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Best Practices for Project Management, Design, and Construction of ...

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If a hospital is found in violation <strong>of</strong> Title 24, OSHPD may take either <strong>for</strong>mal or in<strong>for</strong>mal action.<br />

In<strong>for</strong>mal action takes the <strong>for</strong>m <strong>of</strong> instructions to correct the noncompliant condition. Formal<br />

actions are more severe <strong>and</strong> can have damaging effects on a hospital. Examples include:<br />

• A notice to Stop Work<br />

• A noncompliance letter <strong>for</strong> work per<strong>for</strong>med without a permit (commonly referred to as<br />

“bootlegged” work or unauthorized construction)<br />

Even if Licensing & Certification chooses not to take action as a result <strong>of</strong> a noncompliance<br />

condition cited by OSHPD FDD, there still remains heightened risk to the hospital from action by<br />

CMS that could materially affect the hospital’s Medicare payment or JCAHO accreditation.<br />

Noncompliance matters should be taken very seriously.<br />

OSHPD Plan Review <strong>and</strong> Permitting Processes<br />

OSHPD has several processes available <strong>for</strong> plan review, approval, <strong>and</strong> permitting. The type, size,<br />

<strong>and</strong> complexity <strong>of</strong> projects will <strong>of</strong>ten be the guiding factors used to determine which process is<br />

most suitable. The processes are: St<strong>and</strong>ard Review, Phased Plan Review, Over-the-Counter<br />

Review, Rapid Review, Field Review, <strong>and</strong> SB 1838 Exempt. For more in<strong>for</strong>mation about the<br />

processes available <strong>for</strong> plan review, approval <strong>and</strong> permitting.<br />

(OSHPD <strong>Best</strong> <strong>Practices</strong>) Page 6 DRAFT FINAL, Sept. 2011

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