Part I. Definitions and General Information
12VAC5-391-10. Definitions.
The following words and terms when used in these regulations shall have the following meaning unless the context clearly indicates otherwise.
"Activities of daily living" means bathing, dressing, toileting, transferring, bowel control, bladder control and eating/feeding.
"Administer" means the direct application of a controlled substance, whether by injection, inhalation, ingestion, or any other means, to the body of a patient by (i) a practitioner or by his authorized agent and under his supervision or (ii) the patient at the direction and in the presence of the practitioner as defined in § 54.1-3401 of the Code of Virginia.
"Administrator" means a person designated, in writing, by the governing body as having the necessary authority for the day-to-day management of the hospice program. The administrator must be a member of the hospice staff. The administrator, director of nursing, or another clinical director may be the same individual if that individual is dually qualified.
"Adverse outcome" means the result of drug or health care therapy that is neither intended nor expected in normal therapeutic use and that causes significant, sometimes life-threatening conditions or consequences at some future time. Such potential future adverse outcome may require the arrangement of appropriate follow-up surveillance and perhaps other departures from the usual plan of care.
"Attending physician" means a physician licensed in Virginia, according to Chapter 29 (§ 54.1-2900 et seq.) of Title 54.1 of the Code of Virginia, or licensed in an adjacent state and identified by the patient as having the primary responsibility in determining the delivery of the patient's medical care. The responsibilities of physicians contained in this chapter may be implemented by nurse practitioners or physician assistants as assigned by the supervising physician and within the parameters of professional licensing.
"Available at all times during operating hours" means an individual is available on the premises or by telecommunications.
"Barrier crimes" means certain offenses specified in § 32.1-162.9:1 of the Code of Virginia that automatically bar an individual convicted of those offenses from employment with a hospice program.
"Bereavement service" means bereavement counseling as defined in 42 CFR 418.3.
"Cannabidiol oil" means the same as that term is defined in subsection A of § 54.1-3408.3 of the Code of Virginia.
"Commissioner" means the State Health Commissioner.
"Coordinated program" means a continuum of palliative and supportive care provided to a terminally ill patient and the patient's family, 24 hours a day, seven days a week.
"Core services" means those services that must be provided by a hospice program. Such services are: (i) nursing services, (ii) physician services, (iii) counseling services, and (iv) medical social services.
"Counseling services" means the provision of bereavement services, dietary services, spiritual and any other counseling services for the patient and family while the person is enrolled in the program.
"Criminal record report" means the statement issued by the Central Criminal Records Exchange, Virginia Department of State Police.
"Designated support person" means a person who is knowledgeable about the needs of a person with a disability and who is designated, orally or in writing, by the individual with a disability, the individual's guardian, or the individual's care provider to provide support and assistance, including physical assistance, emotional support, assistance with communication or decision-making, or any other assistance necessary as a result of the person's disability, to the person with a disability at any time during which health care services are provided.
"Dispense" means to deliver a drug to the ultimate user by or pursuant to the lawful order of a practitioner, including the prescribing and administering, packaging, labeling or compounding necessary to prepare the substance for that delivery as defined in § 54.1-3401 of the Code of Virginia.
"Employee" means an individual who is appropriately trained and performs a specific job function for the hospice program on a full-time or part-time basis with or without financial compensation.
"Governing body" means the individual, group, or governmental agency that has legal responsibility and authority over the operation of the hospice program.
"Home attendant" means a nonlicensed individual performing personal care and environmental services, under the supervision of the appropriate health professional, to a patient in the patient's residence. Home attendants are also known as certified nursing assistants or CNAs, home care aides, home health aides, and personal care aides.
"Hospice" means a hospice as defined in § 32.1-162.1 of the Code of Virginia.
"Hospice facility" means an institution, place, or building as defined in § 32.1-162.1 of the Code of Virginia.
"Inpatient" means the provision of services, such as food, laundry, housekeeping, and staff to provide health or health-related services, including respite and symptom management, to hospice patients, whether in a hospital, nursing facility, or hospice facility.
"Interdisciplinary group" means the group responsible for assessing the health care and special needs of the patient and the patient's family. Providers of special services, such as mental health, pharmacy, and any other appropriate associated health services may also be included on the team as the needs of the patient dictate. The interdisciplinary group is often referred to as the IDG.
"Licensee" means a licensed hospice program provider.
"Medical director" means a physician currently licensed in Virginia, according to Chapter 29 (§ 54.1-2900 et seq.) of Title 54.1 of the Code of Virginia, and responsible for the medical direction of the hospice program.
"Medical record" means a continuous and accurate documented account of services provided to a patient, including the prescription and delivery of the treatment or care.
"Medication error" means one or more violations of the five principles of medication administration: the correct drug to the right patient at the prescribed time in the prescribed dose via the prescribed route.
"Nursing services" means the patient care performed or supervised by a registered nurse according to a plan of care.
"OLC" means the Office of Licensure and Certification of the Virginia Department of Health.
"Operator" means any individual, partnership, association, trust, corporation, municipality, county, local government agency, or any other legal or commercial entity responsible for the day-to-day administrative management and operation of the hospice.
"Palliative care" means treatment directed at controlling pain, relieving other symptoms, and focusing on the special needs of the patient and family as they experience the stress of the dying process. Palliative care means treatment to enhance comfort and improve the quality of a patient's life during the last phase of his life.
"Patient" means a hospice patient as defined in § 32.1-162.1 of the Code of Virginia.
"Patient's family" means a hospice patient's family as defined in § 32.1-162.1 of the Code of Virginia.
"Patient's residence" means the place where the individual or patient makes his home.
"Person" means any individual, partnership, association, trust, corporation, municipality, county, local government agency, or any other legal or commercial entity that operates a hospice.
"Plan of care" means a written plan of services developed by the interdisciplinary group to maximize patient comfort by symptom control to meet the physical, psychosocial, spiritual, and other special needs that are experienced during the final stages of illness, during dying, and bereavement.
"Primary caregiver" means an individual that, through mutual agreement with the patient and the hospice program, assumes responsibility for the patient's care.
"Progress note" means a documented statement contained in a patient's medical record, dated and signed by the person delivering the care, treatment, or service, describing the treatment or services delivered and the effect of the care, treatment, or services on the patient.
"Quality improvement" means ongoing activities designed to objectively and systematically evaluate the quality of care and services, pursue opportunities to improve care and services, and resolve identified problems. Quality improvement is an approach to the ongoing study and improvement of the processes of providing services to meet the needs of patients and their families.
"Separate and distinct entrance" means an entrance to the hospice facility other than the formal public entrance used by patients and family members.
"Staff" means an employee who receives financial compensation.
"Supervision" means the ongoing process of monitoring the skills, competencies, and performance of the individual supervised and providing regular face-to-face guidance and instruction.
"Terminally ill" means a medical prognosis that life expectancy is six months or less if the illness runs its usual course.
"THC-A oil" means the same as that term is defined in subsection A of § 54.1-3408.3 of the Code of Virginia.
"Volunteer" means an employee who receives no financial compensation.
Statutory Authority
§§ 32.1-12 and 32.1-162.5 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 21, Issue 23, eff. November 1, 2005; amended, Virginia Register Volume 24, Issue 11, eff. March 5, 2008; Volume 26, Issue 26, eff. September 30, 2010; Volume 27, Issue 11, eff. March 2, 2011; Volume 36, Issue 23, eff. August 6, 2020; Volume 37, Issue 15, eff. April 14, 2021.
12VAC5-391-20. [Reserved].
Derived from Virginia Register Volume 21, Issue 23, eff. November 1, 2005.
12VAC5-391-30. License.
A. A license to operate a hospice program is issued to a person.
B. The State Health Commissioner shall issue or renew a license to establish or operate a hospice program if the commissioner finds that the hospice program is in compliance with the law and this chapter.
C. A separate license shall be required for hospice programs maintained at separate locations, even though they are owned or are operated under the same management.
D. Every hospice program shall be designated by an appropriate name. The name shall not be changed without first notifying the OLC.
E. Licenses shall not be transferred or assigned.
F. Any person establishing, conducting, maintaining, or operating a hospice program without a license shall be guilty of a Class 1 misdemeanor according to § 32.1-27 of the Code of Virginia.
Statutory Authority
§§ 32.1-12 and 32.1-162.5 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 21, Issue 23, eff. November 1, 2005; amended, Virginia Register Volume 24, Issue 11, eff. March 5, 2008.
12VAC5-391-40. Exemption from licensure.
A. This chapter is not applicable to hospice programs described in § 32.1-162.2 of the Code of Virginia.
B. The hospice program must file a request for exemption from licensure in writing to the director of the OLC. The request shall contain documentation explaining the hospice program's relationship to the practice of religious tenets of a recognized church or denomination.
C. The hospice program shall be notified in writing that the exemption from licensure has been registered.
D. Exempt hospice programs shall remain subject to complaint investigations in keeping with state law.
Statutory Authority
§§ 32.1-12 and 32.1-162.5 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 21, Issue 23, eff. November 1, 2005; amended, Virginia Register Volume 24, Issue 11, eff. March 5, 2008; Volume 26, Issue 26, eff. September 30, 2010.
12VAC5-391-50. License application; initial and renewal.
A. The OLC will provide prelicensure consultation and technical assistance to any person regarding the licensure process. The purpose of such consultation is to explain the regulation and to review an applicant's proposed hospice program plans, forms, and other documents, as they relate to the regulation. Prelicensure consultations can be arranged after an initial application has been filed.
B. Licensure applications are obtained from the OLC. The OLC shall consider an application complete when all requested information and the appropriate fee, stated in 12VAC5-391-70, are submitted. If the OLC finds the application incomplete, the applicant will be notified in writing of the incomplete application.
An incomplete application shall become inactive six months after it is received by the OLC. Applicants must reapply for licensure with a completed application and application fee. An application for a license may be withdrawn at any time.
C. A completed application for initial licensure must be submitted at least 60 days prior to the hospice program's planned opening date to allow the OLC time to act on the application.
D. The activities and services of each applicant or licensee of a hospice license shall be subject to an inspection by the OLC to determine if the hospice program is in compliance with the provisions of this chapter and state law. Hospice programs submitting an initial application shall receive an announced inspection prior to accepting patients.
E. Licenses are renewed annually. The OLC shall make renewal applications available at least 60 days prior to the expiration date of the current license.
F. The hospice program shall submit the completed renewal application form along with any required attachments and the application fee by the date indicated in the cover letter. Providers operating dedicated hospice facilities shall include a copy of the facility deficiency report and plan of correction from their latest facility licensure inspection when applying to renew their hospice program license.
G. It is the hospice program's responsibility to complete and return the renewal application to assure timely processing. Should a current license expire before a new license is issued, the current license shall remain in effect provided a complete and accurate application was filed on time.
H. Providers operating a dedicated hospice facility shall maintain compliance with the applicable licensure regulations described in 12VAC5-391-120. Failure to maintain compliance may be taken into consideration in the OLC decision to renew a hospice program license.
Statutory Authority
§§ 32.1-12 and 32.1-162.5 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 21, Issue 23, eff. November 1, 2005; amended, Virginia Register Volume 24, Issue 11, eff. March 5, 2008.
12VAC5-391-60. Changes to or reissuance of a license.
A. It is the responsibility of the hospice program's governing body to maintain a current and accurate license, including appropriate facility licensure if the hospice program operates a dedicated hospice facility.
B. A hospice program shall give written notification 30 working days in advance of any proposed changes that may require the reissuance of the license. Notices shall be sent to the attention of the director of the OLC.
The following circumstances require the reissuance of a license and payment of a fee:
1. A change in ownership or operator;
2. A change in hospice program name; or
3. Relocation of the hospice program's administrative office.
C. The OLC will evaluate written information about any planned changes in operation that affect the terms of the license or the continuing eligibility for a license. A licensing representative may inspect the hospice program during the process of evaluating a proposed change.
D. The hospice program will be notified in writing whether a license can be reissued or a new application is needed.
Statutory Authority
§§ 32.1-12 and 32.1-162.5 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 21, Issue 23, eff. November 1, 2005; amended, Virginia Register Volume 24, Issue 11, eff. March 5, 2008.
12VAC5-391-70. Fees.
A. The OLC shall collect a fee of $500 for each initial and renewal license. Fees shall accompany the licensure application and are not refundable.
B. A processing fee of $250 shall be collected for each reissuance or replacement of a license and shall accompany the written request for reissuance or replacement.
C. In addition, a late fee of $50 shall be collected for a hospice program's failure to file a renewal application by the date specified.
Statutory Authority
§§ 32.1-12 and 32.1-162.5 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 21, Issue 23, eff. November 1, 2005; amended, Virginia Register Volume 24, Issue 11, eff. March 5, 2008.
12VAC5-391-80. On-site inspections.
A. A OLC representative shall make periodic unannounced on-site inspections of the hospice program as necessary, but not less often than biennially. The hospice program shall be responsible for correcting any deficiencies found during any on-site inspection, including deficiencies found during announced initial inspections. Compliance with all standards will be determined by the OLC according to applicable law. The administrator will be notified whenever any item in the plan of correction is determined to be unacceptable.
B. The hospice program shall make available to the OLC representative any necessary records and shall allow access to interview the agents, employees, contractors, and any person under its control, direction or supervision.
C. After the on-site inspection, the OLC representative shall discuss the findings of the inspection with the administrator or designee.
D. The administrator shall submit, within 15 working days from the date of the deficiency report, an acceptable plan for correcting any deficiencies found during an on-site inspection. The plan of correction shall contain:
1. A description of the corrective action or actions to be taken and the personnel to implement and monitor the corrective action;
2. The expected correction date;
3. A description of the measures implemented to prevent a recurrence of the violation; and
4. The signature of the hospice program's administrator.
E. The administrator shall be responsible for assuring the plan of correction is implemented and monitored so that compliance is maintained.
F. Completion of corrective actions shall not exceed 45 working days from the last day of the inspection.
Statutory Authority
§§ 32.1-12 and 32.1-162.5 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 21, Issue 23, eff. November 1, 2005; amended, Virginia Register Volume 24, Issue 11, eff. March 5, 2008.
12VAC5-391-90. Home visits.
A. As part of any inspection, an OLC representative may conduct home visits subject to obtaining consent from the patient and the patient's family or caretaker.
B. The hospice program shall be responsible for arranging in-home visits with patients, family members, and caregivers for the OLC representative.
C. The hospice program shall explain clearly to the patient, patient's family or caretaker, that a home visit is voluntary and that refusal to consent to a home visit will in no way affect the patient's care.
Statutory Authority
§§ 32.1-12 and 32.1-162.5 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 21, Issue 23, eff. November 1, 2005; amended, Virginia Register Volume 24, Issue 11, eff. March 5, 2008.
12VAC5-391-100. Complaint investigation.
A. The OLC has the responsibility to investigate any complaints regarding alleged violations of this chapter and applicable law.
B. Complaints may be received in written or oral form and may be anonymous.
C. When the investigation is complete, the licensee and the complainant, if known, will be notified in writing of the findings of the investigation.
D. The administrator shall submit an acceptable plan for correcting any deficiencies found during a complaint investigation.
E. The administrator will be notified in writing whenever any aspect of the plan of correction is determined to be unacceptable.
F. The administrator shall be responsible for assuring the plan of correction is implemented and monitored so that compliance is maintained.
Statutory Authority
§§ 32.1-12 and 32.1-162.5 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 21, Issue 23, eff. November 1, 2005; amended, Virginia Register Volume 24, Issue 11, eff. March 5, 2008.
12VAC5-391-110. Criminal records checks.
A. Section 32.1-162.9:1 of the Code of Virginia requires hospice providers, as defined in § 32.1-162.1 of the Code of Virginia, to obtain a criminal record report on applicants for compensated employment from the Virginia Department of State Police. Section 32.1-162.9:1 also requires that all applicants for compensated employment in a hospice program provide a sworn statement regarding their criminal history.
B. The criminal record report shall be obtained within 30 days of compensated employment. It is the hospice program's responsibility to ensure that its compensated employees have not been convicted of any of the barrier crimes listed in § 32.1-162.9:1 of the Code of Virginia.
C. The hospice program shall not accept a criminal record report dated more than 90 days prior to the date of compensated employment.
D. Only the original criminal record report shall be accepted. An exception is permitted for hospice programs using temporary staffing agencies for the provision of substitute staff. The hospice program shall obtain a letter from the temporary staffing agency containing the following information:
1. The name of the substitute staffing person;
2. The date of employment by the temporary staffing agency; and
3. A statement verifying that the criminal record report has been obtained within 30 days of employment, is on file at the temporary staffing agency, and does not contain any barrier crimes listed in § 32.1-162.9:1 of the Code of Virginia.
E. A criminal record report remains valid as long as the compensated employee remains in continuous service with the same hospice program.
F. A new criminal record report shall be required when an individual terminates compensated employment at one hospice program and begins compensated employment at another hospice program. The following exceptions are permitted:
1. When an employee transfers, within 30 days, to a hospice program owned and operated by the same entity. The employee's file shall contain a statement indicating that the original criminal record report has been transferred or forwarded to the new work location.
2. A criminal record report for an individual who takes a leave of absence will remain valid as long as the period of separation does not exceed six consecutive months. If a period of six consecutive months has passed, a new criminal record report and sworn disclosure statement are required.
G. The sworn disclosure statement shall be completed by all applicants for compensated employment. The sworn disclosure statement shall be attached to and filed with the criminal record report.
H. Any applicant denied compensated employment because of convictions appearing on his criminal record report shall be provided a copy of the report by the hiring hospice program.
I. All criminal records reports shall be confidential and maintained in locked files accessible only to the administrator or designee.
J. Further dissemination of the criminal record report and sworn disclosure statement information is prohibited other than to the commissioner's representative or a federal or state authority or court as may be required to comply with an express requirement of law for such further dissemination.
Statutory Authority
§§ 32.1-12 and 32.1-162.5 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 21, Issue 23, eff. November 1, 2005.
12VAC5-391-120. Hospice facilities.
A. Providers seeking to operate a hospice facility shall comply with the appropriate facility licensing regulation as follows:
1. Facilities with 16 or fewer beds shall be licensed as a hospice facility pursuant to this chapter. Such facilities with six or more beds shall obtain a Certificate of Use and Occupancy with a Use Group designation of I-2; or
2. Facilities with more than 16 beds shall be licensed as a hospital pursuant to 12VAC5-410 or as a nursing facility pursuant to 12VAC5-371. Such facilities shall obtain the applicable Certificate of Public Need prior to the development or construction of the facility.
B. Only patients diagnosed terminally ill shall be admitted to a hospice facility. The facility shall admit only those patients whose needs can be met by the accommodations and services provided by the facility.
C. To the maximum extent possible, care shall be provided in the patient's home. Admission to a hospice facility shall be the decision of the patient in consultation with the patient's physician. No patient shall be admitted to a hospice facility at the discretion of, or for the convenience of, the hospice provider, the primary caregiver, or the family.
D. All hospice providers operating a hospice facility shall use its facility to provide, to the extent possible, respite and symptom management services to all patients in the hospice program needing such services.
E. If the Governor has declared a public health emergency related to the novel coronavirus (COVID-19), all hospice providers operating a hospice facility shall allow a person with a disability who requires assistance as a result of such disability to be accompanied by a designated support person at any time during which health care services are provided.
1. If the duration of health care services in a hospice facility is anticipated to last more than 24 hours, the person with a disability may designate more than one designated support person. However, no hospice facility shall be required to allow more than one designated support person to be present with a person with a disability at any time.
2. A designated support person shall not be subject to any restrictions on visitation adopted by the hospice facility. However, such designated support person may be required to comply with all reasonable requirements of the hospice facility adopted to protect the health and safety of patients and staff of the hospice facility.
3. Every hospice provider operating a hospice facility shall establish policies applicable to designated support persons and shall:
a. Make such policies available to the public on a website maintained by the hospice facility; and
b. Provide such policies in writing to the patient at such time as health care services are provided.
F. No hospice facility shall receive patients for care, palliative treatment, respite, or symptom management services in excess of its licensed bed capacity.
G. No hospice facility provider shall add additional patient beds or renovate facility space without first notifying the OLC. OLC notifications must be in writing to the director of the OLC.
H. The OLC will not accept any requests for variances to this section.
Statutory Authority
§§ 32.1-12 and 32.1-162.5 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 21, Issue 23, eff. November 1, 2005; amended, Virginia Register Volume 24, Issue 11, eff. March 5, 2008; Volume 27, Issue 11, eff. March 2, 2011; Volume 37, Issue 15, eff. April 14, 2021.
12VAC5-391-130. Variances.
A. The OLC can authorize variances only to its own licensing regulations, not to regulations of another agency or to any requirements in federal, state, or local laws.
B. A hospice program may request a variance to a particular regulation or requirement contained in this chapter when the standard or requirement poses a special hardship and when a variance to it would not endanger the safety or well-being of patients. The request for a variance must describe the special hardship to the hospice program and to the patients it serves. When applicable, the request should include proposed alternatives to meet the purpose of the requirements that will ensure the protection and well-being of patients. At no time shall a variance approved for one individual be extended to general applicability. If a variance is denied, expires, or is rescinded, routine enforcement of the regulation or portion of the regulation shall be resumed. The hospice program may at any time withdraw a request for a variance.
C. The OLC shall have the authority to waive, either temporarily or permanently, the enforcement of one or more of these regulations provided safety, patient care and services are not adversely affected. The OLC may attach conditions to the granting of the variance in order to protect persons in care.
D. The OLC may rescind or modify a variance when (i) conditions change; (ii) additional information becomes known that alters the basis for the original decision; (iii) the hospice program fails to meet any conditions attached to the variance; or (iv) results of the variance jeopardize the safety, comfort, or well-being of persons in care.
E. Consideration of a variance is initiated when a written request is submitted to the director of the OLC. The OLC shall notify the hospice program in writing of the receipt of the request for a variance.
F. The licensee shall be notified in writing if the requested variance is denied.
G. The hospice program shall develop procedures for monitoring the implementation of any approved variance to assure the ongoing collection of any data relevant to the variance and the presentation of any later report concerning the variance as requested by the OLC.
Statutory Authority
§§ 32.1-12 and 32.1-162.5 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 21, Issue 23, eff. November 1, 2005; amended, Virginia Register Volume 24, Issue 11, eff. March 5, 2008.
12VAC5-391-140. Revocation or suspension of a license.
A. The commissioner is authorized to revoke or suspend any license if the licensee fails to comply with the provisions of Article 7 (§ 32.1-162.1 et seq.) of Chapter 5 of Title 32.1 of the Code of Virginia or the regulations of the board.
Providers operating a dedicated hospice facility shall also maintain compliance with the applicable licensure regulations as described in 12VAC5-391-120. Failure to maintain compliance may be taken into consideration when the commissioner decides to revoke or suspend a hospice program license.
B. If a license is revoked, the commissioner may issue a new license when the conditions upon which revocation was based have been corrected and compliance with all provisions of the law and this chapter has been achieved.
C. Suspension of a license shall in all cases be for an indefinite time. The suspension may be lifted and rights under the license fully or partially restored at such time as the commissioner determines that the interests of the public will not be jeopardized by resumption of services.
D. When a license is revoked or suspended, the hospice program shall cease operations. If the hospice program continues operating, the commissioner may request the Office of the Attorney General to petition the circuit court of the jurisdiction in which the hospice program is located for an injunction to cause such hospice program to cease operations.
Statutory Authority
§§ 32.1-12 and 32.1-162.5 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 21, Issue 23, eff. November 1, 2005.
12VAC5-391-150. Return of a license.
A. The circumstances under which a license must be returned include:
1. A change in ownership or operator;
2. A change in program name;
3. The relocation of the administrative office;
4. The discontinuation of any core services; and
5. The relocation of a hospice facility.
B. The licensee shall notify its patients and the OLC in writing 30 days prior to discontinuing any services.
C. If the hospice program is no longer operational, or the license is revoked or suspended, the license shall be returned to the OLC within five working days. The licensee is responsible for notifying its patients and the OLC where all medical records will be located.
Statutory Authority
§§ 32.1-12 and 32.1-162.5 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 21, Issue 23, eff. November 1, 2005; amended, Virginia Register Volume 24, Issue 11, eff. March 5, 2008; Volume 27, Issue 11, eff. March 2, 2011.