333-076-0101 Definitions As used in OAR chapter 333, division 76 unless the context requires otherwise, the following definitions apply: (1) "Affiliated with" means controlled by or associated with other persons under common ownership or control. (2) "Ambulatory Surgical Center" (ASC) means: (a) A facility or portion of a facility that operates exclusively for the purpose of providing surgical services to patients who do not require hospitalization and for whom the expected duration of services does not exceed 24 hours following admission. (b) Ambulatory surgical center does not mean: (A) Individual or group practice offices of private physicians or dentists that do not contain a distinct area used for outpatient surgical treatment on a regular and organized basis, or that only provide surgery routinely provided in a physician’s or dentist’s office using local anesthesia or conscious sedation; or (B) A portion of a licensed hospital designated for outpatient surgical treatment. (3) "Authentication" means verification that an entry in the patient medical record is genuine. (4) "Authority" means the Oregon Health Authority. (5) "CMS" means Centers for Medicare and Medicaid Services. (6) "Certified ambulatory surgical center" means a facility that is licensed by the Authority and is certified by the CMS as meeting the conditions for coverage for ambulatory surgical services, 42 CFR 416, Subpart C. (7) "Certified Nurse Anesthetist" (CRNA) means a registered nurse certified by the National Board of Certification and Recertification for Nurse Anesthetists and licensed by the Oregon State Board of Nursing (OSBN). (8) "Certified Nursing Assistant" (CNA) means a person who is certified by the Oregon State Board of Nursing (OSBN) to assist licensed nursing staff in the provision of nursing care. (9) "Conditions for Coverage" mean the applicable federal regulations that ASCs are required to comply with in order to participate in the federal Medicare and Medicaid programs. (10) "Conscious sedation" has the same meaning as "moderate sedation". (11) "Deemed status" means an ASC that has been inspected by a CMS- approved national accrediting organization, has been found to meet or exceed all applicable Medicare conditions, and CMS finds the ASC to be in compliance. (12) "Deep sedation" means an induced controlled state of depressed consciousness in which the patient experiences a partial loss of protective reflexes, as evidenced by the inability to respond purposefully either to physical stimulation or to verbal command and the patient’s ability to independently and continuously maintain an airway may be impaired. (13) "Dentist" means a person licensed under ORS chapter 679 to practice dentistry by the Oregon Board of Dentistry. (14) "Direct ownership" has the meaning given the term ‘ownership interest’ in 42 CFR 420.201. (15) "Extended stay center" means a facility that provides extended stay services. (16) "Extended stay services" means post-surgical and post-diagnostic medical and nursing services provided to a patient who is recovering from a surgical procedure performed in an ambulatory surgical center. (17) "Financial interest" means a five percent or greater direct or indirect ownership interest. (18) "General anesthesia" means an induced controlled state of unconsciousness in which the patient experiences complete loss of protective reflexes, as evidenced by the inability to independently maintain an airway, the inability to respond purposefully to physical stimulation, or the inability to respond purposefully to verbal command. (19) "Governing body" means the body or person legally responsible for the direction and control of the operation of the facility. (20) "Health care facility" (HCF) has the meaning given the term in ORS 442.015. (21) "Health Care Facility Licensing Law" means ORS 441.015-441.990 and rules thereunder. (22) "High complexity non-certified" means a facility that is licensed by the Authority, is not CMS certified, and performs surgical procedures involving deep sedation or general anesthesia. (23) "Hospital" has the meaning given that term in ORS 442.015. (24) "Indirect ownership" has the meaning given the term ‘indirect ownership interest’ in 42 CFR 420.201. (25) "Licensed" means that the person or facility to whom the term is applied is currently licensed, certified or registered by the proper authority to follow his or her profession or vocation within the State of Oregon, and when applied to a health care facility means that the facility is currently and has been duly and regularly licensed by the Authority. (26) "Licensed Practical Nurse" (LPN) means a person licensed under ORS chapter 678 to practice practical nursing. (27) "Local anesthesia" means the administration of an agent that produces a transient and reversible loss of sensation in a circumscribed portion of the body. (28) "Local hospital" means the closest most appropriate hospital that has the capability to treat medical emergencies or other care associated with the type of surgery performed at the affiliated ASC. (29) "Moderate complexity non-certified" means a facility licensed by the Authority, is not CMS certified, and performs procedures requiring not more than conscious sedation. (30) "Moderate sedation" means an induced controlled state of minimally depressed consciousness in which the patient retains the ability to independently and continuously maintain an airway and to respond purposefully to physical stimulation and to verbal command. Formerly referred to as conscious sedation. (31) "New construction" means a new building or an addition to an existing building. (32) "NFPA" means National Fire Protection Association. (33) "Nursing staff" means a person licensed by the OSBN as a registered nurse (RN), licensed practical nurse (LPN) or certified as a nursing assistant (CNA). (34) "Patient audit" means review of the medical record or patient observation including the care provided to a patient from admission to discharge. (35) "Person" means an individual, a trust or estate, a partnership, a corporation (including associations, joint stock companies and insurance companies), a state, or a political subdivision or instrumentality, including a municipal corporation, of a state. (36) "Physician" means a person licensed under ORS chapter 677 to practice medicine or osteopathic medicine by the Oregon Medical Board. (37) "Podiatric physician and surgeon" means a person licensed under ORS chapter 677 to practice podiatry medicine by the Oregon Medical Board. (38) "Podiatry" has the meaning given that term in ORS 677.010. (39) "Registered Nurse" (RN) means a person licensed as a Registered Nurse under ORS chapter 678. (40) "These rules" means OAR 333-076-0001 through 333-076-0270 and OAR 333-076-0800 through 333-076-1100. Statutory/Other Authority: ORS 441.025 Statutes/Other Implemented: ORS 441.015-ORS 441.065, 441.098 & 442.015 History: PH 1-2019, amend filed 01/07/2019, effective 01/07/2019 PH 7-2016, f. & cert. ef. 2-24-16 PH 28-2016, f. & cert. ef. 10-6-13 PH 26-2010, f. 12-14-10, cert. ef. 12-15-10 PH 25-2006, f. 10-31-06, cert. ef. 11-1-06 Reverted to HD 3-1990, f. 1-8-90, cert. ef. 1-15-90 PH 4-2006(Temp), f. & cert. ef. 3-2-06 thru 8-1-06 HD 3-1990, f. 1-8-90, cert. ef. 1-15-90