definiens: shall mean any of the approximate 5, 000 acute care institutions in the Territory that ( i ) are licensed and operated as hospitals, ( ii ) are accred ited as a hospital by the Joint Commission on Accre ditation of Health Care Organizations or the Bureau of Hospital s of the American Osteopathic Association and, in e ach case, are certified as a hospital provider under Me dicare, ( iii ) provide for the care and treatment of resident in - patients for a variety of medical conditions, both surgical and non - surgical, and ( iv ) provide treatme nt under the supervision of a staff of physicians with twenty fo ur ( 24)-hour a day nursing care and internal labora tory services . The term shall not include any affiliated clinic or treatment center or physician office or physician practice unless that clinic, treatment ce nter, physician office or physician practice is who lly - owned by an institution described in the first sentence of t his definition