Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 93 - Hospitals › Subchapter A - General Provisions › Section I-9303 - Definitions

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 following definitions of selected terminology are used in connection with
					 Chapter 93.
Accredited
- the approval by the Joint
						Commission on Accreditation of Healthcare Organizations, American Osteopathic
						Association, or Det Norske Veritas.
Administrator
-(see Chief Executive
						Officer).
Anesthesiologist
-a physician, dentist,
						or osteopath physician, who has successfully completed an
approved
residency program in anesthesiology, or who is a
						diplomat of either the American Board of Anesthesiology or the American
						Osteopathic Board of Anesthesiology, or who was made a Fellow of the American
						College of Anesthesiology before 1972.
Approved
-acceptable to the authority
						having jurisdiction.
Authority Having Jurisdiction
-an
						organization, office, or individual responsible for approving equipment, an
						installation, or a procedure.
Average Daily Census (ADC)
-calculated
						by adding the midnight daily census of the main hospital or its off-site
						campus(es), independent of one another, for each day of the 12-month period and
						dividing the total number by the number of days in the year. In calculating the
						ADC for purposes of determining whether an entity meets the requirements of
						primarily engaged, LDH may utilize a period of between three months and 12
						months.
Average Length of Stay (ALOS)
-the
						average of the number of inpatient days a person is in the main hospital or its
						off-site campus(es). ALOS is calculated by dividing the total inpatient days by
						the total discharges during a specified period of time, which results in an
						average number of days in the main hospital or its off-site campus(es) for each
						person admitted. In calculating ALOS, LDH may utilize a period of between three
						months and 12 months. For purposes of calculating the ALOS of the main hospital
						or its off-site campus(es), each facility shall be considered an independent
						entity.
Certified Nurse Midwife
-an advanced
						practice registered nurse as defined by
						R.S.
						37:913.
Certified Registered Nurse
						Anesthetist
-an advanced practice registered nurse as defined by
						R.S.
						37:913.
Cessation of Business
-when a hospital
						stops providing services to the community.
Chief Executive Officer
						(CEO)/Administrator
-the person responsible for the operation of the
						hospital commensurate with the authority conferred by the governing
						body.
Clinical Nurse Specialist
-an advanced
						practice registered nurse as defined by
						R.S.
						37:913.
Crisis Receiving Center-
a specialty
						unit of a hospital that shall receive, examine, triage, refer or treat an
						individual who is experiencing a behavioral health crisis.
Department
-Louisiana Department of
						Health.
Food Delivery Services
-the
						transportation of the nutritional and therapeutic dietetic services by a food
						management company that is delivered to the hospital and served to the patients
						of the hospital.
Food Management Company
-an off-site
						vendor who provides nutritional and therapeutic dietetic services to the
						hospital through a contractual agreement and that is required to meet the same
						standards for food and dietetic services as provided by the hospital
						directly.
Governing Body
-the board of trustees,
						owner or person(s) designated by the owner with ultimate authority and
						responsibility (both moral and legal) for the management, control, conduct and
						functioning of the hospital.
Hospital
-any institution, place,
						building, or agency, public or private, whether for profit or not, maintaining
						and operating facilities, 24 hours a day, seven days a week, having a minimum
						of 10 licensed beds, having staff and equipment sufficient to meet patient
						needs, and providing hospital services, care and treatment for injured,
						disabled or sick persons who are admitted with the expectation that he or she
						will require hospital care that is expected to span at least two midnights.
						Except as otherwise noted in these licensing regulations, a hospital shall be
						primarily engaged in providing inpatient services to inpatients, by or under
						the supervision of licensed physicians. The term hospital does not include the
						following:
a. physicians' offices,
					 clinics or programs where patients are not kept as bed patients for 24 hours or
					 more;
b. nursing homes providing
					 intermediate and/or skilled care as defined by and regulated under the
					 provisions of R.S. 40:2009-2009.23;
c. persons, schools, institutions, or
					 organizations engaged in the care and treatment of children with intellectual
					 disabilities and which are required to be licensed by the provisions of the
					 Developmental Disability Law,
					 R.S.
					 28:451.1 et seq.;
d. hospitalization or care facilities
					 maintained by the state at any of its penal or correctional
					 institutions;
e. hospitalization or
					 care facilities maintained by the federal government or agencies
					 thereof;
f. infirmaries or clinics
					 maintained solely by any college or university exclusively for treatment of
					 faculty, students and employees; or
NOTE: Free standing emergency departments (or an entity
						that holds itself out to the public mainly as a free standing emergency
						department) shall not be licensed as a hospital.
Hospital Record
-a compilation of the
						reports of the various clinical
departments
within a hospital,
						as well as reports from health care providers, as are customarily catalogued
						and maintained by the hospital medical records department.
Hospital
						records
include reports of procedures such as X-rays and
						electrocardiograms, but they do not include the image or graphic matter
						produced by such procedures, according to state law.
Immediate and Serious Threat
-a crisis
						situation in which the health and safety of patients is at risk. It is a
						deficient practice which indicates the operator's inability to furnish safe
						care and services, although it may not have resulted in actual harm. The threat
						of probable harm is real and important and could be perceived as something
						which will result in potentially severe temporary or permanent injury,
						disability or death.
Inpatient
-a person who admitted to a
						hospital with the status of inpatient for purposes of receiving hospital
						services with the expectation that he/she will require hospital care expected
						to span at least two nights and occupy a bed even though it is later determined
						that the patient can be discharged or transferred to another hospital and not
						actually use a hospital bed overnight. Persons in hospital observation status
						are not inpatients.
Inpatient Hospital Services or Inpatient
						Service
-includes, but is not limited to, the following services
						provided to inpatients of the hospital as either: diagnostic and therapeutic
						services for medical diagnosis, treatment, and care of injured, disabled, or
						sick persons; or rehabilitation services for the rehabilitation of injured,
						disabled, or sick persons.
a. bed and
					 board;
b. 24-hour nursing services
					 and other related services;
c. use
					 of hospital facilities;
d. medical
					 social services;
e. drugs,
					 biologicals, supplies, appliances, and equipment;
f. certain other diagnostic or therapeutic
					 services;
g. medical or surgical
					 services provided by certain interns or residents-in-training; and
h. transportation services, including
					 transport by ambulance.
License Under Suspensive Appeal
- a
						full or provisional license against which the department has taken a licensing
						action and the hospital has filed an administrative appeal.
Licensed Bed
-an adult and/or pediatric
						bed set up or capable of being set up within 24 hours in a hospital for the use
						of patients, based upon bedroom criteria expressed in these standards. Labor,
						delivery, newborn bassinets, emergency and recovery room beds are
						excluded.
Licensed Independent Practitioner
- a
						person who is
approved
by his board for independent practice
						and who is
approved
by the medical staff and credentialed and
approved
by the Governing Board.
Licensed Nuclear Medicine
						Technologist
-any person licensed to practice nuclear medicine
						technology by the Louisiana State Radiologic Technology Board of
						Examiners.
Licensed Practical Nurse (LPN)
-a person
						licensed to practice practical nursing by the Louisiana State Board of
						Practical Nurse Examiners and is practicing within his/her scope of practice,
						training, experience, and competency.
Licensed Radiation Therapy
						Technologist
-any person licensed to practice radiation therapy
						technology by the Louisiana State Radiologic Technology Board of
						Examiners.
Licensed Radiographer
-any person
						licensed to practice general radiography by the Louisiana State Radiologic
						Technology Board of Examiners.
Minor Alteration
-repair or replacement
						of building materials and equipment with materials and equipment of a similar
						type that does not diminish the level of construction beyond that which existed
						prior to the alteration. This does not include any alteration to the
						"functionality" or original design of the construction. (For example, normal
						maintenance, re-roofing, painting, wallpapering, asbestos removal, and changes
						to the electrical and mechanical systems.)
Monolithic Ceiling Construction
-a
						continuous membrane ceiling composed of plaster or gypsum wallboard, but not
						moveable or "lay-in" ceiling tiles.
Naloxone Nasal Spray
-an over-the-counter
						(OTC) Food and Drug Administration (FDA) approved medication that rapidly
						reverses the effects of opioid overdose.
Neonatal
-newborn immediately succeeding
						birth and continuing through the first 28 days of life.
New Construction
-any of the following
						started after March 1, 1995:
a. new
					 buildings to be used as a hospital;
b. additions to existing buildings to be used
					 as a hospital;
c. conversions of
					 existing buildings or portions thereof for use as a hospital;
d. alterations other than
minor
					 alterations
to an existing hospital;
Nurse Practitioner
-an advanced practice
						registered nurse as defined by
						R.S.
						37:913.
Nurses Call System
-a system that
						audibly transmits calls electronically from its place of origin (the patient's
						bed) to the place of receipt (the nurses' station).
Nutritional and Therapeutic Dietetic
						Services
-the provision of a nourishing, palatable, well-balanced diet
						that meets the patients daily nutritional and special dietary needs in
						accordance with the licensed practitioners prescribed plan of care, and taking
						into consideration the preferences of each patient.
Observation Bed/Unit
- outpatient
						service in which patients are admitted for a period of no longer than 24 hours
						for observation. After 24 hours, the patient must be admitted, transferred or
						discharged. This outpatient unit must not provide acute care nursing. A
						registered nurse must be on site while there are patients in this unit.
Office of the Secretary
-office of the
						person serving as the Secretary of the Department of Health.
Off-Site Campus
- all premises on which
						hospital services (inpatient and/or outpatient) are provided and that are not
						adjoining to the main hospital buildings or grounds. Each off-site campus of a
						hospital shall be licensed as a part of the main hospital. An off-site campus
						shall be located within 50 miles of the main hospital campus.
a. Exception. If a state-owned or operated
					 hospital ceases to do business and surrenders its license, the offsite
					 campus(es) of that hospital which provided outpatient services may be licensed
					 as an off-site campus(es) of another state-owned and/or operated hospital,
					 provided that the off-site campus(es) is located within 100 miles of the main
					 hospital campus of the state-owned and/or operated hospital.
Organ
-a human kidney, liver, heart,
						lung or pancreas.
Primarily Engaged
-a hospital is directly
						providing inpatient hospital services to inpatients, by or under the
						supervision of licensed physicians. Inpatient hospital services are services
						defined in this licensing rule and are provided to inpatients of the hospital
						as one of the following:
a. diagnostic
					 and therapeutic services for medical diagnosis, treatment, and care of injured,
					 disabled, or sick persons; or
b.
					 rehabilitation services for the rehabilitation of injured, disabled, or sick
					 persons.
Note: Having the capacity or potential to provide
						inpatient hospital services is not the equivalent of actually providing such
						care.
Radiologist
-a doctor of medicine or
						osteopathy who is qualified by education and experience in radiology.
Registered Dietitian
-a dietitian who is
						qualified based on registration by the Commission on Dietetic Registration of
						the American Dietetic Association and licensing by the Louisiana Board of
						Examiners in Dietetics and Nutrition.
Registered Nurse
-any person licensed to
						practice nursing by the Louisiana State Board of Nursing.
Surgical Smoke Plume
-the byproduct of
						using heat-producing equipment on tissue during surgery.
Unit Definition
- a licensed patient
						room.