KRS 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 pursuan t

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 outpat ient 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 shal l 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 cente r 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 exceeding the capital expenditure minimum, or any person, hea lth

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) Is made to obtain by lease or comparable arrangement any facility or part

thereof or any equipment for a facility or part thereof;

(8) "Capital expenditure minimum" means the annually adjusted amount set by the

cabinet. In determining whether an expenditure exceeds the expenditure minimum,

the cost of any studies, surveys, designs, plans, working drawings, spec ifications,

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 acqui red

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;

(9) "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;

(10) "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 a bsence of a physician, to a

registered nurse licensed under KRS Chapter 314;

(11) "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 (6 0) 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;

(12) "Formal review process" means the ninety (90) day cer tificate-of-need review

conducted by the cabinet;

(13) "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 ho spitals, physical rehabilitation hospitals, chemical

dependency programs, nursing facilities, nursing homes, personal care homes,

intermediate care facilities, assisted living communities, family care homes,

outpatient clinics, ambulatory care facilities, ambulatory surgical centers,

emergency care centers and services, ambulance providers, hospices, community

mental health centers, home health agencies, kidney disease treatment centers and

freestanding hemodialysis units, freestanding birthing centers as d efined in KRS

216B.198, and others providing similarly organized services regardless of

nomenclature;

(14) "Health services" means clinically related services provided within the

Commonwealth to two (2) or more persons, including but not limited to diagnos tic,

treatment, or rehabilitative services, and includes alcohol, drug abuse, and mental

health services;

(15) "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;

(16) "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 opera ting 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 ph ysician assistant, performing any task within the role of a

physician assistant, as required by the operating physician incident to the

particular procedure being performed;

(17) "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. In determining whether medical equipment has a

value in excess of the medical equipment expenditure minimum, the value of

studies, surveys, designs, p lans, working drawings, specifications, and other

activities essential to the acquisition of the equipment shall be included;

(18) "Nonsubstantive review" means an expedited review conducted by the cabinet of an

application for a certificate of need as authorized under KRS 216B.095;

(19) "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;

4. Ventilation systems;

5. Heating or air conditioning, or both;

6. Energy conservation; or

7. Administrative offices;

(20) "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;

(21) "Perioperative nursing" means a practice of nursing in which the nurse provides

preoperative, intraoperative, and postoperative nursing care to surgical patients;

(22) "Person" means an individual, a trust or estate, a partn ership, a corporation, an

association, a group, state, or political subdivision or instrumentality including a

municipal corporation of a state;

(23) "Physician assistant" means the same as the definition provided in KRS 311.550;

(24) "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 admi nistrative regulations promulgated by the

cabinet;

(25) "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 degre e 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 Ser vices, 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; or

(b) The addition of a health service subject to licensure under this chapter;

(30) "Substantial change in bed capacity" means the addition or reduction of b eds 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, t ransfer, 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 c apital 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 con sideration 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.