Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 130.000 - Hospital Licensure › Section 130.020 - Definitions

Current through Register 1525, July 5, 2024
Accreditation
. Process of evaluation
				and approval of hospitals conducted by the Joint Commission, the American
				Osteopathic Association (AOA), or conducted by another accrediting body
				approved by the federal Centers for Medicare and Medicaid Services (CMS) and
				the Commissioner.
Ambulatory Care Service
. Health care
				services that do not require overnight hospital stay.
Autopsy
. A post mortem examination
				performed by a physician, including the removal and examination of organs, to
				determine a medical disease, medical condition, or the cause and manner of
				death, or for other diagnostic, education, quality improvement, or research
				purposes.
Beds Out of Service
. Beds not occupied
				and not qualified for patient occupancy pursuant to the applicable requirements
				of
				105 CMR
				130.000.
Birth Center
. A home-like facility
				where low risks births are planned to occur following normal, uncomplicated
				pregnancy.
Birth Center Services
. Professional
				midwifery services provided to low risk childbearing women during pregnancy,
				birth, and puerperium and to the infant during the immediate newborn period by
				nurse-midwives or by obstetricians or family practitioners. Birth center
				services are provided in a free standing facility.
Burn Unit
. An intensive care unit for
				burned inpatients needing care of a more intensive nature than is provided in
				medical/surgical beds. Burn units are staffed with specially trained
				physicians, nurses, and support personnel and contain specialized monitoring
				and therapeutic equipment needed to provide care for severely burned
				patients.
Campus
. One of several premises on the
				license of a hospital that provides health care services.
Cardiac Catheterization Services
.
				Diagnostic and interventional services, other than cardiac surgery, that
				involve the introduction of physical objects (such as catheters) into the
				heart, its chambers, the pericardium, or the great vessels proximal to the
				heart.
Cardiac Surgery
. Surgery on the heart
				and the thoracic great vessels. Most cardiac surgery requires the use of a
				heart-lung machine. Those procedures previously requiring the heart-lung
				machine but now sometimes performed "off-pump" (
e.g
. coronary
				artery bypass) are still considered as cardiac surgery. Examples of cardiac
				surgery include coronary artery bypass grafts, heart valve repair or
				replacement, heart transplantation, surgery of the thoracic aorta, repair of
				congenital heart defects and minimally invasive heart surgery.
Center for Health Information and
				Analysis
or
CHIA
. The entity established
				pursuant to M.G.L. c. 12C.
Chronic Care Service
. A service, other
				than a rehabilitation, psychiatric, substance use disorder, intermediate care
				facility, or skilled nursing facility service, that has an average length of
				inpatient stay greater than 25 days and that meets the long-term care hospital
				patient level criteria issued by the Federal Centers for Medicare and Medicaid
				Services.
Commissioner
. The Commissioner of the
				Massachusetts Department of Public Health or his or her designee.
Coronary Care Unit
. An intensive care
				unit staffed with specially trained nursing and supportive personnel and
				equipped with necessary diagnostic, monitoring, and therapeutic equipment
				needed to provide specialized medical and nursing care to inpatients who,
				because of heart seizure, open heart surgery, or conditions threatening to the
				heart, require intensified, comprehensive observation and care.
Critical Care Beds
. Beds licensed as
				intensive care, coronary care, pediatric intensive care, neonatal intensive
				care and (intensive) burn unit service beds.
Data Analysis Center (DAC)
. The
				organization contracted by the Department to receive, process, analyze and
				report on the patient-specific cardiac surgery and Percutaneous Coronary
				Interventions (PCI) outcome data submitted by the acute care hospital.
Decedent
. A deceased individual or
				fetus, including a stillborn infant.
Deemed Status
. That standing granted
				to an accredited hospital by the Commissioner under
				105 CMR
				130.000, which exempts the hospital from inspection
				for compliance with most Medicare Conditions of Participation.
Department
. The Massachusetts
				Department of Public Health.
Designated Trauma Center
. A hospital
				that has been verified by the American College of Surgeons as a level 1, 2 or 3
				adult trauma center, or a level 1 or 2 pediatric trauma center and meets
				applicable Department standards for designation, or a hospital that has applied
				for and is in the process of verification as specified in
				105
				CMR 130.851 and meets applicable Department
				standards for designation.
Dialysis Service
. Chronic or acute
				service, provided in a discrete unit or facility, for treatment of patients
				with kidney failure. This service includes hemodialysis, peritoneal dialysis or
				both and related specialized staff and support services.
Emergency Service
. A service
				maintained primarily to provide care to outpatients who are in need of
				immediate medical care to prevent loss of life or aggravation of physiological
				or psychological illness or injury.
Electrophysiology Service
. The study
				of the electrical conduction activity of the heart and characterization of
				atrial and ventricular arrhythmias obtained by means of a cardiac
				catheterization procedure.
Essential Health Service
. A campus, or
				any of the services enumerated in the definition of service in
				105
				CMR 130.020 that is not included in the
				Excluded Services list. Essential Health Service also includes outpatient
				dental services, outpatient psychiatric and mental health services, and
				outpatient reproductive health services:
Excluded Services List:
(1) Skilled nursing facility
			 service;
(2) Intermediate care
			 facility service;
(3) Cardiac
			 catheterization service (diagnostic, pediatric, diagnostic and
			 interventional);
(4) Chronic care
			 service;
(5)
			 Electrophysiology;
(6)
			 Hematopoietic Progenitor/Stem Cell Collection, Processing, and Transplant
			 Service;
(7) Hematopoietic
			 Progenitor/Stem Cell Transplantation Program or Clinical Transplantation
			 Program;
(8) Trauma service as a
			 designated trauma center as defined in
			 105
			 CMR 130.851;
(9) Primary Stroke Service;
(10) Medical Control Service.
Hospice Service
. A coordinated program
				of home care and inpatient care and services, provided by or arranged to be
				provided by an interdisciplinary team for persons who are determined to be
				terminally ill with a limited life expectancy. Inpatient hospital beds used to
				care for hospice patients shall be licensed as medical/surgical beds.
Hospital
. Any institution in
				Massachusetts, however named, whether conducted for charity or for profit, that
				is advertised, announced, established or maintained for the purpose of caring
				for persons admitted thereto for diagnosis or medical, surgical or restorative
				treatment which is rendered within said institution.
Hospital
shall not include any hospital operated by
				the Commonwealth of Massachusetts or by the United States.
Intensive Care Unit
. A unit physically
				and identifiably separate from general routine (and other) patient care areas,
				in which are concentrated special equipment and skilled personnel for the care
				of critically ill inpatients requiring immediate and concentrated continuous
				care and observation, and which meets the Medicare requirements in
				42 CFR
				413.53(d) for intensive care
				type inpatient hospital units.
Intermediate Care Facility Service
.
				For services licensed prior to April 21, 1988, a long-term care service that
				provides routine nursing services and periodic availability of skilled nursing,
				restorative and other therapeutic services. Intermediate care patients are in a
				stable condition, needing only supportive nursing care, supervision and
				observation, and do not require the constant care provided in skilled nursing
				beds.
Licensed Mental Health Professional
. A
				licensed mental health professional shall be a:
(1) licensed physician who specializes in the
			 practice of psychiatry;
(2)
			 licensed psychologist;
(3) licensed
			 independent clinical social worker;
(4) licensed certified social
			 worker;
(5) licensed mental health
			 counselor;
(6) licensed supervised
			 mental health counselor;
(7)
			 licensed physician assistant who practices in the field of
			 psychiatry;
(8) licensed
			 psychiatric clinical nurse specialist;
(9) licensed psychiatric mental health nurse
			 practitioner;
(10) healthcare
			 provider qualified within the scope of the individual's license to conduct an
			 evaluation of a mental health condition, including a physician who is in
			 training pursuant to the policies and practices of the hospital; or
(11) other licensed master's level mental
			 health clinician, including but not limited to licensed alcohol and drug
			 counselor and licensed marriage and family therapist.
Medical/Surgical Service
. A general,
				routine adult acute care service providing medical and/or surgical and nursing
				care to inpatients on the basis of physicians' orders and nursing care
				plans.
National Cardiovascular Data Registry
				(NCDRT)
. The Cath PCI database developed and maintained by the
				American College of Cardiology.
Non English Speaker
. A person who
				cannot speak or understand, or has difficulty speaking or understanding
				English, because the speaker primarily or only uses a spoken language other
				than English.
Organ
. Organs, tissues, and other
				parts of a human body, including but not limited to eyes, skin, bones, and
				arteries.
Organ
shall not mean tissue samples or
				fluids that are retained to determine the cause and manner of death.
Order of Priority
. The ranking of an
				individual who is qualified to provide consent to an autopsy.
Pediatric Cardiac Catheterization
				Services
. Providing cardiac catheterization services on an
				organized, regular basis to infants and children younger than 18 years
				old.
Percutaneous Coronary Interventions
				(PCI)
. The procedure for remodeling a blood vessel through the
				introduction of an expandable balloon catheter.
Primary Stroke Service
. Emergency
				diagnostic and therapeutic services provided by a multidisciplinary team and
				available 24 hours per day, seven days per week to patients presenting with
				symptoms of acute stroke.
Psychiatric Service
. A service for
				inpatients in need of intensive, 24-hour, psychiatric and nursing care and
				supervision, not including persons hospitalized for substance use disorders. A
				staff of mental health specialists provides psychiatric, psychological and
				social evaluation, treatment and aftercare planning.
Rehabilitation Service
. A service that
				provides physical restoration and emotional, mental, social and vocational
				restoration and adjustment for persons with disabilities and meets the
				inpatient rehabilitation hospital patient and facility criteria issued by the
				Federal Centers for Medicare and Medicaid Services. The service consists of
				evaluation, treatment, education, training and placement provided by qualified
				personnel. A rehabilitation service is directed by a physician experienced and
				qualified in the field of rehabilitation; and consists of a team effort of the
				various disciplines of rehabilitation services. The services that shall be
				provided include at a minimum intensive skilled rehabilitation nursing,
				physical therapy, occupational therapy, speech therapy, pathology, social
				services, prosthetic and/or orthotic fitting, and psychological services.
				Optional services include recreation therapy, dental services, special
				education, and vocational assessment and counseling.
Rural Hospital
. An acute care hospital
				licensed under M.G.L. c. 111, § 51, which:
(1) has 50 or fewer licensed beds and based
			 on the published United States Census 2000 data of the US Census Bureau is in a
			 city or town whose population is less than 20,000 and is located within a city,
			 town, service area, or County whose population density is less than or equal to
			 500 people per square mile and which applies for such a designation;
			 or
(2) is a hospital designated as
			 a Critical Access Hospital as of July 1, 2005 by the Federal Department of
			 Health and Human Services in accordance with federal regulations and state
			 requirements.
Satellite Emergency Facility (SEF)
. A
				health care facility off the premises of a hospital that is listed on the
				license of the hospital, at which the hospital is authorized pursuant to
				105
				CMR 130.820 through
				130.836 to accept patients
				transported to the SEF by ambulance, and which operates on a seven day per week
				24 hour per day basis. SEFs must comply with all requirements of the federal
				Emergency Medical Treatment and Active Labor Act (EMTALA).
Satellite Unit
. An operation off the
				premises of the hospital at which the hospital provides outpatient health care
				services.
Service
. Any of the following specific
				services, which the Department will list on a hospital's license if the
				Department licenses the hospital to deliver the service.
Ambulatory Care Services
Birth Center Services
Burn Unit
Cardiac Catheterization Services (diagnostic)
Cardiac Catheterization Services (diagnostic and
				interventional)
Cardiac Catheterization Services (pediatric)
Cardiac Surgery
Chronic Care Service
Continuing Care Nursery Service
Coronary Care Unit
Designated Trauma Center
Dialysis Service
Electrophysiology Service
Emergency Services
Hematopoietic Progenitor/Stem Cell Collection, Processing and
				Transplantation Services Hematopoietic Progenitor/Stem Cell Transplantation
				Program or Clinical Transplantation Program
Intensive Care Unit
Intermediate Care Facility Service
Maternal and Newborn Service
Medical Control Service
Medical/Surgical Service
Neonatal Intensive Care Unit
Pediatric Intensive Care Unit
Pediatric Service
Primary Stroke Service
Psychiatric Service
Rehabilitation Service
Satellite Emergency Facility
Skilled Nursing Facility Service
Special Care Nursery Service
Substance Use Disorder Service
Skilled Nursing Facility Service
. For
				services licensed prior to April 21, 1988, a long-term care service that
				provides continuous skilled nursing care, and restorative and other therapeutic
				services where beneficial, for patients who have a deteriorating condition
				requiring skilled care or who show potential for improvement or restoration to
				a stabilized condition. Patients in skilled nursing care require more intense
				and continuous skilled nursing care than the supportive nursing care provided
				in intermediate care beds.
Society of Thoracic Surgeons (STS) National
				Database
. The cardiac surgery database developed and maintained by
				the Society of Thoracic Surgeons (STS).
Substance Use Disorder Service
. A
				detoxification and/or rehabilitative treatment service for individuals and
				their families experiencing the dysfunctional effects of the use of alcohol
				and/or drugs.
Support Service
means any of the
				following:
(1) Blood Bank means a
			 facility or support service equipped and staffed to procure, draw, process
			 and/or store and dispense to transfusion services human whole blood and/or its
			 components and/or derivatives.
(2)
			 Clinical Laboratory means a facility or place, however named, the purpose of
			 which is to make biological, serological, chemical, immunohematological,
			 cytological, pathological, or other examinations of materials derived from a
			 human body.
(3) Transfusion Support
			 Service means a facility or place designed, equipped and staffed to administer
			 human whole blood and/or its components and/or derivatives in transfusion.
Trauma
. Tissue injury due to the
				direct effects of externally applied mechanical, thermal, electrical,
				electromagnetic or nuclear energy, as further defined in the Statewide
				Treatment Protocols established under
				105 CMR
				170.000:
Emergency Medical Services
				System
. Trauma shall not mean toxic ingestion, poisoning or foreign
				body ingestion.