{"data":{"id":"us-ky/krs-216b.015","jurisdiction":"us-ky","citation":"KRS 216B.015","heading":"Definitions for chapter.","body":"Except as otherwise provided, for purposes of this chapter, the following definitions shall\napply:\n(1) \"Abortion facility\" means any place in which an abortion is performed;\n(2) \"Administrative regulation\" means a regulation adopted and promulgated pursuan t\nto the procedures in KRS Chapter 13A;\n(3) \"Affected persons\" means the applicant; any person residing within the geographic\narea served or to be served by the applicant; any person who regularly uses health\nfacilities within that geographic area; health facilities located in the health service\narea in which the project is proposed to be located which provide services similar to\nthe services of the facility under review; health facilities which, prior to receipt by\nthe agency of the proposal being reviewed , have formally indicated an intention to\nprovide similar services in the future; and the cabinet and third -party payors who\nreimburse health facilities for services in the health service area in which the project\nis proposed to be located;\n(4) (a) \"Ambulatory surgical center\" means a health facility:\n1. Licensed pursuant to administrative regulations promulgated by the\ncabinet;\n2. That provides outpatient surgical services, excluding oral or dental\nprocedures; and\n3. Seeking recognition and reimbursement as an ambulatory surgical center\nfrom any federal, state, or third -party insurer from which payment is\nsought.\n(b) An ambulatory surgical center does not include the private offices of\nphysicians where in -office outpat ient surgical procedures are performed as\nlong as the physician office does not seek licensure, certification,\nreimbursement, or recognition as an ambulatory surgical center from a\nfederal, state, or third-party insurer.\n(c) Nothing in this subsection shal l preclude a physician from negotiating\nenhanced payment for outpatient surgical procedures performed in the\nphysician's private office so long as the physician does not seek recognition or\nreimbursement of his or her office as an ambulatory surgical cente r without\nfirst obtaining a certificate of need or license required under KRS 216B.020\nand 216B.061;\n(5) \"Applicant\" means any physician's office requesting a major medical equipment\nexpenditure exceeding the capital expenditure minimum, or any person, hea lth\nfacility, or health service requesting a certificate of need or license;\n(6) \"Cabinet\" means the Cabinet for Health and Family Services;\n(7) \"Capital expenditure\" means an expenditure made by or on behalf of a health\nfacility which:\n(a) Under generally accepted accounting principles is not properly chargeable as\nan expense of operation and maintenance or is not for investment purposes\nonly; or\n(b) Is made to obtain by lease or comparable arrangement any facility or part\nthereof or any equipment for a facility or part thereof;\n(8) \"Capital expenditure minimum\" means the annually adjusted amount set by the\ncabinet. In determining whether an expenditure exceeds the expenditure minimum,\nthe cost of any studies, surveys, designs, plans, working drawings, spec ifications,\nand other activities essential to the improvement, expansion, or replacement of any\nplant or any equipment with respect to which the expenditure is made shall be\nincluded. Donations of equipment or facilities to a health facility which if acqui red\ndirectly by the facility would be subject to review under this chapter shall be\nconsidered a capital expenditure, and a transfer of the equipment or facilities for\nless than fair market value shall be considered a capital expenditure if a transfer of\nthe equipment or facilities at fair market value would be subject to review;\n(9) \"Certificate of need\" means an authorization by the cabinet to acquire, to establish,\nto offer, to substantially change the bed capacity, or to substantially change a health\nservice as covered by this chapter;\n(10) \"Certified surgical assistant\" means a certified surgical assistant or certified first\nassistant who is certified by the National Surgical Assistant Association on the\nCertification of Surgical Assistants, the Liaison Council on Certification of Surgical\nTechnologists, or the American Board of Surgical Assistants. The certified surgical\nassistant is an unlicensed health -care provider who is directly accountable to a\nphysician licensed under KRS Chapter 311 or, in the a bsence of a physician, to a\nregistered nurse licensed under KRS Chapter 314;\n(11) \"Continuing care retirement community\" means a community that provides, on the\nsame campus, a continuum of residential living options and support services to\npersons sixty (6 0) years of age or older under a written agreement. The residential\nliving options shall include independent living units, nursing home beds, and either\nassisted living units or personal care beds;\n(12) \"Formal review process\" means the ninety (90) day cer tificate-of-need review\nconducted by the cabinet;\n(13) \"Health facility\" means any institution, place, building, agency, or portion thereof,\npublic or private, whether organized for profit or not, used, operated, or designed to\nprovide medical diagnosis, treatment, nursing, rehabilitative, or preventive care and\nincludes alcohol abuse, drug abuse, and mental health services. This shall include\nbut shall not be limited to health facilities and health services commonly referred to\nas hospitals, psychiatric ho spitals, physical rehabilitation hospitals, chemical\ndependency programs, nursing facilities, nursing homes, personal care homes,\nintermediate care facilities, assisted living communities, family care homes,\noutpatient clinics, ambulatory care facilities, ambulatory surgical centers,\nemergency care centers and services, ambulance providers, hospices, community\nmental health centers, home health agencies, kidney disease treatment centers and\nfreestanding hemodialysis units, freestanding birthing centers as d efined in KRS\n216B.198, and others providing similarly organized services regardless of\nnomenclature;\n(14) \"Health services\" means clinically related services provided within the\nCommonwealth to two (2) or more persons, including but not limited to diagnos tic,\ntreatment, or rehabilitative services, and includes alcohol, drug abuse, and mental\nhealth services;\n(15) \"Independent living\" means the provision of living units and supportive services,\nincluding but not limited to laundry, housekeeping, maintenance , activity direction,\nsecurity, dining options, and transportation;\n(16) \"Intraoperative surgical care\" includes the practice of surgical assisting in which the\ncertified surgical assistant or physician assistant is working under the direction of\nthe opera ting physician as a first or second assist, and which may include the\nfollowing procedures:\n(a) Positioning the patient;\n(b) Preparing and draping the patient for the operative procedure;\n(c) Observing the operative site during the operative procedure;\n(d) Providing the best possible exposure of the anatomy incident to the operative\nprocedure;\n(e) Assisting in closure of incisions and wound dressings; and\n(f) Performing any task, within the role of an unlicensed assistive person, or if\nthe assistant is a ph ysician assistant, performing any task within the role of a\nphysician assistant, as required by the operating physician incident to the\nparticular procedure being performed;\n(17) \"Major medical equipment\" means equipment which is used for the provision of\nmedical and other health services and which costs in excess of the medical\nequipment expenditure minimum. In determining whether medical equipment has a\nvalue in excess of the medical equipment expenditure minimum, the value of\nstudies, surveys, designs, p lans, working drawings, specifications, and other\nactivities essential to the acquisition of the equipment shall be included;\n(18) \"Nonsubstantive review\" means an expedited review conducted by the cabinet of an\napplication for a certificate of need as authorized under KRS 216B.095;\n(19) \"Nonclinically related expenditures\" means expenditures for:\n(a) Repairs, renovations, alterations, and improvements to the physical plant of a\nhealth facility which do not result in a substantial change in beds, a substantial\nchange in a health service, or the addition of major medical equipment, and do\nnot constitute the replacement or relocation of a health facility; or\n(b) Projects which do not involve the provision of direct clinical patient care,\nincluding but not limited to the following:\n1. Parking facilities;\n2. Telecommunications or telephone systems;\n3. Management information systems;\n4. Ventilation systems;\n5. Heating or air conditioning, or both;\n6. Energy conservation; or\n7. Administrative offices;\n(20) \"Party to the proceedings\" means the applicant for a certificate of need and any\naffected person who appears at a hearing on the matter under consideration and\nenters an appearance of record;\n(21) \"Perioperative nursing\" means a practice of nursing in which the nurse provides\npreoperative, intraoperative, and postoperative nursing care to surgical patients;\n(22) \"Person\" means an individual, a trust or estate, a partn ership, a corporation, an\nassociation, a group, state, or political subdivision or instrumentality including a\nmunicipal corporation of a state;\n(23) \"Physician assistant\" means the same as the definition provided in KRS 311.550;\n(24) \"Record\" means, as applicable in a particular proceeding:\n(a) The application and any information provided by the applicant at the request\nof the cabinet;\n(b) Any information provided by a holder of a certificate of need or license in\nresponse to a notice of revocation of a certificate of need or license;\n(c) Any memoranda or documents prepared by or for the cabinet regarding the\nmatter under review which were introduced at any hearing;\n(d) Any staff reports or recommendations prepared by or for the cabinet;\n(e) Any recommendation or decision of the cabinet;\n(f) Any testimony or documentary evidence adduced at a hearing;\n(g) The findings of fact and opinions of the cabinet or the findings of fact and\nrecommendation of the hearing officer; and\n(h) Any other items required by admi nistrative regulations promulgated by the\ncabinet;\n(25) \"Registered nurse first assistant\" means one who:\n(a) Holds a current active registered nurse licensure;\n(b) Is certified in perioperative nursing; and\n(c) Has successfully completed and holds a degre e or certificate from a\nrecognized program, which shall consist of:\n1. The Association of Operating Room Nurses, Inc., Core Curriculum for\nthe registered nurse first assistant; and\n2. One (1) year of postbasic nursing study, which shall include at least\nforty-five (45) hours of didactic instruction and one hundred twenty\n(120) hours of clinical internship or its equivalent of two (2) college\nsemesters.\nA registered nurse who was certified prior to 1995 by the Certification Board of\nPerioperative Nursing shall not be required to fulfill the requirements of paragraph\n(c) of this subsection;\n(26) \"Secretary\" means the secretary of the Cabinet for Health and Family Services;\n(27) \"Sexual assault examination facility\" means a licensed health facility, emergency\nmedical facility, primary care center, or a children's advocacy center or rape crisis\ncenter that is regulated by the Cabinet for Health and Family Ser vices, and that\nprovides sexual assault examinations under KRS 216B.400;\n(28) \"State health plan\" means the document prepared triennially, updated annually, and\napproved by the Governor;\n(29) \"Substantial change in a health service\" means:\n(a) The addition  of a health service for which there are review criteria and\nstandards in the state health plan; or\n(b) The addition of a health service subject to licensure under this chapter;\n(30) \"Substantial change in bed capacity\" means the addition or reduction of b eds by\nlicensure classification within a health facility;\n(31) \"Substantial change in a project\" means a change made to a pending or approved\nproject which results in:\n(a) A substantial change in a health service, except a reduction or termination of a\nhealth service;\n(b) A substantial change in bed capacity, except for reductions;\n(c) A change of location; or\n(d) An increase in costs greater than the allowable amount as prescribed by\nregulation;\n(32) \"To acquire\" means to obtain from another by purchase, t ransfer, lease, or other\ncomparable arrangement of the controlling interest of a capital asset or capital\nstock, or voting rights of a corporation. An acquisition shall be deemed to occur\nwhen more than fifty percent (50%) of an existing capital asset or c apital stock or\nvoting rights of a corporation is purchased, transferred, leased, or acquired by\ncomparable arrangement by one (1) person from another person;\n(33) \"To batch\" means to review in the same review cycle and, if applicable, give\ncomparative con sideration to all filed applications pertaining to similar types of\nservices, facilities, or equipment affecting the same health service area;\n(34) \"To establish\" means to construct, develop, or initiate a health facility;\n(35) \"To obligate\" means to enter  any enforceable contract for the construction,\nacquisition, lease, or financing of a capital asset. A contract shall be considered\nenforceable when all contingencies and conditions in the contract have been met.\nAn option to purchase or lease which is not  binding shall not be considered an\nenforceable contract; and\n(36) \"To offer\" means, when used in connection with health services, to hold a health\nfacility out as capable of providing, or as having the means of providing, specified\nhealth services.","path":["KRS Chapter 216B"],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=56419","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:52:23Z","sha256":"2bacb5ebe0364f3bbcd55196fe80d1d29606430d838a7006e12c3d1eda5a1b3a","source_id":"us-ky","stale":false,"prev":"us-ky/krs-216b.010","next":"us-ky/krs-216b.017"},"notice":"GroundRules: Original legal text. Not legal advice."}