A. This chapter and the rules adopted by the director pursuant to this chapter do not authorize the licensure, supervision, regulation or control of:

1. 1. The remedial care or treatment of residents or patients in any home or institution conducted only for those who rely solely on treatment by prayer or spiritual means in accordance with the creed or tenets of any well-recognized church or religious denomination.
2. 2. Establishments, such as motels, hotels and boarding houses, that provide domiciliary and ancillary commercial services but do not provide adaptive, medical, hospital, nursing, behavioral health, health-related or supervisory care services.

3. 3. Private offices and clinics of health care providers licensed under title 32 that are not freestanding urgent care centers, unless:

   1. (a) Patients of the office or clinic are kept overnight as bed patients or treated otherwise under general anesthesia, except when treatment by general anesthesia is regulated by title 32, chapter 11.
   2. (b) The office or clinic is an abortion clinic. For the purposes of this subdivision, "abortion clinic" has the same meaning prescribed in section 36-449.01.
   3. (c) The office or clinic is a pain management clinic. For the purposes of this subdivision, "pain management clinic" has the same meaning prescribed in section 36-448.01.
4. 4. Dispensaries and first aid stations that are located within business or industrial establishments and that are maintained solely for the use of employees if the facility does not contain inpatient beds and is under the supervision of a physician or a registered nurse practitioner.
5. 5. The collection, processing or distribution of whole human blood, blood components, plasma, blood fractions or derivatives that are procured, processed or distributed by federally licensed and regulated blood banks.
6. 6. Places where four or fewer adults who are not related to the administrator or owner receive adult day health services for compensation on a regular basis.
7. 7. Places at which persons receive health-related services only from relatives or from legal guardians or places that do not purport to be establishments that regularly provide health-related services and at which one or two persons receive health-related services on a twenty-four-hour basis.
8. 8. The personal residence of a terminally ill person, or the personal residence of that person's relative or guardian, where that person receives hospice services from a hospice service agency.
9. 9. All medical and health-related facilities and services that are provided to inmates who are confined in a state prison. The state department of corrections shall annually evaluate the medical and health-related facilities and services that are provided to inmates to determine that the facilities and services meet the applicable standards that are adopted by the director of the department of health services. The state department of corrections shall report the results of its annual evaluation and the actual findings, including a plan of correction for any deficiencies, to the director of the department of health services. The department of health services shall conduct validation surveys on a percentage of the medical and health-related facilities, the number of which shall be determined by the state department of corrections and the department of health services. The director of the state department of corrections shall maintain the annual evaluation reports. This paragraph does not apply to licensed behavioral or mental health inpatient treatment facilities that the state department of corrections operates.
10. 10. A facility that provides medical and health services to inmates who are confined in a county jail. The sheriff shall annually evaluate the facility to determine if it meets the applicable standards that are adopted by either a national corrections commission on health care or an American correctional association, or the sheriff shall annually submit the facility to a similar separate inspection by an outside agency with medical standards. The sheriff must submit the certificate of accreditation or proof of successful inspection to the department annually and keep a copy of the certificate or proof of inspection.
11. 11. Community education, advocacy or recovery support groups that are not owned or operated by or contracted to provide services with a health care institution.

12. 12. An outpatient treatment center that has the same direct owner or indirect owner as a hospital licensed pursuant to this chapter, that is staffed by health care providers who are licensed pursuant to title 32 and that provides notice to the department of its decision to be exempt from licensure under this chapter, unless:

    1. (a) Patients are kept overnight in the outpatient treatment center or are treated under general anesthesia, except when the treatment by general anesthesia is regulated pursuant to title 32, chapter 11.
    2. (b) The outpatient treatment center is an abortion clinic as defined in section 36-449.01.
    3. (c) The outpatient treatment center is a pain management clinic as defined in section 36-448.01.

B. A medical and health-related facility that provides medical and health services exclusively to persons who are incarcerated, detained or confined under court order or court jurisdiction is exempt from the patient-per-room capacity requirements provided in rule if the facility:

1. 1. Does not exceed its intended medical and custodial purposes.
2. 2. Adopts policies and procedures to comply with the national commission on correctional health care standards, or equivalent standards.
3. 3. As soon as practicable, becomes accredited by the national commission on correctional health care, or by an equivalent organization.
4. 4. Once accreditation is obtained, submits a certificate of accreditation to the department of health services annually.
5. 5. Maintains a copy of the certificate of accreditation.
6. 6. Maintains patient and custodial records, including on-site current photographs and fingerprints, if permitted by applicable law.
7. 7. Makes patient lists with inmate identifiers available to the state department of corrections on reasonable request.
8. 8. Provides timely notice of any major incident involving public safety to the appropriate law enforcement agency and allows that agency access to the facility for the purposes of law enforcement and investigation.