Hawaii Administrative Rules › Title 11 - DEPARTMENT OF HEALTH › Subtitle 1 - GENERAL DEPARTMENTAL PROVISIONS › Chapter 95 - FREESTANDING SURGICAL OUTPATIENT FACILITIES › Section 11-95-2 - Definitions

Current through June, 2024
as used in this chapter:
"Administrator" is the person to whom is delegated the
				  responsibility for the interpretation and implementation of the policies and
				  programs established by the governing body. This person may or may not be the
				  same as the medical director. The administrator shall have had suitable and
				  sufficient previous experience in administration of a medical facility.
"Anesthesia assistant" means a person who has successfully
				  completed a four year educational program for physicians' assistants that
				  includes two years of specialized academic and clinical training in
				  anesthesia.
"Anesthesiologist" means a physician whose specialized
				  training and experience qualify the physician to administer anesthetic agents
				  and to monitor the patient under the influence of these agents.
"Anesthetist" means a certified registered nurse
				  anesthetist.
"Broad service hospital" means a medical facility which is
				  staffed and equipped to provide inpatient medical and surgical care for acute
				  illness, injury, and obstetrics over a period of time longer than twenty-four
				  hours.
"Cardiopulmonary resuscitation" or "CPR" means an emergency
				  first aid procedure that consists of opening and maintaining a patient's
				  airway, providing artificial ventilation by means of rescue breathing, and
				  providing artificial circulation by means of external cardiac
				  compression.
"Chest x-ray" means a full-sized 11" x 14" film taken by the
				  standard technique.
"Dentist" means any person having a valid, unrevoked,
				  license issued by the State of Hawaii to practice "dentistry" as defined by
				  chapter
				  448,
				  HRS.
"Department" means the department of health of the State of
				  Hawaii.
"Dietitian" means a person who:
(1) Is registered by the American Dietetic Association;
				  or
(2) Is eligible for examination to become a registered
				  dietitian.
"Director" means the director of health of the State of
				  Hawaii.
"Freestanding surgical outpatient facility" is a facility
				  developed for the purpose of performing surgical procedures which do not
				  require hospitalization. The procedures are referred to as permitted
				  procedures. Patients admitted to the facility shall remain only long enough to
				  satisfy the objective of the facility and in no case shall they remain longer
				  than eighteen hours. The facility shall provide for continuous physician's
				  services and for continuous registered professional nursing services, on the
				  premises, whenever a patient is in the facility. It shall have an organized
				  administrative structure. The facility shall not be an integral part of a broad
				  service hospital and shall not include the offices of private physicians,
				  dentists, or podiatrists. if the facility is located in the same building with
				  a broad service hospital or with physician's offices, the freestanding surgical
				  outpatient facility shall be a "distinct part", separate from the other medical
				  facilities. A "distinct part" shall be an entire, physically identifiable unit
				  with its own staff, own records, and own equipment. There shall not be any
				  question as to the distinctness of the freestanding surgical outpatient
				  facility from the other medical facilities and services in the same
				  building.
"Governing body" means the individual, individual agency,
				  group, or corporation which has the ultimate responsibility and authority for
				  the conduct of the freestanding surgical outpatient facility and is named in
				  the license as the governing body.
"Licensee" means the governing body to whom the license is
				  issued.
"Licensed practical nurse" means a nurse licensed as such by
				  the State of Hawaii, as defined by chapter 457, HRS.
"Local hospital" means a licensed hospital on the same
				  island as the freestanding surgical outpatient facility.
"Medical director" is the physician who is responsible for
				  planning, organizing, conducting and directing the medical affairs of the
				  facility. The medical director shall currently hold active surgical or
				  anesthesiologist privileges at a local hospital.
"Medical staff" are physicians and dentists authorized by
				  the governing body to practice their profession within the facility.
"Operating room" is a room specifically set aside in which
				  surgical procedures only are performed.
"Outpatient" is a person seeking treatment from the
				  freestanding surgical outpatient facility and who does not stay overnight in
				  the facility.
"Pathologist" means a physician certified or eligible to be
				  certified by the American Board of Pathology.
"Patient" means a person admitted to and receiving care in a
				  freestanding surgical outpatient facility.
"Permitted procedures" are those which:
(1) Are commonly performed on an inpatient basis in hospitals
				  but may be safely performed in a freestanding surgical outpatient
				  facility;
(2) Are not of a type that are commonly or safely performed
				  in physicians' offices.
(3) Are limited to those requiring a dedicated operating
				  room, or suite, and generally requiring a post-operative recovery room or short
				  term convalescent room;
(4) Do not generally result in extensive blood loss;
(5) Do not generally require major or prolonged invasion of
				  body cavities;
(6) Do not generally involve major blood vessels;
(7) Are not generally of an emergency or life threatening
				  nature;
(8) Do not include procedures where the surgical operating
				  time plus the post-anesthetic recovery time would normally exceed the planned
				  business hours of the facility.
"Pharmacist" means a "registered pharmacist" as defined by
				  chapter
				  461, HRS.
"Physician" means a person having in the State of Hawaii a
				  valid license to practice medicine pursuant to chapters 453 or 460, HRS.
"Post-anesthetic recovery time" means that period of time
				  which ends when:
(1) The patient is alert and oriented and has reached
				  pre-operative mental status; and
(2) The patient's vital signs have returned to be within
				  normal physiological limits; and
(3) The patient is able to ambulate without dizziness and has
				  regained pre-operative ambulation ability; and
(4) The patient is not nauseated or vomiting and can retain
				  fluids by mouth.
"Recovery area" refers to a specific room or space used for
				  post-anesthetic recovery of surgical patients.
"Registered professional nurse" means a person who is
				  licensed as a "registered nurse" in the State of Hawaii, as defined by chapter
				  457, HRS.
"Tuberculin test" means an intradermal injection of .0001 mg
				  (5 tuberculin units) of purified protein derivative in 0.1 cc of sterile
				  diluent. If the size of any resulting palpable induration at forty-eight hours
				  and seventy-two hours after injection is equal to or greater than 10 mm in its
				  transverse diameter, the reaction to the skin test shall be considered
				  positive.