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. (a) In addition to the basic services offered under the
license, a general acute care hospital may be approved in accordance
with subdivision (c) of Section 1277 to offer special services,
including, but not limited to, the following:
(1) Radiation therapy department.
(2) Burn center.
(3) Emergency center.
(4) Hemodialysis center (or unit).
(5) Psychiatric.
(6) Intensive care newborn nursery.
(7) Cardiac surgery.
(8) Cardiac catheterization laboratory.
(9) Renal transplant.
(10) Other special services as the department may prescribe by
regulation.
(b) A general acute care hospital that exclusively provides acute
medical rehabilitation center services may be approved in accordance
with subdivision (b) of Section 1277 to offer special services not
requiring surgical facilities.
(c) The department shall adopt standards for special services and
other regulations as may be necessary to implement this section.
(d) (1) For cardiac catheterization laboratory service, the
department shall, at a minimum, adopt standards and regulations that
specify that only diagnostic services, and what diagnostic services,
may be offered by a general acute care hospital or a multispecialty
clinic as defined in subdivision (l) of Section 1206 that is approved
to provide cardiac catheterization laboratory service but is not
also approved to provide cardiac surgery service, together with the
conditions under which the cardiac catheterization laboratory service
may be offered.
(2) Except as provided in paragraph (3), a cardiac catheterization
laboratory service shall be located in a general acute care hospital
that is either licensed to perform cardiovascular procedures
requiring extracorporeal coronary artery bypass that meets all of the
applicable licensing requirements relating to staff, equipment, and
space for service, or shall, at a minimum, have a licensed intensive
care service and coronary care service and maintain a written
agreement for the transfer of patients to a general acute care
hospital that is licensed for cardiac surgery or shall be located in
a multispecialty clinic as defined in subdivision (l) of Section
1206. The transfer agreement shall include protocols that will
minimize the need for duplicative cardiac catheterizations at the
hospital in which the cardiac surgery is to be performed.
(3) Commencing March 1, 2013, a general acute care hospital that
has applied for program flexibility on or before July 1, 2012, to
expand cardiac catheterization laboratory services may utilize
cardiac catheterization space that is in conformance with applicable
building code standards, including those promulgated by the Office of
Statewide Health Planning and Development, provided that all of the
following conditions are met:
(A) The expanded laboratory space is located in the building so
that the space is connected to the general acute care hospital by an
enclosed all-weather passageway that is accessible by staff and
patients who are accompanied by staff.
(B) The service performs cardiac catheterization services on no
more than 25 percent of the hospital's inpatients who need cardiac
catheterizations.
(C) The service complies with the same policies and procedures
approved by hospital medical staff for cardiac catheterization
laboratories that are located within the general acute care hospital,
and the same standards and regulations prescribed by the department
for cardiac catheterization laboratories located inside general acute
care hospitals, including, but not limited to, appropriate
nurse-to-patient ratios under Section 1276.4, and with all standards
and regulations prescribed by the Office of Statewide Health Planning
and Development. Emergency regulations allowing a general acute care
hospital to operate a cardiac catheterization laboratory service
shall be adopted by the department and by the Office of Statewide
Health Planning and Development by February 28, 2013.
(D) Emergency regulations implementing this paragraph have been
adopted by the department and by the Office of Statewide Health
Planning and Development by February 28, 2013.
(E) This paragraph shall not apply to more than two general acute
care hospitals.
(4) After March 1, 2014, an acute care hospital may only operate a
cardiac catheterization laboratory service pursuant to paragraph (3)
if the department and the Office of Statewide Health Planning and
Development have adopted regulations in accordance with the
requirements of Chapter 3.5 (commencing with Section 11340) of Part 1
of Division 3 of Title 2 of the Government Code that provide
adequate protection to patient health and safety including, but not
limited to, building standards contained in Part 2.5 (commencing with
Section 18901) of Division 13.
(5) Notwithstanding Section 129885, cardiac catheterization
laboratory services expanded in accordance with paragraph (3) shall
be subject to all applicable building standards. The Office of
Statewide Health Planning and Development shall review the services
for compliance with the OSHPD 3 requirements of the most recent
version of the California Building Standards Code.
(e) For purposes of this section, "multispecialty clinic," as
defined in subdivision (l) of Section 1206, includes an entity in
which the multispecialty clinic holds at least a 50-percent general
partner interest and maintains responsibility for the management of
the service, if all of the following requirements are met:
(1) The multispecialty clinic existed as of March 1, 1983.
(2) Prior to March 1, 1985, the multispecialty clinic did not
offer cardiac catheterization services, dynamic multiplane imaging,
or other types of coronary or similar angiography.
(3) The multispecialty clinic creates only one entity that
operates its service at one site.
(4) These entities shall have the equipment and procedures
necessary for the stabilization of patients in emergency situations
prior to transfer and patient transfer arrangements in emergency
situations that shall be in accordance with the standards established
by the Emergency Medical Services Authority, including the
availability of comprehensive care and the qualifications of any
general acute care hospital expected to provide emergency treatment.
(f) Except as provided in this section and in Sections 100921 and
100922, under no circumstances shall cardiac catheterizations be
performed outside of a general acute care hospital or a
multispecialty clinic, as defined in subdivision (l) of Section 1206,
that qualifies for this definition as of March 1, 1983.