I. The commissioner of the department of health and human services shall adopt a separate set of rules under RSA 541-A, for each classification of health facility based on the care setting and also taking into consideration acuity levels and facility size for those facilities with overnight beds, relative to:
(a)Standards for licensing and classifying facilities under this chapter, including, but not limited to, provisions for sanitation, organization, administration, physical environment, health and safety, nursing units, resident environment, dietary needs, medical records, medication, disease control, personnel, and clinical records.
(b)Exemptions from licensing requirements.
(c)License application requirements under RSA 151:4.
(d)License expiration dates under RSA 151:5.
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I. The commissioner of the department of health and human services shall adopt a separate set of rules under RSA 541-A, for each classification of health facility based on the care setting and also taking into consideration acuity levels and facility size for those facilities with overnight beds, relative to:
(a) Standards for licensing and classifying facilities under this chapter, including, but not limited to, provisions for sanitation, organization, administration, physical environment, health and safety, nursing units, resident environment, dietary needs, medical records, medication, disease control, personnel, and clinical records.
(b) Exemptions from licensing requirements.
(c) License application requirements under RSA 151:4.
(d) License expiration dates under RSA 151:5.
(e) Inspections under RSA 151:6 and RSA 151:6-a.
(f) Procedures for reclassifying, denying, suspending, or revoking licenses under RSA 151:7.
(g) Procedures for issuing warnings under RSA 151:7-a.
(h) Procedures for rehearings and appeals under RSA 151:8.
(i) Procedures for reinstating licenses under RSA 151:8-a.
(j) Fees for witnesses at hearings.
(k) Procedures for reviewing documentation of the mandatory completion of, and reimbursement for, a state approved program under RSA 326-B for assistants to nurses and licensed nursing assistants authorized to administer medication pursuant to RSA 326-B:14, II-a, in facilities licensed under RSA 151:2 in accordance with the Title XIX Medicaid state plan.
(l) A schedule of administrative fines which may be imposed under RSA 151:16-a for violation of this chapter or the rules adopted pursuant to it.
(m) Procedures for notice and hearing prior to the imposition of an administrative fine imposed under RSA 151:16-a.
(n) The administration of the pediatric vaccine distribution program under section 1928(a) of the Social Security Act.
(o) The reporting by hospitals of hospital acquired infections and hospital infection data under RSA 151:33.
(p) Procedures for laboratories performing testing under RSA 151:12-c.
II. [Repealed.]
II-a. The commissioner of the department of health and human services shall adopt rules relative to the requirements for licensing near a critical access hospital under RSA 151:4-a.
III. The state fire marshal, after consultation with the department of health and human services, shall have the authority to adopt rules pursuant to RSA 541-A, and supervise and enforce all laws relative to the protection of life and property from fire, fire hazards and related matters, and it may make or cause to be made inspections relative to such matters.
IV. No rules shall be adopted or enforced which would have the effect of denying a license to a facility required to be licensed hereunder, solely by reason of the school or system of practice employed or permitted to be employed by physicians therein if such school or system of practice is recognized by the laws of the state.
V. No rules shall be adopted under this chapter for any facility conducted for those who rely upon treatment by spiritual means or prayer in accordance with the creed or tenets of any well recognized church or religious denomination, except as to the sanitary and safe conditions of the premises, cleanliness of operation, and its physical equipment.
VI. The commissioner of the department of health and human services shall, by January 1, 1986, adopt rules under RSA 541-A to require from hospitals such information as necessary to support the activities of the department of health and human services.
VII. (a) The rules adopted under RSA 151:9, I for residential care facilities shall, in establishing licensure classifications, recognize the following licensure levels which correspond to a continuum of care requiring different programs and services to assure quality of life in the least restrictive environment possible:
(1) Residential care, requiring a minimum of regulation and reflecting the availability of assistance in personal and social activities with a minimum of supervision or health care, which can be provided in a home or home-like setting.
(2) Supported residential health care, reflecting the availability of social or health services, as needed, from appropriately trained or licensed individuals, who need not be employees of the facility, but shall not require nursing services complex enough to require 24-hour nursing supervision. Such facilities may also include short-term medical care for residents of the facility who may be convalescing from an illness and these residents shall be capable of self-evacuation.
(3) Nursing facilities providing a range of social and health services, including 24-hour-a-day supervision and the provision of medical care and treatment, according to a plan of care, by appropriately trained or licensed individuals who are employees of or who are under contract to the facility.
(4) Special needs residential facilities, other than specialty hospitals, which, in addition to meeting the criteria of subparagraph (1), (2), or (3), reflect the availability of specialized supervision and treatment appropriate to the needs of the residents being cared for by appropriately trained or licensed individuals.
(b) Additional levels of classification may be established within each major level, and a facility may hold more than one license. The commissioner of the department of health and human services may, in adopting rules under RSA 151:9, I, establish limits on the number of residents to be cared for at different licensure levels.
VIII. The commissioner of the department of health and human services shall establish a program, by rule, to certify facilities that provide services to fewer than 3 individuals, beyond room and board care, in a residential setting, as an alternative to nursing facility care, which offers residents a home-like living arrangement, social, health, or medical services, including, but not limited to, medical or nursing supervision, medical care or treatment by appropriately trained or licensed individuals, assistance in daily living, or protective care.
IX. (a) When adopting, readopting, or amending rules relative to health facilities, the commissioner of health and human services shall address the following criteria and shall ensure that all criteria are met:
(1) The number of rules and regulations shall be kept at the minimum level necessary to adequately protect the health and safety of consumers.
(2) Rules shall be appropriate to the setting in which services are delivered and the size of the provider delivering services.
(3) Rules shall strike an appropriate balance between the protection afforded and the cost to implement, considering the cost to both the state and the provider.
(b) Any rule that fails to meet the criteria established in subparagraphs (a)(1)-(3) shall be considered to exceed the statutory authority of the agency, be contrary to legislative intent, and be contrary to public interest, and shall be null and void.
1947, 216:1, par. 9. RSA 151:9. 1961, 237:1. 1979, 399:8. 1981, 460:8. 1983, 274:5; 291:1, I. 1985, 190:13, 83. 1986, 230:3. 1988, 156:7, 8. 1991, 355:40; 365:9. 1994, 403:1. 1995, 310:170, VI, 181, 182. 2002, 101:1. 2004, 5:1, 2, eff. May 18, 2004. 2005, 293:4, eff. July 1, 2005 at 12:01 a.m. 2007, 199:1, eff. Aug. 17, 2007. 2009, 225:2, eff. Jan. 1, 2010. 2020, 32:11, eff. Sept. 22, 2020; 39:66, eff. July 1, 2020. 2022, 249:2, eff. Jan. 1, 2023. 2023, 122:1, eff. Aug. 29, 2023.