135.61 - DEFINITIONS.

        135.61  DEFINITIONS.
         As used in this division, unless the context otherwise requires:
         1.  "Affected persons" means, with respect to an application
      for a certificate of need:
         a.  The person submitting the application.
         b.  Consumers who would be served by the new institutional
      health service proposed in the application.
         c.  Each institutional health facility or health maintenance
      organization which is located in the geographic area which would
      appropriately be served by the new institutional health service
      proposed in the application.  The appropriate geographic service area
      of each institutional health facility or health maintenance
      organization shall be determined on a uniform basis in accordance
      with criteria established in rules adopted by the department.
         d.  Each institutional health facility or health maintenance
      organization which, prior to receipt of the application by the
      department, has formally indicated to the department pursuant to this
      division an intent to furnish in the future institutional health
      services similar to the new institutional health service proposed in
      the application.
         e.  Any other person designated as an affected person by rules
      of the department.
         f.  Any payer or third-party payer for health services.
         2.  "Birth center" means a facility or institution, which is
      not an ambulatory surgical center or a hospital or in a hospital, in
      which births are planned to occur following a normal, uncomplicated,
      low-risk pregnancy.
         3.  "Consumer" means any individual whose occupation is other
      than health services, who has no fiduciary obligation to an
      institutional health facility, health maintenance organization or
      other facility primarily engaged in delivery of services provided by
      persons in health service occupations, and who has no material
      financial interest in the providing of any health services.
         4.  "Council" means the state health facilities council
      established by this division.
         5.  "Department" means the Iowa department of public health.
         6.  "Develop", when used in connection with health services,
      means to undertake those activities which on their completion will
      result in the offer of a new institutional health service or the
      incurring of a financial obligation in relation to the offering of
      such a service.
         7.  "Director" means the director of public health, or the
      director's designee.
         8.  "Financial reporting" means reporting by which hospitals
      and health care facilities shall respectively record their revenues,
      expenses, other income, other outlays, assets and liabilities, and
      units of services.
         9.  "Health care facility" means health care facility as
      defined in section 135C.1.
         10.  "Health care provider" means a person licensed or
      certified under chapter 147, 148, 148A, 148C, 149, 151, 152, 153,
      154, 154B, 154F, or 155A to provide in this state professional health
      care service to an individual during that individual's medical care,
      treatment, or confinement.
         11.  "Health maintenance organization" means health
      maintenance organization as defined in section 514B.1, subsection 6.

         12.  "Health services" means clinically related diagnostic,
      curative, or rehabilitative services, and includes alcoholism, drug
      abuse, and mental health services.
         13.  "Hospital" means hospital as defined in section 135B.1,
      subsection 3.
         14.  "Institutional health facility" means any of the
      following, without regard to whether the facilities referred to are
      publicly or privately owned or are organized for profit or not or
      whether the facilities are part of or sponsored by a health
      maintenance organization:
         a.  A hospital.
         b.  A health care facility.
         c.  An organized outpatient health facility.
         d.  An outpatient surgical facility.
         e.  A community mental health facility.
         f.  A birth center.
         15.  "Institutional health service" means any health service
      furnished in or through institutional health facilities or health
      maintenance organizations, including mobile health services.
         16.  "Mobile health service" means equipment used to provide a
      health service that can be transported from one delivery site to
      another.
         17.  "Modernization" means the alteration, repair, remodeling,
      replacement or renovation of existing buildings or of the equipment
      previously installed therein, or both.
         18.  "New institutional health service" or "changed
      institutional health service" means any of the following:
         a.  The construction, development or other establishment of a
      new institutional health facility regardless of ownership.
         b.  Relocation of an institutional health facility.
         c.  Any capital expenditure, lease, or donation by or on
      behalf of an institutional health facility in excess of one million
      five hundred thousand dollars within a twelve-month period.
         d.  A permanent change in the bed capacity, as determined by
      the department, of an institutional health facility.  For purposes of
      this paragraph, a change is permanent if it is intended to be
      effective for one year or more.
         e.  Any expenditure in excess of five hundred thousand dollars
      by or on behalf of an institutional health facility for health
      services which are or will be offered in or through an institutional
      health facility at a specific time but which were not offered on a
      regular basis in or through that institutional health facility within
      the twelve-month period prior to that time.
         f.  The deletion of one or more health services, previously
      offered on a regular basis by an institutional health facility or
      health maintenance organization or the relocation of one or more
      health services from one physical facility to another.
         g.  Any acquisition by or on behalf of a health care provider
      or a group of health care providers of any piece of replacement
      equipment with a value in excess of one million five hundred thousand
      dollars, whether acquired by purchase, lease, or donation.
         h.  Any acquisition by or on behalf of a health care provider
      or group of health care providers of any piece of equipment with a
      value in excess of one million five hundred thousand dollars, whether
      acquired by purchase, lease, or donation, which results in the
      offering or development of a health service not previously provided.
      A mobile service provided on a contract basis is not considered to
      have been previously provided by a health care provider or group of
      health care providers.
         i.  Any acquisition by or on behalf of an institutional health
      facility or a health maintenance organization of any piece of
      replacement equipment with a value in excess of one million five
      hundred thousand dollars, whether acquired by purchase, lease, or
      donation.
         j.  Any acquisition by or on behalf of an institutional health
      facility or health maintenance organization of any piece of equipment
      with a value in excess of one million five hundred thousand dollars,
      whether acquired by purchase, lease, or donation, which results in
      the offering or development of a health service not previously
      provided.  A mobile service provided on a contract basis is not
      considered to have been previously provided by an institutional
      health facility.
         k.  Any air transportation service for transportation of
      patients or medical personnel offered through an institutional health
      facility at a specific time but which was not offered on a regular
      basis in or through that institutional health facility within the
      twelve-month period prior to the specific time.
         l.  Any mobile health service with a value in excess of one
      million five hundred thousand dollars.
         m.  Any of the following:
         (1)  Cardiac catheterization service.
         (2)  Open heart surgical service.
         (3)  Organ transplantation service.
         (4)  Radiation therapy service applying ionizing radiation for the
      treatment of malignant disease using megavoltage external beam
      equipment.
         19.  "Offer", when used in connection with health services,
      means that an institutional health facility, health maintenance
      organization, health care provider, or group of health care providers
      holds itself out as capable of providing, or as having the means to
      provide, specified health services.
         20.  "Organized outpatient health facility" means a facility,
      not part of a hospital, organized and operated to provide health care
      to noninstitutionalized and nonhomebound persons on an outpatient
      basis; it does not include private offices or clinics of individual
      physicians, dentists or other practitioners, or groups of
      practitioners, who are health care providers.
         21.  "Outpatient surgical facility" means a facility which as
      its primary function provides, through an organized medical staff and
      on an outpatient basis to patients who are generally ambulatory,
      surgical procedures not ordinarily performed in a private physician's
      office, but not requiring twenty-four hour hospitalization, and which
      is neither a part of a hospital nor the private office of a health
      care provider who there engages in the lawful practice of surgery.
      "Outpatient surgical facility" includes a facility certified or
      seeking certification as an ambulatory surgical center, under the
      federal Medicare program or under the medical assistance program
      established pursuant to chapter 249A.
         22.  "Technologically innovative equipment" means equipment
      potentially useful for diagnostic or therapeutic purposes which
      introduces new technology in the diagnosis or treatment of disease,
      the usefulness of which is not well enough established to permit a
      specific plan of need to be developed for the state.  
         Section History: Early Form
         [C79, 81, § 135.61; 82 Acts, ch 1194, § 1, 2] 
         Section History: Recent Form
         87 Acts, ch 215, § 39; 91 Acts, ch 225, §1; 97 Acts, ch 93, §1, 2;
      2002 Acts, ch 1162, §77; 2008 Acts, ch 1088, §86
         Referred to in § 135.63, 135.131, 505.27, 708.3A