Iowa Administrative Code › Agency 641 - Public Health Department › Chapter 202 - Certificate of Need Program › Rule 641-202.1 - Definitions

Current through Register Vol. 47, No. 3, July 24, 2024
For purposes of this chapter, the following definitions
				apply:
"Acute care category of bed usage,"
as the
				term applies in Iowa Code section
				10A.713(2)
"k,"
is the same as the acute care categories listed in the
				state survey section of the American Hospital Association Annual Survey of
				Hospitals.
"Any expenditure in excess of five hundred thousand
				dollars,"
as defined in Iowa Code section
				10A.711(18)
"e,"
means new capital expenditures necessary to
				operate the service for a year.
"Any mobile health service with a value in excess of
				one million five hundred thousand dollars,"
as defined in Iowa Code
				section 10A.711(18)
"l,"
means the value of all equipment used to provide the
				service, including the trailer. The party providing the equipment is the
				applicant regardless of the location of that party.
"Appropriate geographic service area,"
as the
				term applies to defining affected persons in Iowa Code section
				10A.711(1)
"c,"
is defined as follows:
1. For applications regarding hospitals,
			 hospitals located in the same county and in Iowa counties contiguous to the
			 county wherein the applicant hospital's proposed project will be
			 located.
2. For applications
			 regarding health care facilities, other health care facilities located in the
			 same county and in Iowa counties contiguous to the county wherein the
			 applicant's proposed health care facility will be located.
3. For applications sponsored by other than
			 the hospitals or health care facilities specified in paragraphs "1" and "2,"
			 those providers within the same county who offer similar service or might
			 logically be viewed as potential providers of such service.
"Bed capacity"
is defined as follows:
1. For hospitals, bed capacity is defined as
			 the total facility licensed beds as reported on the state survey section of the
			 American Hospital Association Annual Survey of Hospitals.
2. For health care facilities, bed capacity
			 is defined as a facility's licensed bed capacity according to the department of
			 inspections, appeals, and licensing.
"Cardiac catheterization service,"
as the term
				applies to anew or changed institutional health service in Iowa Code section
				10A.711(18)
"m"
(1), means the initiation or expansion of this
				service.
"Consumers served by a new institutional health
				service"
means those consumers residing in the service area as
				determined by the department.
"Long-term (acute) care hospital,"
for
				purposes of these rules, means a hospital that has been approved to participate
				in the Title XVIII (Medicare) program as a long-term care hospital-prospective
				payment system (LTCH-PPS) hospital in accordance with 42 CFR Part 412 as
				amended to March 29, 1985.
"Open heart surgical service,"
as the term
				applies to new or changed institutional health service in Iowa Code section
				10A.711(18)
"m"
(2), means the initiation or expansion of this
				service.
"Organ transplantation service,"
as the term
				applies to a new or changed institutional health service in Iowa Code section
				10A.711(18)
"m"
(3), means the initiation or expansion of this
				service. Each type of organ transplant shall be considered separately.
"Permanent change in bed capacity of an institutional
				health facility"
includes but is not limited to the following:
1. A conversion of a long-term acute care
			 hospital, a rehabilitation hospital or a psychiatric hospital as defined by
			 federal regulations to a general acute care hospital or to a different type of
			 specialty hospital.
2. A hospital
			 that has deleted beds pursuant to Iowa Code section
			 10A.713(2)
"g"
for the purpose of receiving designation as a critical
			 access hospital reestablishes the deleted beds at a later time, provided that
			 the number of beds reestablished does not exceed the number of beds maintained
			 prior to the deletion as reported on the bed reduction form.
"Physical facility,"
as the term applies in
				Iowa Code section 10A.711(18)
"f,"
means a separately licensed facility.
"Private offices and private clinics of an individual
				physician, dentist, or other practitioner or group of health care
				providers."
The meaning of this term as used in Iowa Code section
				10A.713(2)
"a"
is determined by looking at factors that include
				but are not limited to:
1. The type of
			 health care service delivered.
2.
			 The control and supervision of medical judgment in the care of and treatment of
			 patients.
3. The control and
			 supervision of professional assistants, including nurses, physician assistants,
			 and technicians.
4. The ownership
			 and maintenance of medical records of patients.
This term excludes an ambulatory surgical center as defined in
				Iowa Code section 135R.1.
"Radiation therapy service applying ionizing radiation
				for the treatment of malignant disease using megavoltage external beam
				equipment,"
as the term applies to new or changed institutional health
				service in Iowa Code section
				10A.711(18)
"m"
(4), means the initiation or expansion of this
				service.
"Rehabilitation hospital,"
for the purposes of
				these rules, means a hospital that has been approved to participate in the
				Title XVIII (Medicare) program as an inpatient rehabilitation
				facility-prospective payment system (IRF-PPS) hospital in accordance with 42
				CFR Part 412.23(b), 412.25 or
				412.29 as amended to March 29,
				1985.
"Relocation of an institutional health
				facility,"
as the term applies to new or changed institutional health
				service in Iowa Code section
				10A.711(18)
"b,"
means the replacement of a facility located in one county
				with a facility located in another county.
"Value in excess of one million five hundred thousand
				dollars,"
as used in Iowa Code section
				10A.711(18)
"g,", "h," "i"
and
"j,"
means the value of
				the equipment including any applicable sales tax, delivery charge and
				installation charge. With respect to the initiation of radiation therapy
				services applying ionizing radiation for the treatment of malignant disease
				using the megavoltage external beam equipment, the term includes the cost of
				constructing a vault.