Section R9-10-202. Supplemental Application Requirements

A.      In addition to the license application requirements in A.R.S. § 36-422 and 9 A.A.C. 10, Article 1, an applicant for an initial license shall include:

1.        On the application the requested licensed capacity for the hospital, including:

a.         The number of inpatient beds for each organized ser- vice, not including well-baby bassinets; and

b.        If applicable, the number of inpatient beds for each multi-organized service unit;

2.        On the application, if applicable, the requested licensed occupancy for providing behavioral health observation/ stabilization services to:

a.         Individuals who are under 18 years of age, and

b.        Individuals 18 years of age and older; and

3.        A list, in a format provided by the Department, of medi- cal staff specialties and subspecialties.

B.       For a single group license authorized in A.R.S. § 36-422(F), in addition to the requirements in subsection (A), a governing authority applying for an initial or renewal license shall submit the following to the Department, in a format provided by the Department, for each satellite facility under the single group license:

1.        The name, address, and telephone number of the satellite facility;

2.        The name of the administrator; and

3.        The hours of operation during which the satellite facility provides medical services, nursing services, or health- related services.

C.      For a single group license authorized in A.R.S. § 36-422(G), in addition to the requirements in subsection (A), a governing authority applying for an initial or renewal license shall submit the following to the Department in a format provided by the Department for each accredited satellite facility under the sin- gle group license:

1.        The name, address, and telephone number of the accred- ited satellite facility;

2.        The name of the administrator;

3.        The hours of operation during which the accredited satel- lite facility provides medical services, nursing services, or health-related services; and

4.        A copy of the accredited satellite facility’s current accred- itation report.

D.      A governing authority shall:

1.        Notify the Department at least 30 calendar days before a satellite facility or an accredited satellite facility on a sin- gle group license terminates operations; and

2.        Submit an application, according to the requirements in 9

A.A.C. 10, Article 1, at least 60 calendar days but not more than 120 calendar days before a satellite facility or an accredited satellite facility licensed under a single group license anticipates providing medical services, nursing services, or health-related services under a license separate from the single group license.

Historical Note

New Section made by final rulemaking at 8 A.A.R. 2785, effective October 1, 2002 (Supp. 02-2). Amended by final

rulemaking at 14 A.A.R. 4646, effective December 2,

2008 (Supp. 08-4). Amended by exempt rulemaking at 19

A.A.R. 2015, effective October 1, 2013 (Supp. 13-2). Amended by exempt rulemaking at 20 A.A.R. 1409, pur- suant to Laws 2013, Ch. 10, § 13; effective July 1, 2014

(Supp. 14-2).