2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART I - Hospitals, Institutions, And Health Programs (§§ 1 — 343k) › Chapter 19 - Health Facilities (§§ 331 — 334j) › Subchapter III - Certificates of Necessity and Convenience (§§ 334 — 334j) › § 334 - Definitions

For the purposes of §§ 334—334j of this title, the following words shall have the meaning expresses [sic] below:
(a) Secretary. — The Secretary of Health of the Commonwealth of Puerto Rico.
(b) Department. — The Department of Health of the Commonwealth of Puerto Rico.
(c) Person. — A natural or juridical person.
(d) Health facilities. — Hospitals, extended care facilities, nursing care facilities, rehabilitation centers, renal disease centers, including portable hemodialysis units, centers for ambulatory surgery, home health services program, diagnosis and treatment centers, pharmacies, blood banks, clinical laboratories and radiology facilities, as defined in §§ 334—334j of this title.
(e) Certificate of Necessity and Convenience. — A document issued by the Secretary of Health authorizing a person to carry out any of the activities covered by §§ 334—334j of this title, certifying that the same is necessary for the population it is to serve and that it will not unduly affect the existing services, thus contributing to the orderly and adequate development of health services in Puerto Rico.
(f) Construction. — Construction shall include the initiation, remodeling, expansion of the facility with the purpose of completing the construction of a health facility.
(f-a) Relocate. — The relocation of a health facility previously located in a specific geographical limit, place or territory. This does not include the relocation of services within the same physical structure or an adjacent one.
(g) Hospital. — An institution that primarily provides inpatients, by or under medical supervision, with diagnosis, treatment, care or rehabilitation services for injured, disabled or sick persons. It includes general hospitals as well as specialized hospitals.
(h) Extended care facilities (Skilled nursing care). — An institution that primarily provides skilled nursing care and related health services to hospitalized patients that do not require the direct medical supervision provided by a hospital for their condition.
(i) Diagnostic and treatment center. — An independent facility, or one operated in connection with a hospital that provides integrated health services for the diagnosis and treatment of ambulatory patients and that gives or makes available through arrangements with other health facilities, X-ray and clinical laboratory services.
(j) Nursing care facilities. — An institution that provides health-related care and services to physically or mentally ill persons who do not require the degree of care and treatment that a hospital or extended care facility provides.
(k) To offer or develop a new health service. — It shall be deemed that a person is proposing to offer or develop a new health service when he plans to undertake one of the following activities:
(1) The construction, development or establishment, or any sort of acquisition of a health facility.
(2) The addition of a health service by any facility covered by §§ 334—334j of this title that has operating expenses in excess of the limit fixed in subsection (8) of § 334a of this title, when said limit is applicable.
(l) Rehabilitation center. — An institution for hospitalized patients that operates for the purpose of assisting in the rehabilitation of physically or mentally disabled persons through an integrated program of medical and other services, under the supervision of specialized professional personnel.
(m) Renal dialysis center. — A unit of a hospital authorized to provide diagnostic, treatment and rehabilitation services to patients with chronic renal diseases. It also includes portable facilities for hemodialysis treatment.
(n) Center for ambulatory surgery. — An independent facility of a hospital that provides medical-surgical services to patients that do not require hospitalization.
(o) Program of health services in the home. — Institution that offers skilled nursing services and other therapeutic and support services to patients with severe, chronic and terminal conditions in their home or substitute venue, including hospice care to the latter.
(p) Health services. — Any service related to clinical, diagnostic, treatment or rehabilitation aspects, including services related to alcoholism, drug addiction and mental health, when they are rendered in or through a health facility.
(q) Pharmacy. — An establishment registered and authorized by the Secretary of Health in which chemical products, drugs, pharmaceutical products, pharmaceutical or proprietary specialities, prescriptions, medicines and poisons are prepared, preserved, sold and bottled for retail trade, and may also deal with other articles of legal trade, which are customarily sold in drugstores in Puerto Rico.
(r) Blood bank. — Any center for collecting, processing and preserving blood obtained from human beings in order to keep it available to be used at any time it may be necessary.
(s) Clinical laboratory. — Any institution where bacteriological, microscopical, hematological, serological, biochemical or histopathological examinations are conducted to help in the diagnosis, control, prevention or treatment of diseases of the human race.
(t) Radiological facilities. — Facilities dedicated to the diagnosis of diseases through the use of X-ray equipment, sonography, computerized tomography or any other similar equipment for invasive procedures.
(u) Acquisition. — To acquire the legal title of land, buildings, medical equipment or property through purchase, option for purchase, lease, or any other form, such as a legacy or donation.
(v) Capital investment. — Use of capital for or in favor of a health facility, that according to the generally accepted and consistently applied accounting principles cannot be accounted for as as operating and maintenance expense.
(w) Highly-specialized medical equipment. — Medical equipment whose cost exceeds the established minimum investment of two hundred fifty thousand dollars ($250,000) or more, and whose acquisition has the purpose of offering a health service.
(x) Health maintenance organization. — A public or private organization that meets the requirements of § 1310(d) of the Federal Public Health Act 93-222, as amended, or that:
(1) Provides or offers health services to the participants, including basic health services such as routine medical services, hospitalization, laboratory, radiological, emergency and preventive services, and that also provides these services outside of the service area of the organization.
(2) Offers these services on the basis of the fees paid periodically without taking into consideration the date on which the services are rendered, and that said fee is established regardless of the frequency, use or the type of service that is rendered.
(3) Provides medical services offered mainly by doctors that are employees or partners of the organization or by doctors who are in individual private practice or by doctors in group practice through agreements.
(y) Affected persons. — Any person directly affected by the decision of the Secretary regarding a petition for exemption or a certificate of necessity and convenience, including:
(1) The petitioner or applicant.
(2) The health facilities located in the service area of the project, which provide services similar to those proposed.
(3) The health facilities that, prior to receiving the application under consideration, have informed, in writing, their intention to render similar services in the future.
(4) Any agency that establishes rates for the health facilities in Puerto Rico.
(z) Petitioner or Proponent. — Any person who plans to carry out any of the activities regulated in §§ 334—334j of this title, whether he be exempted or not of the need to request a certificate of necessity and convenience, pursuant to the provisions of §§ 334—334j of this title.
History —Nov. 7, 1975, No. 2, p. 922, § 1; July 26, 1979, No. 189, p. 521, § 3; Sept. 19, 1983, No. 16, p. 385, § 3; July 18, 1986, No. 139, p. 441, § 1; Aug. 24, 2000, No. 187, § 1.