ARSD Article 44:75 — HOSPITAL, SPECIALIZED HOSPITAL, AND CRITICAL ACCESS HOSPITAL FACILITIES

HEALTH HEALTH

Chapter 44:75:01

ARSD 44:75:01:01 Definitions

Terms used in this article mean:

(1) "Abuse," shown by a criminal conviction for, or substantial evidence of:

(a) Emotional or psychological abuse as defined in SDCL 22-46-1;

(b) Exploitation as defined in SDCL 22-46-1; or

(2) "Activities program," a diversional program under the direction of a therapeutic recreation specialist or activity professional eligible for certification from the National Certification Council of Activity Professionals, or a qualifed occupational therapist or occupational therapy assistant licensed in accordance with SDCL chapter 36-31;

(3) "Administrator," a person appointed by the owner or governing body of a facility who is responsible for managing the facility and who maintains an office on the premises of the facility;

(4) "Client advocate," an agency responsible for the protection and advocacy of patients;

(5) "Clinical nurse specialist," a person who practices the nurse specialty of a clinical nurse specialist and who is licensed to practice in this state in accordance with SDCL chapter 36-9;

(6) "Circulating nurse," a registered nurse trained, educated, or experienced in perioperative nursing who is responsible for coordinating and monitoring the nursing care and safety needs of a patient in the operating or procedure room and who also meets the needs of the operating and procedure room team members during surgery. The circulating nurse works outside the sterile field in which the procedure takes place and duties include but are not limited to recording the progress of the procedure, accounting for instruments, and handling specimens;

(7) "Department," the South Dakota Department of Health;

(8) "Dietary manager," a person who is a dietitian, a graduate of an accredited dietetic technician or dietetic manager training program, a graduate of a course that provides one hundred twenty or more hours of classroom instruction in food service supervision, or a certified dietary manager recognized by the Certifying Board for Dietary Managers and who supervises food service with consultation from a dietitian;

(9) "Dietitian," a person who is registered with the Academy of Nutrition and Dietetics and holds a current license to practice in accordance with SDCL chapter 36-10B;

(10) "Distinct part," an entire ward or contiguous wards, wing, floor, or building, that is licensed at a specific level, including all beds and related facilities in the unit;

(11) "Emergency care," professional health services immediately necessary to preserve life or stabilize health due to the sudden, severe, and unforeseen onset of illness or accidental bodily injury;

(12) "Exploitation," as defined in SDCL 22-46-1;

(13) "Facility," the place of business licensed as a general hospital, specialized hospital, critical access hospital, or rural emergency hospital used to provide health care to patients that is licensed by the department;

(14) "Governing body," an organized body of persons that is ultimately responsible for the quality of care in a health care facility, credentialing of and granting privileges to the medical staff, maintaining the financial viability of the facility, and formulating institutional policy;

(15) "Healthcare personnel," any employee or individual working in a healthcare setting;

(16) "Interdisciplinary team," a group of persons selected from multiple health disciplines who have a diversity of knowledge and skills and who function as a unit to collectively address the medical, physical, mental or cognitive, and psychosocial needs of a patient;

(17) "Licensed health professional," a physician; physician's assistant; nurse practitioner; clinical nurse specialist; physical therapist; speech-language pathologist; occupational therapist; physical or occupational therapy assistant; nurse; nursing facility administrator; dietitian; pharmacist; respiratory therapist; or social worker who holds a current license to practice in this state or privilege to practice;

(18) "Medical staff," practitioners that operate under bylaws approved by the governing body and who are responsible for reviewing the qualifications of practitioners applying for clinical privileges and for the provision of medical care to patients in a health care facility;

(19) "Misappropriation of patient property," the deliberate misplacement, exploitation, or wrongful, temporary or permanent use of a patient's belongings or money without the patient's consent;

(20) "Neglect," as defined in SDCL 22-46-1;

(21) "Nurse," a registered nurse or a licensed practical nurse licensed in accordance with SDCL chapter 36-9;

(22) "Nurse practitioner," a person licensed in accordance with SDCL chapter 36-9A;

(23) "Nursing unit," a patient unit that is limited to one floor of a health care facility and has all patient room entrances and exits within sight or control of nursing personnel;

(24) "Patient," a person with a valid order by a practitioner for diagnostic or treatment services in a hospital, specialized hospital, critical access hospital, rural emergency hospital, or swing bed;

(25) "Pharmacist," a person registered in accordance with SDCL chapter 36-11;

(26) "Physician," a person licensed to practice medicine in accordance with SDCL chapter 36-4;

(27) "Physician assistant," a person licensed in accordance with SDCL chapter 36-4A;

(28) "Practitioner," one of the following:

(a) A physician;

(b) A dentist licensed in accordance with SDCL chapter 36-6A;

(d) An optometrist licensed in accordance with SDCL chapter 36-7;

(e) A chiropractor licensed in accordance with SDCL chapter 36-5;

(f) A pharmacist;

(g) A physical therapist licensed in accordance with SDCL chapter 36-10;

(h) An occupational therapist licensed in accordance with SDCL chapter 36-31;

(i) A nurse practitioner;

(j) A physician assistant;

(k) A speech-language pathologist licensed in accordance with chapter 36-37; or

(i) A clinical nurse specialist;

(29) "Regular diet," a nutritionally adequate diet using food items and written recipes that can be prepared and correctly served by a staff person;

(30) "Restraint," a physical, chemical, or mechanical device used to restrict the movement of a patient or the movement or normal function of a portion of the patient's body, excluding devices used for specific medical and surgical treatment;

(31) "Seclusion room," a room used for the involuntary confinement of a patient from which the patient is prevented from leaving and where most outside stimulus is eliminated to allow a patient to deescalate and feel calm;

(32) "Social worker," a person licensed in accordance with SDCL chapter 36-26;

(33) "Sufficient personnel," a number of qualified personnel sufficient to perform the duties required to meet the performance criteria established by this article;

(34) "Swing bed," a licensed hospital bed that has been approved by the department pursuant to § 44:75:11:10 to also provide short-term nursing care;

(35) "Therapeutic diet," any diet other than a regular diet that is ordered by a physician, physician assistant, nurse practitioner, or dietitian as part of the treatment for a disease or clinical condition to increase, decrease, or to eliminate certain substances in the diet, and to alter food consistency;

(36) "Unlicensed assistive personnel," a person who is not licensed as a nurse in accordance with SDCL chapter 36-9 but who is trained to assist a nurse in the provision of nursing care to a patient as delegated by the nurse and authorized by chapter 20:48:04.01.

Note: National Certification Council of Activity Professionals, https://www.nccap.org.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13, 34-12-32.

ARSD 44:75:01:02 Licensure of facilities by classification

Each health care facility shall identify its classification on the application for licensure. The license shall include each facility address at which services licensed under this chapter are provided. A facility shall comply only with those chapters in this article that apply to the classification of license issued. Each facility address shall post the current license in a place conspicuous to the public. The license remains the property of the department.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-7.
Law Implemented: SDCL 34-12-5, 34-12-7.

ARSD 44:75:01:02.01 Rural emergency hospital -- Services

A rural emergency hospital must provide emergency department services, observation care, outpatient medical care, and other health care services with a patient length of stay of less than twenty-four hours. A rural emergency hospital may not provide inpatient services, except those furnished in a unit that is a distinct part of the rural emergency hospital and is licensed as a skilled nursing facility to furnish posthospital extended care services.

History

Source: 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-7, 34-12-13(5).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:01:02.02 Rural emergency hospital -- Provider agreement

A rural emergency hospital shall have in effect a provider agreement with the Centers for Medicare and Medicaid Services.

History

Source: 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-7, 34-12-13(5).
Law Implemented: SDCL 34-12-1.1(14).

ARSD 44:75:01:03 Name of facility

Each facility shall use a pertinent and distinctive name in applying for a license. The facility name may not imply services rendered in excess of the facility's licensure classification. The governing body of the facility or designee must provide prior written notice to the department of any name change for the facility.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-7.
Law Implemented: SDCL 34-12-7.

ARSD 44:75:01:04 Bed capacity

The department shall establish the bed capacity of each facility in accordance with chapters 44:75:13 and 44:75:14. The patient census may not exceed the bed capacity for which the facility is licensed. A request by the facility for an adjustment in bed capacity because of change of purpose or construction may only be approved by the department before any changes are made.

A critical access hospital (CAH) may license no more than twenty-five beds. A CAH may establish a distinct part with no more than ten beds. The distinct part's beds do not count toward the CAH bed limit.

A rural emergeny hospital may license no more than fifty beds.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-6(3)(9), 34-12-7.
Law Implemented: SDCL 34-1-17(4), 34-12-7, 34-12-14.

ARSD 44:75:01:05 Acceptance and retention of patients

A facility shall accept and retain patients based on the facility's capabilities to meet the needs of the patients, the services provided in accordance with the facility's classification as determined by the facility's governing body, and with written policies and procedures that:

(1) A patient accepted for care by a licensed facility must be housed and treated within the facility;

(2) Healthcare personnel essential to maintaining sufficient personnel may not leave a facility during their tour of duty in the facility to provide services to persons who are not patients of the facility with the exception of providing emergency care on premises contiguous to the facility's property;

(3) For a hospital, if the facility accepts or retains a patient for other than short-term acute care, it must provide the facilities, equipment, programs, and care needed by the patient;

(4) A facility that accepts or retains a patient with a developmental disability, as defined in SDCL 27B-1-18, or a patient with a mental disease that causes the patient to lack sufficient undertanding or capacity to make responsible decisions to meet the ordinary demands of life, as evidenced by the patient's behavior, or that causes the patient to be a danger to self or others, shall provide facilities and programs consistent with the needs of the patient;

(5) If a person other than an inpatient is accepted for care or to participate in any nursing service, dietary service, or activity program, the facility must include the person in the evaluation of staffing of nursing, dietary, and activity programs; and the provision of an infection control program. Services or programs provided to persons other than inpatients may not infringe upon the needs of the inpatients; and

(6) A critical access hospital may provide inpatient acute care up to an annual average length of stay of ninety-six hours.

A facility may not accept or retain a patient who requires care in excess of the classification for which it is licensed.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-7, 34-12-13(5).
Law Implemented: SDCL 34-12-7, 34-12-13.

ARSD 44:75:01:06 Joint occupancy

The use of a portion of a building for a purpose other than that covered by the license may be approved by the department only if it can be shown that joint occupancy is not detrimental to the welfare of the patients. The area shall be open to inspection by the department.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).

ARSD 44:75:01:07 Reports to department

44:75:01:07. Reports to the department. Each facility shall report any of the following events to the department through the department's online reporting system within twenty-four hours of the discovery of the event:

(1) An attempted suicide by a patient;

(2) An incident or event where there is reasonable cause to suspect abuse or neglect of any patient by any person;

(3) A death resulting from other than natural causes originating on facility property;

(4) A missing patient;

(5) A fire in the facility;

(6) A loss, for more than twenty-four hours, of utilities, emergency generator, fire alarm, sprinklers, or other critical equipment necessary for operation of the facility; or

(6) An unsafe water sample from a pool or spa.

The facility shall conduct an internal investigation of the event and report the results to the department no later than five working days after the event.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023; 52 SDR 41, effective October 27, 2025.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13.

ARSD 44:75:01:07.01 Reports to the Department of Human Services, law enforcement, or state's attorney

A facility shall report an event involving any reasonable cause to suspect abuse or neglect of any patient by any person within twenty-four hours of the discovery of the event, orally or in writing, to the Department of Human Services, to a law enforcement officer, or to the state's attorney of the county in which the facility is located.

History

Source: 50 SDR 62, effective November 27, 2023; 52 SDR 41, effective October 27, 2025.
General Authority: SDCL 34-12-13(14).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:01:08 Plans of correction

Within ten days of the receipt of the statement of deficiencies, each licensed facility must submit to the department a written plan of correction for the citation of noncompliance with licensure requirements. The plan of correction must be signed, dated, and on the original forms provided by the department. The department may reject the plan of correction if there is no evidence the plan will cause the facility to attain or maintain compliance with SDCL chapter 34-12 and this article.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:01:09 Modifications

The department may approve modifications to the staffing requirements provided in § 44:75:03:02 or 44:75:06:05 for facilities that are physically combined and jointly operated if:

(1) A hospital and nursing facility are co-located and the nursing facility has a licensed bed capacity of sixteen or less or the hospital has an acute care patient daily census of less than five: or

(2) A hospital and assisted living center are co-located.

The health and safety of the patients in either facility may not be jeopardized.

Modifications to the staffing requirements in this article may be approved by the department for a critical access hospital if there are no acute care or swing bed patients present.

A modification specified by this section may be requested by the health care facility.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(5)(14).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:01:10 Scope of article

Nothing in article 44:75 limits or expands the rights of any healthcare personnel to provide services within the scope of the personnel's license, certification, or registration, as provided by law.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13(5).

Chapter 44:75:02

ARSD 44:75:02:01 Sanitation

The facility shall be designed, constructed, maintained, and operated to minimize the sources and transmission of infectious diseases to patients, personnel, visitors, and the community at large. This requirement shall be accomplished by providing the physical resources, personnel, and technical expertise necessary to ensure good public health practices for institutional sanitation.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13(1).

ARSD 44:75:02:02 Pets

No pet kept in or visiting a facility may negatively affect the well-being of a patient.

Cross-Reference: Physically disabled, blind, or deaf person's right to be accompanied by guide dog without extra charge, SDCL 20-13-23.2.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13(1).

ARSD 44:75:02:03 Cleaning methods and facilities

The facility shall have supplies, equipment, work areas, and complete written procedures for cleaning, sanitizing, disinfecting, or sterilizing all work areas, equipment, utensils, and medical devices used for patients' care. Common use equipment shall be disinfected or sterilized after each use. Facilities shall have separate clean and soiled utility rooms.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(2).
Law Implemented: SDCL 34-12-13(2).

ARSD 44:75:02:04 Chemicals used to sanitize, disinfect, or sterilize

The label of chemicals used to sanitize, disinfect, or sterilize shall indicate registration with the Environmental Protection Agency as effective, safe, and approved for their intended use.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(2).
Law Implemented: SDCL 34-12-13(2).

ARSD 44:75:02:05 Sterilization

A facility shall decontaminate any instruments, supplies, utensils and equipment that are not single service before sterilization in a manner that will make them safe for handling by personnel. Supplies and equipment commercially prepared and sterilized to retain sterility indefinitely are acceptable in lieu of sterilization in the facility. A facility shall bacteriologically monitor autoclaves used for steam sterilization at least weekly. Supplies and equipment sterilized and packaged in the facility must have the processing date, the sterilizer number or unique identifier if more than one sterilizer is used, the cycle or load number, a description of the contents, and the identifier of the assembler on the package and must be reprocessed in accordance with any specific manufacturer's recommendation for sterilization and packaging.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(2).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:02:06 Housekeeping cleaning methods and equipment

The facility shall establish written housekeeping procedures for the cleaning of all areas in the facility and copies made available to all housekeeping personnel. All parts of the facility shall be kept clean, neat, and free of visible soil, litter, and rubbish. Equipment and supplies shall be provided for cleaning of all surfaces. Such equipment shall be maintained in a safe, sanitary condition. Hazardous cleaning solutions, chemicals, poisons, and substances shall be labeled, stored in a safe place, and kept in an enclosed section separate from other cleaning materials. Cleaning of areas designed for patient use shall be performed by dustless methods that minimize the spread of pathogenic organisms in the facility's atmosphere. Each vacuum used in medical facilities shall be equipped to provide effective discharge air filtration of particles larger than 0.3 microns. Cleaning shall include all environmental surfaces within the facility that are subject to contamination from dust, direct splash, or pathogenic organisms except medical equipment, supplies, or devices that are the responsibility of other services or departments of the facility.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(2).
Law Implemented: SDCL 34-12-13(2).

ARSD 44:75:02:07 Food service

Food service must be provided by a facility or food service establishment licensed in accordance with SDCL chapter 34-18, that is inspected by a local, state, or federal agency. The facility shall meet the safety and sanitation procedures for food service in §§ 44:02:07:01, 44:02:07:02, and 44:02:07:04 to 44:02:07:95, inclusive. A facility of seventeen beds or more shall have a mechanical dishwasher. The facility shall have the space, equipment, supplies, and mechanical systems for efficient, safe, and sanitary food preparation if any part of the food service is provided by the facility.

Cross Reference: Food Service Code, chapter 44:02:07.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(5)(8).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:02:08 Handwashing facilities

A handwashing facility consisting of hot and cold running water dispensed through a mixing faucet controlled with blade handles or hands-free controls, a towel dispenser with single-service towels or a hand-drying device, and wall-mounted hand cleanser dispenser must be located in each dietary area, utility room, nurses' station, pharmacy, laboratory, nursery, surgical suite, delivery suite, physical therapy room, examination and treatment room, emergency room, laundry, and toilet room. A handwashing facility must be provided in each patient room or in a bath or toilet room connected directly to the room. If existing faucets and controls are replaced or changed, they must be replaced with mixing faucets controlled with blade handles or other hands-free controls.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1)(4).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:02:09 Linen

The supply of bed linen and towels must equal two times the licensed capacity of the facility. The facility shall develop and implement written procedures for the storage and handling of soiled and clean linens. The facility shall contract with a commercial laundry service or the laundry service of another licensed health care facility for all common use linens if laundry services are not provided on the premises. A facility providing laundry services shall have adequate space and equipment for the safe and effective operation of the laundry service.

The facility must process commingled patients' personal clothing, common-use linen, any isolation clothing, and housekeeping items by methods that ensure disinfection. The facility must process laundry following the laundry equipment and cleaning agent recommendations. If hot water is used for disinfection, minimum water temperatures supplied for laundry purposes must be one hundred sixty degrees Fahrenheit or seventy-one degrees centigrade. If chlorine bleach is added to the laundry process following the manufacturer's direction, the minimum hot water temperatures supplied for laundry purposes may be reduced to one hundred twenty degrees Fahrenheit or forty-nine degrees centigrade. The facility may wash commingled patients' personal clothing, common-use linen, and any isolation clothing in water temperatures less than one hundred twenty degrees Fahrenheit if:

(1) The supplier of the chemical specifies low-temperature wash formulas in writing for the machines used in the facility;

(2) Charts providing specific information concerning the formulas to be used for each machine are posted in an area accessible to personnel;

(3) The facility ensures laundry personnel receive in-service training by the chemical supplier on a routine basis, regarding chemical usage and monitoring of wash operations; and

(4) The facility ensures personnel monitor chemical usage and wash water temperatures at least monthly to ensure conformance with the chemical supplier's instructions.

Any patient's personal clothing that is not commingled may be processed according to manufacturer's recommendations using water temperatures and detergent in a quantity as recommended by the garment or detergent manufacturer. The facility shall have distinct areas for the storage and handling of clean and soiled linens. Areas used for the storage and handling of soiled linens must be negatively pressurized. The facility shall establish procedures for the handling and processing of contaminated linens. Soiled linen must be placed in closed containers prior to transportation. Clean linens must be transported in containers used exclusively for clean linens, must be kept covered with dust covers at all times while in transit or in hallways, and must be stored in areas designated exclusively for this purpose. The department must review and approve any written request for any modification of the requirements of this section as to a facility's policy and procedure before any changes are made.

The facility must sort and process environmental cleaning and disinfection cleaning cloths, microfiber cloths, mop head, and other textiles in loads separate from healthcare textiles.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1)(4).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:02:10 Infection prevention and control program

Each facility shall have an active, facility-wide program for the surveillance, prevention, and control of healthcare-associated infections and other infectious disease. The program must demonstrate adherence to nationally recognized infection prevention and control guidelines.

Each facility shall, based on recommendations from the facility’s medical and nursing leadership, appoint an infection prevention and control director who is qualified through education, training, experience, or certification in infection prevention and control, to be responsible for the infection prevention and control program including:

(1) Developing and implementing policies and procedures for facility-wide infection surveillance, prevention, and control that reflect the scope and complexity of services furnished by the facility and that maintain a clean and sanitary environment;

(2) Documenting infection prevention, control, and surveillance activities;

(3) Communicating and collaborating with the quality assessment and performance program required by § 44:75:04:14 and the antibiotic stewardship program required by § 44:75:02:10.01 on infection prevention and control issues;

(4) Ensuring competency-based training and education is provided to the facility’s healthcare personnel; and

(5) Auditing adherence to the facility’s infection prevention and control policies.

The governing body of each facility shall ensure systems are in place and operational for the tracking of all infection surveillance, prevention, and control activities to demonstrate implementation, success, and sustainability of activities.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1), 34-22-9(8).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:02:10.01 Antibiotic stewardship program

Each facility shall have an active facility-wide program for the optimization of antibiotic use through stewardship. The program must demonstrate adherence to nationally recognized best practices for improving antibiotic use and reducing antibiotic-resistant organisms.

Each facility shall, based on recommendations from the facility’s medical and pharmacy leadership, appoint an antibiotic stewardship director who is qualified through education, training, experience, or certification in infectious disease or antibiotic stewardship, to be responsible for the antibiotic stewardship program including:

(1) Developing and implementing policies and procedures for facility-wide antibiotic stewardship to monitor and improve the facility’s use of antibiotics that reflect the scope and complexity of services furnished by the facility;

(2) Documenting antibiotic stewardship activities to include sustained improvements in proper antibiotic use;

(3) Communicating and collaborating with medical, nursing, and pharmacy personnel and with the quality assessment and performance program required by § 44:75:04:14 and the infection prevention and control program required by § 44:75:02:10 on antibiotic stewardship issues;

(4) Ensuring competency-based training and education is provided to the facility’s healthcare personnel on the practical application of antibiotic stewardship guidelines, policies, and procedures; and

(5) Auditing adherence to the facility’s antibiotic stewardship policies.

The governing body of each facility shall ensure a system is in place and operational for the tracking of all antibiotic use activities to demonstrate implementation, success, and sustainability of activities.

History

Source: 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1), 34-22-9(8).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:02:11 Plumbing

Facility plumbing systems must be designed and installed in accordance with SDCL 36-25-15 and 36-25-15.1. Plumbing must be sized, installed, and maintained to carry required quantities of water to required locations throughout the facility.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1)(14).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:02:12 Water supply

A facility's water supply must be obtained from a public water system or, in its absence, from a supply approved by the Department of Agriculture and Natural Resources. Each private water supply must have a water sample bacteriologically tested at least monthly. The volume of water must be sufficient for the needs of the facility, including firefighting requirements. The hot water system must be capable of supplying the work and patient areas with water at the required temperatures. The maximum temperature of hot water for patient use is one hundred twenty-five degrees Fahrenheit or fifty-two degrees centigrade. The minimum temperature of hot water for patient use is one hundred degrees Fahrenheit or thirty-eight degrees centigrade. A facility shall monitor water temperatures monthly, and maintain documentation in accordance with facility policy.

Cross-References:

Standards adopted for plumbing -- Conformity to Uniform Plumbing Code, SDCL 36-25-15.

Scope and objectives of plumbing standards and rules, SDCL 36-25-15.1.

History

Source: 42 SDR 51, effective October 13, 2015; SL 2021, ch 1, §§ 8, 19, effective April 19, 2021; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:02:12.01 Water supply -- Control of Legionella

Each water supply system in a facility must maintain one part per million free residual chlorine at remote point-of-use fixtures in the facility, or other equivalent bacteriological control method for the control of Legionella. A facility may increase the water temperature range from one hundred twenty-two degrees to one hundred twenty-five degrees Fahrenheit or fifty degrees to fifty-two degrees centigrade for the control Legionella. The facility shall document water temperatures to verify the hot water temperature is being maintained within the acceptable range for the control Legionella. If hot water temperatures are outside the acceptable range, the facility must conduct chlorine testing using photocell and light source N, N, Diethyl-p-phenylenediamine test kits, and the facility shall log the test results. If testing demonstrates that consistent chlorine levels are maintained, the facility may conduct monthly chlorine testing.

History

Source: 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:02:13 Ventilation

Electrically powered exhaust ventilation shall be provided in all soiled areas, wet areas, toilet rooms, and storage rooms. Clean storage rooms may also be ventilated by supplying and returning air from the building's air-handling system.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13(1).

ARSD 44:75:02:14 Lighthing

44:75:02:14. Lighting. Spaces occupied by people, machinery, and equipment within buildings and their approaches and parking lots shall have artificial lighting at a level for general safety. Patient bedrooms shall have general lighting and night lighting. A reading light shall be provided for each patient who can benefit from one. Required exits shall be equipped with continuous emergency lighting. Emergency power shall be provided if the main source of power fails.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13(1).

ARSD 44:75:02:15 Refuse and waste disposal

Garbage, refuse, and waste shall be handled and disposed of in a safe and sanitary manner. Final disposal of all refuse and waste shall comply with articles 74:27 and 74:28. Putrescible garbage shall be removed at a frequency to contain or prevent odors, insects, and vermin.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13(1).

ARSD 44:75:02:16 Insect and rodent control

The facility shall take effective measures to protect against the entrance into the facility and the breeding or presence on the premises of rodents, flies, roaches, and other vermin. The facility may use chemical substances of a poisonous nature in accordance with the requirements of this section to control or eliminate various types of vermin. The substances shall be properly colored and labeled to identify them as poisons, shall be used and stored in a safe manner, and may not be stored with food or drugs used for human consumption. Extreme care shall be taken to prevent any poisons from contaminating food or food products.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13(1).

ARSD 44:75:02:17 Sewage disposal

Sewage shall be disposed of in a public sewage works system or, in its absence, in a manner approved by the department in accordance with the provisions of SDCL chapter 34A-2.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13(1).

ARSD 44:75:02:18 Occupant protection

Each facility must be constructed, arranged, equipped, maintained, and operated to avoid injury or danger to the occupants. The extent and complexity of occupant protection precautions is determined by the services offered and the physical needs of the patients admitted to the facility. The facility shall:

(1) Develop and implement a written and scheduled preventive maintenance program;

(2) Provide securely constructed and conveniently located grab bars in all toilet rooms and bathing areas used by patients;

(3) Provide a call system for each patient bed and in all toilet rooms and bathing facilities routinely used by patients. The call system must be capable of being easily activated by the patient and must register at a nurses’ station serving the unit. A wireless call system may be used;

(4) Provide grounded or double-insulated electrical equipment or protect the equipment with ground fault circuit interrupters. Ground fault circuit interrupters must be provided in wet areas and for outlets within six feet of sinks;

(5) Prohibit the use of a portable space heater, portable halogen lamp, household-type electric blanket, or household-type heating pad in the facility;

(6) Ensure that any light fixture located over a patient bed, bathing or treatment area, clean supply storage room, clean laundry and linen storage area, or medication set-up area be equipped with a lens cover or a shatterproof lamp;

(7) Ensure that any clothes dryer have a galvanized metal transition duct for exhaust or flexible transition duct listed and labeled in accordance with UL 218A; and

(8) Ensure that the storage and transfilling of oxygen cylinders or containers meet the requirements of the NFPA 99 Health Care Facilities, 2012 Edition, chapter 11.

Reference: NFPA 99 Health Care Facilities, 2012 edition, National Fire Protection Association. Copies may be obtained at https://nfpa.org/Codes-and-Standards/All-Codes-and-Standards/List-of-Codes-and-Standards. Cost: $111.00.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1)(3).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:02:19 Area requirements for currently licensed patient rooms

Each licensed patient room must have at least seventy-five square feet or 6.98 square meters of floor space per bed, with at least three feet or 0.91 meters between beds, in a multi-bed room exclusive of closets and wardrobes; and ninety-five square feet or 8.83 square meters in a single room, exclusive of closets and wardrobes. Each patient shall have for individual use in the assigned room a bed, a bedside stand, and a chair appropriate to the needs and comfort of the patient. Each hospital shall have twenty square feet or 1.86 square meters of general storage for each bed. Each facility must be constructed, equipped, and operated to maintain the privacy and dignity of all patients. In a multi-bed room, each bed must be able to be separated from the other beds by privacy curtains.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1)(3).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:02:20 Room required for isolation techniques

When an authorized healthcare personnel determines isolation is required, the facility must provide a private room with necessary equipment, including handwashing facilities, to carry out isolation techniques. The room must have a negative air pressure with regard to the corridor and connecting rooms and a minimum of six air exchanges an hour exhausted to the outside air.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1)(3), 34-22-9.
Law Implemented: SDCL 34-12-13.

ARSD 44:75:02:21 Office required for social services activities

An office which is large enough to accommodate private consultation and record keeping and which is easily accessible to patients shall be provided for social services activities.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13(5).

ARSD 44:75:02:22 Physical plant changes

A facility shall submit to the department any proposed change due to new construction, remodeling, or change of use of an area. Any change must have the approval of the department before it is made.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1)(3).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:02:23 Location

The location of and access to facilities shall promote the health, treatment, comfort, safety, and well-being of persons accepted and retained for care. A facility shall be served by good, passable roads. Easy accessibility for employees, visitors, and fire-fighting services shall be maintained.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (14).
Law Implemented: SDCL 34-12-13(1), (3), and (14).

ARSD 44:75:02:24 Heating and cooling

The temperature in any occupied space in the facility must be maintained between sixty-eight and eighty degrees Fahrenheit during waking hours and not lower than sixty-four degrees Fahrenheit during sleeping hours. Individual patient space may be maintained outside the required range when desired by the occupant.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:02:25 Seclusion rooms

A facility must arrange each seclusion room for the safety of the patient and to prevent patient hiding, escape, injury, or suicide. The room must be without sharp corners. The room door must swing out of the patient room, but not into a general traffic corridor. Each room door must permit staff observation of the patient while still providing for patient privacy. Each finish fastener and hardware must be tamper resistant. Security fixtures must be provided for lighting. Nine foot ceiling heights must be provided. An anteroom at the seclusion room entrance must be provided to allow staff-controlled access to the seclusion room toilet facility. Any lock on a seclusion room must be controlled by staff at the door location and must unlock when released by the staff person. A locking device may be manual or automatic.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1)(14).
Law Implemented: SDCL 34-12-13.

Chapter 44:75:03

ARSD 44:75:03:01 Fire safety code requirements

A facility shall meet applicable fire safety standards in NFPA 101 Life Safety Code, 2012 edition, chapters 18 and 19.

Reference: NFPA 101 Life Safety Code, 2012 edition, National Fire Protection Association. Copies may be obtained at https://www.nfpa.org/product/nfpa-101-code/p0101code?Edition=2012&Language=English&Format=Softbound&type=digital. Cost: $160.00.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023; 51 SDR 53, effective November 11, 2024.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13.

ARSD 44:75:03:02 General fire safety

Each facility must be constructed, arranged, equipped, maintained, and operated to avoid undue danger to the lives and safety of its occupants from fire, smoke, fumes, or resulting panic during the period of time reasonably necessary for escape from the structure in case of fire or other emergency. The facility shall conduct fire drills quarterly for each shift. If the facility is not operating with three shifts, the facility must conduct monthly drills to provide training for all healthcare personnel. At least two healthcare personnel must be on duty at all times. In a multilevel facility, at least one personnel must be on duty on each floor containing occupied beds.

Cross-Reference: Fire safety code requirements, § 44:75:03:01.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13.

Chapter 44:75:04

ARSD 44:75:04:01 Governing body

Each facility operated by limited liability partnership, a corporation, or political subdivision shall have an organized governing body legally responsible for the overall conduct of the facility. If the facility is operated by an individual or partnership, the individual or partnership shall carry out the functions in this chapter pertaining to the governing body. The governing body shall establish and maintain administration policies, procedures, or bylaws governing the operation of the facility. The governing body of a facility shall determine which categories of practitioners are eligible candidates for appointment to the medical staff and shall credential and grant admitting or patient care privileges to appointees to the medical staff. The governing body may appoint members to the medical staff only after considering the recommendations of the existing members of the medical staff.

Cross-Reference: Hospital medical staff, § 44:75:04:03.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13(5).

ARSD 44:75:04:02 Hospital medical staff

A hospital shall have a medical staff organized under bylaws and rules approved by the governing body and responsible to the governing body of the hospital for the quality of all medical care provided patients in the hospital and for the ethical and professional practices of its members. The responsibility for the conduct of medical staff affairs shall be assigned to an individual physician. The medical staff shall establish a credentials committee to review the qualifications of practitioners applying for admitting or patient care privileges and recommend to the governing body practitioners eligible for appointment to the medical staff by the governing body. The review shall include recommendations regarding delineation of admitting and patient care privileges. The medical staff shall conduct appraisals of its members at least every two years.

Cross-Reference: Governing body, § 44:75:04:02.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13(5).

ARSD 44:75:04:03 Administrator

The governing body shall designate a qualified administrator to represent the owner or governing body and to be responsible for the daily overall management of the facility. The administrator shall designate a qualified person to represent the administrator during the administrator's absence. The governing body shall notify the department in writing of any change of administrator.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13(5).

ARSD 44:75:04:04 Personnel

The facility shall have a sufficient number of qualified personnel to provide effective and safe care. Healthcare personnel on duty must be awake at all times. Any supervisor must be eighteen years of age or older. The facility shall make available written job descriptions and personnel policies and procedures to personnel of all departments and services. The facility may not knowingly employ any person with a conviction for abusing another person. The facility shall establish and follow policies regarding healthcare personnel on contract.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:04:05 Personnel training

The facility shall have a formal orientation program and an ongoing education program for all healthcare personnel. These programs must be completed by all healthcare personel within thirty days of hire and annually thereafter, and must include the following subjects:

(1) Fire prevention and response;

(2) Emergency procedures and preparedness;

(3) Infection control and prevention;

(4) Accident prevention and safety procedures;

(5) Proper use of restraints and seclusion;

(6) Patient rights;

(7) Confidentiality of patient information;

(8) Incidents and diseases subject to mandatory reporting and the facility's reporting mechanisms;

(9) Care of patients with unique needs;

(10) Dining assistance, nutritional risks, and hydration needs of patients;

(11) Advanced directives; and

(12) Abuse and neglect.

Any personnel whom the facility determines will have no contact with patients are exempt from training required by subdivisions (5), (8), (9), (10), (11), and (12) of this section.

The facility shall provide additional personnel education based on the facility's identified needs.

The facility shall make available current professional and technical reference books and periodicals for personnel.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:04:06 Personnel health program

The facility shall have a personnel health program for the protection of the patients. Before assignment to duties or within fourteen days after employment, personnel must be evaluated by a licensed health professional to ensure they are not infected with any reportable communicable disease that poses a threat to others including an assessment of previous vaccinations, tuberculin skin tests, or blood assay test. The facility may not allow anyone with a communicable disease, during the period of communicability, to work in a capacity that would allow spread of the disease. Any personnel absent from duty because of a reportable communicable disease that may endanger the health of patients and fellow personnel may not return to duty until they are determined by a physician, physician’s designee, physician assistant, nurse practitioner, or clinical nurse specialist to no longer have the disease in a communicable stage.

Cross-Reference: Definitions and reportable diseases and conditions, chapter 44:20:01.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1)(5)(14).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:04:07 Admissions of patients

The governing body of the facility shall establish and maintain admission, transfer, and discharge policies, with written evidence to ensure the patients admitted to and retained in the facility are within the licensure classification of the facility or its distinct part. The facility may admit and retain, on the orders of a practitioner, only those patients for whom it can provide care safely and effectively.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13(5).

ARSD 44:75:04:08 Disease prevention

Each facility shall provide an organized infection control program for preventing, investigating and controlling infection. The facility shall establish written policies regarding visitation in the various services and departments of the facility. Any visitor who has an infectious disease, who has recently recovered from such a disease, or who has recently had contact with such a disease shall be discouraged from entering the facility.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (5), and (14).
Law Implemented: SDCL 34-12-13(1), (5), and (14).

ARSD 44:75:04:09 Tuberculin screening and testing requirements

Each facility shall develop criteria to screen healthcare personnel for Mycobacterium tuberculosis (TB) based on the Tuberculosis Screening, Testing, and Treatment of U.S. Health Care Personnel: Recommendations from the National Tuberculosis Controllers Association and CDC, 2019. Each facility shall establish policies and procedures for conducting TB risk assessments that include the key components of responsibility, surveillance, and containment. The frequency of repeat screening depends upon annual facility risk results.

Tuberculin screening requirements for healthcare personnel are as follows:

(1) Each new healthcare personnel shall receive an initial individual Tb risk assessment that is documented and the two-step method of tuberculin skin test or a TB blood assay test to establish a baseline within twenty-one days of employment. Any two documented tuberculin skin tests completed within a twelve-month period prior to the date of employment are considered two-step. A TB blood assay test completed within a twelve-month period prior to the date of employment or direct patient care is considered an adequate baseline test. Skin testing or TB blood assay tests are not necessary if a new healthcare personnel transfers from one licensed healthcare facility to another licensed healthcare facility within the state if the facility received documentation, from the transferring healthcare facility or personnel, of the last skin or blood assay TB testing having been completed within the prior twelve months. Skin testing or TB blood assay test are not necessary if documentation is provided of a previous positive reaction to either test. Any healthcare personnel who has a newly recognized positive reaction to the skin test or TB blood assay test must have a medical evaluation and a chest X-ray to determine the presence or absence of the active disease;

(2) Each healthcare personnel who provides documentation of a positive reaction to the tuberculin skin test or TB blood assay test must have a medical evaluation and chest X-ray to determine the presence or absence of the active disease;

(3) Each healthcare personnel with a history of a positive reaction to the tuberculin skin test or TB blood assay must be evaluated annually by a physician, physician assistant, nurse practitioner, clinical nurse specialist, or a nurse and a record maintained of the presence or absence of symptoms of TB. If this evaluation supports the possibility of active tuberculosis, the healthcare personnel must be referred for further medical evaluation to confirm the presence or absence of tuberculosis; and

(4) Each healthcare personnel identified at increased risk for TB because of an occupational risk or current or planned immunosuppression must receive an annual TB risk screening.

Reference: Tuberculosis Screening, Testing, and Treatment of U.S. Health Care Personnel: Recommendations from the National Tuberculosis Controllers Association and CDC, 2019. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report, May 17, 2019/68(19); pages 439-443. Copies are at no cost at https://www.cdc.gov/mmwr/volumes/68/wr/mm6819a3.htm.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1)(5)(14), 34-22-9.
Law Implemented: SDCL 34-12-13.

ARSD 44:75:04:09.01 TB education for healthcare personnel

All healthcare personnel shall receive Mycobacterium tuberculosis (TB) education annually. TB education must include information on TB risk factors, the signs and symptoms of TB disease, and TB infection control policies and procedures of the facility.

History

Source: 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1)(5), 34-22-9.
Law Implemented: SDCL 34-12-13.

ARSD 44:75:04:10 Care policies

Each facility must establish and maintain policies, procedures, and practices that follow accepted standards of professional practice to govern care, and related medical or other services necessary to meet the patients' needs.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:04:11 Secured units

A facility shall comply with the following provisions:

(1) A physician's, physician assistant's, or nurse practitioner's order for confinement that includes medical symptoms that warrant seclusion or placement must be documented in the patient's chart and must be reviewed periodically by the physician, physician assistant, or nurse practitioner;

(2) Therapeutic programming must be provided and documented in the overall plan of care;

(3) Confinement may not be used as a punishment or for the convenience of the staff;

(4) Confinement and its necessity must be based on a comprehensive assessment of the patient's physical, cognitive, and psychosocial needs, and the risks and benefits of this confinement must be communicated to the patient's family;

(5) Locked doors must conform to§§ 18.2.2.2.5 and 19.2.2.2.5 of NFPA 101 Life Safety Code, 2012 edition; and

(6) Staff assigned to the secured unit must have specific training regarding the unique needs of patients in that unit. The facility shall ensure adequate staff are on duty at all times to safely provide care and services to the patients.

For the purposes of this section, the term, secured unit, means a distinct area of a facility in which the physical environment and design maximizes functioning abilities, promotes safety, and encourages independence for a defined, unique population and that is staffed by persons with training to meet the needs of patients admitted to the unit.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023; 51 SDR 53, effective November 11, 2024.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13.

ARSD 44:75:04:12 Restraints

Each facility must have written policies and procedures for all restraint use, including emergency restraints, bedrails, and locked doors. The use of restraints must be based on a comprehensive assessment of the patient's physical and cognitive abilities, evaluation and effectiveness of less restrictive alternatives, and an involvement of the patient in weighing the benefits and consequences. Restraint use requires a physician's, physician assistant's, or nurse practitioner's order specifying time frames and types of restraints. Continued use of the restraint and reorders may be given only by a physician's, physician assistant's, or nurse practitioner's order and a review of the patient condition by the interdisciplinary team. Restraints must be physically checked as ordered and documented by nursing personnel. Restraints may not be used to limit mobility, for convenience of staff, for punishment, or as a substitute for supervision. Restraints may not hinder evacuation of the patient during fire or cause injury to the patient.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(14).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:04:12.01 Seclusion

Each facility shall have written policies and procedures for all seclusion use. The use of seclusion must be based on a comprehensive assessment of the patient’s behaviors to prevent harm to self and others. Seclusion use requires a physician’s, physician assistant’s, or nurse practitioner’s order specifying time frames and type of seclusion. Continued use of seclusion and reorders may be given only by a physician, physician assistant, or nurse practitioner after a review of the patient’s condition. Seclusion may not be used to limit mobility, for convenience of staff, for punishment, or as a substitute for supervision. Seclusion may not hinder evacuation of the patient during fire or cause injury to the patient. Patients in seclusion must be visually monitored by staff at all times. A facility may not rely solely on the use of video surveillance of a patient in seclusion to meet the requirement for visual monitoring.

History

Source: 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(14).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:04:13 Transfer agreement

44:75:04:13. Transfer agreements. Each specialized hospital, critical access hospital, and rural emergency hospital must have a transfer agreement with one or more hospitals to provide services not available on site or each physician, physician assistant, or nurse practitioner must have admitting privileges to a Medicare participating or nonparticipating hospital. A rural emergency hospital must have a transfer agreement with a level 1 or level 2 trauma center. Any agreement must provide for an interchange of medical and other necessary information.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:04:14 Quality assessment and performance improvement program

Each facility shall develop and implement a facility-wide, data-driven quality assessment and performance improvement program that reflects the complexity of the facility and focuses on indicators related to improved health outcomes and the prevention and reduction of medical errors. The facility must maintain and demonstrate evidence of its quality assessment and performance improvement program for review by the department.

The quality assessment and performance improvement program must measure, analyze, and track adverse patient events, medical errors, staffing, and other aspects of performance that assess processes of patient care and implement preventative actions and mechanisms, feedback, and learning throughout the hospital to address identified issues.

The program shall set priorities for quality assessment and performance improvement that:

(1) Focus on high-risk, high-volume, or problem areas;

(2) Consider the incidence, prevalence, and severity of problems in those areas; and

(3) Affect health outcomes, patient safety, and quality of care.

The governing body of the facility, its medical staff, and its administrative officials are responsible and accountable for ensuring adequate resources are allocated for measuring, assessing, improving, and sustaining the performance and reducing risks to patients.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(5).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:04:15 Discharge planning

A facility must have an effective discharge planning process that includes the patient and the patient’s caregiver or support person as active partners for post-discharge care. The discharge planning process and discharge plan must:

(1) Be consistent with the patient’s goals and treatment preferences;

(2) Ensure an effective transition of the patient from the hospital to discharge care; and

(3) Reduce the factors leading to preventable hospital readmissions.

A facility shall have policies and procedures to support the discharge planning process that outline the person responsible for discharge planning, members of the discharge planning team, a list of all area agencies and resources, and a description of the process.

Within twenty-four hours after admission, a hospital must determine each patient's potential need for continuing care following discharge. The facility must initiate planning with applicable agencies to meet the patient's identified needs. To avoid any delays, the patient must be offered assistance to obtain needed services prior to discharge. The patient’s discharge plan must be reevaluated and modified as needed according to the patient’s condition.

A facility must assess its discharge planning process on a regular basis. The assessment must include ongoing periodic review of a representative sample of discharge plans.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(5)(14).
Law Implemented: SDCL 34-12-13.

Chapter 44:75:05

ARSD 44:75:05:01 Admissions

Each patient admitted to a hospital may be admitted only on the order of a physician, physician assistant, or nurse practitioner. The patient's health care must continue under the supervision of a physician who is a member of the medical staff. Before or on admission of a patient, the patient's physician must provide the staff of the facility with documented information regarding current medical findings, admitting diagnoses, and written orders for the immediate care of the individual.

The patient's history and physical examination must be completed no more than seven days prior to admission or forty-eight hours after admission; or within thirty days prior to admission with documentation of an update of the patient's current medical status completed within seven days prior to admission or forty-eight hours after admission. The patient's history and physical examination must be completed prior to surgery except in emergency situations.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(6).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:05:02 Medical orders

All medical orders, including verbal orders, must be in writing or electronic format and must be dated, timed, and authenticated promptly by the practitioner. Verbal orders may be taken only when there is an urgent need to initiate or change a medical order. Each patient's practitioner is responsible for documenting written or electronic orders and progress notes on the patient's medical record.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(6).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:05:03 Emergency physician coverage

A patient's physician shall arrange for the care of the patient by an alternate physician during the physician's unavailability. A hospital shall have one or more physicians on duty or call at all times and available to the hospital on-site, by telephone, or by other reliable communications device within thirty minutes to give necessary orders or medical care to patients in case of emergency.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(6).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:05:04 Physician assistant, nurse practitioner, or clinical nurse specialist

If the services of a physician assistant, nurse practitioner, or clinical nurse specialist are utilized, the facility shall develop written policies regarding their role in the care of the patient.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(6).
Law Implemented: SDCL 34-12-13(6).

ARSD 44:75:05:05 Medical director required

A facility shall appoint a physician licensed in South Dakota to serve as a medical director. The medical director shall ensure physician services are provided only by qualified caregivers.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(5) and (6).
Law Implemented: SDCL 34-12-13(5) and (6).

ARSD 44:75:05:06 Physician services for hospice patients

A facility shall provide or arrange for physician services, including emergencies once a patient elects hospice care. Each patient shall designate an attending physician upon admission or when they elect hospice care.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(6).
Law Implemented: SDCL 34-12-13(6).

Chapter 44:75:06

ARSD 44:75:06:01 Organized nursing service

A facility shall have an organized nursing service with a written organizational plan that delineates its functional structure.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(7).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:06:02 Director of nursing service

A facility shall have a full-time registered nurse designated as the director of nursing service who is responsible for the organization of the entire nursing service and who serves during the day shift. The director may not serve in a dual role as the administrator of the facility and the director of nursing.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(7).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:06:03 Nursing policies and procedures

The facility shall establish and maintain policies and procedures that assist the nursing staff with meeting its administrative and technical responsibilities in providing care to patients including:

(1) The noting of diagnostic and therapeutic orders;

(2) Assigning the nursing care of patients;

(3) Administration and control of medications;

(4) Charting by nursing personnel;

(5) Infection control;

(6) Patient safety;

(7) Delineation of orders from nonphysician practitioners; and

(8) Discharge planning.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(7).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:06:04 Patient care plans and programs

The facility shall provide nursing services that are safe and effective from the day of admission through the ongoing development and implementation of a written care plan for each patient. The care plan must address medical, physical, mental, and emotional needs of the patient.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(7).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:06:05 Nursing service staffing

A hospital shall maintain sufficient personnel at all times to provide supervision of and nursing care for all patients. A registered nurse must be designated as charge nurse for each nursing care unit at all times. A critical access hospital is required to staff with a registered nurse only when it admits an acute care patient. A critical access hospital is required to staff with a licensed nurse when it has only swing bed patients. A facility shall develop staffing patterns for each patient care unit, including surgical and obstetrical suites, emergency services, special care units, and other services.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(7).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:06:06 Intermittent nursing care

Unlicensed personnel of a facility may not accept any delegated skilled tasks from any nonemployed, noncontracted nurse, physical therapist, occupational therapist, or speech-language pathologist.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(7).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:06:07 Hospice services

Each facility offering hospice services, as defined in § 44:79:01:01, shall provide services to a terminally ill individual or arrange for the services by a hospice program under a written plan established and periodically reviewed by the individual's attending physician, physician assistant, or nurse pracitioner. The hospice agency shall provide for care and services in the facility or on a short-term inpatient basis. Personnel providing hospice care shall include at least one physician, one registered nurse, and one social worker. Unlicensed personnel of a facility may not accept any delegated nursing tasks from any hospice providers.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(7).
Law Implemented: SDCL 34-12-13.

Chapter 44:75:07

ARSD 44:75:07:01 Dietetic services

The facility shall have an organized dietetic service that meets the daily nutritional needs of patients.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13(8).

ARSD 44:75:07:02 Food safety

Hot food must be held at or above one hundred thirty-five degrees Fahrenheit or 57.2 degrees centigrade and served promptly after being removed from the temperature holding device. Cold foods must be held at or below forty-one degrees Fahrenheit or five degrees centigrade and served promptly after being removed from the holding device. Milk and milk products must be from a source approved by the state Department of Agriculture and Natural Resources. Fluid milk must be Grade A, and only fluid milk may be used for drinking purposes. Grade A pasteurized dried milk may be used to fortify nutritional supplements only if consumed within four hours of preparation.

Cross-Reference: Food Service Code, chapter 44:02:07.

History

Source: 42 SDR 51, effective October 13, 2015; SL 2021, ch 1, §§ 8, 19, effective April 19, 2021; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:07:03 Nutritional adequacy

The dietetic service shall prepare food that is nutritionally adequate in accordance with the recommended dietary allowances and is chosen from each of the five basic food groups listed in the Dietary Guidelines for Americans, 2020-2025, U.S. Department of Agriculture, in accordance with consideration for individual needs and reasonable preferences.

Reference: Dietary Guidelines for Americans, 2020-2025, United States Department of Agriculture. Copies may be obtained free of charge at https://www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:07:04 Food substitutions

The facility shall offer reasonable substitutions of equal nutritional value to patients who refuse or are unable to eat the food served.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13(8).

ARSD 44:75:07:05 Food supply

The facility shall maintain an on-site supply of perishable and nonperishable foods adequate to meet the planned menus for three days. A facility shall maintain additional nonperishable foods as part of their emergency preparedness plan. A facility may use military meals ready to eat in an emergency event according to the facility's emergency response plan.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:07:06 Therapeutic diets

In each facility the dietetic service shall provide for the needs of those patients requiring therapeutic diets.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13(8).

ARSD 44:75:07:07 Social needs, Repealed

44:75:07:07. Social needs. Repealed.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.

ARSD 44:75:07:08 Written dietetic policies

The facility shall develop written policies and procedures that govern all dietetic activities. Policies and procedures must include food handling procedures, length of duration for leftovers, and opened packages of commercially prepared food in accordance with chapter 44:02:07. The facility shall review the policies and procedures biennially and revise as necessary.

Cross Reference: Food Service Code, chapter 44:02:07.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(5)(8).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:07:09 Written menus

Any regular and therapeutic menu, including therapeutic diet menu extensions for all diets served in the facility, shall be written, prepared, and served as prescribed by each patient's physician, physician assistant, nurse practitioner, or dietitian. Each menu must be written at least one week in advance. A dietician shall annually review and approve each planned menu for each facility. The dietician shall review any menu changes from month to month and each menu must be reviewed and approved by the dietitian at least annually. Each menu as served shall meet the nutritional needs of the patient in accordance with the orders of a physician, physician assistant, nurse practitioner, or dietician and the Dietary Guidelines for Americans 2020-2025, United States Department of Agriculture. The facility shall file and retain a record of each menu as served for thirty days.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:07:10 Preparation of food

Food shall be wholesome and prepared by methods that conserve nutritive value, flavor, and appearance and shall be attractively served at the temperature applicable to the particular food in a form to meet the individual patient's needs.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13(8).

ARSD 44:75:07:11 Director of dietetic services

A general hospital, specialized hospital, or critical access hospital shall have a full time dietary manager who is responsible to the administrator to direct the dietetic services.

Any dietary manager that has not completed a dietary manager's course, approved by the Association of Nutrition and Foodservice Professionals, shall enroll in the course within ninety days of the manager's hire date and complete the course within eighteen months. The dietary manager and at least one cook shall successfully complete and possess a current certificate from a ServSafe Food Protection Program offered by various retailers, or the Certified Food Protection Professional's Sanitation Course offered by the Association of Nutrition and Foodservice Professionals, or successfully completed equivalent training as determined by the department. Individuals seeking ServSafe recertification are only required to take the national examination.

The dietary manager shall monitor the dietetic service to ensure that the nutritional and therapeutic dietary needs for each patient are met. If the dietary manager is not a dietitian, the facility must schedule dietitian consultations onsite at least monthly. The dietitian shall approve all menus, assess the nutritional status of patients with problems identified in the assessment, and review and revise dietetic policies and procedures during scheduled visits.

The facility shall have sufficient personnel to meet the dietetic needs of the patients and provide dietetic services for a minimum of ten hours each day.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:07:12 Hospitals without in-house dietary departments

Each hospital without an in-house dietary department shall develop and maintain a written contract or agreement for dietary services for the patients. The facility shall have a person responsible to the administrator who monitors the receiving, storage, and service of the food to patients in accordance with § 44:75:07:02. The facility shall have at least one full-time person who has completed the ServSafe Food Protection Program and possesses a current certificate. Individuals seeking ServSafe recertification are only required to take the national examination.

Each hospital without an in-house dietary department shall employ or contract a qualified dietitian and schedule a minimum of monthly on-site consultations. The facility's dietitian shall review the facility's food contract agreement and make recommendations. The facility's dietitian shall review, sign, and approve menus annually. The facility's dietitian shall review menus served monthly, oversee the operation of the dietetic services, assess the nutritional status and needs of patients, and review and revise the dietetic service policies and procedures.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13(8).

ARSD 44:75:07:13 Diet manual

A current therapeutic diet manual with description of all diets served in the facility shall be readily available in the facility to food service personnel, nursing service personnel, and practitioners.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13(8).

ARSD 44:75:07:14 Frequency of meals

Each facility shall serve at least three meals at regular times with not more than a 14-hour span between a substantial evening meal and breakfast.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13(8).

ARSD 44:75:07:15 Feeding assistance

The facility shall provide feeding assistance for patients in need of help in eating.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:07:16 Nutritional screening and assessments

A licensed nurse or dietary manager must complete a nutritional screen upon each patient admission and make a referral to the dietitian of any patient:

(1) With a significant change in diet, eating ability, or nutritional status;

(2) Receiving tube feedings; or

(3) With a disease or condition that puts the patient at significant nutritional risk.

A monthly tube feeding assessment must include nutritional adequacy of calories, protein, and fluids. An annual assessment shall be completed for each swing bed patient.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13.

ARSD 44:75:07:17 Required dietary inservice training

The hospital's dietary manager or the dietitian shall provide ongoing inservice training for all dietary and food-handling personnel. The person-in-charge of any hospital that uses a food service establishment licensed in accordance with SDCL 34-18 shall provide ongoing inservice training for all dietary and food-handling personnel. Training must be completed within thirty days of hire and annually for any dietary or food-handling personnel and must cover:

(1) Food safety;

(2) Handwashing;

(3) Food handling and preparation techniques;

(4) Food-borne illnesses;

(5) Serving and distribution procedures;

(6) Leftover food handling policies;

(7) Time and temperature controls for food preparation and service;

(8) Nutrition and hydration; and

(9) Sanitation requirements.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(8).
Law Implemented: SDCL 34-12-13.

Chapter 44:75:08

ARSD 44:75:08:01 Policies and procedures

Each facility shall establish and implement written policies and procedures for medication control that include:

(1) A requirement that each patient's prescribing physician, physician assistant, or nurse practitioner provide to the facility electronic or written signed orders for:

(a) Any medications taken by the patient;

(b) Authorization for medications kept on the patient or in the room of the patient; and

(2) Provisions for proper storage of prescribed medications so that the medications are inaccessible to patients and visitors with requirements for:

(a) Separate storage of poisons, topical medications, and oral medications;

(b) Each patient's medication to be stored in the container in which it was originally received and not transferred to another container; and

(3) Self-administration of medications to be accomplished with the supervision of a licensed nurse to include:

(a) A description of the responsibilities of the patient, the patient's family members, and the facility personnel; and

(b) The provision of written educational material explaining to the patient and the patient's family the patient's rights and responsibilities associated with self-administration; and

(4) The proper disposition of medications due to:

(a) Patient discharge or death of the patient;

(b) Outdated medication; or

The facility shall also establish written policies and procedures for the manner of issuance, proper storage, control, accountability, and administration of medications or drugs in accordance with pharmaceutical and nursing practices as well as professional standards.

For the purpose of subdivision (3), the phrase, self-administration of medications, means the removal of the correct dosage from the pharmaceutical container and self-injecting, self-ingesting, or self-applying the medication with no assistance or with assistance from qualified personnel of the facility for the correct dosage or frequency.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(9).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:08:02 Written orders for medication required

All medications administered to patients must be ordered electronically or in writing and dated, timed, and authenticated by the prescriber. Verbal orders for medications or drugs may be taken only when there is an urgent need to initiate or change an order and accepted only by a pharmacist or licensed nurse in hospitals. The prescriber shall date, time, and authenticate the orders for hospital patients on the next visit to the facility. A facility shall establish a policy on stop orders for antibiotics, anticoagulants, and controlled drugs based on recommendations of the medical staff.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(9).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:08:03 Repealed

44:75:08:03. Medication therapy review. Repealed.

History

Source: 42 SDR 51, effective October 13, 2015; 42 SDR 173, effective June 21, 2016.

ARSD 44:75:08:04 Storage and labeling of medications

A facility shall store all medications in a well illuminated, locked storage area that is well-ventilated, maintained at a temperature appropriate for medication storage, and inaccessible to patients and visitors at all times. Medications suitable for storage at room temperature must be maintained between fifty-nine and eighty-six degrees Fahrenheit or fifteen and thirty degrees centigrade. Medications that require refrigeration must be maintained between thirty-six and forty-six degrees Fahrenheit or two and eight degrees centigrade. Poisons and medications prescribed for external use must be stored separately from medications prescribed for internal use, locked, and made inaccessible to patients and visitors.

Locked storage does not apply to drugs and medications needed for emergency use in intensive care, emergency room, neonatal intensive care, pediatric intensive care, or coronary care units. Medications utilized in these care units must be in a storage area that is readily available to the professional staff but inaccessible to patients or visitors.

The medication of each patient for whom medications are facility-administered must be stored in the containers in which the medication was originally received. Special modification of this requirement may be made if single dose packaging is used. Each prescription drug container, including manufacturer's complimentary samples, must be labeled with the patient's name; physician, physician assistant, or nurse practitioner’s name; medication name and strength; directions for use; and prescription date.

A container with a medication that will not be used within thirty days of issue or with contents that expire in less than thirty days of issue must bear an expiration date. If a single dose system is used, the drug name and strength, expiration date, and a control number must be on the unit dose packet.

A co-located hospital and assisted living center may procure and stock, including in bulk form, non-legend medications and administer them in accordance with written policies and procedures that provide for oversight by qualified personnel.

If a stock bottle system is used in a facility with a licensed pharmacy, the container must be labeled with the drug name and strength, expiration date, and a control number. Any container with a worn, illegible, or missing label must be destroyed pursuant to § 44:73:08:06. A licensed pharmacist is responsible for the labeling, relabeling, or altering of labels on medication containers.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(9).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:08:05 Control and accountability of medications

A medication brought from a patient's home may be used if ordered by the attending physician, physician assistant, or nurse practitioner, and, if prior to administration, it is identified as the prescribed medication. Medications prescribed for one patient may not be administered to another. Patients may not keep medications on their person or in their room without a physician's, physician assistant's, or nurse practitioner's order allowing self-administration. The patient's physician, physician assistant, or nurse practitioner must authorize the release of any medication to a patient upon discharge, transfer, or temporary leave from the facility. The release of medication must be documented in the patient's record, indicating quantity, medication name, and strength. The facility shall maintain records that account for all medications from their receipt through administration, destruction, or return.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(9).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:08:06 Documentation of medication disposal

A facility shall ensure that a legend drug not controlled under SDCL chapter 34-20B is destroyed or disposed of by a nurse and another witness. Destruction or disposal of medications controlled under SDCL chapter 34-20B must be witnessed by two persons, both of whom must be a nurse or pharmacist, as designated by facility policy. Methods of destruction or disposal may include:

(1) Disposal by using a professional waste hauler to take the medications to a permitted medical waste facility or by facility disposal at a permitted municipal solid waste landfill. Prior to disposal all medications must be removed from original containers and made unpalatable by the addition of adulterants and alteration of solid dosage forms by dissolving or combination into a solid mass;

(2) Return to the dispensing pharmacy for destruction according to federal and state regulations;

(3) Return to an authorized reverse distributor company licensed by the South Dakota Board of Pharmacy; or

(4) Release to patient upon discharge after authorization by the patient's prescribing practitioner.

The facility shall document destruction or disposal of medications in the patient's record and must include the method of disposition; the medication name and strength; prescription number; quantity; date of disposition; and the name of any person who witnessed the destruction or disposal.

A facility may return medication, excluding those controlled under SDCL chapter 34-20B, contained in unit dose packaging meeting the requirements of § 20:51:13:02.01 to the dispensing pharmacy for credit and redispensing.

Any medication held for disposal must be physically separated from the medications being used in the facility and locked in an area with limited access. The facility shall establish a system to reconcile, audit, and monitor medication held for disposal to prevent diversion.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(9).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:08:07 Medication administration

The healthcare personnel administering medication to a patient shall record the administration in the patient's medical record. Medication errors and drug reactions must be reported to the patient's physician, physician assistant, or nurse practitioner and an entry made in the patient's medical record. Orders involving abbreviations and chemical symbols may be carried out only if the facility has a standard list of abbreviations and symbols approved by the medical staff or, in the absence of an organized medical staff, by the medical director. The facility shall make the list available to its nursing personnel. All medications must be administered to patients by personnel acting under delegation of a licensed nurse, or licensed to administer medications.

A person may not administer medications prepared by another person unless the medication was prepared by a pharmacist.

Medication administration must comply with §§ 44:75:08:02 to 44:75:08:05, inclusive, and with the requirements for training in §§ 20:48:04.01:14 and 20:48:04.01:15 and for supervision in § 20:48:04.01:02. The supervising nurse shall provide an orientation to the unlicensed assistive personnel who will administer medications. The orientation must be specific to the facility and relevant to the patients receiving administered medications.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(9).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:08:08 Medication records

A facility must use medication administration records and regularly check the record against the practitioner's orders. Each medication administered must be recorded in the patient's medical record and signed by the individual administering the medication.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(9).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:08:09 Administration of facility pharmacy

A facility with a licensed full or part-time pharmacy must have its pharmaceutical service directed by a licensed pharmacist accountable to the administration of the facility.

Only prepackaged or a single dose drugs may be removed from the pharmacy when the pharmacist is not available. A drug may be removed by a designated registered nurse or physician, physician assistant, or nurse practitioner in amounts sufficient only for immediate therapeutic needs. A record of the removal must be made by the designated nurse or the physician, physician assistant, or nurse practitioner removing the drug.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(9).
Law Implemented: SDCL 34-12-13.

Chapter 44:75:09

ARSD 44:75:09:01 Medical record department

Each facility shall have an organized medical record system. Each facility shall maintain a medical record for each level of care for each patient admitted to the facility.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(10).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:09:02 Medical record department personnel

Each facility shall have medical record functions performed by personnel trained and equipped to facilitate the accurate processing, checking, indexing, filing, and retrieval of all medical records. The individual responsible for the medical records service must have knowledge and training in the field of medical records.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(10).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:09:03 Written policies and confidentiality of records

Each facility shall have written policies and procedures for the medical record service that address the confidentiality and safeguarding of medical records, the record content, continuity of a patient's medical records during subsequent admissions, requirements for completion of the record, and the entries to be made by various authorized personnel.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(10).
Law Implemented: SDCL 34-12-13(10).

ARSD 44:75:09:04 Record content

The facility must ensure each medical record shows the condition of the patient from the time of admission until discharge and must include:

(1) Identification data;

(2) Consent forms, except when unobtainable, or in an emergency;

(3) Inpatient and outpatient history;

(4) A current overall plan of care;

(5) A report of the initial and periodic physical examinations, evaluations, and all plans of care with subsequent changes;

(6) Diagnostic and therapeutic orders;

(7) Progress notes from practitioners of all disciplines;

(8) Laboratory and radiology reports;

(9) A description of treatments, diet, and services provided and medications administered;

(10) All indications of an illness or an injury, including the date and time of the illness or injury, and the date and time of action taken on each;

(11) A final diagnosis; and

(12) A discharge summary, including all discharge instructions for home care.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(10).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:09:05 Authentication

A facility shall ensure entries to the medical record are signed or electronically authenticated. If the facility permits any portion of the medical record to be generated by electronic or optical means, policies and procedures shall exist to prohibit the use of authentication by unauthorized users.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(10).
Law Implemented: SDCL 34-12-13(10).

ARSD 44:75:09:06 Retention of medical records

A facility shall retain medical records for a minimum of ten years from the actual visit date of service or patient care. The retention of the record for ten years is not affected by additional and future visit dates. Records of minors must be retained until the minor reaches the age of eighteen plus an additional two years, but no less than ten years from the actual visit date of service or patient care.

Cross-Reference: Storage of medical records, § 44:75:09:07.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(10).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:09:07 Storage of medical records

A facility shall provide for filing, safe storage, and easy accessibility of medical records. The medical records must be preserved as original records or in another readily retrievable and reproducible form. Medical records must be protected against access by unauthorized individuals. All medical records must be retained by the health care facility upon change of ownership.

Cross-Reference: Disposition of medical records on closure of facility or transfer of ownership, § 44:75:09:09.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(10).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:09:08 Destruction of medical records

After the required retention period outlined in § 44:75:09:06, the facility may, at its discretion, destroy the medical record. Before the destruction of the medical record, the facility must prepare and retain a patient index or abstract. The patient index or abstract must include the patient's:

(1) Name;

(2) Medical record number;

(3) Date of birth;

(4) Summary of visit dates;

(5) Attending or admitting physician; and

(6) Diagnosis or diagnosis code.

The facility shall destroy the medical record in a way that maintains confidentiality.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(10).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:09:09 Disposition of medical records on closure of facility or transfer of ownership

If a facility ceases operation, the facility shall provide for safe storage and prompt retrieval of medical records and the patient indexes specified in § 44:75:09:08. The facility may arrange storage of medical records with another facility of the same licensure classification, transfer medical records to another health care provider at the request of the patient or patient's legal representative, relinquish medical records to the patient or patient's legal representative, or arrange storage of remaining medical records with a third-party storage vendor. At least thirty days before closure, the facility must notify the department in writing indicating the provisions for the safe preservation of medical records and the record's location and publish or share in the nearest legal newspaper or the facility's website, the location and disposition arrangements of the medical records.

If ownership of the facility is transferred, the new owner must maintain the medical records as if there was not a change in ownership.

Cross-Reference: Storage of medical records, § 44:75:09:07.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(10).
Law Implemented: SDCL 34-12-13.

Chapter 44:75:10

ARSD 44:75:10:01 Clinical laboratory services

Each hospital shall provide emergency laboratory services which are available twenty-four hours a day, seven days a week, including holidays. Laboratory examinations necessary for diagnosis and treatment of the patient must be performed in the hospital or by arrangement. The medical staff and facility bylaws determine whether laboratory examinations are required for patients upon admission to the hospital. The original laboratory report must be made a part of the patient's medical record.

Note: CLIA applications may be obtained from the Center for Clinical Standards and Quality, 7500 Security Boulevard S2-12-17, Baltimore, MD 21244-1850. Telephone (410)-786-3531, or online at https://www.cms.gov/medicare/cms-forms/downloads/cms116/pdf.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; 29 SDR 81, effective December 11, 2002; transferred from § 44:04:10:01, 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(11).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:10:02 Clinical pathology services

Each hospital laboratory shall have the services of a pathologist available within the facility or by arrangement. The pathologist shall examine tissues removed from hospital patients as outlined in hospital policy. Pathology services shall be governed by written policies and procedures establishing guidelines for the prompt transportation of specimens and submission of reports.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; 29 SDR 81, effective December 11, 2002; transferred from § 44:04:10:02, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(11).
Law Implemented: SDCL 34-12-13(11).

ARSD 44:75:10:03 Technical laboratory operations

Each hospital laboratory shall have a policy and procedural manual for each phase of operation. There shall be a quality control program to insure the reliability of laboratory test data. Each item of diagnostic test equipment shall be routinely checked and shall be precise in terms of calibration as shown by records maintained in the laboratory.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:10:03, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(11).
Law Implemented: SDCL 34-12-13(11).

ARSD 44:75:10:04 Blood transfusion services

Each facility providing transfusion services shall provide facilities and equipment for the procurement, storage, and administration of blood products. The transfusion service shall be under the supervision of the medical staff. The medical staff or quality improvement committee shall review all transfusions and transfusion reactions and make recommendations concerning policies and procedures governing such practices.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:10:04, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(11).
Law Implemented: SDCL 34-12-13(11).

ARSD 44:75:10:05 Diagnostic x-ray services

Each hospital shall provide for emergency diagnostic x-ray services which are available 24-hours a day, 7 days a week, including holidays, except for specialized hospitals which can document to the satisfaction of the department that this service is not essential to the specialty being served. Safety and sanitation procedures as required by the department for the radiological service which will protect the patient and the radiological worker shall be established and enforced. There shall be a quality control program with records maintained in the facility.

Cross-Reference: Radiation safety, art 44:03.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:10:05, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(11).
Law Implemented: SDCL 34-12-13(11).

ARSD 44:75:10:06 Radiological service policies and manuals required

There shall be a policy and procedural manual for all phases of the radiological services. If radioactive isotopes are to be used within the facility, policies which are approved by the medical staff shall be established.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:10:06, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(11).
Law Implemented: SDCL 34-12-13(11).

ARSD 44:75:10:07 Radiological department personnel

There shall be trained personnel to provide the scope of services offered by the facility. If therapeutic radiological services are provided, the services shall be under the direct supervision of a radiologist.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:10:07, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(11).
Law Implemented: SDCL 34-12-13(11).

ARSD 44:75:10:08 Radiological reports

Complete signed reports of the interpretations of all radiological examinations made by practitioners shall be made a part of the patient's clinical record. The radiological department shall have a policy that requires any record to be retained for at least ten years and any film to be retained for at least five years.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; 26 SDR 96, effective January 23, 2000; transferred from § 44:04:10:08, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(10).
Law Implemented: SDCL 34-12-13(10).

Chapter 44:75:11

ARSD 44:75:11:01 Surgical services

Each hospital in which surgery is performed must maintain an operating suite with appropriate equipment, including X-ray viewing devices. The suite must be supervised by a registered nurse with training and experience in operating room services. A circulating nurse must be assigned to each operating or procedure room during each procedure and must be present for the duration of the surgical procedure unless it becomes necessary for the nurse to leave the operating or procedure room as part of the procedure or the nurse is relieved by another circulating nurse. A facility shall develop and implement written policies and procedures for surgical services that govern surgical personnel privileges, supportive services of other professional and perioperative personnel, and operating suite procedures. A facility shall develop, implement, and post policies and procedures pertaining to safety controls. Each facility shall maintain a roster of surgical staff members that delineates the surgical privileges of each member on file in the operating suite. For the purposes of this section, the term, circulating nurse, means a registered nurse trained, educated, or experienced in perioperative nursing who is responsible for coordinating and monitoring the nursing care and safety needs of a patient in the operating or procedure room and who also meets the needs of the operating and procedure room team members during surgery. The circulating nurse works outside the sterile field in which the procedure takes place and duties include but are not limited to recording the progress of the procedure, accounting for instruments, and handling specimens.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; 26 SDR 96, effective January 23, 2000; 29 SDR 81, effective December 11, 2002; transferred from § 44:04:11:01, 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(12).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:11:02 Surgical records

When surgery is performed, the following record requirements apply:

(1) An operating room register must be complete and up to date. It must at a minimum include; patient name, hospital identification number, date of operation, inclusive or total time of operation, name of surgeon and any assistants, name of nursing personnel, type of anesthesia and name of person administering, operation performed, pre and post-operative diagnosis, and patient age;

(2) The patient's medical record is available in the surgical suite at the time of surgery. The record must contain:

(a) The patient's medical history;

(b) A copy of the physician's examination;

(d) A signed consent for the surgical procedure to be performed; and

(e) A preoperative diagnosis; and

(3) The operating surgeon shall record an accurate and complete description of the operative procedure within forty-eight hours of the completion of surgery.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; 26 SDR 96, effective January 23, 2000; transferred from § 44:04:11:02, 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(10)(12).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:11:03 Obstetric and newborn services

Each hospital offering obstetric and newborn services shall maintain facilities, equipment, and supplies appropriate to the service. The hospital shall establish, implement, and maintain written policies and procedures and have techniques and methods that will provide safe intrapartum and postpartum care on the nursing unit for obstetric patients, immediate delivery room care, recovery period care, and continuing nursery care for the newborn infants. A medical record for each obstetrical patient and newborn infant, and a delivery room register shall be maintained.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:11:03, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(12).
Law Implemented: SDCL 34-12-13(12).

ARSD 44:75:11:04 Emergency services

Each hospital offering emergency services must have a written plan and procedural manual for the provision of twenty-four hour a day emergency care that provides for assessment and either treatment or referral to an appropriate facility. A referring hospital shall initiate essential life-saving measures and provide emergency procedures that will minimize aggravation of a patient's condition during transportation. A facility shall reserve an area of the facility with healthcare personnel, equipment, medications, supplies, and ancillary services commensurate with the scope of anticipated needs for ill or injured persons exclusively for the patients requiring emergency care. A facility shall maintain a medical record for each patient receiving emergency service.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:11:04, 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(12).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:11:05 Anesthesia services

Each hospital shall provide anesthesia services organized, directed, and integrated with other related services of the hospital commensurate with the scope and needs of patients. The delivery of anesthesia care to patients shall be provided by qualified persons according to written policies relating to anesthesia procedures approved by the medical staff. Safety and sanitation controls shall be established. All anesthetizing locations which are not protected against potential explosive hazards shall have a legible sign posted prohibiting the use of flammable gas as anesthetics.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:11:05, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(12).
Law Implemented: SDCL 34-12-13(12).

ARSD 44:75:11:06 Rehabilitation services

A hospital offering physical therapy, occupational therapy, or speech pathology shall maintain facilities, equipment, and supplies appropriate for services provided. There shall be written policies and procedures for the organization and function of the services. If physical therapy is offered, services shall be provided under the supervision of a licensed physical therapist. If occupational therapy is offered, services shall be provided under the supervision of a registered occupational therapist. If speech pathology is offered, services shall be provided under the supervision of a speech pathologist with a certificate of clinical competence from the American Speech and Hearing Association. Physical therapy, occupational therapy, or speech pathology services shall be given in accordance with a practitioner's orders and documented in the patient's medical record.

Cross-References: Physical therapists, SDCL 36-10; Occupational therapists, SDCL 36-31.

History

Source: 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:11:06, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(12).
Law Implemented: SDCL 34-12-13(12).

ARSD 44:75:11:07 Outpatient rehabilitation services

A hospital offering outpatient rehabilitation services shall maintain written policies and procedures relating to staff, functions of services, and outpatient medical records. The outpatient rehabilitation department shall have space and equipment to meet the needs of the patient, staff, and visitors; and shall maintain cooperative arrangements and communications with treatment-related community agencies. A physician shall be responsible for the professional services. A physician or administrator shall be responsible for administrative services.

History

Source: 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; 26 SDR 96, effective January 23, 2000; transferred from § 44:04:11:07, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(12).
Law Implemented: SDCL 34-12-13(12).

ARSD 44:75:11:08 Social services

A hospital offering social services shall maintain written policies and procedures relating to staffing requirements and functions of services and shall provide social services facilities as required by § 44:75:02:21. If social services are offered, services shall be provided under the supervision of a social worker or the facility shall have a written agreement with a social worker for regularly scheduled consultation and assistance. The social services staff shall participate in discharge planning to assist patients to access inpatient, outpatient, extended care, hospice, and home health services in the community. Social services summaries shall be entered in the patient's medical record.

Cross-Reference: Social workers, SDCL 36-26, art 20:59.

History

Source: 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; 26 SDR 96, effective January 23, 2000; transferred from § 44:04:11:08, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(12).
Law Implemented: SDCL 34-12-13(12).

ARSD 44:75:11:09 Repealed

44:75:11:09. Swing-bed services. Repealed.

History

Source: 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; 30 SDR 84, effective December 4, 2003; transferred from § 44:04:11:10, 42 SDR 51, effective October 13, 2015.

ARSD 44:75:11:10 Eligibility to offer swing-bed services

A hospital with less than 100 staffed beds may offer swing-bed services after obtaining approval from the department pursuant to § 44:75:11:11. A hospital with less than 50 staffed beds may not designate more than one-half of its staffed beds as swing beds, but a hospital with less than 50 licensed beds may designate up to one-half of its licensed beds as swing beds. A critical access hospital may have no more than 15 swing beds. A hospital with 50 to 99 staffed beds, inclusive, may not designate more than 10 beds as swing beds. A hospital which subsequently exceeds 99 staffed beds may not offer swing-bed services. For purposes of this section and § 44:75:11:11, staffed beds are inpatient beds utilized and staffed for by the hospital, exclusive of beds for newborn, obstetrical delivery, intensive care, coronary care, and any psychiatric or rehabilitation unit excluded from the Medicare prospective payment system, except during a catastrophe, such as a disaster or epidemic, to which the hospital responds.

History

Source: 14 SDR 81, effective December 10, 1987; 15 SDR 155, effective April 20, 1989; 22 SDR 70, effective November 19, 1995; 26 SDR 96, effective January 23, 2000; 27 SDR 59, effective December 17, 2000; 29 SDR 81, effective December 11, 2002; 30 SDR 84, effective December 4, 2003; transferred from § 44:04:11:11, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(12).
Law Implemented: SDCL 34-12-13(12).

ARSD 44:75:11:11 Application for approval to offer swing-bed services

A hospital may not offer swing-bed services without first applying in writing to the department for approval. The application shall contain the following:

(1) The effective date the swing-bed services will begin;

(2) Designation of the bed category for which the hospital is requesting approval to offer swing-bed services, either a critical access hospital, not more than 49 staffed beds, or greater than 49 staffed beds and fewer than 100 staffed beds;

(3) The number of staffed beds which will be designated as swing beds;

(4) Evidence of the hospital's ability to comply with the provisions of § 44:75:11:13; and

(5) Written assurance that the hospital will operate within the bed category it has designated and will not operate more than the number of swing beds designated on the face of the license.

The department shall denote the number of designated swing beds on the face of the license. A hospital may not change the number of designated swing beds or the designated bed category without first applying to the department for approval in accordance with this section.

General Authorit y: SDCL 34-12-5, 34-12 -13(12).

History

Source: 15 SDR 155, effective April 20, 1989; 22 SDR 70, effective November 19, 1995; 26 SDR 96, effective January 23, 2000; transferred from § 44:04:11:11.01, 42 SDR 51, effective October 13, 2015.
Law Implemented: SDCL 34-12-5, 34-12-13(12).

ARSD 44:75:11:12 Suspension of approval to offer swing-bed services

Pursuant to the contested case provisions of SDCL 1-26, the department may prohibit a hospital from admitting new swing bed patients for not more than 3 months if the department has determined by inspections that the hospital has substantially failed to comply with the provisions of § 44:75:11:13 on at least 2 occasions in any 12 consecutive months. A hospital which has been prohibited from admitting new swing-bed patients shall reapply to the department for approval to offer swing-bed services to new admissions in accordance with § 44:75:11:11.

History

Source: 15 SDR 155, effective April 20, 1989; 22 SDR 70, effective November 19, 1995; 30 SDR 84, effective December 4, 2003; transferred from § 44:04:11:11.02, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(12), 34-12-19.
Law Implemented: SDCL 34-12-13(12), 34-12-21.

ARSD 44:75:11:13 Patient care requirements for swing-bed services

Hospital and critical access hospital swing-bed services shall provide nursing and related care services to meet patients' care needs at all times. Patient care services shall include at least the following:

(1) Patient rights as stated in chapter 44:75:15;

(2) Specialized rehabilitative services needed by patients to improve and maintain functioning. Specialized rehabilitative services may include physical therapy, speech pathology and audiology, and occupational therapy; and the services shall be provided by the hospital or arranged for by written agreement with qualified personnel;

(3) Dental services for routine and emergency dental care;

(4) Social services as stated in § 44:73:10:04;

(5) Patient activities as stated in § 44:73:10:02;

(6) Discharge planning services to ensure that patients have a planned program of continuing care which meets post-discharge needs. The hospital shall have written policies for the discharge planning process and shall comply with § 44:73:04:18; and

(7) Comprehensive assessment to assist with the development of a comprehensive care plan.

History

Source: 14 SDR 81, effective December 10, 1987; 19 SDR 95, effective January 7, 1993; 22 SDR 70, effective November 19, 1995; 29 SDR 81, effective December 11, 2002; 32 SDR 128, effective January 30, 2006; transferred from § 44:04:11:12, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(12).
Law Implemented: SDCL 34-12-13(12).

Chapter 44:75:12

ARSD 44:75:12:01 Supportive services

Each hospital accepting long-term care patients, and hospital and critical access hospital with swing beds shall provide supportive services that comply with §§ 44:75:12:02 to 44:75:12:04, inclusive.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(13).
Law Implemented: SDCL 34-12-13(13).

ARSD 44:75:12:02 Activities program

Each hospital shall develop an individualized activities program that holistically meets the needs and interests of patients and maintains optimal levels of physical and psychosocial functining of patients.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(13).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:12:03 Spiritual needs

The facility shall provide for the spiritual needs of the patients. Patient requests to see a clergyman shall be honored. No specific religious beliefs or practices may be imposed on any patient contrary to the patient's choice.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(13).
Law Implemented: SDCL 34-12-13(13).

ARSD 44:75:12:04 Provision of social services

A facility shall provide or make arrangements to provide social services for each patient as needed. A staff social worker or social services designee is responsible to facilitate the provision of social services. The staff social worker or social services designee must have a degree in a behavioral science field, two years of previous supervised experience in a behavioral science field, or be a licensed nurse. If the staff member is not a licensed social worker, the facility shall have a written agreement with a licensed social worker for consultation and assistance to be provided on a regularly scheduled basis but at least quarterly.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(13).
Law Implemented: SDCL 34-12-13.

Chapter 44:75:13

ARSD 44:75:13:01 Application of chapter

The provisions of this chapter apply to any new facility and to any renovation, addition, or change in space use of any currently licensed, existing facility.

Each facility shall comply with NFPA 101 Life Safety Code, 2012 edition. Each facility providing off-site services must comply with Business Occupancy standards and other occupancies standards as applicable for the use of the facility from NFPA 101 Life Safety Code, 2012 edition, chapter 38.

Reference: NFPA 101 Life Safety Code, 2012 edition, National Fire Protection Association. Copies may be obtained at https://nfpa.org/Codes-and-Standards/All-Codes-and-Standards/List-of-Codes-and-Standards. Cost: $150.50.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-1-17(4)(5), 34-12-13(3).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:13:02 Medical records unit

The medical records unit shall include active and closed record storage and a work area.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).

ARSD 44:75:13:03 Storage rooms

There shall be at least 20 square feet (1.858 square meters) of central storage provided for each bed. General storage shall be concentrated in one area in the facility, but up to 50 percent of the general storage space may be provided on the premises. Each patient shall be provided with an individual closet, locker, or wardrobe that is located within or directly connected to the patient room.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).

ARSD 44:75:13:04 Swing bed patient dining and recreation area

The total areas set aside for patient dining, recreation, and other central use areas may not be less than 45 square feet (4.18 square meters) for each bed. The patient dining space shall be at least 25 square feet (2.32 square meters) for each bed. Storage shall be provided for recreational equipment and supplies.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).

ARSD 44:75:13:05 Outside area

Each secure unit shall have for the patient access to an outdoor area that is enclosed by a fence. The fence shall extend to a minimum of six feet above grade level and be designed to be safe for patient contact. Hard surface walking paths shall be provided in the outside area. Space shall be provided for lounging. If the access to the outside area is through a required building exit a gate shall be provided to exit the outside area to allow emergency egress and allow access for maintenance.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3) and (14).
Law Implemented: SDCL 34-12-13(3) and (14).

ARSD 44:75:13:06 Patient rooms

A facility shall ensure a patient room has:

(1) A maximum room capacity not exceeding two patients;

(2) A minimum area, exclusive of toilet rooms, closets, lockers, wardrobes, or vestibules, of one hundred twenty square feet or 10.8 square meters in each one-bed room and two hundred square feet or 18.58 square meters in each two-bed room. The minimum dimension of a patient room is nine feet six inches or 2.90 meters;

(3) For each bed in a two-bed room, cubicle curtains or equivalent built-in devices for full visual privacy that allow access to the toilet room and corridor without entering the roommate's space;

(4) A windowsill not higher than three feet or 0.91 meters above the floor;

(5) A floor that is above grade;

(6) A call button at each bed for calling personnel stations;

(7) A toilet room and lavatory. Each patient toilet room must be directly accessible for each patient without going through the general corridor. In a remodeling project, a one toilet room with hand sink in a patient room may serve two patient rooms, but not more than four beds. For new construction, a toilet room may not be shared between patient rooms. Each patient toilet room must have a water closet, hand sink, mirror, and private individual storage. In two-bed rooms a separate hand sink must be provided in the patient room. All new construction of toilet rooms used by patients must be wheelchair accessible;

(8) A locker, wardrobe, or closet for each patient; and

(9) Each patient room door located not more than one hundred fifty feet or 45.72 meters from the nurse's station.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:13:07 Service area in care units

The facility shall ensure each care unit contains a service area which includes:

(1) A nurses' station with convenient access to handwashing facilities;

(2) Nurses' charting;

(3) Doctors' charting;

(4) Communications;

(5) Storage for supplies and personnel's personal effects;

(6) A personnel toilet room;

(7) A nurses' office;

(8) A clean workroom for the storage and assembly of supplies for nursing procedures, containing a work counter and sink;

(9) A soiled workroom with a work counter, a handwashing facility, a waste receptacle, soiled linen receptacles, a clinical sink with an exposed water trap seal, siphon jet or blowout action, and a bedpan flushing device;

(10) A medicine room adjacent to the staff station containing sink, refrigerator, locked storage, and facilities for preparation and administration of medication;

(11) A clean linen storage area in an enclosed storage space;

(12) A nourishment station containing refrigerated storage, self-dispensing ice machine, and a sink for serving between-meal nourishments;

(13) An equipment storage room on each patient wing or floor for storage of patient care equipment;

(14) Patient bathing facilities containing one shower, bathtub, or whirlpool for each of the fifteen beds not individually served. Whirlpool units with lifts may serve thirty beds;

(15) A janitor's closet for storage of housekeeping supplies and equipment, containing a floor receptor or service sink. The janitor's closet space and equipment may be incorporated into the soiled workroom;

(16) Isolation facilities for the use of those prone to infections as well as those suffering from infections. One isolation room must be provided for every thirty acute-care beds. The entry into the isolation room must be through an anteroom equipped with handwashing, gowning space and supplies, and space to handle clean and soiled supplies for the room or rooms served. Toilet, bathing, and handwashing facilities must be available for the isolation room patient without entry into the anteroom or general corridor. A nursing unit is not required to maintain an isolation facility if the facility is provided elsewhere in the institution;

(17) Playroom facilities for pediatric patients; and

(18) Multipurpose rooms for personnel, patients, and patients' families for conferences, reports, education, training sessions, and consultation.

If outpatient therapy services are offered, the therapy unit must provide access to outpatient services without traversing inpatient areas; locked records storage; hand sinks located convenient to treatment areas; cubicle curtains for privacy at treatment areas; and be sized and equipped to accommodate the therapy modalities offered.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:13:08 Social services office

In hospitals, a social services office which is in accordance with § 44:75:02:18 shall be provided.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).

ARSD 44:75:13:09 Dietary department

The facility shall construct, equip, and install the dietary department in compliance with §§ 44:02:07:01, 44:02:07:02, and 44:02:07:04 to 44:02:07:95, inclusive. The installation of food service equipment must comply with § 44:75:14:10 unless the facility uses a commercial service. If a commercial service is used, dietary areas and equipment shall meet the requirements for sanitary storage, processing, and handling.

Cross Reference: Food Service Code, chapter 44:02:07.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:13:10 Food preparation services and equipment

The facility shall ensure the dietary area is completely cleanable by conventional methods. The location and design of the dietary area must enable convenient handling of incoming supplies, preparation of meals, including tray service, and disposal of rubbish and garbage. Equipment and space provided must include:

(1) In dietary areas serving seventeen beds or more, a dishwashing area including a commercial dishwasher supplied with one hundred eighty-degree Fahrenheit or eighty-two degrees centigrade rinse water or a chemical sanitizing cycle, a soiled dish table with at least seven feet or 2.13 meters of work space, a garbage disposal, a garbage can, a clean dish table with room for at least three dish racks, and handwashing facilities;

(2) A dry food storage area with at least one and one-half linear feet or 0.46 meters of shelving twenty inches or 0.51 meters wide for each patient bed and a functional aisle;

(3) Refrigerated storage space providing at least one and one-half cubic feet or 0.042 cubic meters of refrigerated space and one-half cubic feet or 0.014 cubic meters of freezer space per patient bed with sufficient refrigerated storage space located within the food production area for convenient food preparation;

(4) Aisles within the dietary area not less than three feet or 0.91 meters wide. Aisles adjoining equipment locations with doors or aisles utilized for cart traffic must be at least four feet or 1.22 meters wide;

(5) Pot and pan washing facilities, including a three-compartment sink with eighteen inch drainboards on both sides and drying and storage facilities for pots and pans;

(6) A vegetable preparation area with a two-compartment sink with drainboards on both sides;

(7) Cart storage areas;

(8) Waste disposal facilities;

(9) Employee dining facilities;

(10) Dietary manager's office or desk;

(11) Janitor's closet with storage for housekeeping supplies and equipment and floor receptor or service sink;

(12) Food production equipment sized and designed to prepare a complete meal for the total bed complement and for personnel, guests, day-care patients, or other catering services;

(13) Food holding and transportation equipment capable of protecting food from contamination and of maintaining cold food at forty-one degrees Fahrenheit or five degrees centigrade or below and hot food at one hundred thirty-five degrees Fahrenheit or 57.2 degrees centigrade or above during the total serving period;

(14) Ventilation equipment sized and designed to effectively remove steam, heat, cooking vapors, and grease from food production areas, dishwashing areas, and serving areas;

(15) Handwashing facilities that are convenient to each work area, consisting of hot and cold running water, towel dispenser with single-service towels or hand drying device and wall mounted hand cleanser;

(16) Dietary areas serving seventeen beds or more, a personnel toilet facility convenient to the dietary department; and

(17) An ice maker with bin or self-dispensing ice maker. Any ice maker accessible to patients or visitors must be self-dispensing.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1)(2)(14).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:13:11 Laundry

The laundry shall include the following:

(1) Soiled linen holding room with a storage capacity of one and three quarters square feet (0.1626 square meters) of floor area for each bed, to be used for storage, sorting, and weighing of soiled linen;

(2) Linen cart storage;

(3) Janitor's closet with storage for housekeeping supplies and equipment and a floor receptor or service sink convenient to the laundry;

(4) Storage for laundry supplies;

(5) Lavatories conveniently accessible to soiled, clean, and processing rooms; and

(6) Laundry processing room with separate soiled and clean work areas with commercial equipment. Each clothes dryer shall have a galvanized metal vent pipe for exhaust: and

(7) A clinical sink with an exposed water trap seal, siphon jet or blow action, and a sprayer device.

The space and equipment layout shall be sized and designed to produce quality linen with a work flow that minimizes potential for cross-contamination of clean linen by soiled linen, contaminated equipment, contaminated air, or splash. The laundry department shall be capable of processing ten pounds (4.54 kilograms) of soiled linen for each bed during a normal work day. Any modification to the standard may be made if the services are contracted to an outside organization. A modification shall be requested in writing by the facility and approved by the department.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (4).
Law Implemented: SDCL 34-12-13(1) and (4).

ARSD 44:75:13:12 Personnel facilities

The facility shall provide a locker room for personnel containing lockers and a separate toilet room with handwashing facility.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:13:13 Engineering service and equipment areas

The requirements for engineering service and equipment areas for each facility are as follows:

(1) A boiler room with two remote doors to the exit or exit access;

(2) An engineer's office which may be combined with a maintenance shop;

(3) Mechanical and electrical equipment rooms;

(4) A maintenance shop with at least one room;

(5) A storage room for building maintenance supplies;

(6) A refuse room for trash storage which is conveniently located near the service entrance or exterior trash receptacles; and

(7) A yard equipment storage room or exterior building.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).

ARSD 44:75:13:14 Corridor restrictions

Drinking fountains, telephone booths, fire extinguisher cabinets, and vending machines shall be located so that they do not project into the required width of exit corridors. Handrails installed in corridors shall return to the wall at the ends. Handrails if installed shall be installed with the top 34 to 38 inches, inclusive, from the floor. Handrails shall be installed with one and one half inch spacing between the wall and the handrail.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).

ARSD 44:75:13:15 Doors

Any door to a patient room toilet or bathroom shall be equipped with hardware that permits access in any emergency. A pocket or sliding door may not be installed except on a clothes closet or restroom in a patient room. Any hardware on a restroom pocket or sliding door shall provide for ease of operation for a patient with limited mobility. Any door opening onto a corridor, except an elevator door, shall be hinged on the side. An alcove or similar space which generally does not require doors are excluded from this requirement. No door may swing into the corridor except a closet door. Thresholds and expansion joint covers, if used, shall be flush with the floor. Any cross-corridor door shall be provided with vision panels.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).

ARSD 44:75:13:16 X ray protection

Protection of X ray and gamma ray installations must conform to requirements in Medical X ray, Electron Beam, and Gamma ray Protection for Energies up to 50 MeV--Equipment Design and Use, NCRP Report No. 102, 1989, and in Structural Shielding Design for Medical X-Ray Imaging Facilities, NCRP Report No. 147, 2004.

Cross References: Medical X ray, Electron Beam, and Gamma ray Protection for Energies up to 50 MeV--Equipment Design and Use, NCRP Report No. 102, National Council on Radiation Protection and Measurements, June 30, 1989. Copies may be obtained at https://ncrponline.org/shop/reports/report-no-102-medical-x-ray-electron-beam-and-gamma-ray-protection-for-energies-up-to-50-mev-equipment-design-performance-and-use-supersedes-ncrp-report-no-33-1989/. Cost: $50.

Structural Shielding Design and Evaluation for Medical X-Ray Imaging Facilities, NCRP Report No. 147, 2004. Copies may be obtained at https://www.aapm.org/pubs/ncrp/detail.asp?docid=31. Cost: $110.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1)(14).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:13:17 Ceiling heights

The ceilings of corridors, storage rooms, patient toilet rooms, and other minor rooms may not be less than seven feet, eight inches (2.34 meters). The ceilings of all other rooms may not be less than seven feet, ten inches (2.39 meters).

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).

ARSD 44:75:13:18 Insulation

The facility shall ensure boiler rooms, food preparation centers, and laundries are insulated and ventilated to prevent any floor surface above them from exceeding a temperature of eighty-five degrees Fahrenheit or 29.4 degrees centigrade. All combustible insulation within the building must be covered with a fire-resistive material giving fire protection equivalent to one-half inch or 0.01 meters gypsum board, unless the materials meet International Building Code, 2012 edition, section 2603.4 for use without a thermal barrier as installed.

Reference: International Building Code, 2012 edition. Copies may be obtained at https://shop.iccsafe.org/. Cost: $81.75.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:13:19 Floor surface finish

Floors shall be easily cleanable and shall have the wear resistance appropriate for the location involved. Floors in kitchens and related spaces shall be water-resistant. In all areas where floors are subject to wetting, they shall have a nonslip finish. A walking surface that is not flush with an adjacent surface shall be provided with a transition. A change in level up to one eight inch may be vertical and without edge treatment. Changes in level between one eight inch and one half inch are to be beveled with a slope no greater than 1:2. A change in level may not exceed one half inch. Gaps in the walking surface may not exceed ½ inch wide in the direction of travel.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).

ARSD 44:75:13:20 Wall and ceiling finish

Walls shall be washable, and in the immediate area of plumbing fixtures the finish shall be protected from water damage. Wall bases in dietary areas shall be free of spaces that can harbor insects. Wall bases in any areas used for surgical and obstetrical procedures shall be integral with either the wall or the floor surface material and shall be without voids that can harbor harmful bacteria. All surgical, obstetrical, emergency, nursery, X-ray film processing rooms, and dietary ceilings shall be washable or easily cleanable. This requirement does not apply to any boiler room, mechanical and building equipment room, shop, or similar space. A ceiling in any surgical, central sterilization, isolation, and x-ray film processing room shall be a gypsum board surface.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).

ARSD 44:75:13:21 Elevators

All facilities where either patients' beds or a critical service, such as operating, delivery, diagnostic, recreation, patient dining, dietary, laundry, central storage, or therapy rooms, is located, other than the first floor, shall have an electrical or electrohydraulic elevator. Each elevator car and platform shall be constructed of noncombustible material, except that material treated with fire retardant may be used if each exterior surface of the car is covered with metal. A hospital-type elevator shall have inside dimensions that will accommodate a patient's bed and attendants and shall be at least five feet (1.52 meters) wide by seven feet six inches (2.29 meters) deep. The car door shall have a clear opening of not less than three feet eight inches (1.12 meters). Each elevator shall have automatic two-way leveling with accuracy within plus or minus one half inch (0.01 meters). Elevators, except freight elevators, shall be equipped with a two-way special service switch to permit each car to bypass all landing button calls and to be dispatched directly to any floor.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3) and (4).
Law Implemented: SDCL 34-12-13(3) and (4).

ARSD 44:75:13:22 Steam and hot water systems

A facility shall have the capacity to supply steam and hot water to meet the normal requirements of all the facility's systems and equipment. Supply and return mains and risers of space heating and process steam systems must be valved to isolate the various sections of each system. Each piece of equipment must be valved at the supply and return end. Boilers, smoke breeching, steam supply piping, high pressure steam return piping, and hot water space heating supply and return piping must be insulated with insulation having a flame spread index of twenty-five or less and a smoke emission rating of fifty or less using ASTM E84-23D, 2010 edition, Standard Test Method for Surface Burning Characteristics of Building Materials or equivalent test procedures.

Reference: ASTM E84-23D, 2010 edition, Standard Test Method for Surface Burning Characteristics of Building Materials. Copies may be obtained at https://www.astm.org/e0084-23d.html. Cost: $119.00.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023; 51 SDR 53, effective November 11, 2024.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13.

ARSD 44:75:13:23 Ventilating systems

A facility shall ensure its ventilating systems maintain temperatures, minimum air changes of outdoor air per hour, minimum total air changes, and relative humidities as follows:

(1) For operating rooms, sixty-eight to seventy-three degrees Fahrenheit or twenty to 22.8 degrees centigrade, three outdoor, twenty total, and twenty to sixty percent humidity;

(2) For delivery rooms, sixty-eight to seventy-three degrees Fahrenheit or twenty to 22.8 degrees centigrade, three outdoor, fifteen total, and twenty to sixty percent humidity;

(3) For recovery rooms, at least seventy degrees Fahrenheit or 21.1 degrees centigrade, two outdoor, six total, and twenty to sixty percent humidity;

(4) For nursery rooms, at least seventy-five degrees Fahrenheit or 23.9 degrees centigrade, two outdoor, six total, and twenty to sixty percent humidity; and

(5) For intensive care rooms, seventy to seventy-five degrees Fahrenheit or 21.1 to 23.9 degrees centigrade, two outdoor, six total, and twenty to sixty percent humidity.

For all other occupied areas, the facility shall maintain a minimum temperature of seventy-five degrees Fahrenheit or 23.9 degrees centigrade and at least fifteen percent humidity at winter design conditions with a minimum of at least two total air changes an hour. All air supply and air exhaust systems must be mechanically operated. All fans serving exhaust systems must be located at the discharge end of the system. Outdoor ventilation air intakes, other than for individual room units, must be located as far away as practicable but not less than twenty-five feet or 7.62 meters from plumbing vent stacks and the exhausts from any ventilating system or combustion equipment. The bottom of outdoor intakes serving central air systems must be located as high as possible but not less than six feet or 1.83 meters above the ground level or, if installed through the roof, three feet or 0.91 meters above roof level. The mechanical ventilation systems must be designed and balanced to provide make-up air and safe pressure relationships between adjacent areas to preclude the spread of infections and assure the health of the occupants. Room supply air inlets, recirculation, and exhaust air outlets must be located with the grill or diffuser opening not less than three inches or 0.08 meters above the floor. Corridors may not be used to supply air to or exhaust air from any room, except that exhaust air from corridors may be used to ventilate bathrooms, toilet rooms, or janitor's closets opening directly on corridors. Continuous mechanical exhaust ventilation must be provided in all soiled areas, wet areas, and storage rooms. In unoccupied service areas, ventilation may be reduced or discontinued when the health and comfort of the occupants are not compromised.

Laboratories must be ventilated at a rate of six total air changes an hour. All ventilation air from the laboratory must be directly exhausted to the outside. If this ventilation rate does not provide the air required to ventilate fume hoods and safety cabinets, additional air must be provided. A filter with ninety percent efficiency must be installed in the air supply system at its entrance to the media transfer room. Hoods in which highly radioactive materials are processed must have a face velocity of one hundred fifty feet per minute or 0.76 meters per second, have a high-efficiency 99.97% filter, and each hood must have an independent exhaust system with the fan installed at the discharge point of the system. Hoods used for processing infectious materials must have a face velocity of seventy-five feet per minute or 0.38 meters per second.

Cooking appliances, other than microwave ovens, must be provided with exhaust ventilation to the exterior of the building that is able to remove cooking odors, heat, and moisture.

Each vehicle parking garage must be provided with carbon monoxide detection to activate exhaust ventilation of six air changes each hour or to open the garage door if the area of the garage is under one thousand square feet. A sign must be posted at the front of each parking space advising the driver to shut off the engine.

Crawl spaces must be provided with mechanical ventilation at least one-half air changes each day or be provided with open perimeter venting as required by the International Building Code, 2012 edition, section 1203.

Cross Reference: International Building Code, 2012 edition. Copies may be obtained from the International Code Council at https://shop.iccsafe.org/. Cost: $81.75.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1)(3)(4).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:13:24 Filtration

A facility shall have a ventilation system using a recirculated central air system equipped with a minimum of two filter beds. Filter bed number one must be located upstream of the conditioning equipment and must have a minimum efficiency of thirty percent. Each supply air unit must have filters that are at least thirty percent effective. Each central ventilation system must have filters that are at least eighty percent effective. Each common use area must have filters that are eighty percent effective on an air supply system. Each air supply system serving solely an administrative area must have filters that are at least thirty percent effective. These filter efficiencies must be warranted by the manufacturer and must be based on the 2017 edition of the American Society of Heating, Refrigeration, and Air Conditioning Engineers (ASHRAE) Standard 52.2 dust spot test method with atmospheric dust. Each filter frame must be durable and carefully dimensioned and shall provide an airtight fit with the enclosing duct work. Each joint between filter segments and the enclosing duct work must be gasketed or sealed to provide a positive seal against air leakage. A manometer must be installed across each filter bed serving a central air system.

Reference: ASHRAE 52.2, 2017 edition, American Society of Heating, Refrigeration, and Air Conditioning Engineers. Copies may be obtained at no cost at https://www.ashrae.org/File%20Library/Technical%20Resources/COVID-19/52_2_2017_COVID-19_20200401.pdf.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1)(3)(4).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:13:25 Ducts

A facility shall ensure its ducts are constructed of iron, steel, aluminum, or other approved metal or materials as defined in NFPA 101 Life Safety Code 2012 edition, section 32.3.6.2.1. Duct linings, coverings, vapor barriers, and the adhesives used for applying them must have a flame spread index of not more than twenty-five and a smoke emission rating of not more than fifty using ASTM E84-23D, 2010 edition, Standard Test Method for Surface Burning Characteristics of Building Materials. A fire and smoke damper must be provided on each opening through each required two-hour or greater fire-resistive wall or floor and on each opening through the walls of a vertical shaft, unless the shaft has a fire and smoke damper at the floor level. Access for maintenance must be provided at all dampers. Duct systems serving hoods must be constructed of corrosion resistant material. Duct systems serving hoods in which highly radioactive materials and strong oxidizing agents are used must be constructed of stainless steel for a minimum distance of ten feet, or 3.05 meters, from the hood and must be equipped with washdown facilities. Each cold air duct must be insulated wherever necessary to maintain the efficiency of the system or to minimize condensation problems.

References: ASTM E84-23D, 2010 edition, Standard Test Method for Surface Burning Characteristics of Building Materials. Copies may be obtained at https://www.astm.org/e0084-23d.html. Cost: $119.00.

NFPA 101 Life Safety Code, 2012 edition, National Fire Protection Association. Copies may be obtained at https://www.nfpa.org/product/nfpa-101-code/p0101code?Edition=2012&Language=English&Format=Softbound&type=digital. Cost: $150.50.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023; 51 SDR 53, effective November 11, 2024.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13.

ARSD 44:75:13:26 Food service ventilation

The air from dining areas may be used to ventilate the food preparation areas only after it has been passed through a filter with 80 percent efficiency. Each exhaust hood in food preparation centers shall have a minimum exhaust rate of 50 cubic feet a minute for each square foot (0.25 cubic meters a second for each square meter) of hood face area. Each hood over cooking ranges shall be equipped with fire extinguishing systems interconnected to shut off the fuel source. A cleanout openings shall be provided every 20 feet (6.10 meters) in horizontal exhaust duct systems serving hoods.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (4).
Law Implemented: SDCL 34-12-13(1), (3), and (4).

ARSD 44:75:13:27 Plumbing fixtures

The material used for plumbing fixtures shall be of nonabsorptive acid-resistant material. Each lavatory and sink required in patient care areas shall have the water supply spout mounted so that the discharge is a minimum of five inches (0.13 meters) above the rim of the fixture. Handwashing facilities used by medical and care staff, patients, and food handlers shall be equipped with hands-free controls. Single lever devices may be used. Handles on scrub sinks and clinical sinks may not be less than six inches (0.15 meters) long. Each clinical sink shall have an integral trap in which the upper portion of a visible trap seal provides a water surface. If blade handles are used, proper clearance shall be maintained for operation. An aerator is not approved for use on faucet spouts. A paper towel dispenser or hand-drying device shall be provided at each lavatory and sink used for handwashing. A mirror or paper towel dispenser with reflective surface may not be provided at each handwashing facility in the laboratory, nursery, clean utility, central sterilizing, dietary, or other critical area where grooming could potentially cause contamination.

Each water closet shall be an elongated bowl type and be equipped with an open front seat.

Any shower shall that is not required to be wheelchair transfer or standard roll-in type stall shall have curb heights not more than six inches above the finished floor. The shower floor elevation and bathroom finished floor elevation shall be level where possible but the difference in elevation cannot exceed three inches.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).

ARSD 44:75:13:28 Water supply systems

A facility shall ensure its water supply system supplies water to the fixtures and equipment on the facility's upper floors at a minimum pressure of fifteen pounds per square inch or 1055.9 kilograms per square meter during maximum demand periods. Each water service main, branch main, riser, and branch to a group of fixtures must be valved. Stop valves must be provided at each fixture. Hot, cold, and chilled water piping and waste piping on which condensation may occur must be insulated. Insulation of cold and chilled water lines must include an exterior vapor barrier.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1)(4)(14).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:13:29 Vacuum breakers

An antisiphon device or backflow preventer shall be installed on hose bibs and on any fixtures to which hoses or tubing can be attached such as laboratory, janitor sink, bedpan flushing attachment, handheld shower, and autopsy table. An antisiphon device or backflow preventer shall be installed on all plumbing and equipment where any possibility exists for contamination of the potable water supply.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (4), and (14).
Law Implemented: SDCL 34-12-13(1), (4), and (14).

ARSD 44:75:13:30 Hot water systems

Hot water distribution systems over 50 feet (15.24 meters) long shall recirculate to provide hot water at each fixture at all times. The hot water heating equipment shall have sufficient capacity to supply water at a minimum temperature of 140 degrees Fahrenheit (60 degrees centigrade) and amounts indicated in the following:

(1) Three gallons an hour (0.0033 liters a second) for each bed;

(2) Two gallons an hour (0.0020 liters a second) for each bed for dietary use; and

(3) Two gallons an hour (0.0020 liters a second) per bed for laundry.

Storage tanks provided shall be fabricated of noncorrosive metal or lined with noncorrosive material.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (4), and (14).
Law Implemented: SDCL 34-12-13(1), (4), and (14).

ARSD 44:75:13:31 Drainage systems

A facility shall ensure each drain line from sinks in which acid wastes may be poured is fabricated from an acid resistant material. Any piping over each operating and delivery room, nursery, food preparation center, food serving facility, food storage area, and any other critical area must be kept to a minimum and may not be exposed. Special precautions must be taken to protect these areas from possible leakage of necessary overhead piping systems. Floor drains may not be installed in operating rooms, procedure rooms, or delivery rooms. The building sewers must discharge into a community sewerage system. If that system is not available, a facility providing sewage treatment that conforms to applicable local and state regulations is required.

Water from roof systems must be collected and discharged away from the building foundation. Rain gutters with downspouts and splash blocks must be provided for pitched roof systems. The facility shall avoid having water accumulate on sidewalks and parking areas around the building.

The building sewer system must have a cleanout located outside the perimeter of the building foundation.

Cross Reference: Individual and small on-site wastewater systems, ch 74:53:01.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1)(4)(14).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:13:32 Electrical distribution system

All material including equipment, conductors, controls, and signaling devices shall be installed to provide a complete electrical system with the necessary characteristics and capacity to supply the electrical facilities shown in the specifications or indicated on the plans. All materials shall be listed as complying with applicable standards of Underwriters' Laboratories, Inc., or other similarly established standards. Fixed and mobile X ray units shall be connected by means of independent feeders or circuits. Each circuit breaker or fusible switch that provide disconnecting means and overcurrent protection for conductors connected to switchboard and distribution panel board shall be enclosed or guarded to provide a dead front type of assembly. The main switchboard shall be located in a separate enclosure accessible only to authorized persons. The switchboard shall be convenient for use, readily accessible for maintenance, clear of traffic lanes, and in a dry ventilated space devoid of corrosive fumes or gases. Each overload protective device shall be designed for operating in the ambient temperature conditions. Each lighting and appliance panel board shall be provided for the circuit on each floor. The provisions of this section do not apply to emergency system circuits.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (14).
Law Implemented: SDCL 34-12-13(1), (3), and (14).

ARSD 44:75:13:33 Lighting

Any space occupied by people, machinery, or equipment within buildings, the approaches to the buildings, and parking lots shall have artificial lighting approved by the department. Each patient bedroom shall have general lighting of at least ten footcandles (0.929 lumens per square meter) and night lighting. If task illumination is required, a light with an intensity of at least 30 footcandles (2.79 lumens per square meter) at the work surface shall be provided for each patient. At least one luminaire for night lighting shall be switched at the entrance to each patient room. Any patient's reading light and other fixed light not switched at the door shall have a switch control convenient for use at the luminaire. Each switch for control of lighting in a patient area shall be of the quiet operating type. Illumination of at least 100 footcandles (9.29 lumens per square meter) shall be provided at the medication set-up area. Illumination of at least 50 footcandles (4.65 lumens per square meter) shall be provided at the activity room work tables. Illumination of at least 30 footcandles (2.79 lumens per square meter) shall be provided in each dining area, physical and restorative therapy area, and at any bathing facility.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).

ARSD 44:75:13:34 Receptacles or convenience outlets

Each operating, delivery, and emergency room shall have at least three receptacles. In locations where mobile X ray is used, an additional receptacle, distinctively marked for X ray use, shall be provided. Each patient bedroom shall have duplex receptacles as follows: one on each side of the head of each bed; receptacles for luminaires and motorized beds, if used; and one receptacle on each wall. Single polarized receptacles marked for use of X ray only shall be located in corridors of patient areas so that mobile equipment may be used in any location within a patient room. If the same mobile X ray unit is used in operating rooms and in nursing areas, all receptacles for X ray use shall be the same. Where capacitive discharge or battery-powered mobile X ray units are used, polarized receptacles are not required. Duplex receptacles for general use shall be installed approximately 50 feet apart in all corridors and within 25 feet of ends of corridors. Receptacles in patient rooms of pediatric units shall be of the safety type. Receptacles in corridors of pediatric units shall be of a safety type or shall be controlled by switches located at a nurses' station or another supervised location.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(4) and (14).
Law Implemented: SDCL 34-12-13(4) and (14).

ARSD 44:75:13:35 Staff call system

A staff call system shall be provided for patient use to summon assistance from staff. Staff call systems which provide two-way voice communication shall be equipped with an indicating light at each calling station which lights and remains lighted as long as the voice circuit is operating. An emergency calling station convenient for patient use shall be provided at each patient toilet, bath, or shower and at toilets serving patients in laboratory, physical therapy, emergency, and X ray departments. An emergency staff calling station shall be provided for staff use in each operating, delivery, recovery, emergency, and intensive nursing care room and in nurseries, supervised wards for mental patients, and rooms for children.

The system shall be utilized and maintained in such a manner as to ensure that it is a consistent and effective means for a patient to alert staff of the need for assistance. The call stations convenient for patient use shall be provided at each bed, patient toilet, bathing or shower facility used by the patient. The call system shall also meet at least one of the following requirements:

(a) The call system utilizing fixed call stations that are convenient for patient use and activated by a pull cord or other approved device. The fixed system shall actuate a visual signal at the patient room door, and in the clean workroom, soiled workroom, and nourishment station of the nursing unit. In multicorridor nursing units, additional visible signals shall be installed at corridor intersections;

(b) The call system utilizing wireless devices that are convenient for patient use and activated by a pull cord or other approved device. The wireless system shall actuate a visual and audible signal at the staff station and on pocket paging devices carried by all direct care staff. Wireless devices shall be fully supervised, shall be capable of alarm reset at the source, and transmit low battery alert. Wireless devices shall utilize batteries that are readily available; or

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(4) and (14).
Law Implemented: SDCL 34-12-13(4) and (14).

ARSD 44:75:13:36 Submittal of plans and specifications

Plans and specifications for new construction shall be submitted to the department for evaluation of function and fire protection including concealed spaces. The department's approval shall be obtained before beginning construction. Modification during construction shall be submitted to the department for review and shall be approved prior to the modification. A written narrative describing the intended use of the proposed construction shall accompany the plans and specifications.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).

ARSD 44:75:13:37 Pipe requirements

A facility shall ensure all piping systems for potable water are installed to eliminate any dead-end runs of piping. Before placing any potable water system in service, the piping system must be disinfected in accordance with article 20:54 and certification must be available from the installer showing the method used, date of installation, test procedure used to verify chlorine concentrations, and date the system was flushed and placed in service.

Pipe covering, vapor barriers, and adhesives used must have a flame spread index of not more than twenty-five and a smoke emission factor of not more than fifty when tested in accordance with the ASTM E84-23D, 2010 edition, Standard Test Method for Surface Burning Characteristics of Building Material.

Reference: ASTM E84-23D, 2010 edition, Standard Test Method for Surface Burning Characteristics of Building Materials. Copies may be obtained at https://www.astm.org/e0084-23d.html. Cost: $119.00.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023; 51 SDR 53, effective November 11, 2024.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13.

ARSD 44:75:13:38 Detached structures

A detached structure or auxiliary building used for combustible storage or vehicle parking built adjacent to, but not directly attached to, a health care facility shall either be separated from the facility by a minimum distance of 20 feet or provided with two-hour fire rated separation, or equip the structure with a complete automatic sprinkler system.

Cross-Reference: Fire safety code requirements, § 44:75:03:01.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).

ARSD 44:75:13:39 Water therapy facilities

A facility shall ensure each water therapy facility operated by a facility and used by any patient or the public, must be designed, constructed, and maintained using the Recommended Standards for Swimming Pool Design and Operation, 1996 edition.

A facility shall collect and submit at least one water sample weekly for each swimming pool or spa facility under the facility's control to an EPA-certified laboratory for bacteriological analysis. The facility must report any unsafe water sample test results to the department within three days after receipt of such test results. Upon the receipt of an unsafe water sample, the facility must submit two consecutive negative samples to the department to confirm treatment procedures have eliminated the contamination. If a resample test is positive, the facility must close the affected water facility and submit two consecutive negative samples prior to allowing patient or public use of the affected water treatment facility. The facility shall use a colorimetric test kit for the monitoring and adjusting of disinfectant levels and pH in the swimming pool or spa facility. The facility shall maintain a daily log of disinfectant levels and pH.

Collateral Reference: Recommended Standards for Swimming Pool Design and Operation. Copies are available at no cost at https://doh.sd.gov/topics/food-lodging-safety/food-and-lodging-licensure-and-codes/lodging-licensure-and-codes/.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(1)(14).
Law Implemented: SDCL 34-12-13.

Chapter 44:75:14

ARSD 44:75:14:01 Application of standards

The construction standards in this chapter apply to all new hospital facilities and to any alteration, addition, and change in space use to currently approved existing hospital facilities. In a hospital with a capacity of 50 beds or less, some functions allotted separate spaces or rooms in these standards may be combined if the resulting plan does not compromise safety or medical practice.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:01, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-1-17(4) and (5), 34-12-13(1), (3), and (4).
Law Implemented: SDCL 34-12-13(1), (3), and (4).

ARSD 44:75:14:02 Newborn nursery unit

Each nursery shall provide a lavatory, emergency nurses call, oxygen, and facilities for viewing the babies. Each full-term nursery room may contain not more than 12 bassinets with a minimum area of 24 square feet (2.23 square meters) per bassinet. An examination and workroom with lavatory shall be provided and may serve up to 24 bassinets. A janitor's closet for storage of housekeeping supplies and equipment which contains a floor receptor or service sink shall be provided.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:02, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (4).
Law Implemented: SDCL 34-12-13(1), (3), and (4).

ARSD 44:75:14:03 Psychiatric unit

If a psychiatric unit is included as a separate nursing unit, it shall be designed as other nursing units with extra care taken to provide close supervision for patients. Service areas shall be provided.

Cross-Reference: Requirements for service areas in each nursing unit, § 44:75:13:07.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:04, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (4).
Law Implemented: SDCL 34-12-13(1), (3), and (4).

ARSD 44:75:14:04 Surgical suites

Hospitals with 50 beds or less that accept surgical patients shall provide one operating room. The number of operating rooms for hospitals over 50 beds shall be based on the expected surgical workload. The surgical suite shall be located to prevent through traffic. A recovery room with charting space, medication storage and preparation space, and a clinical sink is required.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:05, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (4).
Law Implemented: SDCL 34-12-13(1), (3), and (4).

ARSD 44:75:14:05 Service areas in surgical suite

The size of the service areas in each surgical suite depends on the surgical workload. Each surgical suite shall include the following service areas:

(1) A surgical supervisor station;

(2) Sterilizing facilities near the operating room with high speed autoclave;

(3) Facilities for storage and preparation of medication;

(4) Scrub-up facilities located adjacent to operating rooms;

(5) Soiled workroom containing a counter with sink, clinical sink, hand sink, waste receptacle, and soiled linen receptacles;

(6) Storage for sterile and unsterile supplies, which may be in a clean workroom;

(7) Storage room or cabinet for anesthetic agents;

(8) Nitrous oxide and oxygen facilities with storage room if these services are not piped in;

(9) Clean work area for storage and assembly of supplies containing counter and sink;

(10) Equipment storage area for surgical and monitoring equipment;

(11) Floor receptor or service sink and storage for housekeeping supplies and equipment;

(12) Clothing change areas, lockers, and toilet rooms for doctors, nurses, technicians, and other personnel; and

(13) Stretcher alcove.

History

Source: SL 1975, ch 16, § 1; 4 SDR 14, effective September 14, 1977; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:06, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (4).
Law Implemented: SDCL 34-12-13(1), (3), and (4).

ARSD 44:75:14:06 Obstetrical suite

The obstetrical suite shall be located to prevent through traffic. The number of delivery rooms and labor rooms required shall be based on the estimated annual birthrate. A patients' toilet room shall be provided adjoining each labor room or shall be conveniently accessible within the obstetrical suite. Bathing facilities shall be conveniently available.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:07, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (4).
Law Implemented: SDCL 34-12-13(1), (3), and (4).

ARSD 44:75:14:07 Service areas in obstetrical suite

The size of the service areas in each obstetrical suite depends on the obstetrical workload. Each obstetrical suite shall include the following service areas:

(1) A supervisor's station;

(2) Sterilizing facilities with high speed autoclave convenient to delivery rooms;

(3) Facilities for storage and preparation of medication;

(4) Scrub-up facilities adjacent to delivery rooms;

(5) A soiled workroom containing a counter with a sink, clinical sink, hand sink, waste receptacle, and soiled linen receptacles;

(6) Storage for sterile and unsterile supplies, which may be in clean workroom;

(7) Storage room or cabinet for anesthetic agents;

(8) Nitrous oxide and oxygen facilities with storage room if these services are not piped in;

(9) Clean work area for storage and assembly of supplies, containing counter and sink;

(10) Equipment storage area for surgical and monitoring equipment;

(11) Floor receptor or service sink and storage for housekeeping supplies and equipment;

(12) Clothing change areas, lockers, and toilet rooms with handwashing facility for doctors, nurses, technicians, and other personnel; and

(13) Stretcher alcove.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:08, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (4).
Law Implemented: SDCL 34-12-13(1), (3), and (4).

ARSD 44:75:14:08 Emergency and outpatient care areas of the facility

The size of emergency and outpatient care areas shall be based on admissions and shall be located to prevent outpatients from traversing inpatient areas. Emergency and outpatient care areas shall include:

(1) A well marked and sheltered entry with nearby emergency parking and convenient access for ambulances;

(2) Admission and patient records area;

(3) Examination and treatment room with lavatory;

(4) A handwashing sink;

(5) Storage for sterile supplies;

(6) Wheelchair and stretcher alcove;

(7) Floor receptor or service sink and storage for housekeeping supplies and equipment;

(8) A secure area for storage and preparation of medications;

(9) A soiled workroom.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; 26 SDR 96, effective January 23, 2000; transferred from § 44:04:14:09, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (4).
Law Implemented: SDCL 34-12-13(1), (3), and (4).

ARSD 44:75:14:09 Diagnostic imaging suite

The diagnostic imaging suite shall contain:

(1) One or more radiographic rooms with necessary radiation protection;

(2) A film processing room;

(3) Toilet room adjoining each fluoroscopy and ultrasound room;

(4) Dressing area for ambulatory patients;

(5) Holding area for stretcher patients;

(6) Waiting space; and

(7) An office with film viewing facilities.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:10, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (4).
Law Implemented: SDCL 34-12-13(1), (3), and (4).

ARSD 44:75:14:10 Laboratory suite

Clinical laboratory facilities and equipment consistent with the needs of the patients shall be provided. Handwashing fixtures shall be provided and equipped with valves which can be operated without the use of hands.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:11, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (4).
Law Implemented: SDCL 34-12-13(1), (3), and (4).

ARSD 44:75:14:11 Pharmacy or drug room

The pharmacy or drug room shall be well ventilated and have a locking door. The pharmacy or drug room shall be sized for the distribution system used and shall have a work counter with sink, a separate locked and fastened compartment or room for the storage of controlled substances, refrigerated and frozen storage spaces, and other approved storage for drugs. If additive injectables are prepared, a sterile products area shall be provided. The work space shall be well illuminated. Emergency power shall be provided for essential services. Heating, ventilation, and air conditioning services shall be provided to maintain the temperature of the room between 59 degrees Fahrenheit (15 degrees centigrade) and 86 degrees Fahrenheit (30 degrees centigrade).

History

Source: SL 1975, ch 16, § 1; 4 SDR 14, effective September 14, 1977; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:12, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), (4) and (9).
Law Implemented: SDCL 34-12-13(1), (3), (4) and (9).

ARSD 44:75:14:12 Administration department

The facility's administration department shall include a business office, information center, administrator's office, admitting office, personnel lounge, medical library, lobby, and public and personnel toilet rooms. There must be an office for the director of nursing, space for inservice training, and a housekeeper's office.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:13, 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(3)(4).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:14:13 Medical records unit

The medical records unit shall include an active record storage area; record review and dictating area; work area for sorting, recording, or microfilming; and an inactive record storage area which may be omitted if microfilming is used.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:14, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3) and (10).
Law Implemented: SDCL 34-12-13(3) and (10).

ARSD 44:75:14:14 Central medical and surgical supply department

The clean and soiled areas of the central medical and surgical supply department shall be separated from each other. Space for cleaning equipment and disposing or processing of unclean articles shall be provided in the decontamination area and the plumbing fixtures shall be at least those provided for the soiled utility room. The clean workroom shall be divided into work space, clean storage area, sterilizing facilities, and storage area for sterile supplies. Pathological waste sterilization may not be done in this area. An unsterile supply storage area shall be provided, but it may be located in an area outside this department. Handwashing fixtures shall be provided between the clean and soiled work areas. The decontamination area shall contain a two compartment sink with a drainboard on both sides.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; 26 SDR 96, effective January 23, 2000; transferred from § 44:04:14:15, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).

ARSD 44:75:14:15 Central stores

General central storage rooms shall have a total area of not less than 20 square feet (1.86 square meters) for each bed. General storage should be concentrated in one area on-site, but up to 50 percent of the general storage space may be provided off-site.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:16, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).

ARSD 44:75:14:16 Details and finishes

Ceiling heights of operating rooms, delivery rooms, cystoscopic rooms, radiographic rooms, and rooms with ceiling-mounted surgical light fixtures shall be at least nine feet (2.74 meters).

The ceilings in isolation rooms, X-ray film processing rooms, central sterilization rooms, and operating rooms shall be an epoxy painted gypsum board membrane or an equivalent material for ease of cleaning and for improved maintenance of clean surfaces below the ceilings.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; 26 SDR 96, effective January 23, 2000; 29 SDR 81, effective December 11, 2002; transferred from § 44:04:14:17, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).

ARSD 44:75:14:17 Ventilation

All air supply and air exhaust systems shall be mechanically operated. All fans serving exhaust systems shall be located at the discharge end of the system. All air supplied to an operating room, delivery room, nursery or any other sensitive area shall be delivered at or near the ceiling of the area served. All air exhausted from the area shall be removed near floor level. At least two exhaust outlets shall be used in each operating and delivery room. Exhaust wall outlets shall be located not less than three inches (0.076 meters) above the floor.

A ventilation system in operating, delivery, emergency, isolation, central sterilization, or nursery room shall be a ducted system. A ventilation system using the building concealed space (return air plenum) from a clean room is not acceptable.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; 29 SDR 81, effective December 11, 2002; transferred from § 44:04:14:18, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (4).
Law Implemented: SDCL 34-12-13(1), (3), and (4).

ARSD 44:75:14:18 Air filters

The facility shall ensure that each ventilation system serving an operating room, delivery room, nursery, isolation room, and laboratory sterile room is equipped with a minimum of two filter beds. Filter bed number one must be located upstream of the conditioning equipment and must have a minimum efficiency of thirty percent. Filter bed number two must be located downstream of the conditioning equipment and must have a minimum efficiency of ninety percent. Central systems using one hundred percent outdoor air and serving other than sensitive areas must be provided with filters rated at eighty percent efficiency. These filter efficiencies must be warranted by the manufacturer and shall be based on the 2017 edition of the American Society of Heating, Refrigeration, and Air Conditioning Engineers (ASHRAE) Standard 52.2 dust spot test method with atmospheric dust. The exhausts from all laboratory hoods in which infectious or radioactive materials are processed must be equipped with filters with a ninety-nine percent efficiency. Filter frames must be durable and must provide an airtight fit with the enclosing ductwork. All joints between filter segments and the enclosing ductwork must have a positive seal against air leakage.

Cross Reference: ASHRAE 52.2, 2017 edition, American Society of Heating, Refrigeration, and Air Conditioning Engineers. Copies may be obtained at no cost at https://www.ashrae.org/File%20Library/Technical%20Resources/COVID-19/52_2_2017_COVID-19_20200401.pdf.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:19, 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(2), (3)(14).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:14:19 Ducts

Ducts which penetrate construction intended for X ray or other ray protection shall not impair the effectiveness of the protection. Porous duct lining materials may not be used in the interior of duct systems serving sensitive areas such as operating and delivery rooms, nurseries, and isolation rooms.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:20, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (2), (3), and (14).
Law Implemented: SDCL 34-12-13(1), (2), (3), and (14).

ARSD 44:75:14:20 Plumbing fixture devices

Flush valves installed on plumbing fixtures shall be of a quiet operating type equipped with silencers. Bedpan flushing devices shall be provided in each patient toilet room and in the soiled workrooms.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:21, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1) and (3).
Law Implemented: SDCL 34-12-13(1) and (3).

ARSD 44:75:14:21 Operating and delivery room lighting

Operating and delivery rooms shall have general lighting for the room in addition to special lighting units at the surgical and obstetrical tables. Each special lighting unit for local lighting at tables shall be connected to an independent circuit.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:22, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3) and (4).
Law Implemented: SDCL 34-12-13(3) and (4).

ARSD 44:75:14:22 Equipment installation in special areas

X ray stationary installations and mobile equipment shall conform to rules of the state electrical commission.

Cross-Reference: Electrical installations, ch 20:44:05.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:23, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(3).
Law Implemented: SDCL 34-12-13(3).

ARSD 44:75:14:23 Emergency electric supply

Each facility shall have an emergency source of electric supply to provide electricity during an interruption of the normal electric supply. The source of emergency electric supply shall be an automatic emergency generating set when the normal service is supplied by one or more central station transmission lines, or an automatic generating set or a central station transmission line when the normal electric supply is generated on the premises. The required emergency generating set, including the prime mover and generator, shall be located on the premises. The emergency generator set shall be of sufficient kilowatt capacity to supply all lighting and power load demands of the emergency system.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:24, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (14).
Law Implemented: SDCL 34-12-13(1), (3), and (14).

ARSD 44:75:14:24 Emergency electrical circuit connections

Emergency electrical service shall be furnished to circuits as follows:

(1) Lighting of exit ways and all necessary ways of approach to them, including exit signs and exit direction signs, exterior of exits, exit doorways, stairways, and corridors;

(2) Surgical, obstetrical, and emergency room operating lights;

(3) Lighting for nursery, laboratory, recovery room, intensive care areas, nursing stations, medication preparation areas, and labor rooms;

(4) Lighting for the generator set location, the switch gear location, and the boiler room;

(5) Equipment essential to life safety and for protection of important equipment or vital materials;

(6) Nurses calling system;

(7) Alarm system, including fire alarms actuated at manual stations;

(8) Water flow alarm devices of sprinkler system if electrically operated;

(9) Fire detecting and smoke detecting systems;

(10) Paging or speaker systems if intended for issuing instructions during emergency conditions;

(11) Alarms required for nonflammable medical gas systems, if installed;

(12) Receptacles for incubators for infants;

(13) Pump for central suction system;

(14) Sewage or sump lift pump, if installed;

(15) Receptacles for blood bank refrigerator;

(16) At least two duplex receptacles for the laboratory;

(17) Receptacles in operating, recovery, intensive care, and delivery rooms except those for X ray;

(18) At least one duplex receptacle in each nursery;

(19) Duplex receptacles in patient corridors; and

(20) Equipment, such as burners and pumps, necessary for operation of one or more boilers required for heating and sterilization and their necessary auxiliaries and controls.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:25, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (14).
Law Implemented: SDCL 34-12-13(1), (3), and (14).

ARSD 44:75:14:25 Emergency power for electrical heating

If electricity is the only source of power normally used for space heating, the emergency service shall provide for heating of operating, delivery, labor, recovery, intensive care, nurseries, and patient rooms. Emergency heating of patient rooms is not required if the hospital is supplied by at least two utility service feeders, each supplied by separate generating sources, or a network distribution system fed by two or more generators, with the facility feeders routed, connected, and protected so that a fault any place between the generators and the facility will not be likely to cause an interruption of more than one of the facility service feeders.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:26, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (14).
Law Implemented: SDCL 34-12-13(1), (3), and (14).

ARSD 44:75:14:26 Emergency electrical system details

The emergency electrical system shall be so controlled that after interruption of the normal electric power supply the generator is brought to full voltage and frequency and connected within ten seconds through one or more primary automatic transfer switches to all emergency lighting; all alarms; blood banks; nurses' call; equipment necessary for maintaining telephone service; pump for central suction system; and receptacles in operating and delivery rooms, patient corridors, recovery rooms, intensive care nursing areas, and nurseries. All other lighting and equipment required to be connected to the emergency system shall either be connected through the primary automatic transfer switching or shall be subsequently connected through other automatic or manual transfer switching. A receptacle connected to the emergency system shall be distinctively marked for identification. A storage-battery-powered light, provided to augment the emergency lighting or for continuity of lighting during the interim of transfer switching immediately following an interruption of the normal service supply, may not be used as a substitute for the required generator. If fuel is normally stored on the site, the storage capacity shall be sufficient for 24-hour operation. If fuel is normally piped underground to the site from a utility distribution system, storage facilities on the site are not required.

History

Source: SL 1975, ch 16, § 1; 6 SDR 93, effective July 1, 1980; 14 SDR 81, effective December 10, 1987; 22 SDR 70, effective November 19, 1995; transferred from § 44:04:14:27, 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(1), (3), and (14).
Law Implemented: SDCL 34-12-13(1), (3), and (14).

Chapter 44:75:15

ARSD 44:75:15:01 Application of chapter - Swing bed patients' rights policies

Each facility offering swing bed services shall comply with this chapter. Each facility offering swing bed services shall establish policies consistent with this chapter to protect and promote the rights of each swing bed patient.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(15).
Law Implemented: SDCL 34-12-13(15).

ARSD 44:75:15:02 Facility to inform swing bed patient of rights

Prior to or at the time of admission, a facility must inform the swing bed patient or patient representative, both orally and in writing, of the patient's rights and of the rules governing the patient's conduct and responsibilities while in the facility. The patient or patient representative shall acknowledge in writing that the patient received the information. During the patient's stay the facility must notify the patient or patient representative, both orally and in writing, of any changes to the original information. The facility shall outline the patient's right to receive visitors in the facility's policies and procedures. Visiting hours and policies of the facility must permit and encourage the visiting of patients by friends and relatives. Visitors may not cause a disruption to the care and services patients receive or infringement on other patients’ rights or place an undue burden on the facility.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR 62, effective November 27, 2023.
General Authority: SDCL 34-12-13(15).
Law Implemented: SDCL 34-12-13.

ARSD 44:75:15:03 Facility to provide information on available services

A facility shall provide the following information in writing to each patient:

(1) A list of services available in the facility and the charges for such services. The facility shall specify which items and services are included in the services for which the patient may not be charged, those other items and services that the facility offers and for which the patient may be charged, and the amount of any such charges;

(2) A description of how a patient can protect personal funds;

(3) A list of names, addresses, and telephone numbers of client advocates;

(4) A description of how to file a complaint with the department concerning abuse, neglect, and misappropriation of patient property;

(5) A description of how the patient can contact the patient's physician, including the name and specialty of the physician;

(6) A description of how to apply for and use Medicare and Medicaid benefits, and the right to establish eligibility for Medicaid, including the addresses and telephone numbers of the nearest office of the South Dakota Department of Social Services and of the United States Social Security Administration;

(7) A description of the bed-hold policy which indicates the length of time the bed will be held for the patient, any policies regarding the held bed, and readmission rights of the patient; and

(8) A description explaining the responsibilities of the patient and family members regarding self-administered medication.

A signed and dated admission agreement between the patient or the patient's legal representative and the facility shall include subdivisions (1) to (8), inclusive, of this section. The patient or patient's legal representative and the facility shall complete the admission agreement before or at the time of admission and before the patient has made a commitment for payment for proposed or actual care. The agreement may not include ambiguous or misleading information and may not be in conflict with this chapter. The agreement shall be printed for ease of reading by the patient. If the agreement exceeds three pages, it shall contain a table of contents or an index of principal sections. Any change in the information shall be given to the patient or the patient's legal representative as a signed and dated addendum to the original agreement.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13.

ARSD 44:75:15:04 Notification when patient's condition changes

A facility shall immediately inform the patient, consult with the patient's physician, and, if known, notify the patient's legal representative or interested family member when any of the following occurs:

(1) An accident involving the patient which results in injury or has the potential for requiring intervention by a physician;

(2) A significant change in the patient's physical, mental, or psychosocial status;

(3) A need to alter treatment significantly; or

(4) A decision to transfer or discharge the patient from the facility.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13.

ARSD 44:75:15:05 Notification of patient's room assignment or rights change

A facility shall promptly notify the patient and, if known, the patient's legal representative, as specified in SDCL 34-12C-3, or interested family member when there has been a change in the patient's room or roommate assignment or when there has been a change in the patient's rights.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13.

ARSD 44:75:15:06 Right to manage financial affairs

A patient may manage personal financial affairs. A facility may not require patients to deposit their personal funds with the facility. If the patient chooses to deposit funds with the facility and gives written authorization, the facility shall hold the funds in accordance with SDCL 34-12-15.1 to 34-12-15.10, inclusive.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13(15).
Law Implemented: SDCL 34-12-13(15).

ARSD 44:75:15:07 Choice in planning care

A patient may choose a personal attending physician, be fully informed in advance about care and treatment and of any changes in that care or treatment that may affect the patient's well-being, and, unless adjudged incompetent or otherwise found to be incapacitated under the laws of the state, participate in planning care and treatment or changes in care or treatment.

Cross-References:

Right to choose own physician unimpaired by public health programs -- Misdemeanor, SDCL 34-1-20.

Rights of authorized person as incapacitated person, SDCL 34-12C-6.

Liability of health care provider -- Liability of authorized decision maker, SDCL 34-12C-7.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13.

ARSD 44:75:15:08 Privacy and confidentiality

A facility shall provide for privacy and confidentiality for the patient, including the patient's accommodations, medical treatment, written and telephone communications, personal care, visits, and meetings of family and patient groups. A facility is not required to provide a private room for each patient. A facility shall permit patients to perform the following:

(1) To send and receive unopened mail and to have access to stationery, postage, and writing implements at the patient's own expense;

(2) To access and use a telephone without being overheard;

(3) To visit a spouse or, if both are patients of the same facility, to share a room with the spouse, within the capacity of the facility, upon the consent of both spouses;

(4) Except in an emergency, to have room doors closed and to require knocking before entering the patient's room;

(5) To have only authorized staff present during treatment or activities of personal hygiene;

(6) To retire and rise according to the patient's wishes, as long as the patient does not disturb other patients;

(7) To meet, associate, and communicate with any person of the patient's choice in a private place within the facility;

(8) To participate in social, religious, and community activities that do not interfere with the rights of other patients in the facility; and

(9) To approve or refuse the release of personal and medical records to any individual outside the facility, except when the patient is transferred to another health care facility or when the release of the record is required by law. With the patient's permission, a facility shall allow the state ombudsman or a representative of the ombudsman access to the patient's medical records.

Cross-Reference: Written policies and confidentiality of records, § 44:75:09:03.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13.

ARSD 44:75:15:09 Quality of life

A facility shall provide care and an environment that contributes to the patient's quality of life, including:

(1) A safe, clean, comfortable, and homelike environment;

(2) Maintenance or enhancement of the patient's ability to preserve individuality, exercise self-determination, and control everyday physical needs;

(3) Freedom from physical or chemical restraints imposed for purposes of discipline or convenience;

(4) Freedom from verbal, sexual, physical, and mental abuse and from involuntary seclusion, neglect, or exploitation imposed by anyone, and theft of personal property;

(5) Retention and use of personal possessions, including furnishings and clothing, as space permits, unless to do so would infringe upon the rights or health and safety of other patients; and

(6) Support and coordination to assure pain is recognized and addressed appropriately.

Cross-Reference: Care policies § 44:75:04:11.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13.

ARSD 44:75:15:10 Grievances

A patient may voice grievances without discrimination or reprisal. A patient's grievance may be in writing or oral and may relate to treatment furnished, treatment that has not been furnished, the behavior of other patients, and infringement of the patient's rights. A facility shall adopt a grievance process and make the process known to each patient and to the patient's immediate family. The grievance process shall include the facility's efforts to resolve the grievance and documentation of:

(1) The grievance;

(2) The names of the persons involved;

(3) The disposition of the matter; and

(4) The date of disposition.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13.

ARSD 44:75:15:11 Availability of survey results

Survey results, along with the corresponding Plan of Correction shall be provided to patients and individuals upon request.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13.

ARSD 44:75:15:12 Right to refuse to perform services

A patient may refuse to perform services on behalf of the facility, unless otherwise agreed to in the patient's plan of care. The patient may perform services for the facility when the following conditions are met:

(1) The plan of care includes documentation of the need or desire for work;

(2) The nature of the services performed is specified, including whether the services are voluntary or paid;

(3) Compensation for paid services is at or above prevailing rates; and

(4) The patient agrees to the work arrangement.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13.

ARSD 44:75:15:13 Self-administration of medications

A patient may self-administer medication if the interdisciplinary team consisting of selected healthcare workers and licensed health professionals, has determined the self-administration to be safe. The determination must be in writing and state whether the patient or the nursing personnel is responsible for storage of the medication and documentation of its administration in accordance with chapter 44:75:08.

Cross-Reference: Medication control, ch 44:75:08.

History

Source: 42 SDR 51, effective October 13, 2015; 50 SDR62, effective November 27, 2023.
General Authority: SDCL 34-12-13(15).
Law Implemented: SDCL 34-12-13(15).

ARSD 44:75:15:14 Admission, transfer, and discharge policies

A facility shall establish and maintain policies and practices for admission, discharge, and transfer of patients which prohibit discrimination based upon payment source and which are made known to patients at or before the time of admission. The policies and practices shall include:

(1) The patient may remain in the facility and may not be transferred or discharged unless the patient's needs and welfare cannot be met by the facility, the patient's health has improved sufficiently so the patient no longer needs the services provided by the facility, the safety or health of individuals in the facility is endangered by the patient, the patient has failed to pay for allowable billed services as agreed to, or the facility ceases to operate;

(2) The facility shall notify the patient and a family member or client advocate in writing at least 30 days before the transfer or discharge unless a change in the patient's health requires immediate transfer or discharge or the patient has not resided in the facility for 30 days. The written notice shall specify the reason for and effective date of the transfer or discharge and the location to which the patient will be transferred or discharged;

(3) Conditions under which the patient may request or refuse transfer within the facility; and

(4) A description of how the patient may appeal a decision by the facility to transfer or discharge the patient.

History

Source: 42 SDR 51, effective October 13, 2015.
General Authority: SDCL 34-12-13.
Law Implemented: SDCL 34-12-13.