Chapter 3722 | Hospitals

Section 3722.01 | Definitions.

• Effective: September 30, 2021
• Latest Legislation: House Bill 110 - 134th General Assembly

As used in this chapter:

(A) "Children's hospital" means either of the following:

(1) A hospital that provides general pediatric medical and surgical care in which at least seventy-five per cent of annual inpatient discharges for the preceding two calendar years were individuals less than eighteen years of age;

(2) A distinct portion of a hospital that provides general pediatric medical and surgical care, has a total of at least one hundred fifty pediatric special care and pediatric acute care beds, and in which at least seventy-five per cent of annual inpatient discharges for the preceding two calendar years were individuals less than eighteen years of age.

(B) "Health care service" means any of the following:

(1) Pediatric intensive care;

(2) Solid organ and bone marrow transplantation;

(3) Stem cell harvesting and reinfusion;

(4) Cardiac catheterization;

(5) Open heart surgery;

(6) Operation of linear accelerators;

(7) Operation of cobalt radiation therapy units;

(8) Operation of gamma knives.

(C) "Hospital" means an institution or facility that provides inpatient medical or surgical services for a continuous period longer than twenty-four hours. "Hospital" includes a children's hospital.

(D) "Political subdivision" means a county, township, municipal corporation, or other body corporate and politic responsible for governmental activities in a geographic area smaller than that of the state.

(E) "State university" has the same meaning as in section 3345.12 of the Revised Code.

Last updated October 19, 2021 at 5:24 PM

Section 3722.02 | Hospital license requirement; exemptions.

• Effective: April 6, 2023
• Latest Legislation: House Bill 558 - 134th General Assembly

(A) It is the intent of the general assembly in enacting Chapter 3722. of the Revised Code to require each hospital operating in this state to be licensed by the director of health. Beginning on September 30, 2024, any reference to a hospital contained in the Revised Code in a chapter other than Chapter 3722. of the Revised Code shall be construed to mean a hospital licensed under Chapter 3722. of the Revised Code.

(B) Beginning on September 30, 2024, no person and no political subdivision, agency, or instrumentality of this state shall operate a hospital without holding a license issued by the director of health under section 3722.03 of the Revised Code.

(C) Division (A) of this section does not apply to any of the following:

(1) A hospital operated by the federal government;

(2) An ambulatory surgical facility or other health care facility licensed as described in section 3702.30 of the Revised Code;

(3) A nursing home or residential care facility licensed under Chapter 3721. of the Revised Code;

(4) A hospital or inpatient unit licensed under section 5119.33 of the Revised Code;

(5) A residential facility as defined in section 5119.34 of the Revised Code;

(6) A residential facility as defined in section 5123.19 of the Revised Code;

(7) A community addiction services provider as defined in section 5119.01 of the Revised Code;

(8) A facility providing services under a contract with the department of developmental disabilities under section 5123.18 of the Revised Code;

(9) A facility operated by a hospice care program licensed under section 3712.04 of the Revised Code and that is used exclusively for the care of hospice patients;

(10) A facility operated by a pediatric respite care program licensed under section 3712.041 of the Revised Code and that is used exclusively for the care of pediatric respite care patients or a location operated by a pediatric transition care program registered under section 3712.042 of the Revised Code that is used exclusively for the care of pediatric transition care patients;

(11) The site where a health care practice is operated, regardless of whether the practice is organized as an individual or group practice;

(12) A clinic providing ambulatory patient services where patients are not regularly admitted as inpatients;

(13) An institution for the sick that is operated exclusively for patients who use spiritual means for healing and for whom the acceptance of medical care is inconsistent with their religious beliefs, accredited by a national accrediting organization, exempt from federal income taxation under section 501 of the Internal Revenue Code of 1986, 26 U.S.C. 1, and providing twenty-four-hour nursing care pursuant to the exemption from the licensing requirements of Chapter 4723. of the Revised Code described in division (E) of section 4723.32 of the Revised Code.

(D)(1) If the director of health determines that a hospital is operating without a license in violation of this section, the director shall do any of the following:

(a) Notify the hospital that it is operating without a license and provide it with an opportunity to apply for licensure, but only within the thirty-day period beginning on the date the hospital received the director's notice;

(b) Direct the hospital to cease operations;

(c) Impose a civil penalty of not more than two hundred fifty thousand dollars;

(d) In addition to the penalty described in division (D)(1)(c) of this section, impose a penalty of not less than one thousand dollars and not more than ten thousand dollars for each day the hospital operates without a license.

(2) If the hospital described in division (D)(1) of this section continues to operate without a license, the director may petition the court of common pleas of the county in which the hospital is located for an order enjoining the hospital from operating.

Last updated March 15, 2023 at 12:49 PM

Section 3722.03 | Applications for licensure.

• Effective: September 30, 2021
• Latest Legislation: House Bill 110 - 134th General Assembly

(A) Subject to division (D) of this section, each person or political subdivision, agency, or instrumentality of this state, including a state university, seeking to operate a hospital shall apply to the director of health for a license to operate a hospital.

The director of health shall not consider any application for licensure until the date that is one year after the effective date of this section . An application shall be submitted in the form and manner prescribed by the director in rules adopted under section 3722.06 of the Revised Code.

(B) To be eligible for a license, an applicant must satisfy all of the following:

(1) Have submitted a complete application, which includes identifying the main hospital location and any location operated by the hospital pursuant to 42 C.F.R. 413.65 and paying the fee specified in rules adopted under section 3722.06 of the Revised Code;

(2) Be certified under Title XVIII of the "Social Security Act," 42 U.S.C. 1395aa, or accredited by a national accrediting organization approved by the federal centers for medicare and medicaid services in accordance with 42 U.S.C. 1395bb(a), or, in the case of a new hospital, eligible under rules adopted under section 3722.06 of the Revised Code;

(3) Demonstrate the ability to comply with standards established in rules adopted under section 3722.06 of the Revised Code;

(4) Specify the number of beds for the hospital, including skilled nursing beds, long-term care beds, and special skilled nursing beds.

(C)(1) If the applicant satisfies the requirements described in division (B) of this section, the director shall issue to the applicant a license to operate a hospital.

(2) A license issued under this section is valid for a three-year period unless revoked or suspended. A license expires on the date that is three years from the date of issuance and may be renewed for additional three-year periods. Applications for renewal shall be submitted to the director in a manner prescribed in rules adopted under section 3722.06 of the Revised Code.

(3) Both of the following apply to a license issued under this section:

(a) The license is valid only for the hospital identified in the application.

(b) The license holder shall post a copy of the license in a conspicuous place in the hospital.

(D) This section does not prohibit the director of health from issuing a license to a hospital that does either or both of the following:

(1) Occupies space in a building that is also used by another hospital or hospitals;

(2) Occupies one or more buildings located on the same campus as buildings used by another hospital or hospitals.

Last updated October 19, 2021 at 5:24 PM

Section 3722.04 | License transfer.

• Effective: October 3, 2023
• Latest Legislation: House Bill 33 - 135th General Assembly

If a hospital licensed under this chapter is assigned, sold, or transferred to a new owner, within thirty days of the assignment, sale, or transfer, the new owner shall apply to the director of health for a license transfer. The application shall be submitted to the director in the form and manner prescribed in rules adopted under section 3722.06 of the Revised Code.

The new owner is responsible for compliance with any action taken or proposed by the director under section 3722.07 or 3722.08 of the Revised Code. If a notice has been served under sections 119.05 and 119.07 of the Revised Code, the new owner becomes party to the notice.

Last updated October 3, 2023 at 4:19 PM

Section 3722.05 | Inspections.

• Effective: September 30, 2021
• Latest Legislation: House Bill 110 - 134th General Assembly

(A) Upon the filing of an initial application for licensure under section 3722.03 of the Revised Code, the director of health may inspect the hospital prior to issuing or denying the applicant a license to operate a hospital. An applicant may avoid such an inspection if the applicant submits with the application a copy of the hospital's most recent final on-site survey report from the federal centers for medicare and medicaid services or an accrediting organization approved under 42 U.S.C. 1395bb(a) demonstrating that the hospital is certified or accredited.

(B) When filing an application to renew a license issued under section 3722.03 of the Revised Code, an applicant may avoid an inspection by the director if the applicant submits with the application a copy of the hospital's most recent final on-site survey report from the federal centers for medicare and medicaid services or an accrediting organization approved under 42 U.S.C. 1395bb(a) demonstrating that the hospital is certified or accredited.

(C) For purposes of this section, a final on-site survey report from the federal centers for medicare and medicaid services or an accrediting organization submitted in accordance with this section is confidential and is not a public record under section 149.43 of the Revised Code.

(D) At least once every thirty-six months, the director shall inspect each licensed hospital's maternity unit, newborn care nursery, and any unit providing health care services.

(E) The director may at any time inspect a licensed hospital in order to address an incident that may impact public health, respond to a complaint submitted to the director, or otherwise ensure the safety of patients cared for by the hospital.

(F) Any inspection conducted under this section is subject to a fee. Upon conducting the inspection, the director shall provide the applicant or license holder with a fee statement. Not later than fifteen days after receiving the fee statement, the applicant or license holder shall submit to the director the total amount of the fee.

Last updated October 19, 2021 at 5:25 PM

Section 3722.06 | Rules.

• Effective: September 30, 2021
• Latest Legislation: House Bill 110 - 134th General Assembly

(A) Not later than the date that is one year after the effective date of this section , the director of health shall adopt rules establishing health, safety, welfare, and quality standards for hospitals licensed under this chapter, including standards for all of the following:

(1) Maternity units;

(2) Newborn care nurseries;

(3) Health care services.

(B) Not later than the date that is one year after the effective date of this section , the director shall adopt rules establishing standards and procedures for the licensure of hospitals, including all of the following:

(1) Procedures for applying and renewing licenses as described in section 3722.03 of the Revised Code;

(2) Procedures for transferring licenses as described in section 3722.04 of the Revised Code;

(3) Procedures for inspections following complaints;

(4) Subject to division (C)(1) of this section, fees for initial applications, license renewals, and license transfers, as well as inspections conducted under section 3722.05 of the Revised Code;

(5) Subject to division (C)(2) of this section, standards and procedures for imposing civil penalties as described in section 3722.07 of the Revised Code;

(6) Subject to division (C)(3) of this section, standards and procedures for correcting violations, including through the submission of correction plans;

(7) Standards and procedures for identifying, monitoring, managing, reporting, and reducing exposures to risk conditions, such as Legionella, including through the use of environmental facility assessments, the development of water management plans, and the use of disinfection measures;

(8) Standards and procedures for data reporting;

(9) Standards and procedures for emergency preparedness;

(10) Standards and procedures for the provision of technical assistance as described in section 3722.09 of the Revised Code;

(11) Standards and procedures for new hospitals to demonstrate eligibility as described in division (B)(2) of section 3722.03 of the Revised Code;

(12) Standards and procedures to address changes to a hospital's license, including adding or removing a location of the hospital.

(C)(1) In the case of an inspection fee described in division (B)(4) of this section, the director shall establish an amount to cover only the cost of the inspection. All other fees established under that division shall be limited to what is necessary to support the hospital licensure program.

(2) The director shall establish a scale for use in determining the amount of a civil penalty that may be imposed under section 3722.07 of the Revised Code. The scale shall include per day amounts for ongoing violations. The total amount of a civil penalty shall not exceed two hundred fifty thousand dollars for each violation.

(3) The director shall accept a corrective action plan that also was accepted by the federal centers for medicare and medicaid services or an accrediting organization approved under 42 U.S.C. 1395bb(a) provided that the plan was submitted to the centers or organization in response to the same deficiencies identified by the director.

(D) The director may adopt any other rules as necessary to implement this chapter.

(E) When adopting rules under this section, all of the following apply:

(1) The director shall adopt the rules in accordance with Chapter 119. of the Revised Code;

(2) Any rules adopted are not subject to division (F) of section 121.95 of the Revised Code;

(3) The director shall collaborate with representatives of this state's hospital industry to maximize the public health utility of rules adopted under this section and limit the administrative burden of and costs of complying with such rules.

(4) The director shall not adopt rules that conflict with requirements under federal laws or regulations.

Last updated October 20, 2021 at 9:04 AM

Section 3722.07 | Enforcement.

• Effective: October 3, 2023
• Latest Legislation: House Bill 33 - 135th General Assembly

(A) Each hospital licensed under this chapter shall comply with the requirements of this chapter and the rules adopted under it.

(B) In accordance with Chapter 119. of the Revised Code, if the director of health finds that a license holder has violated any requirement of this chapter or the rules adopted under it, the director may do any of the following:

(1) Impose a civil penalty of not less than one thousand dollars and not more than two hundred fifty thousand dollars;

(2) Require the license holder to submit a plan to correct or mitigate the violation;

(3) Suspend a health care service or revoke a license issued under this chapter if the director determines that the license holder is not in substantial compliance with this chapter or the rules adopted under it.

(C)(1) If the director takes action under division (B)(3) of this section, the director shall give written notice of proposed action to the hospital. The notice shall specify all of the following:

(a) The nature of the conditions giving rise to the director's judgment;

(b) The measures that the director determines the hospital must take to respond to the conditions;

(c) The date, which shall be not later than thirty days after the notice is delivered, on which the director intends to suspend the health care service or revoke the license if the conditions are not corrected and the director determines that the license holder has not come into substantial compliance with this chapter or the rules adopted under it.

(2) If the licensed hospital notifies the director, within the period of time specified in division (C)(1)(c) of this section, that the conditions giving rise to the director's determination have been corrected and that the hospital is in substantial compliance with this chapter and the rules adopted under it, the director shall conduct an inspection. The director may suspend the health care service or revoke the license if the director determines on the basis of the inspection that the conditions have not been corrected and the license holder has not come into substantial compliance with this chapter or the rules adopted under it.

(3) If the licensed hospital fails to notify the director, within the period of time specified in division (C)(1)(c) of this section, that the conditions giving rise to the director's determination have been corrected and that the hospital is in substantial compliance with this chapter and the rules adopted under it, the director may suspend the health care service or revoke the license.

(D) If the director suspends a health care service or revokes a license under division (C) of this section, the director shall serve a written order of suspension or revocation in accordance with sections 119.05 and 119.07 of the Revised Code. If the license holder subject to the suspension or revocation requests an adjudication, the date set for the adjudication shall be within seven days after the license holder makes the request, unless another date is agreed to by both the individual and the director. The suspension or revocation shall remain in effect, unless reversed by the director, until a final adjudication order issued by the director pursuant to this section and Chapter 119. of the Revised Code becomes effective.

The director shall issue a final adjudication order not later than fourteen days after completion of the adjudication. If the director does not issue a final order within the fourteen-day period, the suspension or revocation is void, but any final adjudication order issued subsequent to the fourteen-day period shall not be affected.

(E) If the director issues a final adjudication order suspending a health care service or suspending or revoking a license issued under this chapter and the license holder continues to operate a hospital, the director may ask the attorney general to apply to the court of common pleas of the county in which the hospital is located for an order enjoining the license holder from operating the hospital.

Last updated October 3, 2023 at 4:20 PM

Section 3722.08 | Imminent threat of harm.

• Effective: September 30, 2021
• Latest Legislation: House Bill 110 - 134th General Assembly

(A) As used in this section, "imminent threat of harm" means imminent danger of serious physical or life-threatening harm to one or more occupants of a hospital.

(B) If, in the judgment of the director of health, an imminent threat of harm exists at any licensed hospital, the director may petition the court of common pleas of the county in which the hospital is located for such injunctive relief as is necessary to close the hospital, suspend a service within the hospital, transfer one or more occupants to other hospitals or other appropriate care settings, or otherwise eliminate the imminent threat of harm. The court has jurisdiction to grant such injunctive relief upon a showing that there is an imminent threat of harm. In such court proceeding, the hospital shall have an opportunity, before the court enters an order granting injunctive relief, to present evidence to the court that an imminent threat of harm does not exist or has been remedied.

(C)(1) If the director determines that an imminent threat of harm exists at a licensed hospital and elects not to immediately seek injunctive relief under division (B) of this section, the director may give written notice of proposed action to the hospital. The notice shall specify all of the following:

(a) The nature of the conditions giving rise to the imminent threat of harm;

(b) The measures that the director determines the hospital must take to respond to the conditions;

(c) The date on which the director intends to seek injunctive relief under division (B) of this section if the director determines that an imminent threat of harm remains at the hospital.

(2) If the licensed hospital notifies the director, within the time specified pursuant to division (C)(1)(c) of this section, that it believes the conditions giving rise to the imminent threat of harm have been substantially corrected, the director shall conduct an inspection to determine whether an imminent threat of harm remains. If the director determines on the basis of the inspection that an imminent threat of harm remains, the director may petition under division (B) of this section for injunctive relief.

(D) On finding that the imminent threat of harm for which injunctive relief was granted under division (B) of this section has been eliminated and that the hospital has demonstrated the capacity to prevent the imminent threat of harm from recurring, the court shall lift the injunctive relief.

If the imminent threat of harm cannot be eliminated practicably within a reasonable time, the court may order the hospital to close, transfer all patients to other hospitals or other appropriate care settings, or suspend a service.

(E) The director of health shall give notice of proposed action under this section to the following:

(1) The hospital's administrator;

(2) The hospital's statutory agent.

A notice shall be delivered by hand or certified mail. If mailed, the notice shall be addressed to the persons specified in this section, as indicated in the department of health's records. If hand delivered, the notice shall be delivered to persons who would reasonably appear to the average prudent person to have authority to accept them.

Last updated October 19, 2021 at 5:26 PM

Section 3722.09 | Technical assistance.

• Effective: September 30, 2021
• Latest Legislation: House Bill 110 - 134th General Assembly

(A) The director of health may provide each licensed hospital with technical assistance in all of the following areas:

(1) Infectious diseases, including measures to prevent and control their spread;

(2) Quality improvement projects, including health equity and disparities;

(3) Population health initiatives;

(4) Data analytics;

(5) Workforce recruitment and development.

(B) The director may engage with one or more quality improvement organizations to assist in providing technical assistance. The director may terminate the assistance of a quality improvement organization at any time.

(C) The director may use any fees and civil penalties collected under this chapter to fund the provision of technical assistance to licensed hospitals, including contracting with entities to provide training or technical assistance as determined necessary by the director.

Last updated October 19, 2021 at 5:26 PM

Section 3722.10 | Hospital governing board.

• Effective: September 30, 2021
• Latest Legislation: House Bill 110 - 134th General Assembly

Each hospital licensed under this chapter shall have a governing board to oversee the hospital's management, operation, and control. The governing board shall be responsible for overseeing the appointment, reappointment, and assignment of privileges to medical staff as described in section 3701.351 of the Revised Code.

Last updated October 19, 2021 at 5:26 PM

Section 3722.11 | Reporting - opioid dependent newborns.

• Effective: September 30, 2021
• Latest Legislation: House Bill 110 - 134th General Assembly

(A) "Opioid" means opioid analgesic as defined in section 3719.01 of the Revised Code.

(B) Beginning on the date that is three years after the effective date of this section , each hospital licensed under this chapter that operates a maternity unit or newborn care nursery shall report to the director of health the number of newborns born to residents of this state in the unit or nursery during the preceding calendar quarter that were diagnosed as opioid dependent at birth. The reports shall be submitted not later than thirty days after the end of each quarter and shall not include any patient-identifying information. A third-party organization may report as described in this division on behalf of the hospital.

(C) The director shall establish standards and procedures for reporting the information required by this section, including reporting submitted by third-party organizations. The information reported under this section shall not be used for law enforcement purposes or disclosed to law enforcement authorities.

(D) The director shall compile the information submitted under this section and make a summary of that information available to the public not later than ninety days after the end of each calendar year.

Last updated October 20, 2021 at 9:04 AM

Section 3722.12 | Reporting - diseases, illnesses, conditions, infectious agents, and biological toxins.

• Effective: September 30, 2021
• Latest Legislation: House Bill 110 - 134th General Assembly

(A) Beginning on the date that is three years after the effective date of this section , each hospital shall report to the director of health the contagious, environmental, or infectious diseases, illnesses, or health conditions or unusual infectious agents or biological toxins for which it provides treatment to patients. A third-party organization may report as described in this division on behalf of the hospital.

(B) The director shall adopt rules that do all of the following:

(1) Specify the diseases, illnesses, conditions, infectious agents, and biological toxins to be reported under this section;

(2) Specify the frequency with which a hospital shall report to the director under this section;

(3) Prescribe the manner in which a hospital or third-party organization shall report to the director under this section.

(C) Any information reported under this section shall be considered protected health information as described in section 3701.17 of the Revised Code and shall be released only in accordance with that section. Information that does not identify an individual may be released in summary, statistical, or aggregate form.

Last updated October 20, 2021 at 9:04 AM

Section 3722.13 | Fees.

• Effective: September 30, 2021
• Latest Legislation: House Bill 110 - 134th General Assembly

All initial license fees, renewal fees, fees for inspections conducted by the director of health and civil penalties collected under this chapter shall be deposited in the state treasury to the credit of the general operations fund created under section 3701.83 of the Revised Code. The moneys shall be used solely for purposes of administering and enforcing this chapter and the rules adopted under it.

Last updated October 19, 2021 at 5:27 PM

Section 3722.14 | Transition to 9/30/2024 hospital license requirement.

• Effective: September 30, 2021
• Latest Legislation: House Bill 110 - 134th General Assembly

From the effective date of this section until the date that is three years after the effective date of this section , the requirements of this chapter apply only to a hospital that has obtained a license to operate issued under section 3722.03 of the Revised Code. Beginning on the date that is three years after the effective date of this section , each hospital is subject to the requirements of this chapter.

Last updated October 19, 2021 at 5:28 PM

Section 3722.99 | Penalty for operating without a license.

• Effective: September 30, 2021
• Latest Legislation: House Bill 110 - 134th General Assembly

Beginning on the date that is three years from the effective date of this section , whoever violates division (B) of section 3722.02 of the Revised Code is guilty of a misdemeanor of the first degree and shall be liable for an additional penalty of one thousand dollars for each day of operation in violation of such division.

Last updated October 19, 2021 at 5:32 PM