1. (1) If the REH provides outpatient medical and health services in addition to providing emergency services and observation care, those services shall meet the needs of the patients in accordance with acceptable standards of practice and shall be governed by the applicable Board rules for each service provided.
2. (2) The REH may provide outpatient and medical health diagnostic and therapeutic items and services that are commonly furnished in a physician's office or at another entry point into the health care delivery system that include, but are not limited to, radiology, laboratory, outpatient rehabilitation, surgical, maternal health, and behavioral health services. Each provider of the outpatient and medical health diagnostic and therapeutic services offered by the REH shall be individually credentialed by the REH's governing authority and shall be governed by the applicable rules for that provider's licensing authority while providing the service.
   

3. (3) If the REH provides outpatient and medical health diagnostic and therapeutic items and services, those items and services must align with the health needs of the community served by the REH. If the REH provides outpatient medical and health services in addition to providing emergency services, the REH must:

   1. (a) Provide items and services based on nationally recognized guidelines and standards of practice.
   2. (b) Have a system in place for referral from the REH to different levels of care, including follow-up care, as appropriate.
   3. (c) Have effective communication systems in place between the REH and the patient (or responsible individual) and their family, ensuring that the REH is responsive to their needs and preferences.
   4. (d) Have established relationships with hospitals that have the resources and capacity available to deliver care that is beyond the scope of care delivered at the REH.
      
      
   5. (e) Have qualified, credentialed personnel approved by the REH's governing authority, providing these services and available at each location where outpatient services are offered, based on the scope and complexity of outpatient services.
   6. (f) For any specialty services offered at the REH, the REH must have a physician, NP, or PA providing services with experience and training in the specialty service area and in accordance with their scope of practice.

Author: Dana H. Billingsley

Statutory Authority: Code of Ala. 1975, §§22-21-20, et seq.

History: New Rule: Published August 31, 2023; effective October 15, 2023.