These hospitals may offer specialized patient care services including:

All Acute Care or General Hospitals are licensed by the state to provide care within the minimum health and safety standards established by regulation and rule. The Department of Health (DOH) enforces the standards by conducting periodic surveys of these facilities.

Medicare pays for services provided by hospitals that voluntarily seek and are approved for certification by the Federal Health and Human Services Centers for Medicare and Medicaid Services (CMS).  CMS contracts with the DOH to evaluate compliance with the federal hospital regulations by periodically conducting surveys of these agencies. 

A hospital may seek accreditation by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) or the American Osteopathic Association (AOA). Surveys conducted by JCAHO and AOA are based on guidelines developed by each of these organizations.

The federal Emergency Medical Treatment and Labor Act (EMTALA) 42 CFR 489.24 applies to all hospitals. This Act requires that any hospital must respond to a person's emergent medical condition by determining the nature of the condition. If an urgent condition exists, it must be treated to the best of the facility's ability regardless of ability to pay. Patients may then be transferred as appropriate after stabilization of the condition.

Acute Care Hospitals

Statute and Rules

Statute: RCW 70.41  
Rules: WAC 246-320  

Application for State License

For persons interested in the application process for state licensure of a new  Hospitals here are steps to follow. 

1. Contact the Department of Health Certificate of Need Unit (CON) at (360) 236-2955 to obtain approval for establishing a hospital.
   

2. Following the issuance of a CON, contact Department of Health Construction Review Services (CRS) at (360) 236-2944 for review and approval of construction documents.
   

3. Once CON and CRS approval is granted, fill out the hospital application packet.
   

4. Submit the completed application and fee along with the licensing fee to Office of Health Care Survey.
   

5. After review and acceptance of the application materials, DOH conducts a survey before issuing the license.

Medicare Certification

Federal Medicare pays for services in hospitals who voluntarily seek certification and are approved by CMS. CMS contracts with DOH, to evaluate compliance with the federal regulations by periodically conducting on-site surveys in these hospitals.

Application for Federal Medicare Certification

For persons interested in Medicare Certification, here are the steps to follow. 

1. Request a copy of the Federal Medicare Regulations for Hospitals. How to Contact Us.
   

2. Contact DOH Construction Review Services (CRS) at (360) 236-2944 to determine if review and approval of construction documents is required.
   

3. Once CON and CRS approval is granted, Contact Us for a Hospital application packet. 
   

4. Submit the completed application to Office of Health Care Survey. 
   

5. After review and acceptance of the application materials, DOH conducts n on-site survey before recommending the hospital for Medicare certification.

Federal medicare Regulations for Hospitals

Regulation: 42 CFR 482.1 Part A  
Regulation: 42 CFR 482.11 Part B  
Regulation: 42 CFR 482.21 Part C  
Regulation: 42 CFR 482.51 Part D  

Critical Access Hospitals (CAH)

Critical Access Hospitals are limited in the number of patients they can admit and the type of services they provide to patients. CAHs are allowed to use on-call staff and to periodically close if there are no patients.  CAHs are state licensed as acute care hospitals.

CAHs must meet the following criteria established by the Medicare Rural Hospital Flexibility Program:

• Located in a rural area of the state that has established a Medicare approved Rural Hospital Flexibility Plan;

• Located more than a 35 mile drive from any other hospital or be certified by the State as a "necessary provider" of health care services to residents in the area;

• House not more than 15 acute care patients at any one time (may have a total of 25 inpatient beds with the balance of patients occupying long-term care beds); and

• Limit patient stays to 96 hours, unless a longer period is required, because of inclement weather or other emergency conditions.

CAHs must meet all the state regulations for hospitals and be licensed by the state, as well as specific federal regulations established by the Federal Health and Human Services Centers for Medicare and Medicaid Services (CMS). CMS contracts with DOH to evaluate compliance with the Medicare CAH regulations by making unannounced on-site surveys in these agencies.

Federal Medicare Regulations for CAH

Regulations: 42 CFR 485.601 Part F Critical Access Hospitals

Contact Office of Community and Rural Health for information on application designated as a  CAH.

Alcoholism and Chemical Dependency Hospitals (ACD)

ACD Hospitals are licensed by the state under specific regulation, WAC 246-324, and not under general hospital regulations.

These hospitals provide:

• Physical and dependency assessments

• Comprehensive treatment and discharge plans

• Pharmacy and medication services

• Laboratory services

• Food services

• A clean and safe environment for patients, staff and visitors

Statutes and Rules for ACD Hospitals

Regulations: RCW 71.12  
Rules: WAC 246-324  

Psychiatric Hospitals

Psychiatric Hospitals provide care to individuals with signs and symptoms of mental illness by a multidisciplinary treatment team. This team is comprised of health professionals such as mental health counselors, nurses, psychiatrists, dieticians, social workers, psychologists, recreational therapists as well as physical therapists. Goals for care are established

Psychiatric Hospitals are licensed by the state under specific regulations.  These hospitals may also be Medicare certified as a psychiatric hospital under special conditions for coverage (42 CFR 482.60 Part E), not under general hospital regulations WAC 246-322. 

These hospitals provide:

• Physical and mental health assessments

• Comprehensive treatment and discharge plans

• Pharmacy and medication services

• Laboratory services

• Food services

• A clean and safe environment for patients, staff and visitors

Statute and Rules for Psychiatric Hospitals

Statute: RCW 71.12  
Rules: WAC 246-322

Federal Regulations for Psychiatric Hospitals

42 CFR482.1 Part A

42 CFR482.11 Part B  

42 CFR482.21 Part C  

42 CFR482.51 Part D  

42 CFR482.60 Part E