Part I. Definitions and General Information and Procedures
Article 1
Definitions
12VAC5-410-10. Definitions.
As used in this chapter, the following words and terms shall have the following meanings unless the context clearly indicates otherwise:
"ACIP" means the Advisory Committee on Immunization Practices of the CDC.
"Activity of daily living" or "ADL" has the same meaning as ascribed to the term in § 32.1-137.08 A of the Code of Virginia.
"Board" means the State Board of Health.
"Business day" means a day that is not a Saturday, Sunday, legal holiday, or day on which the OLC is closed. For the purposes of this chapter, a day on which the Governor authorizes the closing of the state government is considered a legal holiday.
"Campus" means the physical area that is immediately adjacent to the hospital's main buildings, other areas and structures not strictly contiguous to the main buildings but located within 250 yards of the main buildings, and any other areas determined on an individual case basis by the OLC, in accordance with 42 CFR 431.65, to be part of the hospital's campus.
"Care provider" has the same meaning as ascribed to the term in § 32.1-137.08 A of the Code of Virginia.
"CDC" means the Centers for Disease Control and Prevention.
"Certified nursing facility" has the same meaning as ascribed to the term in § 32.1-123 of the Code of Virginia.
"Certified sexual assault nurse examiner" means a nurse who is board certified by the International Association of Forensic Nurses as either a Sexual Assault Nurse Examiner-Pediatric (SANE-P) or a Sexual Assault Nurse Examiner-Adult/Adolescent (SANE-A).
"Chief executive officer" means a job descriptive term used to identify the individual appointed by the governing body to act on its behalf in the overall management of the hospital. Job titles may include administrator, superintendent, director, executive director, president, vice-president, and executive vice-president.
"CMS" means the Centers for Medicare and Medicaid Services.
"Commissioner" means the State Health Commissioner.
"Consultant" means one who provides services or advice upon request.
"Department" means an organized section of the hospital.
"Designated support person" or "DSP" has the same meaning as ascribed to the term in § 32.1-137.08 A of the Code of Virginia and is not a visitor.
"Direction" means authoritative policy or procedural guidance for the accomplishment of a function or activity.
"Emergency department" means a department of the hospital that provides emergency services and is located on or within a 35-mile radius of the campus of the hospital.
"Facilities" means buildings, equipment, and supplies necessary for implementation of services by personnel.
"General hospital" means a hospital with an organized medical staff; with permanent facilities that may include inpatient beds; and with medical services, including physician services, dentist services, and continuous nursing services, to provide diagnosis and treatment for patients who have a variety of medical and dental conditions that may require various types of care, such as medical, surgical, and maternity.
"General hospital accrediting organization" means the Accreditation Commission for Health Care, the Center for Improvement in Healthcare Quality, DNV - Healthcare, the Joint Commission, or any accrediting organization that has been granted deeming authority for hospitals by CMS.
"Home health services" means a formally structured organizational unit of the hospital that is designed to provide health services to patients in their place of residence and that meets Part II (12VAC5-381-150 et seq.) of the Regulations for the Licensure of Home Care Organizations.
"Hospital" has the same meaning ascribed to the term in § 32.1-123 of the Code of Virginia and includes general hospitals and outpatient surgical hospitals.
"Inspector" means an individual employed by or contracted by the Virginia Department of Health and designated by the commissioner to conduct inspections, investigations, or evaluations.
"Intelligent personal assistant" means a combination of an electronic device and a specialized software application designed to assist users with basic tasks using a combination of natural language processing and artificial intelligence, including combinations known as digital assistants or virtual assistants.
"Long-term care nursing unit" means an organized jurisdiction of nursing service in which nursing services are provided on a continuous basis.
"Medical" means pertaining to or dealing with the healing art and the science of medicine.
"Nursing home" has the same meaning as ascribed to the term in § 32.1-123 of the Code of Virginia.
"Nursing services" means patient care services pertaining to the curative, palliative, restorative, or preventive aspects of nursing that are prepared or supervised by a registered nurse.
"OLC" means the Office of Licensure and Certification of the Virginia Department of Health.
"Operating room" means a room in a hospital designated for the performance of surgery.
"Organized" means administratively and functionally structured.
"Organized medical staff" means a formal organization of physicians and dentists with the delegated responsibility and authority to maintain proper standards of medical care and to plan for continued betterment of that care. Organized medical staff may include other practitioners, including independent practice midwives.
"Outpatient surgical hospital" means a hospital that primarily provides facilities for the performance of surgical procedures on outpatients. Such patients may require treatment in a medical environment exceeding the normal capability found in a physician's office, but do not require inpatient hospitalization.
"Outpatient surgical hospital accrediting organization" means the Accreditation Commission for Ambulatory Health Care, the Accreditation Commission for Health Care, the American Association for Accreditation of Ambulatory Surgery Facilities, the Joint Commission, or any accrediting organization that has been granted deeming authority for ambulatory surgical centers by CMS.
"Ownership/person" means any individual, partnership, association, trust, corporation, municipality, county, governmental agency, or any other legal or commercial entity that owns or controls the physical facilities or manages or operates a hospital.
"Person with a disability" has the same meaning as ascribed to the term in § 32.1-137.08 A of the Code of Virginia.
"Rural hospital" means any general hospital in a county classified by the federal Office of Management and Budget (OMB) as rural, any hospital designated as a critical access hospital, any general hospital that is eligible to receive funds under the federal Small Rural Hospital Improvement Grant Program, or any general hospital that notifies the commissioner of its desire to retain its rural status when that hospital is in a county reclassified by the OMB as a metropolitan statistical area as of June 6, 2003.
"Service" means a functional division of the hospital and is also used to indicate the delivery of care.
"Smoke evacuation system" means the same as that term is defined in § 32.1-127 B 32 of the Code of Virginia.
"Special care unit" means an appropriately equipped area of the hospital where there is a concentration of physicians, nurses, and others who have special skills and experience to provide optimal medical care for patients assigned to the unit.
"Staff privileges" means authority to render medical care in the granting institution within well-defined limits based on the individual's professional license and the individual's experience, competence, ability, and judgment.
"Support and assistance necessary due to the specifics of the person's disability" has the same meaning as ascribed to the term in § 32.1-137.08 A of the Code of Virginia.
"Surgery" has the same meaning as ascribed to the term in § 54.1-2400.01:1 A of the Code of Virginia.
"Unit" means a functional division or facility of the hospital.
"Urine drug screening" means a chemical analysis intended to test patients for the presence of multiple drugs, including cocaine, opioids, and phencyclidine.
Statutory Authority
§§ 32.1-12 and 32.1-127 of the Code of Virginia.
Historical Notes
Derived from VR355-33-500 § 1.1, eff. July 28, 1993; amended, Virginia Register Volume 11, Issue 8, eff. April 1, 1995; Volume 11, Issue 16, eff. June 1, 1995; Volume 21, Issue 12, eff. May 9, 2005; Volume 23, Issue 10, eff. March 1, 2007; Volume 29, Issue 19, eff. June 20, 2013; Volume 37, Issue 14, eff. March 31, 2021; Volume 41, Issue 17, eff. May 22, 2025; Volume 42, Issue 1, eff. September 24, 2025; Volume 42, Issue 5, eff. November 19, 2025; Volume 42, Issue 18, eff. June 4, 2026.
Article 2
General Information
12VAC5-410-20. Exceptions; variances.
Article 2
General Information
A. In accordance with the § 32.1-124 of the Code of Virginia the provisions of this chapter shall not be applicable to:
1. A dispensary or first aid facility maintained by any commercial or industrial plant, educational institution or convent;
2. An institution licensed by the State Mental Health, Mental Retardation and Substance Abuse Services Board;
3. An institution or portion thereof licensed by the State Board of Social Services;
4. A hospital owned or operated by an agency of the Commonwealth or of the United States government; or
5. An office of one or more physicians or surgeons unless such office is used principally for performing surgery as defined in 12VAC5-410-10 of this chapter.
B. In accordance with § 32.1-128 of the Code of Virginia nothing in these rules and regulations shall be construed to authorize or require the interference with the supervision, regulation, or treatment of residents, patients, or personnel of any institution operated by and for the adherents of any well-recognized church or denomination who rely upon treatment by mental or spiritual means without the use of any drug or material remedy, provided such institution complies with applicable statutes and regulations on sanitation, life safety and construction design.
Statutory Authority
§§ 32.1-12 and 32.1-127 of the Code of Virginia.
Historical Notes
Derived from VR355-33-500 § 1.2, eff. July 28, 1993; amended, Virginia Register Volume 11, Issue 8, eff. April 1, 1995.
12VAC5-410-30. Allowable variances.
A. Upon the finding that the enforcement of one or more of these regulations would be clearly impractical, the commissioner shall have the authority to waive, either temporarily or permanently, the enforcement of one or more of these regulations, provided safety and patient care and services are not adversely affected.
B. Modification of any individual standard herein, for experimental or demonstrative purposes, or any other purposes, shall require advance written approval from the OLC.
Statutory Authority
§§ 32.1-12 and 32.1-127 of the Code of Virginia.
Historical Notes
Derived from VR355-33-500 § 1.3, eff. July 28, 1993; amended, Virginia Register Volume 11, Issue 8, eff. April 1, 1995; Volume 23, Issue 10, eff. March 1, 2007.
Article 3
Procedures for Licensure or License Renewal
12VAC5-410-40. General.
Article 3
Procedures for Licensure or License Renewal
No person, as defined in 12VAC5-410-10, shall establish, conduct, maintain, or operate in this State any hospital as defined and included within provisions of this chapter without having obtained a license. Any person establishing, conducting, maintaining, or operating a hospital without a license shall be guilty of a Class 6 felony.
Statutory Authority
§§ 32.1-12 and 32.1-127 of the Code of Virginia.
Historical Notes
Derived from VR355-33-500 § 1.4, eff. July 28, 1993; amended, Virginia Register Volume 11, Issue 8, eff. April 1, 1995.
12VAC5-410-50. Classification.
Hospitals to be licensed shall be classified as general hospitals or outpatient surgical hospitals defined by 12VAC5-410-10.
Statutory Authority
§§ 32.1-12 and 32.1-127 of the Code of Virginia.
Historical Notes
Derived from VR355-33-500 § 1.5, eff. July 28, 1993; amended, Virginia Register Volume 11, Issue 8, eff. April 1, 1995; Volume 42, Issue 18, eff. June 4, 2026.
12VAC5-410-60. Separate license.
A. A separate license shall be required by hospitals maintained on separate campuses even though the hospitals are operated under the same management. Separate license is not required for separate buildings on the same campus or within the same complex of buildings or for an emergency department of a general hospital.
B. Hospitals that have separate organized sections, units, or buildings to provide services of a classification covered by provisions of other state statutes or regulations may be required to have an additional applicable license for that type or classification of service (e.g., psychiatric, nursing home, home health services, and outpatient surgery).
Statutory Authority
§§ 32.1-12 and 32.1-127 of the Code of Virginia.
Historical Notes
Derived from VR355-33-500 § 1.6, eff. July 28, 1993; amended, Virginia Register Volume 11, Issue 8, eff. April 1, 1995; Volume 29, Issue 19, eff. June 20, 2013; Volume 42, Issue 18, eff. June 4, 2026.
12VAC5-410-70. Request for issuance.
A. Hospital licenses shall be issued by the commissioner, but all requests for licensing shall be submitted initially to the OLC. The procedure for obtaining the license shall include the following steps:
1. Request for application forms shall be made in writing to the OLC;
2. Application for license or license renewal to establish or maintain a hospital shall be made and submitted to the OLC;
3. All categories of inpatient beds shall be included on the hospital application for licensure in order for the OLC to have an accurate and complete record of the total bed capacity of the facility;
4. Application for initial license, change in license, or license renewal shall be accompanied by a check or money order for the service charge, payable to the OLC; and
5. Application for initial license of a hospital or for additions to an existing licensed hospital must be accompanied by evidence of approval from a representative of the State Fire Marshal and a copy of the occupancy permit issued by the local building official.
6. Application for initial license of a hospital shall include a statement of any agreement made with the commissioner as a condition for Certificate of Public Need approval to provide a level of care at a reduced rate to indigents or accept patients requiring specialized care.
Any initial license issued to any hospital that made such agreement as a condition of its Certificate of Public Need approval shall not be renewed without demonstrating prior to or at the time of applying for license renewal that it is substantially complying with its agreement.
B. The renewal of a hospital license shall be conditioned upon the up-to-date payment of any civil penalties owed as a result of willful refusal, failure, or neglect to honor certain conditions established in their award of a Certificate of Public Need pursuant to § 32.1-102.4 F of the Code of Virginia.
Statutory Authority
§§ 32.1-12 and 32.1-127 of the Code of Virginia.
Historical Notes
Derived from VR355-33-500 § 1.7, eff. July 28, 1993; amended, Virginia Register Volume 11, Issue 8, eff. April 1, 1995; Volume 11, Issue 16, eff. June 1, 1995; Volume 18, Issue 10, eff. February 28, 2002; Volume 23, Issue 10, eff. March 1, 2007.
12VAC5-410-80. Service charge.
A. In accordance with § 32.1-130 of the Code of Virginia, the following service charge shall be made:
0 to 50 beds -- $75
51 to 333 beds -- $1.50 per bed
334 or more -- $500
B. The hospital shall not be required to pay a service charge on hospital beds in a category that requires separate license by the OLC or another state agency (i.e., psychiatric, nursing home).
Statutory Authority
§§ 32.1-12 and 32.1-127 of the Code of Virginia.
Historical Notes
Derived from VR355-33-500 § 1.8, eff. July 28, 1993; amended, Virginia Register Volume 11, Issue 8, eff. April 1, 1995; Volume 23, Issue 10, eff. March 1, 2007.
12VAC5-410-90. License expiration.
Licenses shall expire as specified or at midnight December 31 following date of issue, whichever is first, and shall be renewable annually, upon filing of application and payment of service charge, unless cause appears to the contrary.
Statutory Authority
§§ 32.1-12 and 32.1-127 of the Code of Virginia.
Historical Notes
Derived from VR355-33-500 § 1.9, eff. July 28, 1993; amended, Virginia Register Volume 11, Issue 8, eff. April 1, 1995.
12VAC5-410-100. Name.
Every hospital shall be designated by a permanent and appropriate name that shall appear on the application for license.
Statutory Authority
§§ 32.1-12 and 32.1-127 of the Code of Virginia.
Historical Notes
Derived from VR355-33-500 § 1.10, eff. July 28, 1993; amended, Virginia Register Volume 11, Issue 8, eff. April 1, 1995; Volume 23, Issue 10, eff. March 1, 2007; Volume 42, Issue 18, eff. June 4, 2026.
12VAC5-410-110. Bed capacity.
A. Each license issued by the commissioner shall specify the maximum allowable number of beds. The number of beds allowed shall be determined by the OLC and shall so appear on the license issued by the OLC.
B. Request for licensed bed increase or decrease shall be made in writing to the OLC. No increase will be granted without an approved Certificate of Public Need.
C. Hospitals shall be exempt from the requirement to obtain a license to add temporary beds, for a period of no more than 30 days, when the commissioner has determined that a natural or man-made disaster has caused the evacuation of a hospital or nursing home and that a public health emergency exists due to a shortage of hospital or nursing home beds.
Statutory Authority
§§ 32.1-12 and 32.1-127 of the Code of Virginia.
Historical Notes
Derived from VR355-33-500 § 1.11, eff. July 28, 1993; amended, Virginia Register Volume 11, Issue 8, eff. April 1, 1995; Volume 11, Issue 16, eff. June 1, 1995; Volume 23, Issue 10, eff. March 1, 2007; Volume 35, Issue 24, eff. August 23, 2019.
12VAC5-410-120. Posting of license.
The hospital license issued by the commissioner shall be framed and posted conspicuously on the premises either in the main entrance to the hospital or in a place visible from that main entrance.
Statutory Authority
§§ 32.1-12 and 32.1-127 of the Code of Virginia.
Historical Notes
Derived from VR355-33-500 § 1.12, eff. July 28, 1993; amended, Virginia Register Volume 11, Issue 8, eff. April 1, 1995.
12VAC5-410-130. Surrender of license; mid-term change of license.
A. Upon revocation or suspension of a license, the hospital shall surrender its license to the OLC.
B. The hospital shall notify the director of the OLC in writing by submitting a mid-term change application no fewer than 30 calendar days in advance of implementing any of the following:
1. Change of location of the hospital, including change of location of any emergency department, not located on the hospital's campus;
2. Change of ownership of the hospital;
3. Change of operator of the hospital;
4. Change of name of the hospital;
5. Change of bed capacity, except as provided in 12VAC5-410-110 C, which shall be accompanied by an approved Certificate of Public Need if the requested change is for an increase in bed capacity;
6. Change of services being provided, including any proposed addition or discontinuation, regardless of whether licensure is required for the service; or
7. Closure of the hospital.
C. The OLC shall:
1. Consider the submission date of a mid-term change application to be the date it is postmarked or the date it is received, whichever is earlier; and
2. Notify the licensee in writing if the commissioner will issue a changed license.
D. The commissioner's issuance of a changed license to the hospital shall satisfy the requirements of subdivision C 2 of this section.
E. Upon receipt of the changed license, the licensee shall return its prior license issued by the commissioner to the OLC and destroy any copies of the prior license.
F. A license may not be transferred or assigned. The commissioner may not issue a changed license in response to a change of operator of the hospital, but shall instead require the hospital to obtain a new license. If the hospital intends to implement a change of operator, it shall:
1. File for a new license in accordance with 12VAC5-410-70 no fewer than 30 calendar days in advance of any change of operator; and
2. Upon receipt of the new license, surrender its prior license issued by the commissioner to the OLC and destroy any copies of the prior license.
G. If the hospital is closing or will otherwise no longer be operational, it shall:
1. Notify patients, legal representatives, and the OLC no fewer than seven calendar days prior to closing or ceasing operations where all clinical records are to be located following closure or cessation of operations; and
2. Surrender its license to the OLC and destroy all copies of its license no more than five calendar days after the hospital closes or ceases operations.
H. The OLC shall determine if any changes listed in subsection B of this section affect the terms of the license or the continuing eligibility for a license. An inspector may inspect the hospital during the process of evaluating a proposed change.
Statutory Authority
§§ 32.1-12, 32.1-127, and 32.1-132 of the Code of Virginia.
Historical Notes
Derived from VR355-33-500 § 1.13, eff. July 28, 1993; amended, Virginia Register Volume 11, Issue 8, eff. April 1, 1995; Volume 11, Issue 16, eff. June 1, 1995; Volume 23, Issue 10, eff. March 1, 2007; Volume 35, Issue 24, eff. August 23, 2019; Volume 42, Issue 18, eff. June 4, 2026.
12VAC5-410-140. Inspection procedure.
A. The OLC shall make periodic unannounced on-site inspections of a hospital as necessary but not less frequently than biennially. The OLC may make on-site inspections of applicants for licensure. Compliance with all standards shall be determined by the OLC.
B. The hospital or applicant shall:
1. Make available to the inspector any requested records;
2. Permit an inspector to enter upon and into its property to inspect or investigate as the inspector reasonably deems necessary in order to determine the state of compliance with the provisions of this chapter and all laws administered by the board; and
3. Allow the inspector access to interview the agents, employees, independent contractors, patients, legal representatives, patient family members, and any person under the hospital's or applicant's control, direction, or supervision.
C. After the on-site inspection, the inspector shall:
1. Discuss the findings of the inspection with the chief executive officer or the chief executive officer's designee; and
2. Provide a written inspection report to the chief executive officer or the chief executive officer's designee.
D. If the OLC cites one or more licensing violations in the written inspection report, the chief executive officer or the chief executive officer's designee shall submit a plan of correction in accordance with 12VAC5-410-150.
E. The OLC may presume that a general hospital deemed by a general hospital accrediting organization and certified for participation in Title XVIII of the Social Security Act (42 USC § 301 et seq.) generally meets the requirements of Part II (12VAC5-410-170 et seq.) of this chapter provided the following conditions are met:
1. The general hospital provides to the OLC, upon request, a copy of the most current accreditation survey findings made by the general hospital accrediting organization; and
2. The general hospital notifies the OLC within 10 days after receipt of any notice of revocation or denial of accreditation by the general hospital accrediting organization.
F. The OLC may presume that an outpatient surgical hospital deemed by an outpatient surgical hospital accrediting organization and certified for participation in Title XVIII of the Social Security Act (42 USC § 301 et seq.) generally meets the requirements of Part IV (12VAC5-410-1150 et seq.) of this chapter provided the following conditions are met:
1. The outpatient surgical hospital provides to the OLC, upon request, a copy of the most current accreditation survey findings made by the outpatient surgical hospital accrediting organization; and
2. The outpatient surgical hospital notifies the OLC within 10 days after receipt of any notice of revocation or denial of accreditation by the outpatient surgical hospital accrediting organization.
G. The OLC may presume that a unit or part of a general hospital licensed or certified by another state agency or another section, bureau, or division of the OLC meets the requirements of Part II (12VAC5-410-170 et seq.) of this chapter for that specific unit or part provided the following conditions are met:
1. The general hospital provides the OLC, upon request, a copy of the most current inspection report made by the other state agency; and
2. The general hospital notifies the OLC within 10 days after receipt of any notice of revocation or suspension by the other state agency.
H. The OLC may presume that a unit or part of an outpatient surgical hospital licensed or certified by another state agency or another section, bureau, or division of the OLC meets the requirements of Part IV (12VAC5-410-1150 et seq.) of this chapter for that specific unit or part provided the following conditions are met:
1. The outpatient surgical hospital provides the OLC, upon request, a copy of the most current inspection report made by the other state agency; and
2. The outpatient surgical hospital notifies the OLC within 10 days after receipt of any notice of revocation or suspension by the other state agency.
I. Notwithstanding any other provision of this chapter to the contrary, if the OLC finds, after inspection, violations pertaining to environmental health or life safety, the hospital shall receive a written licensing report of such findings. The hospital shall be required to submit a plan of correction in accordance with provisions of 12VAC5-410-150.
Statutory Authority
§§ 32.1-12 and 32.1-127 of the Code of Virginia.
Historical Notes
Derived from VR355-33-500 § 1.14, eff. July 28, 1993; amended, Virginia Register Volume 11, Issue 8, eff. April 1, 1995; Volume 11, Issue 16, eff. June 1, 1995; Volume 23, Issue 10, eff. March 1, 2007; Volume 42, Issue 18, eff. June 4, 2026.
12VAC5-410-150. Plan of correction.
A. Upon receipt of a written inspection report, the chief executive officer or the chief executive officer's designee shall prepare a written plan of correction addressing each licensing violation cited at the time of inspection.
B. The chief executive officer or the chief executive officer's designee shall submit to the OLC a written plan of correction no more than 15 business days after receipt of the inspection report. The plan of correction shall contain, for each licensing violation cited:
1. A description of the corrective action to be taken and the position title of the employees to implement the corrective action. If employees share the same position title, the chief executive officer or the chief executive officer's designee shall assign the employees a unique identifier to distinguish them;
2. The expected correction date, not to exceed 45 business days from the exit date of the inspection; and
3. A description of the measures implemented to prevent a recurrence of each licensing violation.
C. The chief executive officer or the chief executive officer's designee shall ensure that the person responsible for the validity of the plan of correction signs, dates, and indicates their title on the plan of correction.
D. The OLC shall notify the chief executive officer or the chief executive officer's designee, in writing, if the OLC determines any item in the plan of correction is unacceptable.
E. The OLC may conduct an inspection to verify that any portion of a plan of correction has been implemented.
F. The chief executive officer or the chief executive officer's designee shall ensure the plan of correction is implemented and monitored so that compliance is maintained.
G. The commissioner may deny licensure or renewal of licensure if the chief executive officer or the chief executive officer's designee fails to submit an acceptable plan of correction or fails to implement an acceptable plan of correction.
H. The OLC shall consider the submission date of a plan of correction to be the date the plan of correction is postmarked or the date it is received, whichever is earlier.
Statutory Authority
§§ 32.1-12 and 32.1-127 of the Code of Virginia.
Historical Notes
Derived from VR355-33-500 § 1.15, eff. July 28, 1993; amended, Virginia Register Volume 11, Issue 8, eff. April 1, 1995; Volume 11, Issue 16, eff. June 1, 1995; Volume 23, Issue 10, eff. March 1, 2007; Volume 42, Issue 18, eff. June 4, 2026.
12VAC5-410-160. Disciplinary action.
A. A hospital may not:
1. Violate the provisions of this chapter or Article 1 (§ 32.1-123 et seq.) of Chapter 5 of Title 32.1 of the Code of Virginia;
2. Permit, aid, or abet the commission of any illegal act in the hospital;
3. Engage in a pattern of violations pursuant to § 38.2-3445.01 of the Code of Virginia; or
4. Engage in a pattern of violations of § 38.2-3407.15 B 13 of the Code of Virginia.
B. The commissioner may:
1. For each violation of subsection A of this section:
a. Deny, revoke, or suspend the license to operate a hospital, in accordance with the Administrative Process Act (§ 2.2-4000 et seq. of the Code of Virginia);
b. Refer a hospital for criminal prosecution pursuant to § 32.1-27 A of the Code of Virginia; or
c. Petition an appropriate court for an injunction, mandamus, or other appropriate remedy or imposition of a civil penalty against a hospital pursuant to § 32.1-27 B or C of the Code of Virginia;
2. For each violation of subsection A of this section by or occurring in a long-term care nursing unit of a general hospital if that unit is a certified nursing facility:
a. Restrict or prohibit new admissions to the long-term care nursing unit in accordance with the Administrative Process Act (§ 2.2-4000 et seq. of the Code of Virginia);
b. Petition an appropriate court for imposition of a civil monetary penalty against a hospital pursuant to § 32.1-27.1 A of the Code of Virginia; or
c. Petition an appropriate court for appointment of a receiver for the long-term care nursing unit pursuant to § 32.1-27.1 B of the Code of Virginia; and
3. For each violation of subdivision A 3 of this section, levy a fine upon the hospital in an amount not to exceed $1,000 per violation, in accordance with the Administrative Process Act.
C. Suspension of a license shall in all cases be for an indefinite time.
D. For each violation of subsection A of this section and with the consent of the person who has violated subsection A of this section, the board may provide, in an order issued by the board, for the payment of civil charges for past violations in specific sums, which may not exceed the limits specified in § 32.1-27 of the Code of Virginia or if applicable, the limits specified in § 32.1-27.1 of the Code of Virginia.
E. Upon receipt of a completed application and a nonrefundable service charge, the commissioner may issue a new license to a hospital that has had its license revoked if the commissioner determines that:
1. The conditions upon which revocation was based have been corrected; and
2. The applicant is in compliance with this chapter, Article 1 (§ 32.1-123 et seq.) of Chapter 5 of Title 32.1 of the Code of Virginia, and all other applicable state and federal laws and regulations.
F. Upon receipt of a completed application, the commissioner may partially or completely restore a suspended license to a hospital if the commissioner determines that:
1. The conditions upon which suspension was based have been completely or partially corrected; and
2. The interests of the public will not be jeopardized by resumption of operation.
G. The commissioner may not require an additional service charge for restoring a license pursuant to subsection F of this section.
H. The hospital shall submit evidence relevant to subdivisions E 1, E 2, F 1, and F 2 of this section that is satisfactory to the commissioner or the commissioner's designee. The commissioner or the commissioner's designee may conduct an inspection prior to making a determination.
Statutory Authority
§§ 32.1-12, 32.1-27, 32.1-27.1, 32.1-127, 32.1-135, 32.1-137.07, and 38.2-3407.15 of the Code of Virginia.
Historical Notes
Derived from VR355-33-500 § 1.16, eff. July 28, 1993; amended, Virginia Register Volume 11, Issue 8, eff. April 1, 1995; Volume 42, Issue 18, eff. June 4, 2026.