Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 30 - Division of Regulation and Licensure › Chapter 30 - Ambulatory Surgical Centers and Abortion Facilities › Section 19 CSR 30-30.010 - Definitions and Procedures for Licensing Ambulatory Surgical Centers

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: The Division of Regulation and Licensure,
				  Department of Health and Senior Services has the authority to establish rules
				  for ambulatory surgical centers. This rule defines specific terms and presents
				  procedures to follow in making application for a license.
(1) Definitions.
(A) Administrator means a person who is
				delegated the responsibility of carrying out the policies and programs
				established by the governing body.
(B) Ambulatory surgical center. Any public or
				private establishment operated primarily for the purpose of performing surgical
				procedures or primarily for the purpose of delivering newborns, and which does
				not provide services or other accommodations for patients to stay more than
				twelve (12) hours within the establishment. However, nothing in this definition
				shall be construed to include the offices of dentists currently licensed under
				Chapter 332, RSMo.
1. A facility operated
				primarily for the purpose of performing surgical procedures is one that
				provides surgical services to fifty-one percent (51%) or more of the patients
				treated or seen for any health condition, or one that derives fifty-one percent
				(51%) or more of its revenues from the provision of surgical services or
				related procedures.
2. The term
				ambulatory surgical center does not apply to any facility licensed as part of a
				hospital or any facility used as an office or clinic for the private practice
				of a physician, dentist or podiatrist.
3. A facility licensed as an ambulatory
				surgical center shall not use the term hospital in the name of the facility
				without approval of the Department of Health and Senior Services.
(C) Anesthesiologist. A physician
				licensed under Chapter 334, RSMo, who has successfully completed a postgraduate
				medical education program in anesthesiology approved by the Accreditation
				Council on Graduate Medical Education or the American Osteopathic
				Association.
(D) Anesthesiologist
				assistant. A person who meets each of the following conditions:
1. Has graduated from an anesthesiologist
				assistant program accredited by the American Medical Association's Committee on
				Allied Health Education and Accreditation or by its successor agency;
2. Has passed the certifying examination
				administered by the National Commission on Certification of Anesthesiologist
				Assistants;
3. Has active
				certification by the National Commission on Certification of Anesthesiologist
				Assistants;
4. Is currently
				licensed as an anesthesiologist assistant in the state of Missouri;
				and
5. Provides health care
				services delegated by a licensed anesthesiologist.
(E) Certified nurse anesthetist. A registered
				nurse licensed under Chapter 335, RSMo, who has been graduated from a school of
				nurse anesthesia accredited by the Council on Accreditation of Educational
				Programs of Nurse Anesthesia or its predecessor, and is certified or is
				eligible for certification as a nurse anesthetist by the Council on
				Certification of Nurse Anesthetists.
(F) Dentist means a person licensed to
				practice dentistry pursuant to Chapter 332, RSMo.
(G) Department means the Department of Health
				and Senior Services.
(H) Governing
				body means an individual owner, partnership, corporation or other legally
				established authority in whom the ultimate authority and responsibility for
				management of the ambulatory surgical center is vested.
(I) Governmental unit means any city, county
				or other political subdivision of this state, or any department, division,
				board or other agency of any political subdivision of this state.
(J) Infection control officer. An individual
				who is a licensed physician, licensed registered nurse, has a bachelor's degree
				in laboratory science, or has similar qualifications and has additional
				training or educational preparation in infection control, infectious diseases,
				epidemiology and principles of quality improvement.
(K) Licensed practical nurse (LPN). A person
				who holds a valid license issued by the State Board of Nursing pursuant to
				Chapter 335, RSMo.
(L) Medical
				staff. A formal organization of physicians which may include dentists and
				podiatrists who are appointed by the governing body to attend patients within
				the ambulatory surgical center.
(M)
				Patient. A person admitted to the ambulatory surgical center by and upon the
				order of a physician, or dentist, or podiatrist in accordance with the orders
				of a physician.
(N) Person. Any
				individual, firm, partnership, corporation, company or association, or the
				legal successors of any of them.
(O) Physician means a person licensed to
				practice medicine pursuant to Chapter 334, RSMo and who has active or associate
				staff membership and privileges in a licensed hospital in the
				community.
(P) Physician with
				training or experience in the administration of anesthetics. A person licensed
				to practice medicine under Chapter 334, RSMo whose training and experience
				(credentials) have been evaluated by the medical staff and privileges granted
				to direct the anesthesia service or to administer anesthetics or
				both.
(Q) Podiatrist means a person
				licensed to practice podiatry pursuant to Chapter 330, RSMo.
(R) Qualified anesthesia personnel. An
				anesthesiologist who is a physician with training or experience in the
				administering of anesthetics, a certified registered nurse anesthetist or an
				anesthesiologist assistant.
(S)
				Registered nurse (RN). A person who holds a valid license issued by the State
				Board of Nursing pursuant to Chapter 335, RSMo.
(T) Root cause analysis. A process for
				identifying the basic or causal factor(s) that underlie variation in
				performance, including the occurrence or possible occurrence of a sentinel
				event.
(U) Sentinel event. An
				unexpected occurrence involving death or serious physical or psychological
				injury, or the risk thereof. Serious injury specifically includes loss of limb
				or function. The phrase "or the risk thereof" includes any process variation
				for which a reoccurrence would carry a significant chance of a serious adverse
				outcome.