New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter C - State Hospital Code › Article 1 - General Provisions › Part 700 - General › Section 700.2 - Definitions

Current through Register Vol. 46, No. 28, July 10, 2024
(a) The
					 following definitions of medical facilities, based on standards approved by the
					 commissioner, shall apply to this Chapter unless the context otherwise
					 requires:
(1)
Accredited
					 hospital
or
other accredited medical facility
, as
					 defined in article 28 of the Public Health Law, shall mean a hospital or
					 facility which has been accredited by an accreditation agency to which the
					 Centers for Medicare and Medicaid Services has granted deeming status and which
					 the commissioner has determined has accrediting standards sufficient to assure
					 the commissioner that hospitals or facilities so accredited are in compliance
					 with operational standards under this Chapter.
(2)
Emergency room or
					 department
shall mean a designated area of a hospital that includes
					 one or more reception and treatment rooms appropriately staffed and equipped to
					 provide prompt and efficient care of emergency patients in accordance with the
					 provisions of Subchapter C of this Chapter.
(3)
(i)
Existing hospital
or
other existing medical
					 facility
shall mean a facility which, on the day prior to the
					 effective date of this subparagraph, had a valid operating certificate under
					 article 28 of the Public Health Law.
(ii)
New hospital
or
other new medical facility
shall mean that physical area
					 included in a project for which, both on and after the effective date of this
					 subparagraph, an application is submitted under provisions of Part 710 of
					 Subchapter B of this Title, and which encompasses any or all of the following:
(a) change in scope of services of an
					 existing facility;
(b) acquisition
					 of a physical plant, which was not previously operated as a health care
					 facility for the same level of care, as is proposed;
(c) acquisition of property and construction
					 of a new physical plant;
(d)
					 construction of a new physical plant on property already owned by an
					 established facility;
(e)
					 renovations and/or alterations to an existing facility, which involve:
(1) major physical and/or structural
					 changes;
(2) major fixed equipment
					 changes, other than replacements;
(3) the classification as a new medical
					 facility shall be limited only to those sections and/or wings of an existing
					 facility, for which such renovation, alterations and/or equipment changes are
					 approved;
(f) one or
					 more additions to an existing facility. The classification as a new medical
					 facility shall be limited to the additions.
(iii) The provisions of clause
					 (ii)(
e
) of this paragraph shall not apply to an existing
					 hospital or medical facility, as defined by subparagraph (i) of this paragraph
					 which does not meet the minimum requirements of sections
					 711.4,
					 711.5,
					 711.6,
					 711.7 and
					 711.8 of this Title, because of
					 life safety, structural, physical, mechanical and/or electrical deficiencies,
					 and which is approved to perform such alterations, renovations and/or fixed
					 equipment changes as are necessary to achieve compliance with the
					 aforementioned sections.
(4)
Health-related facility
shall mean a facility, institution, intermediate care facility, or a separate
					 or distinct part thereof, providing therein lodging, board and social and
					 physical care, including but not limited to the recording of health
					 information, dietary supervision and supervised hygienic services incident to
					 such care to six or more residents not related to the operator by marriage or
					 by blood within the third degree of consanguinity.
(5)
Hospital
shall mean an
					 institution with beds for one or more inpatients not related to the operator
					 which is primarily engaged in providing services and facilities to inpatients
					 by or under the supervision of a physician, and which meets the following
					 requirements:
(i) provides diagnostic and
					 therapeutic services for medical diagnosis, treatment and care of injured and
					 sick persons and has, as a minimum, laboratory and radiology services and
					 organized departments of medicine and surgery;
(ii) has an organized medical staff which may
					 include, in addition to doctors of medicine, doctors of osteopathy and
					 dentistry;
(iii) has bylaws, rules
					 and regulations pertaining to standards of medical care and service rendered by
					 its medical staff;
(iv) maintains
					 medical records for all patients;
(v) has a requirement that every patient be
					 under the care of a member of the medical staff;
(vi) provides 24-hour patient
					 services;
(vii) has in effect a
					 written, currently applicable utilization review plan, acceptable to the
					 department, which provides for utilization review studies designed to evaluate
					 the appropriateness of admissions to the hospital, lengths of stay, discharge
					 practices, use of medical and hospital services and all related factors which
					 may contribute to the efficient provision of hospital and physician
					 services;
(viii) has in effect
					 agreements with a home health agency for referral and transfer of patients to
					 home health agency care when such service is appropriate to meet the patient's
					 requirements.
(6)
Home care services agency
shall mean an organization primarily
					 engaged in arranging and/or providing, directly or through contract
					 arrangement, one or more of the following: nursing services, home health aide
					 services, advanced home health aide services, medical supplies, equipment and
					 appliances, and other therapeutic and related services which may include, but
					 shall not be limited to, physical and occupational therapy, speech pathology,
					 nutritional services, medical social services, personal care services,
					 homemaker services and housekeeper services which may be of a preventive,
					 therapeutic, rehabilitative, health guidance and/or supportive nature to
					 persons at home.
(7)
Certified home health agency
shall mean a home care services
					 agency which possesses a valid certificate of approval issued pursuant to the
					 provisions of article 36 of the Public Health Law, or a residential health care
					 facility or hospital possessing a valid operating certificate issued under
					 article 28 of the Public Health Law which is authorized under article 36 to
					 provide a long term home health care program. Such an agency or program must
					 participate as a home health agency under the provisions of titles XVIII and
					 XIX of the Federal Social Security Act.
(8)
Long term home health care
					 program
shall mean a coordinated plan of care and services provided at
					 home to invalid, infirm or disabled persons who are medically eligible for
					 placement in a hospital or residential health care facility, and who would
					 require such placement for an extended period of time if such program were
					 unavailable.
(i) Such program shall be
					 provided in the person's home or in the home of a responsible relative or other
					 responsible adult.
(ii) Such
					 program shall be provided in adult care facilities, other than shelters for
					 adults, certified pursuant to section
					 460-b of
					 the Social Services Law, provided that the person meets the admission and
					 continued-stay criteria for such facility. Services provided by the program
					 shall not duplicate or replace those which the facility is required by law or
					 regulation to provide.
(iii)
					 Approved long term home health care program providers may include, as part of
					 their long term home health care program, upon approval by the commissioner, a
					 discrete AIDS home care program as defined in this section.
(iv) A long term home health care program
					 that does not obtain authorization to provide an AIDS home care program shall
					 not be precluded from providing services within its existing authority to
					 patients who are diagnosed as having AIDS, or are deemed by a physician, within
					 his judgment, to be infected with the etiologic agent of acquired immune
					 deficiency syndrome, and who have an illness, infirmity or disability which can
					 be reasonably ascertained to be associated with such infection.
(9) The terms
treatment
					 center
and
diagnostic center
shall mean a medical
					 facility with one or more organized health services not part of an inpatient
					 hospital facility or vocational rehabilitation center primarily engaged in
					 providing services and facilities to out-of-hospital or ambulatory patients by
					 or under the supervision of a physician or, in the case of a dental service or
					 dispensary, of a dentist, for the prevention, diagnosis and, in the case of a
					 treatment center, treatment of human disease, pain, injury, deformity or
					 physical condition, not including the individual or group private practice of
					 medicine.
(10)
Narcotic
					 addiction rehabilitation center
shall mean an institution with beds
					 for one or more inpatients, not related to the operator, which is primarily
					 engaged in providing facilities and services by or under the supervision of a
					 physician to patients addicted to narcotic drugs, and which meets the following
					 requirements:
(i) provides rehabilitation
					 services for individuals addicted to narcotic drugs, pursuant to the provisions
					 of article 9 of the Mental Hygiene Law;
(ii) has an organized rehabilitation staff
					 which shall include, but not be limited to, physicians, dentists and narcotic
					 rehabilitation officers;
(iii) has
					 rules and regulations pertaining to standards of rehabilitation services
					 rendered by its rehabilitation staff approved by the department;
(iv) maintains medical and rehabilitation
					 records for all clinical patients;
(v) provides 24-hour patient services;
					 and
(vi) has in effect a
					 utilization review plan approved by the department and an affiliation agreement
					 with an accredited hospital for the provisions of those hospital services not
					 provided by the center.
(11)
Nursing home
shall mean
					 a facility, institution, or portion thereof, providing therein, by or under the
					 supervision of a physician, nursing care and other health, health-related and
					 social services as specified in this Chapter for 24 or more consecutive hours
					 to three or more nursing home patients who are not related to the operator by
					 marriage or by blood within the third degree of consanguinity, including, but
					 not limited to, an infirmary section which is identifiable as a nursing home
					 unit in a special area, wing or separate building of a public or voluntary home
					 or of a general or special hospital.
(12) [
Reserved
]
(13)
Outpatient department
shall mean a hospital division or department primarily engaged in providing
					 services for ambulatory patients, by or under the supervision of a physician,
					 for the prevention, diagnosis or treatment of human disease, pain, injury,
					 deformity or physical condition.
(14)
Patient care unit
or
nursing unit
shall mean a designated area, including a group
					 of patient rooms with adequate supporting rooms, areas, facilities, services
					 and personnel providing nursing care and management of patients, which is
					 planned, organized, operated and maintained to function as a unit so as to
					 encourage the efficient delivery of patient services and effective observation
					 of and communication with patients.
(15)
Multiphasic health screening
					 facility
shall mean a treatment center or diagnostic center wherein a
					 battery of tests is performed for the purpose of discovering the presence or
					 absence of clinical findings which may be indicators of early disease and which
					 may provide physicians with a base line of clinical data useful in the medical
					 care and follow-up of patients.
(16)-(18)
					 [
Reserved
]
(19)
Cardiac surgical center
shall mean an inpatient care unit of a
					 hospital which shall be approved as such by the department and shall be
					 appropriately staffed and equipped to provide both diagnostic and surgical
					 services.
(20) A
cardiac
					 diagnostic center
shall mean an inpatient care unit of a hospital,
					 approved by the department, which may exist independent of a complete cardiac
					 surgical service. The diagnostic center shall be appropriately staffed and
					 equipped to provide a full range of diagnostic services, including coronary
					 arteriography and/or other cardiac invasive diagnostic procedures.
(21)
Rural hospital
shall
					 mean any hospital as defined in this subdivision, which does no meet any of the
					 absolute criteria of subparagraph (ii) of this paragraph and which, when
					 assessed against the weighted criteria of subparagraph (i), achieves a total
					 score greater than or equal to six points. Facilities which meet the definition
					 are expected to develop appropriate linkages with hospitals providing a greater
					 range of services and/or medical equipment. Identification as a rural hospital
					 shall not be construed as diminishing the need for such planning efforts.
(i) Weighted criteria.
(a) Size. Facility size shall be measured by
					 capacity as listed on the operating certificate. A certified capacity of 75
					 beds or less shall be worth 3 points; a certified capacity of greater than 75
					 and less than or equal to 100 beds shall be worth 2 points; a certified
					 capacity of greater than 100 beds shall be worth 0 points.
(b) Population density. Population density
					 shall be measured by use of the most recently used New York State Economic
					 Development Board statistics. Location of the facility in a county which has a
					 population density of 100 persons per square mile or less shall be worth 3
					 points; location in a county with a population density of greater than 100 and
					 less than or equal to 150 persons per square mile shall be worth 2 points;
					 location in a county with a population density of greater than 150 persons per
					 square mile shall be worth 0 points.
(c) Facility budget. The size of the facility
					 budget shall be measured by base year financial and statistical data submitted
					 to the department pursuant to Subpart 86-1 of this Title. A budget of
					 $6,500,000 or less shall be worth 2 points; a budget of greater than $6,500,000
					 but less than or equal to $7,500,000 shall be worth 1 point; a budget of
					 greater than $7,500,000 shall be worth 0 points.
(d) Admissions. The number of admissions
					 shall be measured by base year financial and statistical data submitted to the
					 department pursuant to Subpart 86-1 of this Title. Total base year admissions
					 of less than or equal to 4,000 shall be worth 2 points; total base year
					 admissions of greater than 4,000 but less than or equal to 4,500 shall be worth
					 1 point; total base year admissions of greater than 4,500 shall be worth 0
					 points.
(ii) Absolute
					 criteria. A facility which meets any of these criteria shall not be a rural
					 hospital if:
(a) the facility is located in
					 New York City, or in the counties of Monroe, Erie, Nassau, Suffolk, Albany,
					 Westchester, Orange, Schenectady, Rensselaer, Onondaga and Oneida;
(b) the facility is the subject of an action
					 by the commissioner seeking revocation, suspension, limitation or annulment of
					 its operating certificate for structural or operational deficiencies;
(c) the commissioner has found, after
					 considering public need, that suspension, limitation modification or revocation
					 of the facility's operating certificate is consistent with the public interest
					 in conservation of health resources;
(d) the facility is a specialty hospital;
					 or
(e) the facility is located
					 within five miles of an existing acute care unit.
(22)
Part-time clinic
					 site
shall mean an ambulatory care program site operated less than 60
					 hours per month (as determined by the aggregate hours of program site
					 operation) by a general hospital or a diagnostic or treatment center which is
					 approved to operate part-time clinics. A part-time clinic site is a site other
					 than the primary delivery site(s) listed on the primary facility's operating
					 certificate; provided, however, that any health care services provided in
					 elementary or secondary schools to students during regular school hours shall
					 not qualify as part-time clinic sites under this Title.
(23)
Hospice
shall mean a
					 coordinated program of home and inpatient care which treats the terminally ill
					 patient and family as a unit, employing an interdisciplinary team acting under
					 the direction of an autonomous hospice administration. The program provides
					 palliative and supportive care to meet the special needs arising out of
					 physical, psychological, spiritual, social and economic stresses which are
					 experienced during the final stages of illness, and during dying and
					 bereavement.
(24)
Outpatient surgery
is a service organized to provide those
					 surgical procedures of less intensity than ambulatory surgery which are
					 performed in an outpatient treatment room for patients at low risk, require
					 minimal pre- and post-procedure observation and treatment, are not likely to be
					 time-consuming or followed by complications, are not associated with a
					 condition which would require hospitalization and includes those procedures
					 listed in section
					 85.6 of this Title.
(25)
Licensed home care services
					 agency
means a home care services agency issued a license pursuant to
					 article 36 of the Public Health Law.
(26)
(i)
AIDS home care program
means a coordinated plan of care and
					 services provided at home to persons who are medically eligible for placement
					 in a hospital or residential health care facility and who:
(a) are diagnosed by a physician as having
					 acquired immune deficiency syndrome (AIDS); or
(b) are deemed by a physician, within his
					 judgment, to be infected with the etiologic agent of acquired immune deficiency
					 syndrome, and who have an illness, infirmity or disability which can be
					 reasonably ascertained to be associated with such infection.
Such program shall be provided by a long term home health
						care program specifically authorized pursuant to article 36 of the Public
						Health Law to provide an AIDS home care program; or an AIDS center, as defined
						in Part 405 of this Title, specifically authorized pursuant to article 36 of
						the Public Health Law to provide an AIDS home care program. Such program shall
						be provided in the person's home or in the home of a responsible relative,
						other responsible adult, adult care facilities specifically approved to admit
						or retain residents for such program, or in other residential settings as
						approved by the commissioner in conjunction with the Commissioner of Social
						Services. Such program shall provide services, including but not limited to the
						full complement of health, social and environmental services provided by long
						term home health care programs in accordance with regulations promulgated by
						the commissioner. Such programs shall also provide such other services as
						required by the commissioner to assure appropriate care at home for persons
						eligible under such program.
(ii) A long term home health care program
					 that does not obtain authorization to provide an AIDS home care program shall
					 not be precluded from providing services within its existing authority to
					 patients who are diagnosed as having AIDS, or are deemed by a physician, within
					 his judgment, to be infected with the etiologic agent of acquired immune
					 deficiency syndrome, and who have an illness, infirmity or disability which can
					 be reasonably ascertained to be associated with such infection.
(27)
Hospice
					 residence
shall mean a hospice operated home which is residential in
					 character and physical structure, and operated for the purpose of providing
					 more than two hospice patients, but not more than 16 hospice patients, with
					 hospice care.
(28)
Dually
					 certified hospice residence bed
shall mean a bed located in a hospice
					 residence that has been approved by the department to be used alternately for
					 residential hospice care and inpatient hospice care.