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216B.015 Definitions for chapter.
Except as otherwise provided, for purposes of this chapter, the following definitions
shall apply:
(1) "Abortion facility" means any place in which an abortion is performed;
(2) "Administrative regulation" means a regulation adopted and promulgated
pursuant to the procedures in KRS Chapter 13A;
(3) "Affected persons" means the applicant; any person residing within the
geographic area served or to be served by the applicant; any person who
regularly uses health facilities within that geographic area; health facilities
located in the health service area in which the project is proposed to be located
which provide services similar to the services of the facility under review; health
facilities which, prior to receipt by the agency of the proposal being reviewed,
have formally indicated an intention to provide similar services in the future;
and the cabinet and third-party payors who reimburse health facilities for
services in the health service area in which the project is proposed to be
located;
(4) (a) "Ambulatory surgical center" means a health facility:
1.
Licensed pursuant to administrative regulations promulgated by the
cabinet;
2.
That provides outpatient surgical services, excluding oral or dental
procedures; and
3.
Seeking recognition and reimbursement as an ambulatory surgical
center from any federal, state, or third-party insurer from which
payment is sought.
(b) An ambulatory surgical center does not include the private offices of
physicians where in-office outpatient surgical procedures are performed
as long as the physician office does not seek licensure, certification,
reimbursement, or recognition as an ambulatory surgical center from a
federal, state, or third-party insurer.
(c) Nothing in this subsection shall preclude a physician from negotiating
enhanced payment for outpatient surgical procedures performed in the
physician's private office so long as the physician does not seek
recognition or reimbursement of his or her office as an ambulatory
surgical center without first obtaining a certificate of need or license
required under KRS 216B.020 and 216B.061;
(5) "Applicant" means any physician's office requesting a major medical equipment
expenditure of one million five hundred thousand dollars ($1,500,000) or more
after July 15, 1996, adjusted annually, or any person, health facility, or health
service requesting a certificate of need or license;
(6) "Cabinet" means the Cabinet for Health and Family Services;
(7) "Capital expenditure" means an expenditure made by or on behalf of a health
facility which:
(a) Under generally accepted accounting principles is not properly
chargeable as an expense of operation and maintenance or is not for
investment purposes only; or
(b)
(8)
(9)
(10)
(11)
(12)
(13)
Is made to obtain by lease or comparable arrangement any facility or part
thereof or any equipment for a facility or part thereof;
"Capital expenditure minimum" means one million five hundred thousand
dollars ($1,500,000) beginning with July 15, 1994, and as adjusted annually
thereafter. In determining whether an expenditure exceeds the expenditure
minimum, the cost of any studies, surveys, designs, plans, working drawings,
specifications, and other activities essential to the improvement, expansion, or
replacement of any plant or any equipment with respect to which the
expenditure is made shall be included. Donations of equipment or facilities to a
health facility which if acquired directly by the facility would be subject to review
under this chapter shall be considered a capital expenditure, and a transfer of
the equipment or facilities for less than fair market value shall be considered a
capital expenditure if a transfer of the equipment or facilities at fair market
value would be subject to review;
"Certificate of need" means an authorization by the cabinet to acquire, to
establish, to offer, to substantially change the bed capacity, or to substantially
change a health service as covered by this chapter;
"Certified surgical assistant" means a certified surgical assistant or certified
first assistant who is certified by the National Surgical Assistant Association on
the Certification of Surgical Assistants, the Liaison Council on Certification of
Surgical Technologists, or the American Board of Surgical Assistants. The
certified surgical assistant is an unlicensed health-care provider who is directly
accountable to a physician licensed under KRS Chapter 311 or, in the absence
of a physician, to a registered nurse licensed under KRS Chapter 314;
"Continuing care retirement community" means a community that provides, on
the same campus, a continuum of residential living options and support
services to persons sixty (60) years of age or older under a written agreement.
The residential living options shall include independent living units, nursing
home beds, and either assisted living units or personal care beds;
"Formal review process" means the ninety (90) day certificate-of-need review
conducted by the cabinet;
"Health facility" means any institution, place, building, agency, or portion
thereof, public or private, whether organized for profit or not, used, operated, or
designed to provide medical diagnosis, treatment, nursing, rehabilitative, or
preventive care and includes alcohol abuse, drug abuse, and mental health
services. This shall include but shall not be limited to health facilities and health
services commonly referred to as hospitals, psychiatric hospitals, physical
rehabilitation hospitals, chemical dependency programs, tuberculosis hospitals,
skilled nursing facilities, nursing facilities, nursing homes, personal care homes,
intermediate care facilities, family care homes, primary care centers, rural
health clinics, outpatient clinics, ambulatory care facilities, ambulatory surgical
centers, emergency care centers and services, ambulance providers, hospices,
community centers for mental health or individuals with an intellectual disability,
home health agencies, kidney disease treatment centers and freestanding
hemodialysis units, facilities and services owned and operated by health
maintenance organizations directly providing health services subject to
certificate of need, and others providing similarly organized services regardless
(14)
(15)
(16)
(17)
(18)
(19)
of nomenclature;
"Health services" means clinically related services provided within the
Commonwealth to two (2) or more persons, including but not limited to
diagnostic, treatment, or rehabilitative services, and includes alcohol, drug
abuse, and mental health services;
"Independent living" means the provision of living units and supportive
services, including but not limited to laundry, housekeeping, maintenance,
activity direction, security, dining options, and transportation;
"Intraoperative surgical care" includes the practice of surgical assisting in
which the certified surgical assistant or physician assistant is working under the
direction of the operating physician as a first or second assist, and which may
include the following procedures:
(a) Positioning the patient;
(b) Preparing and draping the patient for the operative procedure;
(c) Observing the operative site during the operative procedure;
(d) Providing the best possible exposure of the anatomy incident to the
operative procedure;
(e) Assisting in closure of incisions and wound dressings; and
(f) Performing any task, within the role of an unlicensed assistive person, or
if the assistant is a physician assistant, performing any task within the role
of a physician assistant, as required by the operating physician incident to
the particular procedure being performed;
"Major medical equipment" means equipment which is used for the provision of
medical and other health services and which costs in excess of the medical
equipment expenditure minimum. For purposes of this subsection, "medical
equipment expenditure minimum" means one million five hundred thousand
dollars ($1,500,000) beginning with July 15, 1994, and as adjusted annually
thereafter. In determining whether medical equipment has a value in excess of
the medical equipment expenditure minimum, the value of studies, surveys,
designs, plans, working drawings, specifications, and other activities essential
to the acquisition of the equipment shall be included;
"Nonsubstantive review" means an expedited review conducted by the cabinet
of an application for a certificate of need as authorized under KRS 216B.095;
"Nonclinically related expenditures" means expenditures for:
(a) Repairs, renovations, alterations, and improvements to the physical plant
of a health facility which do not result in a substantial change in beds, a
substantial change in a health service, or the addition of major medical
equipment, and do not constitute the replacement or relocation of a health
facility; or
(b) Projects which do not involve the provision of direct clinical patient care,
including but not limited to the following:
1.
Parking facilities;
2.
Telecommunications or telephone systems;
3.
Management information systems;
(20)
(21)
(22)
(23)
(24)
(25)
4.
Ventilation systems;
5.
Heating or air conditioning, or both;
6.
Energy conservation; or
7.
Administrative offices;
"Party to the proceedings" means the applicant for a certificate of need and
any affected person who appears at a hearing on the matter under
consideration and enters an appearance of record;
"Perioperative nursing" means a practice of nursing in which the nurse
provides preoperative, intraoperative, and postoperative nursing care to
surgical patients;
"Person" means an individual, a trust or estate, a partnership, a corporation, an
association, a group, state, or political subdivision or instrumentality including a
municipal corporation of a state;
"Physician assistant" means the same as the definition provided in KRS
311.550;
"Record" means, as applicable in a particular proceeding:
(a) The application and any information provided by the applicant at the
request of the cabinet;
(b) Any information provided by a holder of a certificate of need or license in
response to a notice of revocation of a certificate of need or license;
(c) Any memoranda or documents prepared by or for the cabinet regarding
the matter under review which were introduced at any hearing;
(d) Any staff reports or recommendations prepared by or for the cabinet;
(e) Any recommendation or decision of the cabinet;
(f) Any testimony or documentary evidence adduced at a hearing;
(g) The findings of fact and opinions of the cabinet or the findings of fact and
recommendation of the hearing officer; and
(h) Any other items required by administrative regulations promulgated by
the cabinet;
"Registered nurse first assistant" means one who:
(a) Holds a current active registered nurse licensure;
(b) Is certified in perioperative nursing; and
(c) Has successfully completed and holds a degree or certificate from a
recognized program, which shall consist of:
1.
The Association of Operating Room Nurses, Inc., Core Curriculum
for the registered nurse first assistant; and
2.
One (1) year of postbasic nursing study, which shall include at least
forty-five (45) hours of didactic instruction and one hundred twenty
(120) hours of clinical internship or its equivalent of two (2) college
semesters.
A registered nurse who was certified prior to 1995 by the Certification Board of
Perioperative Nursing shall not be required to fulfill the requirements of
paragraph (c) of this subsection;
(26) "Secretary" means the secretary of the Cabinet for Health and Family Services;
(27) "Sexual assault examination facility" means a licensed health facility,
emergency medical facility, primary care center, or a children's advocacy
center or rape crisis center that is regulated by the Cabinet for Health and
Family Services, and that provides sexual assault examinations under KRS
216B.400;
(28) "State health plan" means the document prepared triennially, updated
annually, and approved by the Governor;
(29) "Substantial change in a health service" means:
(a) The addition of a health service for which there are review criteria and
standards in the state health plan;
(b) The addition of a health service subject to licensure under this chapter; or
(c) The reduction or termination of a health service which had previously
been provided in the health facility;
(30) "Substantial change in bed capacity" means the addition, reduction, relocation,
or redistribution of beds by licensure classification within a health facility;
(31) "Substantial change in a project" means a change made to a pending or
approved project which results in:
(a) A substantial change in a health service, except a reduction or
termination of a health service;
(b) A substantial change in bed capacity, except for reductions;
(c) A change of location; or
(d) An increase in costs greater than the allowable amount as prescribed by
regulation;
(32) "To acquire" means to obtain from another by purchase, transfer, lease, or
other comparable arrangement of the controlling interest of a capital asset or
capital stock, or voting rights of a corporation. An acquisition shall be deemed
to occur when more than fifty percent (50%) of an existing capital asset or
capital stock or voting rights of a corporation is purchased, transferred, leased,
or acquired by comparable arrangement by one (1) person from another
person;
(33) "To batch" means to review in the same review cycle and, if applicable, give
comparative consideration to all filed applications pertaining to similar types of
services, facilities, or equipment affecting the same health service area;
(34) "To establish" means to construct, develop, or initiate a health facility;
(35) "To obligate" means to enter any enforceable contract for the construction,
acquisition, lease, or financing of a capital asset. A contract shall be
considered enforceable when all contingencies and conditions in the contract
have been met. An option to purchase or lease which is not binding shall not
be considered an enforceable contract; and
(36) "To offer" means, when used in connection with health services, to hold a
health facility out as capable of providing, or as having the means of providing,
specified health services.
Effective:July 12, 2012
History: Amended 2012 Ky. Acts ch. 103, sec. 1, effective July 12, 2012; and ch.
146, sec. 106, effective July 12, 2012. -- Amended 2005 Ky. Acts ch. 99,
sec. 60, effective June 20, 2005. -- Amended 2001 Ky. Acts ch. 36, sec. 1,
effective June 21, 2001. -- Amended 2000 Ky. Acts ch. 96, sec. 1, effective July
14, 2000; ch. 142, sec. 5, effective July 14, 2000; ch. 264, sec. 1, effective July
14, 2000; and ch. 538, sec. 1, effective July 14, 2000. -- Amended 1998 Ky.
Acts ch. 426, sec. 449, effective July 15, 1998; and ch. 582, sec. 1, effective
July 15, 1998. -- Amended 1996 Ky. Acts ch. 233, sec. 8, effective July 15,
1996; and ch. 371, sec. 37, effective July 15, 1996. -- Amended 1994 Ky. Acts
ch. 512, Part 7, sec. 23, effective July 15, 1994. -- Amended 1990 Ky. Acts
ch. 235, sec. 6, effective July 13, 1990; and ch. 499, sec. 1, effective July 13,
1990. -- Amended 1988 Ky. Acts ch. 210, sec. 5, effective July 15, 1988. -Amended 1982 Ky. Acts ch. 347, sec. 2, effective July 15, 1982. -- Created 1980
Ky. Acts ch. 135, sec. 2, effective July 15, 1980.
Legislative Research Commission Note (7/12/2012). This statute was amended
by 2012 Ky. Acts chs. 103 and 146, which do not appear to be in conflict and
have been codified together.
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