Enforcement

1. Hospitals are subject to one or more enforcement actions, which may include a ban or limitation on admissions, suspension or revocation of a license, or a denial to license for the following reasons: a. Noncompliance to the licensure requirements in this chapter have been identified which: (1) Present imminent danger to patients; (2) Have a direct or immediate relationship to the health, safety, or security of the hospital's patients; (3) If left uncorrected, have a potential for jeopardizing patient health or safety if left uncorrected; or (4) Is a recurrence of the same or substantially same violation in a twenty-four-month period. b. Failure to correct any deficiency pursuant to a plan of correction, unless the department approves in writing an extension or modification of the plan of correction. c. Gross incompetence, negligence, or misconduct in operating the hospital as determined through department investigation or through a court of law. d. Fraud, deceit, misrepresentation, or bribery in obtaining or attempting to obtain a license. e. Lending, borrowing, or using the license of another hospital. f. Knowingly aiding or abetting in any way the improper granting of a license. 2. Conditions or practices which the department has determined to present an imminent danger to patients in the hospital must be abated or eliminated immediately or within a fixed period of time as specified by the department. 3. The department shall notify the hospital in writing when a decision is made to initiate a ban or limitation on admissions, a suspension or revocation of a license, or a denial to license. The notice must include the basis of the department's decision and must advise the hospital of the right to: a. Request a review by the department. (1) The hospital's request for a review shall be made to the department in writing within thirty days from the date the department determined the hospital to be noncompliant with the licensure requirements as identified in subsection 1 unless imminent danger to the patients in the hospital has been identified. The request for a review must include documentation that assures the areas of noncompliance have been corrected and the dates this was achieved. Compliance must be achieved prior to the forty-fifth day to allow for completion of a revisit by the department by that date. (2) If a request for an onsite review is made, the department shall review all material relating to the deficiencies specific to the basis on which the enforcement action has been made. The department shall determine, based on review of the material and an onsite revisit if necessary, whether or not to sustain the enforcement action. b. Request a hearing before the office of administrative hearings on the department's decision to initiate a ban or limitation on admissions, a suspension or revocation of a license, or denial to license. (1) The request for a hearing must be filed with the department in writing within sixty days from the date the department notified the hospital of the decision to initiate the enforcement action. A request for a review under subdivision a does not extend the time period in which the hospital must request a hearing before the office of administrative hearings under this subsection. (2) The request for a hearing under this section must be accompanied by written documents including all of the following information: (a) A copy of the notice received from the department. (b) The reason or basis for the requested hearing. (c) The statute or rule related to each disputed issue. (d) The name, address, and telephone number of the individual to whom all notices must be mailed or delivered regarding the requested hearing. (3) Within ten days of receipt of the request for a hearing, the department shall request a hearing officer from the office of administrative hearings as provided in North Dakota Century Code chapter 54-57. (4) The hearing officer must make written findings of fact and conclusions of law, and must recommend a decision to the department. The recommended decision must set forth the reasons for the decision and the evidence upon which the decision is based. (5) The department may accept, modify, or reject the recommended decision. If the department rejects the recommended decision, it may remand the matter to the office of administrative hearings with directions. The department may require the receipt of additional evidence, and submission of amended findings of fact, conclusions of law, and recommended decision which reflects consideration of additional evidence. The department may require that the matter be referred to the same or a different hearing officer, and the office of administrative hearings shall comply with that direction unless compliance is impossible. 4. All enforcement determinations by the department to limit or ban admissions, revoke or suspend a license, or to deny a license become final within sixty days unless a request for a hearing before the office of administrative hearings has been filed by the hospital with the department. The enforcement action takes effect ninety days from the date on which the department notified the hospital of the decision to implement an enforcement action unless the hospital has requested a hearing. 5. The department may place a public notice in the newspapers in the area in which the hospital is located to notify the public of the enforcement action that is to be imposed and the effective dates. The department shall notify the hospital in writing of the impending public notice fifteen days prior to the publication of the notice.