216B.015 Definitions for chapter.

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