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Commonwealth of Pennsylvania Statutes
Health Care Facilities Act
(codified at Pa. Stat. Ann. tit. 35, §§ 448.101 to 448.904).

Title 35. Health and Safety
Chapter 8. Licensing of Health Care Facilities

NOTICE: As to repeal of the Health Care Facilities Act (35 P.S.§ 448.101 et seq.), where inconsistent with § 2102(n), Act 1996, Feb. 23, P.L. 27, No. 10 (71 P.S. § 532(n)), see § 9(b) of said act.

  • § 448.801.Repealed

    Repealed by 1980, July 12, P.L 655, No 136, § 6, imd effective

  • § 448.801a.Purpose

    It is the purpose of this chapter to protect and promote the public health and welfare through the establishment and enforcement of regulations setting minimum standards in the construction, maintenance and operation of health care facilities. Such standards are intended by the legislature to assure safe, adequate and efficient facilities and services, and to promote the health, safety and adequate care of the patients or residents of such facilities. It is also the purpose of this chapter to assure quality health care through appropriate and nonduplicative review and inspection with due regard to the protection of the health and rights of privacy of patients and without unreasonably interfering with the operation of the health care facility or home health agency.

  • § 448.802.Repealed

    Repealed by 1980, July 12, P.L 655, No 136, § 6, imd effective; 1980, Oct 5, P.L 693, No 142, § 336, effective in 60 days

  • § 448.802a.Definitions

    The following words and phrases when used in this chapter shall have, unless the context clearly indicates otherwise, the meanings given them in this section:

    • "AMBULATORY SURGICAL FACILITY."  A facility or portion thereof not located upon the premises of a hospital which provides specialty or multispecialty outpatient surgical treatment. Ambulatory surgical facility does not include individual or group practice offices of private physicians or dentists, unless such offices have a distinct part used solely for outpatient surgical treatment on a regular and organized basis. For the purposes of this provision, outpatient surgical treatment means surgical treatment to patients who do not require hospitalization, but who require constant medical supervision following the surgical procedure performed.
    • "BIRTH CENTER."  A facility not part of a hospital which provides maternity care to childbearing families not requiring hospitalization. A birth center provides a home-like atmosphere for maternity care, including prenatal labor delivery and postpartum care related to medically uncomplicated pregnancies.
    • "HEALTH CARE FACILITY."  For purposes of Chapter 8, a health care facility includes, but is not limited to, a general, chronic disease or other type of hospital, a home health care agency, a hospice, a long-term care nursing facility, cancer treatment centers using radiation therapy on an ambulatory basis, an ambulatory surgical facility, a birth center regardless of whether such health care facility is operated for profit, nonprofit or by an agency of the Commonwealth or local government. The department shall have the authority to license other health care facilities as may be necessary due to emergence of new modes of health care. When the department so finds, it shall publish its intention to license a particular type of health care facility in the Pennsylvania Bulletin in accordance with the act of June 25, 1982 (P.L. 633, No. 181), known as the "Regulatory Review Act." The term health care facility shall not include an office used primarily for the private practice of a health care practitioner, nor a program which renders treatment or care for drug or alcohol abuse or dependence unless located within a health facility, nor a facility providing treatment solely on the basis of prayer or spiritual means. The term health care facility shall not apply to a facility which is conducted by a religious organization for the purpose of providing health care services exclusively to clergymen or other persons in a religious profession who are members of a religious denomination.
    • "HOME HEALTH CARE AGENCY."  An organization or part thereof staffed and equipped to provide nursing and at least one therapeutic service to persons who are disabled, aged, injured or sick in their place of residence. The agency may also provide other health-related services to protect and maintain persons in their own home.
    • "HOSPICE."  An organization licensed under this act to provide a coordinated program of palliative and supportive services provided in a home, independent living environment or inpatient setting which provides for physical, psychological, social and spiritual care of dying persons and their families. Services are provided by a medically directed interdisciplinary team of professionals and volunteers, and bereavement care is available to the family following the death of the patient. The term shall also be deemed to refer to services provided by such an organization.
    • "HOSPITAL."  An institution having an organized medical staff established for the purpose of providing to inpatients, by or under the supervision of physicians, diagnostic and therapeutic services for the care of persons who are injured, disabled, pregnant, diseased, sick or mentally ill, or rehabilitation services for the rehabilitation of persons who are injured, disabled, pregnant, diseased, sick or mentally ill. The term includes facilities for the diagnosis and treatment of disorders within the scope of specific medical specialties, but not facilities caring exclusively for the mentally ill.
    • "LONG-TERM CARE NURSING FACILITY."  A facility that provides either skilled or intermediate nursing care or both levels of care to two or more patients, who are unrelated to the licensee, for a period exceeding 24 hours. Intermediate care facilities exclusively for the mentally retarded, commonly called ICF/MR, shall not be considered long-term care nursing facilities for the purpose of this act and shall be licensed by the Department of Public Welfare.

    HISTORY:  Act 1998-95 (S.B. 996), § 2, approved Oct. 16, 1998, eff. in 90 days.

    LexisNexis® Notes:

    CASE NOTES

    1.  Where the Department of Health had approved a Certificate of Need for a non-profit corporation to operate an intermediate care facility for the mentally retarded, the Department of Public Welfare had the statutory responsibility to either grant or deny the corporation's license application. Woods Servs. v. Department of Pub. Welfare, 681 A.2d 238, 1996 Pa. Commw. LEXIS 314 (Pa. Commw. Ct. 1996).

    2.  Where the Department of Health had approved a Certificate of Need for a non-profit corporation to operate an intermediate care facility for the mentally retarded, the Department of Public Welfare had the statutory responsibility to either grant or deny the corporation's license application. Woods Servs. v. Department of Pub. Welfare, 681 A.2d 238, 1996 Pa. Commw. LEXIS 314 (Pa. Commw. Ct. 1996).

    3.  35 P.S. § 448.802a, which excluded facilities caring exclusively for the mentally ill from its definition of a hospital, related only to the licensing areas of the law of Pennsylvania, and had no control over general land use questions of a city that allowed a corporation to convert a general hospital providing medical and surgical services into a facility for the treatment of individuals suffering from mental problems as a continuation of a nonconforming, pre-existing use. Collis v. Zoning Hearing Bd., 77 Pa. Commw. 4, 465 A.2d 53, 1983 Pa. Commw. LEXIS 1922 (1983).


  • § 448.803.Powers of the department of health

    The department of health shall have the power and its duty shall be:

      • (1)  To promulgate, after consultation with the policy board, the rules and regulations necessary to carry out the purposes and provisions of this chapter; and
      • (2)  To assure that the provisions of this chapter and all rules and regulations promulgated under this chapter are enforced.
  • § 448.804.Administration
    • (a)  DISCRIMINATION PROHIBITED. – Except as otherwise provided by law, no provider shall discriminate in the operation of a health care facility on the basis of race, creed, sex or national origin.
    • (b)  PREVENTION OF DUPLICATION. – In carrying out the provisions of this chapter and other statutes of this Commonwealth relating to health care facilities, the department and other departments and agencies of the State and local governments shall make every reasonable effort to prevent duplication of inspections and examinations. The department may make the dates of licensure expiration coincide with medical assistance and Medicare certification or applicable nationally recognized accrediting agencies accreditation and shall combine these surveys and inspections where practical.
    • (c)  HEALTH CARE INNOVATION. – The department shall administer this chapter so as to encourage innovation and experimentation in health care and health care facilities consistent with the provisions of this chapter and shall encourage contributions of private funds and services to health care facilities.
    • (d)  REPORTS. – The department shall report annually to the General Assembly on the effectiveness of the licensing and enforcement of this chapter. Such report shall include appropriate data according to nature of facility relating to provisional licenses issued, nature of violations of regulations, and number of facilities against which sanctions had to be taken.

    HISTORY: Act 1992-179 (H.B. 1982), § 21, approved Dec. 18, 1992, eff. immediately.


  • § 448.805.State health facility hearing board
    • (a)  HEARINGS AND ADJUDICATIONS. – In addition to the powers and duties otherwise provided by law, the hearing board shall have the power and its duty shall be to hold hearings and issue adjudications in accordance with Title 2 of the Pennsylvania Consolidated Statutes (relating to administrative law and procedure) upon appeal from any final order, decision, decree, determination or ruling of the Department of Health relating to licensure. The issuance of a provisional license may also be appealed.
    • (b)  ACTIONS OF THE BOARD. – Hearings relating to licensure may be held before one or more members of the hearing board, but actions of the board shall be made by the majority vote of those members holding the hearing. Evidentiary hearings when feasible shall be held in the locality where the health care facility is located. Hearings shall be conducted in accordance with rules and regulations adopted by the board. Such rules and regulations shall include procedures for the taking of appeals, locations at which hearings shall be held and such other procedural rules and regulations as may be determined advisable by the board.
    • (c)  REVIEW OF REGULATION. – The board shall receive any evidence as to challenges of the authority of the department or the reasonableness of the criteria or regulations used in the review of the license for the sole purpose of creating a record for any subsequent appeal to the court.
    • (d)  APPEAL. – No action of the department relating to licensure adversely affecting any person shall be final as to such person until such person has had the opportunity to appeal such action to the board. Any such action shall be final as to any person who has not perfected his appeal in the manner specified. A decision by the department choosing to proceed under one or more of the remedies available to it shall not be subject to review by the board.
    • (e)  SUPERSEDEAS. – An appeal taken to the board from a decision of the department relating to licensure shall not act as a supersedeas, but upon cause shown and where circumstances require it, the department or the board or both shall have the power to grant a supersedeas.

    LexisNexis® Notes:

    CASE NOTES

    1.  The Health Care Facilities Act specifically provides the Pennsylvania Health Policy Board with authority to hold evidentiary hearings and to issue adjudications with regard to health care facility licensure appeals, and under 2 Pa. Cons. Stat. § 704, Pennsylvania courts are required to affirm the Board's adjudication unless it is not in accordance with law or substantial evidence does not support any finding of fact made by the Board that is necessary to support its adjudication. Manorcare Health Services-Lansdale v. Pa. Dep't of Health, 854 A.2d 696, 2004 Pa. Commw. LEXIS 563 (Pa. Commw. Ct. 2004).

    2.  Pennsylvania Health Policy Board conducts health care licensure appeals in accordance with the Administrative Agency Law, 2 Pa. Cons. Stat. §§ 501- 508, 701- 704, and the Board's own procedural rules, one of which provides, in 37 Pa. Code § 197.90(a), (c), that the Pennsylvania Department of Health has the burden of proof in licensure appeals and gives the parties the right to present evidence and cross examine witnesses; the Board is authorized to act as a trial adjudicatory body and hears all competent testimony, accepts relevant documentary evidence into the record, weighs the evidence, determines credibility, makes findings of fact and conclusions of law, and issues orders consistent with those findings and conclusions. Manorcare Health Services-Lansdale v. Pa. Dep't of Health, 854 A.2d 696, 2004 Pa. Commw. LEXIS 563 (Pa. Commw. Ct. 2004).

    3.  Pennsylvania Health Policy Board did not err when it partially affirmed a Pennsylvania Department of Health order, which imposed civil penalties and issued a provisional license to a long-term health care facility following the death of one of the facility's patients; the Board was authorized to determine the credibility of the witnesses appearing before it, and the testimony of two health facility quality examiners provided substantial support for the Board's finding that the facility had failed to provide an appropriate standard of care to the deceased patient following a surgical procedure. Manorcare Health Services-Lansdale v. Pa. Dep't of Health, 854 A.2d 696, 2004 Pa. Commw. LEXIS 563 (Pa. Commw. Ct. 2004).

    4.  Health Facilities Hearing Board has two distinct roles under the Health Care Facilities Act, 35 P.S. § 448.101 et seq., depending upon the subject matter of the appeal before it; in Certificate of Need appeals, on the one hand, it is a reviewing body restrained in its decision-making by its scope of review, and in licensure appeals, on the other hand, the board acts by the authority of 35 P.S. § 448.805, as a trial adjudicatory body. Commonwealth, Dep't of Health v. Brownsville Golden Age Nursing Home, Inc., 103 Pa. Commw. 449, 520 A.2d 926, 1987 Pa. Commw. LEXIS 1911 (1987).

    5.  The Health Care Facilities Act specifically provides the Pennsylvania Health Policy Board with authority to hold evidentiary hearings and to issue adjudications with regard to health care facility licensure appeals, and under 2 Pa. Cons. Stat. § 704, Pennsylvania courts are required to affirm the Board's adjudication unless it is not in accordance with law or substantial evidence does not support any finding of fact made by the Board that is necessary to support its adjudication. Manorcare Health Services-Lansdale v. Pa. Dep't of Health, 854 A.2d 696, 2004 Pa. Commw. LEXIS 563 (Pa. Commw. Ct. 2004).

    6.  Pennsylvania Health Policy Board conducts health care licensure appeals in accordance with the Administrative Agency Law, 2 Pa. Cons. Stat. §§ 501- 508, 701- 704, and the Board's own procedural rules, one of which provides, in 37 Pa. Code § 197.90(a), (c), that the Pennsylvania Department of Health has the burden of proof in licensure appeals and gives the parties the right to present evidence and cross examine witnesses; the Board is authorized to act as a trial adjudicatory body and hears all competent testimony, accepts relevant documentary evidence into the record, weighs the evidence, determines credibility, makes findings of fact and conclusions of law, and issues orders consistent with those findings and conclusions. Manorcare Health Services-Lansdale v. Pa. Dep't of Health, 854 A.2d 696, 2004 Pa. Commw. LEXIS 563 (Pa. Commw. Ct. 2004).

    7.  Pennsylvania Health Policy Board did not err when it partially affirmed a Pennsylvania Department of Health order, which imposed civil penalties and issued a provisional license to a long-term health care facility following the death of one of the facility's patients; the Board was authorized to determine the credibility of the witnesses appearing before it, and the testimony of two health facility quality examiners provided substantial support for the Board's finding that the facility had failed to provide an appropriate standard of care to the deceased patient following a surgical procedure. Manorcare Health Services-Lansdale v. Pa. Dep't of Health, 854 A.2d 696, 2004 Pa. Commw. LEXIS 563 (Pa. Commw. Ct. 2004).

    8.  Health Facilities Hearing Board has two distinct roles under the Health Care Facilities Act, 35 P.S. § 448.101 et seq., depending upon the subject matter of the appeal before it; in Certificate of Need appeals, on the one hand, it is a reviewing body restrained in its decision-making by its scope of review, and in licensure appeals, on the other hand, the board acts by the authority of 35 P.S. § 448.805, as a trial adjudicatory body. Commonwealth, Dep't of Health v. Brownsville Golden Age Nursing Home, Inc., 103 Pa. Commw. 449, 520 A.2d 926, 1987 Pa. Commw. LEXIS 1911 (1987).


  • § 448.806.Licensure
    • (a)  LICENSE REQUIRED. – No person shall maintain or operate or hold itself out to be a health care facility without first having obtained a license therefor issued by the department. No health care facility can be a provider of medical assistance services unless it is licensed by the department and certified as a medical assistance provider.
    • (b)  DEVELOPMENT OF REGULATIONS. – In developing rules and regulations for licensure the department shall take into consideration Federal certification standards and the standards of other third party payors for health care services and such nationally recognized accrediting agencies as the department may find appropriate.
    • (c)  FIRE AND EMERGENCY STANDARDS. – Notwithstanding any other provision of law other than standards required for Federal certification by that type of health care facility in the Medicare or Medicaid program, no health care facility shall be required to satisfy any regulation relating to fire or similar emergency circumstance more stringent than those required of hospitals by the Joint Commission on Accreditation of Health Organizations or such nationally recognized accrediting agencies as the department may find appropriate, and the department shall adopt and enforce the appropriate standards.
    • (d)  HOME HEALTH CARE AGENCY REGULATIONS. – In developing rules and regulations for licensure of home health care agencies the department shall take into consideration the standards of nationally recognized accrediting agencies as the department may find appropriate. Home health care agencies certified as providers by the department to the Federal Government for purposes of the Medicare program shall be deemed to comply with and satisfy the department's regulations governing home health care agencies.
    • (e)  PUBLIC DISCLOSURE. – The department shall require disclosure of the persons owning 5% or more of the health care facility as well as the health care facility's officers and members of the board of directors.
    • (f)  AMBULATORY SURGICAL FACILITIES STANDARDS. – Within one year of the effective date of this act, to the extent possible, the department shall publish in the Pennsylvania Bulletin proposed regulations establishing revised standards for licensure of ambulatory surgical facilities. Such standards shall provide for separate licensure criteria for office-based surgical facilities and for comprehensive freestanding ambulatory surgical facilities, including, but not limited to:
      • (1)  fire and safety standards;
      • (2)  personnel and equipment requirements; and
      • (3)  quality assurance procedures.

      The purpose of such criteria shall be to assure quality care delivery in said facilities. Until such time the revised regulations are adopted, the existing rules and regulations governing the licensure of ambulatory surgical facilities shall apply.

    • (f)  HOSPICES.
      • (1)  The department shall promulgate regulations to provide for a fee for application for the licensure of hospices. The fee shall be an amount sufficient to offset all costs incurred by the department related to the licensure and inspection of hospices. The department shall from time to time, as may be necessary, increase or decrease the fee to reflect actual expenditures related to hospices. Until such time as the department provides for the fee by regulation, an application for a hospice license shall be accompanied by a fee of $ 250.
      • (2)  The department shall promulgate regulations for licensure of hospices. The regulations shall, at a minimum, contain the standards set forth in regulations for hospices certified as providers of the Medicare program under Title XVIII of the Social Security Act (49 Stat. 620, 42 U.S.C. § 1395 et seq.). The department may develop additional regulations as necessary to administer the licensure program and to protect the health and safety of the citizens of this Commonwealth.

        Until final regulations are adopted, the department shall operate the licensing program pursuant to interim guidelines consistent with this paragraph.

      • (3)  Notwithstanding any provision to the contrary, any organization which provides or coordinates the provision of volunteer services for Medicare-certified hospice providers in the hospice delivery systems ofits community and which:
        • (i) used "hospice" in its name prior to January 1, 1990;
        • (ii) qualified for exemption from Federal income taxation under section 501(c)(3) of the Internal Revenue Code of 1986 (Public Law 99-514, 26 U.S.C. § 1 et seq.) prior to the effective date of this subsection; and
        • (iii) registered with the Department of State pursuant to the act of December 19, 1990 (P.L. 1200, No. 202), known as the "Solicitation of Funds for Charitable Purposes Act," prior to the effective date of this subsection; may continue to use its name as heretofore.

    HISTORY: Act 1992-179 (H.B. 1982), § 21, approved Dec. 18, 1992, eff. immediately; Act 1998-95 (S.B. 996), § 3, approved Oct. 16, 1998, eff. in 90 days.

    LexisNexis® Notes:

    TREATISES AND ANALYTICAL MATERIALS

    1.  14-246 Pennsylvania Transaction Guide--Legal Forms § 246.21, Division 1 Individuals and Families, Health Care Services Available.


  • § 448.806a. Reporting incidents of professional misconduct
    • (a)  REPORTS REQUIRED. – Health care facilities and hospitals, licensed under this act, shall make a report or cause a report to be made to the State Board of Medical Education and Licensure or the State Board of Osteopathic Examiners, whichever is applicable, within 60 days of the occurrence of any of the following:
      • (1)  The termination or curtailment of the employment, association or professional privileges of a physician, licensed under the provisions of the act of July 20, 1974 (P.L. 551, No. 190), known as the "Medical Practice Act of 1974," or the act of October 5, 1978 (P.L. 1109, No. 261), known as the "Osteopathic Medical Practice Act," whichever the case may be, with a health care facility or hospital where there exists reasonable cause to believe malpractice or misconduct has occurred.
      • (2)  The resignation or withdrawal of association or of privileges with a facility or hospital to avoid the imposition of disciplinary measures.
      • (3)  The receipt of written information which establishes that any physician who has a right to practice or who has applied to practice at the health care facility or hospital has been convicted of a felony.
    • (b)  CONTENTS. – Reports made pursuant to this section shall be made in writing to the State Board of Medical Education and Licensure or the State Board of Osteopathic Examiners, whichever is appropriate, with respect to any physician as licensed under acts referred to in subsection (a). Written reports shall include the following information: name, address, profession and license number of the person involved, a description of the action taken by the facility or hospital, including the reason therefor and date thereof, or the nature of the action or conduct which led to the resignation or withdrawal and the date thereof, any conviction of a felony of which the facility or hospital has received the written information required by subsection (a)(3) and such other information as the Department of State may require.
    • (c)  CONFIDENTIALITY.
      • (1)  Any report or information furnished to the boards in question, in accordance with the provisions of this section, shall be deemed a confidential communication and shall not be subject to inspection or disclosure, in any manner, except upon formal written request by a duly authorized public agency or pursuant to a judicial subpoena issued in a pending action or proceeding.
      • (2)  Any person, facility or corporation which makes a report pursuant to this section in good faith and without malice shall have immunity from any liability, civil or criminal, for having made such a report.

        For the purpose of any proceeding, civil or criminal, the good faith of any person required to make a report shall be presumed.

  • § 448.807. Application for license
    • (a)  SUBMISSION TO DEPARTMENT. – Any person desiring to secure a license to maintain and operate a health care facility shall submit an application therefor to the department upon forms prepared and furnished by it, containing such information as the department considers necessary to determine that the health care provider and the health care facility meet the requirements of licensure under the provisions of this act and the rules and regulations relating to licensure. Application for renewal of a license shall be made upon forms prepared and furnished by the department in accordance with the rules and regulations of the department.
    • (b)  FEES. – Application for a license or for renewal of a license shall be accompanied by the following fees:
      • (1)  Regular or Special License:
        • Home Health Agency $250.00
        • Ambulatory Surgical Facility $250.00
        • Birth Center $70.00
        • Long-Term Care Nursing Facility $250.00
          Plus Per Each Long-Term Care Bed in Excess of 75 Beds $2.00
        • Hospital
          Every Two Years 500.00
          Plus Per Each Inpatient Bed Every Two Years $ 4.00
        • Other Health Care Facility $100.00
      • (2)  Provisional License All Facilities:
        • Provisional I $400.00
          Plus Per Each Inpatient Bed $ 4.00
        • Provisional II 600.00
          Plus Per Each Inpatient Bed $ 6.00
        • Provisional III 800.00
          Plus Per Each Inpatient Bed $ 8.00
        • Provisional IV 1,000.00
          Plus Per Each Inpatient Bed $ 10.00
    • (c)  BOND. – The department by regulations may require new applicants for a license to post a bond.

    HISTORY: Act 1992-179 (H.B. 1982), § 21, approved Dec. 18, 1992, eff. immediately.


  • § 448.808.Issuance of license
    • (a)  STANDARDS. – The department shall issue a license to a health care provider when it is satisfied that the following standards have been met:
      • (1)  that the health care provider is a responsible person;
      • (2)  that the place to be used as a health care facility is adequately constructed, equipped, maintained and operated to safely and efficiently render the services offered;
      • (3)  that the health care facility provides safe and efficient services which are adequate for the care, treatment and comfort of the patients or residents of such facility;
      • (4)  that there is substantial compliance with the rules and regulations adopted by the department pursuant to this act; and
      • (5)  that a certificate of need has been issued if one is necessary
    • (b)  SEPARATE AND LIMITED LICENSES. – Separate licenses shall not be required for different services within a single health care facility except that home health care, hospice or long-term nursing care will require separate licenses. A limited license, excluding from its terms a particular service or portion of a health care facility, may be issued under the provisions of this act.
    • (c)  ADDITION OF SERVICES. – When the certificate of need for a facility is amended as to services which can be offered, the department shall issue an appropriate license for those services upon demonstration of compliance with licensure requirements.

    HISTORY: Act 1992-179 (H.B. 1982), § 21, approved Dec. 18, 1992, eff. immediately; Act 1998-95 (S.B. 996), § 4, approved Oct. 16, 1998, eff. in 90 days.

    LexisNexis® Notes:

    TREATISES AND ANALYTICAL MATERIALS

    1.  14-246 Pennsylvania Transaction Guide--Legal Forms § 246.31, Division 1 Individuals and Families, Standard of Care Owed by Health Care Providers.


  • § 448.809.Term and content of license
    • (a)  CONTENTS. – All licenses issued by the department under this chapter shall:
      • (1)  be issued for a specified length of time as follows, including the provision of section 804(b):
        • (i) all health care facilities other than hospitals for a period of one year, and for hospitals for a period of two years with the expiration date to be the last day of the month in which license is issued;
        • (ii) provisional licenses for the length of time to be determined by the department upon issuance of the provisional license;
      • (2)  be on a form prescribed by the department;
      • (3)  not be transferable except upon prior written approval of the department;
      • (4)  be issued only to the health care provider and for the health care facility or facilities named in the application;
      • (5)  specify the maximum number of beds, if any, to be used for the care of patients in the facility at any one time; and
      • (6)  specify limitations which have been placed on the facility.
    • (b)  POSTING. – The license shall at all times be posted in a conspicuous place on the provider's premises.
    • (c)  VISITATION. – Whenever practicable, the department shall make its visitations and other reviews necessary for licensure contemporaneously with similar visitations and other reviews necessary for provider certification in the Medicare and medical assistance programs and the department shall endeavor to avoid duplication of effort by the department and providers in the certificate of need, medical assistance and Medicare provider certification and licensure procedures. This shall not preclude the department from unannounced visits.
    • (d)  USE OF BEDS IN EXCESS OF MAXIMUM. – Except in case of extreme emergency, no license shall permit the use of beds for inpatient use in the licensed facility in excess of the maximum number set forth in the license without first obtaining written permission from the department: Provided, That during the period of a license, a health care facility may without the prior approval of the department increase the total number of beds by not more than ten beds or 10% of the total bed capacity, whichever is less.

    HISTORY: Act 1992-179 (H.B. 1982), § 21, approved Dec. 18, 1992, eff. immediately.


  • § 448.810.Reliance on accrediting agencies and federal government
    • (a)  REPORTS OF OTHER AGENCIES. – After a provider has been licensed or approved to operate a health care facility for at least two years under this or prior acts, none of which has been pursuant to a provisional license, the department may rely on the reports of the Federal Government or nationally recognized accrediting agencies to the extent those standards are determined by the department to be similar to regulations of the department and if the provider agrees to:
      • (1)  direct the agency or government to provide a copy of its findings to the department; and
      • (2)  permit the department to inspect those areas or programs of the health care facility not covered by the agency or government inspection or where the agency or government report discloses more than a minimal violation of department regulations.
    • (b)  COORDINATION OF INSPECTIONS. – The department shall coordinate, to the extent possible, inspections by State agencies other than the department. Nothing herein shall be interpreted to preclude the department from any follow-up inspection of a health care facility in which deficiencies were found in the original inspections or more frequent inspections of health care facilities that received provisional licenses.
    • (c)  RIGHT OF INSPECTION PRESERVED. – This section shall not be construed to be a limitation on the department's right of inspection otherwise permitted by section 813.

    HISTORY: Act 1992-179 (H.B. 1982), § 21, approved Dec. 18, 1992, eff. immediately.


  • § 448.811.Reasons for revocation or nonrenewal of license

    The department may refuse to renew a license or may suspend or revoke or limit a license for all or any portion of a health care facility, or for any particular service offered by a facility, or may suspend admissions for any of the following reasons:

      • (1)  A serious violation of provisions of this act or of the regulations for licensure issued pursuant to this act or of Federal laws and regulations. For the purpose of this paragraph, a serious violation is one which poses a significant threat to the health or safety of patients or residents.
      • (2)  Failure of a licensee to submit a plan with a reasonable timetable to correct deficiencies.
      • (3)  The existence of a cyclical pattern of deficiencies over a period of two or more years.
      • (4)  Failure, by the holder of a provisional license, to correct deficiencies in accordance with a timetable submitted by the applicant and agreed upon by the department.
      • (5)  Fraud or deceit in obtaining or attempting to obtain a license.
      • (6)  Lending, borrowing or using the license of another, or in any way knowingly aiding or abetting the improper granting of a license.
      • (7)  Incompetence, negligence or misconduct in operating the health care facility or in providing services to patients.
      • (8)  Mistreating or abusing individuals cared for by the health care facility.
      • (9)  Serious violation of the laws relating to medical assistance or Medicare reimbursement.
      • (10)  Serious violation of other applicable Federal or State laws.

    HISTORY: Act 1992-179 (H.B. 1982), § 21, approved Dec. 18, 1992, eff. immediately.

    LexisNexis® Notes:

    CASE NOTES

    1.  Department of Health erred procedurally when it issued a rule to show cause pursuant to 1 Pa. Code § 35.14 in regard to allegations of serious violations of the Health Care Facilities Act because 35 P.S. § 448.811 authorized the department to revoke a health care facility's license, and, upon appeal from a revocation order, the Health Facilities Hearing Board was authorized to hold an evidentiary hearing and issue an adjudication; thus, the department was entrusted with more than a prosecutorial function with regard to licensure of health care facilities in the state. Commonwealth, Dep't of Health v. Brownsville Golden Age Nursing Home, Inc., 103 Pa. Commw. 449, 520 A.2d 926, 1987 Pa. Commw. LEXIS 1911 (1987).

    2.  Department of Health erred procedurally when it issued a rule to show cause pursuant to 1 Pa. Code § 35.14 in regard to allegations of serious violations of the Health Care Facilities Act because 35 P.S. § 448.811 authorized the department to revoke a health care facility's license, and, upon appeal from a revocation order, the Health Facilities Hearing Board was authorized to hold an evidentiary hearing and issue an adjudication; thus, the department was entrusted with more than a prosecutorial function with regard to licensure of health care facilities in the state. Commonwealth, Dep't of Health v. Brownsville Golden Age Nursing Home, Inc., 103 Pa. Commw. 449, 520 A.2d 926, 1987 Pa. Commw. LEXIS 1911 (1987).

    3.  Upon close scrutiny of 35 P.S. §§ 448.811 and 448.814 of the Health Care Facilities Act, 35 P.S. § 448.101 et seq., the Department of Health could revoke a health care facility's license without first considering any plan of correction submitted by the facility, if the department determined that the violation or violations found were so serious as to pose a significant threat to the health of the patients residing at the facility. Commonwealth, Dep't of Health v. Brownsville Golden Age Nursing Home, Inc., 103 Pa. Commw. 449, 520 A.2d 926, 1987 Pa. Commw. LEXIS 1911 (1987).

    TREATISES AND ANALYTICAL MATERIALS

    1.  14-246 Pennsylvania Transaction Guide--Legal Forms § 246.31, Division 1 Individuals and Families, Standard of Care Owed by Health Care Providers.


  • § 448.812.Provisional license

    When there are numerous deficiencies or a serious specific deficiency in compliance with applicable statutes, ordinances or regulations and when the department finds the applicant is taking appropriate steps to correct the deficiencies in accordance with a timetable submitted by the applicant and agreed upon by the department and there is no cyclical pattern of deficiencies over a period of two or more years, then the department may issue a provisional license for a specified period of not more than six months which may be renewed three times at the discretion of the department. Upon substantial compliance, including payment of any fines levied pursuant to section 817(d), a regular license shall be issued.


    HISTORY: Act 1992-179 (H.B. 1982), § 21, approved Dec. 18, 1992, eff. immediately.


  • § 448.813.Right to enter and inspect

    For the purpose of determining the suitability of the applicants and of the premises or for determining the adequacy of the care and treatment provided or the continuing conformity of the licensees to this act and to applicable local, State and federal regulations, any authorized agent of the department may enter, visit and inspect the building, grounds, equipment and supplies of any health care facility licensed or requiring a license under this act and shall have full and free access to the records of the facility and to the patients and employees therein and their records, and shall have full opportunity to interview, inspect, and examine such patients and employees. Upon entering a health care facility the inspectors shall properly identify themselves to the individual on the premises then in charge of the facility.


    LexisNexis® Notes:

    TREATISES AND ANALYTICAL MATERIALS

    1.  14-246 Pennsylvania Transaction Guide--Legal Forms § 246.34, Division 1 Individuals and Families, Medical Records and Communications.

    LAW REVIEWS

    1.  109 Penn St. L. Rev. 363, Comment: Taking Pennsylvania Off Life Support: A Systems-Based Approach to Resolving Pennsylvania's Medical Malpractice Crisis.


  • § 448.814.Provider violations
    • (a)  NOTICE OF VIOLATIONS. – Whenever the department shall upon inspection, investigation or complaint find a violation of this chapter or regulations adopted by the department pursuant to this chapter or pursuant to Federal law, it shall give written notice thereof specifying the violation or violations found to the health care provider. Such notice shall require the health care provider to take action or to submit a plan of correction which shall bring the health care facility into compliance with applicable law or regulation within a specified time. The plan of correction must be submitted within 30 days of receipt of the written notice or sooner if directed to do so by the department. The department may ban admissions or revoke a license before a plan of correction is submitted whenever deficiencies pose a significant threat to the health or safety of patients or residents.
    • (a)  APPOINTMENT OF TEMPORARY MANAGEMENT. – When the health care provider has failed to bring the facility into compliance within the time specified by the department, or when the facility has demonstrated that it is unwilling or unable to achieve compliance, such as would convince a reasonable person that any correction of violations would be unlikely to be maintained, the department may petition the Commonwealth Court or the Court of Common Pleas of the county in which the facility is located to appoint temporary management designated as qualified by the department to assume operation of the facility at the facility's expense to assure the health and safety of the facility's patients or residents until improvements are made to bring the facility into compliance with the laws and regulations for licensure or until there is an orderly closure of the facility. In the alternative, the department in its discretion may proceed in accordance with this chapter.

    HISTORY: Act 1992-179 (H.B. 1982), § 22, approved Dec. 18, 1992, eff. immediately.

    LexisNexis® Notes:

    CASE NOTES

    1.  Upon close scrutiny of 35 P.S. §§ 448.811 and 448.814 of the Health Care Facilities Act, 35 P.S. § 448.101 et seq., the Department of Health could revoke a health care facility's license without first considering any plan of correction submitted by the facility, if the department determined that the violation or violations found were so serious as to pose a significant threat to the health of the patients residing at the facility. Commonwealth, Dep't of Health v. Brownsville Golden Age Nursing Home, Inc., 103 Pa. Commw. 449, 520 A.2d 926, 1987 Pa. Commw. LEXIS 1911 (1987).


  • § 448.815.Effect of departmental orders
    • (a)  ENFORCEMENT. – Orders of the department from which no appeal is taken to the board, and orders of the board from which no timely appeal is taken to the Commonwealth Court, are final orders and may be enforced in court.
    • (b)  Repealed by 1982, Dec. 20, P.L. 1409, No. 326, art. III, § 318 [42 P.S. § 20078], effective in 60 days.
    • (c)  MEDICAL ASSISTANCE PAYMENTS. – Orders of the department, to the extent that they are sustained by the board, which fail to renew a license or which suspend or revoke a license, shall likewise revoke or suspend certification of the facility as a medical assistance provider, and no medical assistance payment for services rendered subsequent to the final order shall be made during the pendency of an appeal for the period of revocation or suspension without an order of supersedeas by the Appellate Court.
  • § 448.816.Actions against unlicensed health care providers
    • (a)  ACTIONS IN EQUITY. – Whenever a license is required by this chapter to maintain or operate a health care facility, the department may maintain an action in the name of the Commonwealth for an injunction or other process restraining or prohibiting any person from establishing, conducting or operating any unlicensed health care facility.
    • (b)  PERMANENT INJUNCTION. – Should a person who is refused a license or the renewal of a license to operate or conduct a health care facility, or whose license to operate or conduct a health care facility is suspended or revoked, fail to appeal, or should such appeal be decided finally favorable to the department, then the court shall issue a permanent injunction upon proof that the person is operating or conducting a health care facility without a license as required by this chapter.
  • § 448.817.Actions against violations of law, rules and regulations
    • (a)  ACTIONS BROUGHT BY DEPARTMENT. – Whenever any person, regardless of whether such person is a licensee, has violated any of the provisions of this chapter or the regulations issued pursuant thereto, the department may maintain an action in the name of the Commonwealth for an injunction or other process restraining or prohibiting such person from engaging in such activity.
    • (b)  CIVIL PENALTY. – Any person, regardless of whether such person is a licensee, who has committed a violation of any of the provisions of this chapter or of any rule or regulation issued pursuant thereto, including failure to correct a serious licensure violation (as defined by regulation) within the time specified in a deficiency citation, may be assessed a civil penalty by an order of the department of up to $ 500 for each deficiency for each day that each deficiency continues. Civil penalties shall be collected from the date the facility receives notice of the violation until the department confirms correction of such violation.
    • (c)  FUNDS COLLECTED AS A RESULT OF THE ASSESSMENT OF A CIVIL PENALTY. – When all other sources of funding have been exhausted, the department shall apply funds collected as a result of the assessment of a civil penalty to the protection of the health or property of patients or residents of the health care facility. Funds may be utilized to:
      • (1)  Provide payment to temporary management.
      • (2)  Maintain the operation of the health care facility pending correction of deficiencies or closure.
      • (3)  In the case of a long-term care nursing facility, relocate residents to other licensed health care facilities.
      • (4)  In the case of a long-term care nursing facility, reimburse residents for misappropriated personal needs allowance.
    • (c)  FACILITY CLOSURE FOR THREAT TO HEALTH OR SAFETY. – Whenever the department determines that deficiencies pose an immediate and serious threat to the health or safety of the patients or residents of the health care facility, the department may direct the closure of the facility and the transfer of patients or residents to other licensed health care facilities.

    HISTORY: Act 1992-179 (H.B. 1982), § 23, approved Dec. 18, 1992, eff. immediately.


  • § 448.817a.Employment of health care practitioners

    A health care practitioner may practice the healing arts as an employee or independent contractor of a health care facility or health care provider or an affiliate of a health care facility or health care provider established to provide health care.


    HISTORY: Act 2003-42 (H.B. 1580), § 1, approved Dec. 16, 2003, eff. in 60 days.


  • § 448.818.Injunction or restraining order when appeal is pending

    Whenever the department shall have refused to grant or renew a license, or shall have suspended or revoked a license required by this act to operate or conduct a health care facility, or shall have ordered the person to refrain from conduct violating the rules and regulations of the department, and the person, deeming himself aggrieved by such refusal or suspension or revocation or order, shall have appealed from the action of the department to the board, or from the order of the board to the court, the court may, during pendence of such appeal, issue a restraining order or injunction upon a showing that the continued operation of the health care facility adversely affects the well-being, safety or interest of the patients of the health care facility; or the court may authorize continued operation of the facility or make such other order, pending final disposition of the case, as justice and equity require.

  • § 448.819.Remedies supplementary

    The provisions of this chapter are supplementary to any other legal rights created in this act or any other act available for the enforcement of provisions of this act and rules and regulations promulgated thereunder.

  • § 448.820.Existing rules and regulations
    • (a)  CONTINUATION OF RULES AND REGULATIONS. – Existing rules and regulations applicable to health care facilities not clearly inconsistent with the provisions of this chapter, shall remain in effect until replaced, revised or amended. Sections 103.2 and 103.6 of Title 28 of the Pennsylvania Code are repealed.
    • (b)  EXPIRATION OF LICENSES. – All health care providers licensed on the effective date of this chapter to establish, maintain or operate a health care facility shall be licensed for the period remaining on the license. At the expiration of the existing license, the health care facility shall be subject to licensure pursuant to this chapter.

    HISTORY: Act 1992-179 (H.B. 1982), § 24, approved Dec. 18, 1992, eff. immediately.


  • § 448.821.Pet therapy programs
    • (a)  USE OF PET THERAPY. – Notwithstanding any inconsistent provision of law, rule or regulation to the contrary, and subject to the approval of the secretary, every health care facility may, at the discretion of the health care provider, invite a nonprofit organization or an individual to bring domesticated pets onto the premises of the facility or may board domesticated pets on the premises of the facility if the pet therapy would, in the determination of the secretary and the health care provider, tend to promote the general well-being of the residents of the facility. The secretary shall adopt rules and regulations necessary to implement the provisions of this act.
    • (b)  LIMITATION OF LIABILITY. – If a health care facility boards domesticated pets in the facility or if a health care facility or health care provider invites a nonprofit organization to bring domesticated pets onto the premises of the facility for the well-being of the residents of the facility, the health care facility or health care provider, or a director, officer or employee of the health care facility or health care provider, or the nonprofit organization, or a director, officer or employee of the nonprofit organization, shall not be liable to any person for civil damages as a result of any acts or omissions arising from the boarding of domesticated pets in the facility or the bringing of domesticated pets onto the premises of the facility unless the conduct of the person falls below the standards generally practiced and accepted in like circumstances by similar persons performing the same or similar acts, and unless it is shown that the person did an act or omitted the doing of an act which the person was under a recognized duty to another to do, knowing or having reason to know that the act or omission created a substantial risk of actual harm to the person or property of another. It shall be insufficient to impose liability to establish only that the conduct of the person fell below ordinary standards of care.
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