedure rooms and adjoining areas: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(g)1.">1.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Procedure rooms shall be designed and located to prevent traffic through them to any other part of the center;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(g)2.">2.</a></td> <td valign="top" style="text-align:left" class="leftalign"> The walls and floors in procedure rooms shall be of material that will permit frequent washing and cleaning;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(g)3.">3.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Sterilizing equipment shall be provided within the center and shall be convenient to the procedure rooms;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(g)4.">4.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Staff dressing rooms and scrubup facilities shall be convenient to the procedure rooms, and shall include a knee or elbow operated scrub sink, soap dispenser, and brushes;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(g)5.">5.</a></td> <td valign="top" style="text-align:left" class="leftalign"> An equipment cleanup area with adequate plumbing, including a sink with counter, shall be provided outside the procedure room;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(g)6.">6.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Enclosed storage facilities for sterile supplies and equipment shall be provided within the procedure areas;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(g)7.">7.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Scrub clothing worn by personnel outside the procedure area shall be changed before returning to the procedure area;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(g)8.">8.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Locations using flammable anesthetic agents shall comply with the following: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(g)8.(i)">(i)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Floors, furniture and equipment in operating rooms shall be of electrically conductive material. Conductive flooring shall extend into contiguous rooms and at least ten (10) feet into the entrance traffic area.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(g)8.(ii)">(ii)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Clean conductive footwear testing device shall be maintained in the procedure rooms.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(g)8.(iii)">(iii)</a></td> <td valign="top" style="text-align:left" class="leftalign"> An anesthesia supply and equipment storage room shall be provided within the procedure area.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(g)8.(iv)">(iv)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Separate storage enclosures shall be provided for flammable gases and combustion supporting gases. Such enclosures shall be constructed of building material with a fire resistive rating of at least one hour and shall not communicate directly with anesthetizing locations or each other. Air shall be adequately exhausted by gravity or spark proof forced ventilation from the flammable storage enclosure to the exterior of the building at a rate of not less than two (2) changes per hour. Storage enclosures for combustion supporting gases of less than 1500 cubic feet cylinder capacity need not be vented to the outside. Flammable materials such as fabrics, rubber and wood shall not be stored in these enclosures.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(g)8.(v)">(v)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Clothing generating large amounts of static electricity shall be prohibited in the procedure rooms.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(g)9.">9.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Locations using flammable anesthetic agents shall be identified by prominently posted signs at all entrances to the procedure room and within the location signifying the type of anesthetics used.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(h)">(h)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Toilet facilities shall be accessible to patients from the treatment, examining and recovery areas. Convenient handwashing facilities shall be provided for both staff and patients, and shall be provided with soap, disposable towels and dispensers. The use of common towels is prohibited.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(i)">(i)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Emergency life support equipment shall be available for immediate use, in patient treatment areas. Such equipment shall include, but not necessarily be limited to the following: suction, IV fluids, oxygen, needles, intracatheters, medications, and ventilatory equipment such as ambu bags, oral and nasal airways and endotracheal tubes. Facilities providing general anesthesia shall also have a defibrillator and tracheotomy equipment and supplies.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(j)">(j)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All medical gases shall be stored in accordance with Bulletin 56A of the National Fire Protection Association.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(k)">(k)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All plumbing shall be designed and installed in accordance with State laws and local ordinances.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(l)">(l)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall be arranged and organized in such a manner as to ensure the comfort, safety, hygiene, privacy, and dignity of patients treated therein.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(m)">(m)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Equipment for sterilizing instruments and supplies shall be conveniently located and of adequate capacity for the workload. Records shall be maintained to assure quality control, including date, time and temperature of each batch of sterilized supplies and equipment.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(n)">(n)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Medicines shall be stored in a conveniently located cabinet with lock, and only licensed persons shall have access.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(o)">(o)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Clean and soiled utility rooms shall be arranged and provided with equipment necessary for proper patient care, including sterilizers, storage cabinets and work counters.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.10(p)">(p)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each center shall provide one or more recovery rooms or areas staffed by qualified personnel. The recovery area shall be adequate for the numbers of patients scheduled. Separate recovery areas and/or cubicle curtains shall be provided for patient privacy, when appropriate.</td> </tr> </table> <h2><a href="/GAC/111-8-4-.11" name="111-8-4-.11" title="111-8-4-.11">Rule 111-8-4-.11 Personnel</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.11(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The governing body shall appoint an administrator who is responsible for the day-today management and operation of the center.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.11(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The administrator shall designate an individual to act for him in his absence in order to provide the center with administrative direction at all times.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.11(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All center personnel shall be currently licensed to perform the services they render when such services require licensure or registration under the laws of the State of Georgia.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.11(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each center shall require that each employee receives a health examination upon employment and a policy shall provide for follow-up examinations. The examination shall be in sufficient detail, including pertinent laboratory and x-ray data, to assure that the employee is physically and mentally qualified to perform the job to which he is assigned.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.11(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> There shall be a separate personnel folder maintained for each employee. This file shall contain all personnel information concerning the employee, including the application and qualifications for employment, physical examination (including laboratory and x-ray reports, if applicable), job description and attendance record.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.11(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Fire and internal disaster drills shall be conducted at least quarterly and the results documented. There shall be an ongoing program of continuing education for all personnel concerning aspects of fire safety and the disaster plan for moving personnel and patients to safety, and for handling patient emergencies.</td> </tr> </table> <h2><a href="/GAC/111-8-4-.12" name="111-8-4-.12" title="111-8-4-.12">Rule 111-8-4-.12 Records</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A full-time employee shall be designated responsible for establishing and maintaining medical records required to be kept by these rules and regulations.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Medical records containing sufficient information to validate the diagnosis and to establish the basis upon which treatment is given shall be maintained on each patient. <P>Contents of individual medical records shall normally contain the following at least:</P> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Admission and discharge data: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(a)1.">1.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Name, address, birth date, sex, marital status, race, etc.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(a)2.">2.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Date and time of admission.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(a)3.">3.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Date and time of discharge.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(a)4.">4.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Admitting diagnosis.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(a)5.">5.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Final diagnosis.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(a)6.">6.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Procedures or operations performed.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(a)7.">7.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Condition on discharge.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(a)8.">8.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Attending practitioner's signature.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> History and physical examination data: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(b)1.">1.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Personal medical history (including all current medication that the patient is taking).</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(b)2.">2.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Family medical history.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(b)3.">3.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Physical examination.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(b)4.">4.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Psychiatric examination (if applicable).</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Treatment data: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(c)1.">1.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Practitioner's orders.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(c)2.">2.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Progress notes.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(c)3.">3.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Nurse notes.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(c)4.">4.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Medication.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(c)5.">5.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Temperature-Pulse-Respiration (Graphic Chart; surgical purposes only).</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(c)6.">6.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Special examination(s) and reports (include x-ray and lab reports).</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(c)7.">7.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Signed informed consent form.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(c)8.">8.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Operation record.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(c)9.">9.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Anesthesia record (if applicable).</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(c)10.">10.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Consultation record (if applicable).</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(c)11.">11.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Tissue findings when performed.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(2)(c)12.">12.</a></td> <td valign="top" style="text-align:left" class="leftalign"> Where dental services are rendered, a complete dental chart with dental diagnosis, treatment, prescription and progress notes shall be part of the clinical record.</td> </tr> </table> </td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All orders on patients shall be signed by the practitioner giving them; admitting diagnosis (purpose of admission) shall be recorded prior to or at the time of admission.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Medical records shall be preserved as original records, microfilms or other usable forms and shall be such as to afford a basis for complete audit of professional information. Centers shall retain all medical records, at least until the sixth anniversary of the patient's discharge. In the case of patients who have not attained majority at the time of the discharge, centers shall retain such records at least six (6) years after patient reaches age of majority. In the event a center shall cease operation, the Department shall be advised of the disposition and/or location of said records.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall collect, retrieve and annually summarize data from the medical record so that it may provide the Department with the following medical statistical information including: <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(5)(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Number of visits by patients.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(5)(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Number of patients seen.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(5)(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Basis of treatment (clinical diagnosis and/or problem for which the patient was treated).</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(5)(d)">(d)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Types and number of operative procedures performed.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(5)(e)">(e)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Age distribution of patients.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(5)(f)">(f)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Complications and emergencies.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(5)(g)">(g)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Number of times a patient was transferred from the center to a hospital.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(5)(h)">(h)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Pathological diagnosis.</td> </tr> </table> </td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.12(6)">(6)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Patient records shall be current and shall be entitled to the same protection as provided for any medical records under Georgia law.</td> </tr> </table> <h2><a href="/GAC/111-8-4-.13" name="111-8-4-.13" title="111-8-4-.13">Rule 111-8-4-.13 Administrative Area and Waiting Rooms</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.13(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each center shall provide administrative space and facilities for admitting patients and other service, such as telephone and information office files and supplies, patients' personal belongings, medical records and files.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.13(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A waiting room area shall be provided with a seating capacity to accommodate the number of patients and others of the public normally present in the facility at one time.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.13(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall have adequate and conveniently located toilets and handwashing facilities for its staff, employees, out-patients and visiting personnel.</td> </tr> </table> <h2><a href="/GAC/111-8-4-.14" name="111-8-4-.14" title="111-8-4-.14">Rule 111-8-4-.14 Clinical Laboratory Services</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.14(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Laboratory services utilized by an ambulatory surgical treatment center shall be consistent with requirements of the Clinical Laboratory Licensure Law, O.C.G.A. § <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=31-22-1&amp;title=31&amp;getbrowsepage=yes#" target="_newtab">31-22-1</a><I>et seq.</I>, and applicable amendments and regulations, which provide for clinical laboratory services to be either licensed under Rules and Regulations of the State of Georgia, Chapter 111-8-10, or to be exempt from licensure as specified in the Clinical Laboratory Licensure Law. If exemption is claimed, the application shall state the name(s) of the practitioner(s) responsible for the operation of the clinical laboratory and there shall be an affidavit by the physician that he/she is responsible for the laboratory claims and the exemption.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.14(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All removed tissues shall be examined immediately by the practitioner, whose findings shall be recorded in the patient's records, in addition to reports of pathologic examinations which may be obtained later.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.14(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Laboratory services shall be provided for each patient, consistent with accepted medical practice and the conditions and needs of the patient. Laboratory reports shall be made a part of patient records.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.14(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A system shall be established for the collection of information and all postoperative surgical complications and infections.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.14(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> The center shall report to the Department all communicable diseases detected or reported for patients.</td> </tr> </table> <h2><a href="/GAC/111-8-4-.15" name="111-8-4-.15" title="111-8-4-.15">Rule 111-8-4-.15 Housekeeping, Laundry, Maintenance and Sterile Supplies</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.15(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Each center shall provide sufficient space and equipment and ensure that housekeeping and maintenance is sufficient to keep the center and equipment in a clean and tidy condition and state of good repair. Proper maintenance shall be provided as necessary to correct, prevent, or adjust faulty equipment and/or correct other undesirable conditions.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.15(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Laundry service shall be provided. Separate space and facilities shall be provided for receiving, sorting and storing soiled laundry, and for sorting, storing and issuing of clean laundry, if reusable items are utilized.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.15(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> There shall be adequate space and facilities for receiving, packaging and proper sterilizing and storage of supplies and equipment, consistent with the services to be provided.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.15(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Special precaution shall be taken to ensure that sterile instruments and supplies are kept separate from non-sterile instruments and supplies. Sterilization records shall be kept and sterile items shall be dated and utilized, based on established procedures.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.15(5)">(5)</a></td> <td valign="top" style="text-align:left" class="leftalign"> A recognized method of checking sterilizer performance shall be adopted.</td> </tr> </table> <h2><a href="/GAC/111-8-4-.16" name="111-8-4-.16" title="111-8-4-.16">Rule 111-8-4-.16 Drug Storage and Dispensing</a></h2> <P>Each center shall provide adequate space and equipment and staff to assure that drugs are stored and administered in compliance with State and Federal laws and regulations.</P> <h2><a href="/GAC/111-8-4-.17" name="111-8-4-.17" title="111-8-4-.17">Rule 111-8-4-.17 Blood Supply and Storage</a></h2> <P>Each center which provides service for which blood is needed, shall provide separate refrigeration for the storage of blood and shall have a written agreement with a source for meeting its blood needs. If blood is retained overnight, such refrigeration shall be equipped with a temperature alarm device, and shall be tied in on an automatic emergency electrical power system. In all cases, refrigeration equipment shall be provided with a temperature recording device or the temperature shall be checked and recorded each day of use.</P> <h2><a href="/GAC/111-8-4-.18" name="111-8-4-.18" title="111-8-4-.18">Rule 111-8-4-.18 X-Ray</a></h2> <P>All X-Ray facilities in the center shall be registered with and meet the requirements of rules and regulations of governing radiological health as promulgated by the Department. X-Rays and x-ray reports shall be made a part of the patient's record.</P> <h2><a href="/GAC/111-8-4-.19" name="111-8-4-.19" title="111-8-4-.19">Rule 111-8-4-.19 Electrical Power</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.19(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All electrical work and equipment shall be designed and installed in accordance with State and local laws and ordinances.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.19(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All areas of the center shall have sufficient artificial lighting for designated purpose.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.19(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Centers which utilize general anesthesia shall provide an emergency electrical system so controlled, that, after interruption of the normal electric power supply, an acceptable auxiliary power source is available and capable of being brought into use within ten seconds with sufficient voltage and frequency to reestablish essential in-house services and other emergency equipment needed to effect a prompt and efficient transfer of patients to an appropriate licensed hospital, when needed.</td> </tr> </table> <h2><a href="/GAC/111-8-4-.20" name="111-8-4-.20" title="111-8-4-.20">Rule 111-8-4-.20 Sanitation and Waste Disposal</a></h2> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.20(1)">(1)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All centers shall provide facilities for maintaining sanitary standards throughout the premises, as well as for water supply, sewerage, garbage and refuse, disposal systems. Such facilities shall meet local and State regulations.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.20(2)">(2)</a></td> <td valign="top" style="text-align:left" class="leftalign"> All garbage, trash and waste shall be stored and disposed of in a manner, by approved methods, that will not permit the transmission of disease, create a nuisance, or provide a breeding place for insects or rodents.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.20(3)">(3)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Arrangements shall be made for proper disposal of all contaminate and/or infection dressings and surgical and obstetrical waste.</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.20(4)">(4)</a></td> <td valign="top" style="text-align:left" class="leftalign"> Effective means shall be provided at all outside doors, windows and other openings to the center to prevent entrance and harborage of flies, other insects and rodents.</td> </tr> </table> <h2><a href="/GAC/111-8-4-.21" name="111-8-4-.21" title="111-8-4-.21">Rule 111-8-4-.21 Advertising</a></h2> <P>Any advertising of the services provided in or by ambulatory surgical treatment center shall include the full name of the center and its Georgia license number, as shown on the face of the permit.</P> <h2><a href="/GAC/111-8-4-.22" name="111-8-4-.22" title="111-8-4-.22">Rule 111-8-4-.22 Waiver of Rule</a></h2> <P>The Department may waive any rule for a stated period of time when it is shown that the specific rule is not applicable or when a waiver is needed to permit experimentation and demonstration of new and innovative approaches to the delivery of services which will not jeopardize the health and safety of the patients, staff or others utilizing the center. Results of such experimentation and demonstration projects shall be submitted to the Department as prescribed by the plan under which the waiver is approved. The Department shall maintain a record of and make available to interested persons information on all waivers granted under this rule.</P> <h2><a href="/GAC/111-8-4-.23" name="111-8-4-.23" title="111-8-4-.23">Rule 111-8-4-.23 Enforcement</a></h2> <P>An ambulatory surgical treatment center which fails to comply with these rules and regulations shall be subject to revocation of its permit or provisional permit and/or other sanctions provided by law. The enforcement and administration of these rules and regulations shall be as prescribed in O.C.G.A. §§ <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=31-5-8&amp;title=31#" target="_newtab">31-5-8</a>, <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=31-5-9&amp;title=31#" target="_newtab">31-5-9</a> and <a href="https://links.casemakerlegal.com/states/ga/books/Code_of_Georgia/browse?ci=25&amp;id=gasos&amp;codesec=31-2-8&amp;title=31#" target="_newtab">31-2-8</a> which includes provision for:</P> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.23(a)">(a)</a></td> <td valign="top" style="text-align:left" class="leftalign"> the misdemeanor penalty for violation of rules and regulations promulgated under this Title;</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.23(b)">(b)</a></td> <td valign="top" style="text-align:left" class="leftalign"> injunctive relief under appropriate circumstances; and</td> </tr> </table> <table border="0" width="100%" cellspacing="4" cellpadding="4"> <tr> <td valign="top" width="1%" style="white-space:nowrap;text-align:left;width:18px;"><a style="white-space:nowrap;" name="111-8-4-.23(c)">(c)</a></td> <td valign="top" style="text-align:left" class="leftalign"> the due process requirements of notice, hearing and appeals.</td> </tr> </table> <h2><a href="/GAC/111-8-4-.24" name="111-8-4-.24" title="111-8-4-.24">Rule 111-8-4-.24 Applicability of Regulations</a></h2> <P>These regulations are applicable only to ambulatory surgical treatment centers and the services provided therein, and expressly do not modify or revoke any of the provisions of the published rules of the Department of Community Health, Chapter 111-8-40 (Rules and Regulations for Hospitals), or Chapter 290-5-32 (Rules and Regulations for Performance of Abortions After the First Trimester of Pregnancy and Reporting Requirements for all Abortions), or of revisions which may be made to said regulations.</P> <h2><a href="/GAC/111-8-4-.25" name="111-8-4-.25" title="111-8-4-.25">Rule 111-8-4-.25 Severability</a></h2> <P>In the event that any rule, sentence, clause or phrase of any of these rules and regulations may be construed by any court of competent jurisdiction to be invalid, illegal, unconstitutional, or otherwise unenforceable, such determination or adjudication shall in no manner affect the remaining rules or portions thereof and such remaining rules or portions thereof shall remain in full force and effect, as if such rule or portions thereof so determined, declared or adjudged invalid or unconstitutional were not originally a part hereof. It is the intent of the Board of Community Health to establish rules and regulations that are constitutional and enforceable so as to safeguard the health and well-being of the people of the State.</P> </div> </div> </HTML> </div> <div id="toc" class="sidebar noprint"> <ul id="toc-children" class="children"><li><a href="/GAC/111-8-4-.01" name="111-8-4-.01" title="111-8-4-.01">Rule 111-8-4-.01 Definitions</a></li><li><a href="/GAC/111-8-4-.02" name="111-8-4-.02" title="111-8-4-.02">Rule 111-8-4-.02 Exemptions</a></li><li><a href="/GAC/111-8-4-.03" name="111-8-4-.03" title="111-8-4-.03">Rule 111-8-4-.03 Organization and Administration</a></li><li><a href="/GAC/111-8-4-.04" name="111-8-4-.04" title="111-8-4-.04">Rule 111-8-4-.04 Classification of Services</a></li><li><a href="/GAC/111-8-4-.05" name="111-8-4-.05" title="111-8-4-.05">Rule 111-8-4-.05 Application for Permits</a></li><li><a href="/GAC/111-8-4-.06" name="111-8-4-.06" title="111-8-4-.06">Rule 111-8-4-.06 Permits</a></li><li><a href="/GAC/111-8-4-.07" name="111-8-4-.07" title="111-8-4-.07">Rule 111-8-4-.07 Provisional Permits</a></li><li><a href="/GAC/111-8-4-.08" name="111-8-4-.08" title="111-8-4-.08">Rule 111-8-4-.08 Inspections</a></li><li><a href="/GAC/111-8-4-.09" name="111-8-4-.09" title="111-8-4-.09">Rule 111-8-4-.09 Professional Services</a></li><li><a href="/GAC/111-8-4-.10" name="111-8-4-.10" title="111-8-4-.10">Rule 111-8-4-.10 Physical Plant and Operational Standards</a></li><li><a href="/GAC/111-8-4-.11" name="111-8-4-.11" title="111-8-4-.11">Rule 111-8-4-.11 Personnel</a></li><li><a href="/GAC/111-8-4-.12" name="111-8-4-.12" title="111-8-4-.12">Rule 111-8-4-.12 Records</a></li><li><a href="/GAC/111-8-4-.13" name="111-8-4-.13" title="111-8-4-.13">Rule 111-8-4-.13 Administrative Area and Waiting Rooms</a></li><li><a href="/GAC/111-8-4-.14" name="111-8-4-.14" title="111-8-4-.14">Rule 111-8-4-.14 Clinical Laboratory Services</a></li><li><a href="/GAC/111-8-4-.15" name="111-8-4-.15" title="111-8-4-.15">Rule 111-8-4-.15 Housekeeping, Laundry, Maintenance and Sterile Supplies</a></li><li><a href="/GAC/111-8-4-.16" name="111-8-4-.16" title="111-8-4-.16">Rule 111-8-4-.16 Drug Storage and Dispensing</a></li><li><a href="/GAC/111-8-4-.17" name="111-8-4-.17" title="111-8-4-.17">Rule 111-8-4-.17 Blood Supply and Storage</a></li><li><a href="/GAC/111-8-4-.18" name="111-8-4-.18" title="111-8-4-.18">Rule 111-8-4-.18 X-Ray</a></li><li><a href="/GAC/111-8-4-.19" name="111-8-4-.19" title="111-8-4-.19">Rule 111-8-4-.19 Electrical Power</a></li><li><a href="/GAC/111-8-4-.20" name="111-8-4-.20" title="111-8-4-.20">Rule 111-8-4-.20 Sanitation and Waste Disposal</a></li><li><a href="/GAC/111-8-4-.21" name="111-8-4-.21" title="111-8-4-.21">Rule 111-8-4-.21 Advertising</a></li><li><a href="/GAC/111-8-4-.22" name="111-8-4-.22" title="111-8-4-.22">Rule 111-8-4-.22 Waiver of Rule</a></li><li><a href="/GAC/111-8-4-.23" name="111-8-4-.23" title="111-8-4-.23">Rule 111-8-4-.23 Enforcement</a></li><li><a href="/GAC/111-8-4-.24" name="111-8-4-.24" title="111-8-4-.24">Rule 111-8-4-.24 Applicability of Regulations</a></li><li><a href="/GAC/111-8-4-.25" name="111-8-4-.25" title="111-8-4-.25">Rule 111-8-4-.25 Severability</a></li></ul> </div> </div> <!--content ends here--> <div id="footer" class="noprint"><span class="footer">Copyright &copy; 2020 Lawriter LLC - All rights reserved.</span>| <a href="mailto:support@casemakerlegal.com?subject=Rules and Regulations of the State of Georgia">Email Us</a> | 844-838-0769 | <a href="http://livechat.casemakerlegal.com/client.php?locale=en" target="_blank" onclick="if(navigator.userAgent.toLowerCase().indexOf('opera') != -1 && window.event.preventDefault)window.event.preventDefault();this.newWindow = window.open('http://livechat.casemakerlegal.com/client.php?locale=en&url='+escape(document.location.href)+'&referrer='+escape(document.referrer), 'webim','toolbar=0,scrollbars=0,location=0,status=1,menubar=0,width=640,height=480,resizable=1');this.newWindow.focus();this.newWindow.opener=window;return false;">Live Chat</a> </div> </div> </body> </html>