(b) Exceptions to license requirement. The following facilities do not require a license from the Department of Health:

1. (1) A facility operated by the federal government; and
2. (2) A first aid station.

(d) Application for license.

1. (1) An applicant shall:

   1. (A) File applications under oath with the Department of Health upon forms provided by the Division of Health Facilities Services; and
   2. (B) Pay annual license fee as indicated by Arkansas Code § 20-9-214.

2. (2)

   1. (A) These fees shall be:

(i) Paid into the State Treasury; or

1. (ii) Refunded to the applicant if a license is denied.

   1. (B) The application shall be signed:

      1. (i) By the owner, if an individual or partnership;
      2. (ii) In the case of a corporation, by two (2) of its officers; or
      3. (iii) In the case of a governmental unit, by the head of the governmental department having jurisdiction over it.

   2. (C) The application shall set forth:

      1. (i) The full name and address of the institution for which license is sought; and
      2. (ii) Such additional information as the Department of Health may require, including affirmative evidence of ability to comply with such reasonable standards and rules as may be lawfully prescribed hereunder.
   3. (D) The application for annual license renewal shall be postmarked no later than January 2 of the year for which the license is issued.
   4. (E) The license applicant for an existing institution postmarked after the date shall be subject to a penalty of one dollar ($1.00) per day for each day and every day after January 2.

2. (3)

   1. (A) A license issued hereunder shall:

      1. (i) Be effective on a calendar-year basis; and
      2. (ii) Expire on December 31 of each calendar year.

   2. (B) A license shall:

      1. (i) Be issued only for the premises and persons in the application; and
      2. (ii) Not be transferable.
   3. (C) If the facility changes ownership, the license shall expire.
   4. (D) The license shall be posted in a conspicuous place on the licensed premises.
   5. (E) A license issued under previous rules shall be effective through the period for which it was issued.
   6. (F) The adequacy of cooperative agreements between hospitals in terms of service provided by each hospital and the type of licenses issued to each hospital shall be determined by the Department of Health.

(e) Facility change of ownership.

1. (1) It shall be the responsibility of the licensed entity to notify the division in writing at least thirty (30) days prior to the effective date of change of ownership.

2. (2) The following information shall be submitted to the division for review and approval:

   1. (A) License application;
   2. (B) Request for Medicare certification, where applicable;
   3. (C) Legal documents, ownership agreements, the license previously issued to the facility, and other information to support relicensure requirements; and
   4. (D) Licensure fee as indicated by Arkansas Code § 20-9-214.

3. (3)

   1. (A) For the purpose of this part, the licensed entity is the party ultimately responsible for operating the facility.

   2. (B) The same entity also bears the final responsibility:

      1. (i) In decisions made in the capacity of a governing body; and
      2. (ii) For the consequences of these decisions.

(f) Facility name change and/or address.

1. (1) The facility shall notify the division of any name and/or address change.
2. (2) The previously issued license shall be returned to the division; and
3. (3) A fee, as indicated in Arkansas Code § 20-9-214 shall be submitted to the division for issuance of a new license.

(g) Management contract.

1. (1)

   1. (A) It shall be the responsibility of the licensed entity to notify the division in writing at least thirty (30) days prior to entering into a management contract or agreement with an organization or firm.
   2. (B) A copy of the contract or agreement shall also be submitted to the division for review to ensure the arrangement does not materially affect the license status.

2. (2)

   1. (A) An organization or firm who contracts with the licensed entity to manage the healthcare facility, subject to governing body approval of operational decisions, is generally considered an agent rather than an owner.
   2. (B) In such instances, a licensure change is not required.

(h) Separate license.

1. (1) An individual license shall be required for an institution maintained on separate premises even though it is operated under the same management, except in cases where the hospital management of a general hospital operates a detached building that can be utilized in a limited way for general medical care.

2. (2) Separate licenses are not required for separate buildings on the same grounds.

   1. (i) Temporary license. This license shall be for:
3. (1) Less than one (1) year; and
4. (2) A time specified on the temporary license by the Department of Health.

(j) Revocation of license.

1. (1)

   1. (A) The Department of Health is empowered to deny, suspend, or revoke a license on any of the following grounds:

      1. (i) Violation of any of the provisions of Arkansas Code § 20-9-201 et seq., § 20-7-123, or this part; or
      2. (ii) Permitting, aiding, or abetting the commission of any unlawful act in connection with the operation of the institution (Arkansas Code § 20-9-215).
   2. (B) The right of appeal of any revocation shall be as specified in the appeal procedure of the Department of Health.
2. (2) Note. If services are to be temporarily suspended, a functional program with plans and specifications as applicable shall be submitted to the division for approval prior to such suspension.

(k) Inspection. Any authorized representative of the Department of Health shall have the right to enter the premises of any institution at any time in order to make whatever inspection necessary in accordance with the minimum standards and rules prescribed herein.

1. (l) Centers for Medicare & Medicaid Services waivers.
2. (1) When the Centers for Medicare & Medicaid Services declares a public health emergency (PHE) with the implementation of waivers that applies to Arkansas, the Department of Health may consider implementing similar waivers.

3. (2) If implemented, the waiver request and authorization may vary based on the type of PHE and Centers for Medicare & Medicaid Services requirements.

   1. (m) Penalties.
4. (1) Any person, partnership, association, or corporation that establishes, conducts, manages, or operates any institution defined herein, without first obtaining a license therefore as herein provided or who violates any portion of this part shall be guilty of a misdemeanor, and upon conviction thereof shall be liable to a fine of not less than twenty-five dollars ($25.00) nor more than one hundred dollars ($100) for the first offense and not less than one hundred dollars ($100) nor more than five hundred dollars ($500) for each subsequent offense and each day such institution operates after a first conviction shall be considered a subsequent offense (Arkansas Code § 20-9-202).

5. (2)

   1. (A) Any institution licensed by the authority of this part that has received damage due to fire, tornado, earthquake, or manmade or natural disaster shall notify the Department of Health by telephone immediately and follow with a:

      1. (i) Preliminary report within forty-eight (48) hours; and
      2. (ii) Complete report when the incident has been thoroughly investigated.
   2. (B) The submitted report shall include but not be limited to damage to the building, damage estimates, injuries to patients, staff, and the public, etc.

   3. (C) If the Department of Health is not notified, the institution shall be assessed a fine in the amount of:

      1. (i) Fifty dollars ($50.00) for each day or portion thereof the incident is not reported; or
      2. (ii) Five hundred dollars ($500) maximum.