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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
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an expense of operation and maintenance or is not for investment purposes
only; or
(b) 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
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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 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,
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including but not limited to the following:
1.
Parking facilities;
2.
Telecommunications or telephone systems;
3.
Management information systems;
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
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(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;
"Secretary" means the secretary of the Cabinet for Health and Family Services;
"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;
"State health plan" means the document prepared triennially, updated annually, and
approved by the Governor;
"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;
"Substantial change in bed capacity" means the addition, reduction, relocation, or
redistribution of beds by licensure classification within a health facility;
"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;
"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;
"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;
"To establish" means to construct, develop, or initiate a health facility;
"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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