Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart F - Ambulatory Surgical Facilities › Chapter 551 - GENERAL INFORMATION › GENERAL PROVISIONS › Section 551.3 - Definitions

Current through Register Vol. 54, No. 28, July 13, 2024
The following words and terms, when used in this subpart,
						have the following meanings, unless the context clearly indicates
						otherwise:
ASF-Ambulatory surgical
						facility
-
(i) A facility or
					 portion thereof not located upon the premises of a hospital which provides
					 specialty or multispecialty outpatient surgical treatment.
(ii) This does not include individual or
					 group practice offices of private physicians or dentists, unless the offices
					 have a distinct part used solely for outpatient surgical treatment on a regular
					 and organized basis. For the purposes of this provision, outpatient surgical
					 treatment means treatment to patients who do not require hospitalization, but
					 who require constant medical supervision following the surgical procedure
					 performed.
Act
-The Health Care Facilities Act
						(35
						P. S. §§
												448.101-448.904).
Ambulatory surgery
-Surgery which is
						performed:
(i) On an outpatient basis
					 in a facility which is not located in a hospital.
(ii) On patients who do not require
					 hospitalization but who do require constant medical supervision following the
					 surgical procedure performed and whose total length of stay does not exceed the
					 standards in this subpart.
Anesthesia
-The use of pharmaceutical
						agents to induce the loss of sensation. For the purpose of this chapter, the
						term applies when any patient, in any setting receives, for any purpose, by any
						route, one of the following:
(i)
					 General, spinal or other regional anesthesia.
(ii) Sedation (with or without analgesia),
					 for which there is a reasonable expectation that, in the manner used, will
					 result in the loss of protective reflexes for a significant percentage of a
					 group of patients.
Anesthesiologist
-A physician licensed
						by the State Board of Medicine under the Medical Practice Act of 1985
						(63
						P. S. §§
												422.1-422.45) who has
						completed an accredited residency training program in anesthesia.
Anesthetist
-A generic term used to
						identify anesthesiologists, nurse anesthetists or dentist anesthetists.
Authenticate
-To verify authorship for
						example by written signature, identifiable initials or computer key.
Authorized person to administer drugs and
						medications
-In an ASF, the term includes the following:
(i) Persons who are currently licensed or
					 certified by the Bureau of Professional and Occupational Affairs, Department of
					 State, and whose scope of practice includes the administration of
					 drugs.
(ii) Registered nurses who
					 are currently licensed by the Bureau of Professional and Occupational Affairs,
					 Department of State.
(iii)
					 Practical nurses who have successfully passed the State Board of Nursing
					 examination.
(iv) Practical nurses
					 licensed by waiver in this Commonwealth who have successfully passed the United
					 States Public Health Service Proficiency Examination.
(v) Practical nurses licensed by waiver in
					 this Commonwealth who have successfully passed a medication course approved by
					 the State Board of Nursing.
(vi)
					 Student nurses of approved nursing programs who are functioning under the
					 direct supervision of a member of the school faculty who is present in the
					 facility.
(vii) Recent graduates of
					 approved nursing programs who are functioning under the direct supervision of a
					 professional nurse who is present in the facility and who possesses valid
					 temporary practice permits. The permits shall expire if the holders of the
					 permits fail the licensing examinations.
(viii) Physician assistants and registered
					 nurse practitioners who are certified by the Bureau of Professional and
					 Occupational Affairs.
Board certified
-A physician licensed to
						practice medicine or osteopathic medicine in this Commonwealth who has
						successfully passed an examination and has maintained certification in the
						relevant specialty or subspecialty area, or both, recognized by one of the
						following groups:
(i) The American
					 Board of Medical Specialties.
(ii)
					 The American Osteopathic Association.
(iii) The foreign equivalent of either group
					 listed in subparagraph (i) or (ii).
Classification levels
-ASFs shall be
						classified as follows:
(i)
Class A
-A private or group practice office of practitioners
					 where procedures performed are limited to those requiring administration of
					 either local or topical anesthesia, or no anesthesia at all and during which
					 reflexes are not obtunded.
(ii)
Class B
-A single-specialty or multiple-specialty facility with
					 a distinct part used solely for ambulatory surgical treatments involving
					 administration of sedation analgesia or dissociative drugs wherein reflexes may
					 be obtunded; and where patients are limited to Physical Status (PS) PS-I or
					 PS-II patients, unless the patient's PS status would not be adversely affected
					 or sought to be remedied by the surgery. A Class B ASF may be a distinct part
					 of a private or group practice medical or dental office so long as the
					 requirements of this subpart are met.
(iii)
Class C
-A
					 single-specialty or multiple-specialty facility used exclusively for the
					 purpose of providing ambulatory surgical treatments which involve the use of a
					 spectrum of anesthetic agents, up to and including general anesthesia and where
					 patients are limited to physical status (PS) PS-1, PS-2 or PS-3 patients.
Classification system
-A process used to
						identify three levels of ASFs (A, B and C) based on the procedure, patient
						status and anesthesia used.
Clinical privileges
-Permission to
						independently render medical care in the ASF which is granted by the governing
						body under §
											553.4(c) and (d)
						(relating to other functions).
Compliance directive
-A directive issued
						by the Department, citing deficiencies which have come to the attention of the
						Department through the survey process, or by onsite inspection and directing
						the ASF to take corrective action as the Department directs or to submit a plan
						of correction.
Deficiency
-A condition which exists
						contrary to, in violation of, or in noncompliance with this subpart.
Dentist
-A person licensed by the State
						Board of Dentistry under The Dental Law (63 P. S.
						§§
												120-130b).
Dentist anesthetist
-A person licensed
						by the State Board of Dentistry who has met the requirements for providing
						anesthesia care services in accordance with the regulations of that
						Board.
Department
-The Department of Health of
						the Commonwealth.
Distinct part
-An area which is part of
						a practitioner's office which is physically identifiable and where surgery is
						performed on a regular and organized basis.
Drug administration
-An act in which a
						single dose of an identified drug is given to a patient.
Drug dispensing
-The issuance of one or
						more doses of a prescribed medication under §§ 25.41-25.101.
Facilities
-Buildings, equipment and
						supplies necessary for implementation of ASF services.
Governing body
-The individuals, group
						or entity that has ultimate authority and responsibility for establishing
						policy, maintaining quality patient care and providing for organizational
						management and planning.
Graduate nurse
-A graduate of an
						approved program of professional nursing practicing the profession under The
						Professional Nursing Law (63 P. S. §§
												221-225).
Licensed practical nurse
-A person
						licensed to practice practical nursing under The Practical Nurse Law
						(63
						P. S. §§
												651-667).
Medical
-Pertaining to the practice of
						medicine, osteopathy, podiatry or dentistry.
Medical staff
-The organized group of
						practitioners who has been appointed by the governing body of the ASF to
						function under §§
											555.1-555.3 (relating to principle;
						medical staff membership; and requirements for membership and
						privileges).
NFPA
-The National Fire Protection
						Association.
New construction
-New buildings,
						additions to existing buildings, conversion of existing buildings or portions
						thereof or portions of buildings undergoing alterations other than
						repair.
Nurse anesthetist
-A registered nurse
						licensed by the State Board of Nursing providing anesthesia care in accordance
						with the requirements of the regulations of that Board.
Nurse practitioner
-A person who has
						been certified by the State Board of Nursing and the State Board of Medicine to
						perform acts of medical diagnosis or prescription of medical, therapeutic or
						corrective measure in collaboration with and under the direction of a physician
						licensed to practice medicine in this Commonwealth, under the Medical Practice
						Act of 1985 and The Professional Nursing Law.
Nursing services
-Patient care aspects
						of nursing that are performed by registered nurses or by licensed practical
						nurses and ancillary nursing personnel under the direct supervision of a
						registered nurse.
Organized
-Administratively and
						functionally structured to include the following:
(i) Governing body.
(ii) Medical staff.
(iii) Quality assurance.
(iv) Nursing services.
(v) Pharmacy services.
(vi) Medical record services.
(vii) Laboratory and radiology
					 services.
(viii) Environmental
					 services.
(ix) Fire and safety
					 services.
Outpatient surgical treatment
-Surgical
						procedures performed upon patients who do not require hospitalization but who
						require constant medical supervision following the surgical procedure
						performed.
Person in charge
-The individual
						appointed by the governing body to act in its behalf in the overall management
						of the ASF.
Pharmacist
-A person licensed to engage
						in the practice of pharmacy in this Commonwealth under The Pharmacy Act
						(63
						P. S. §§
												390.1-390.13).
Pharmacy
-A place where the practice of
						pharmacy is conducted under The Pharmacy Act.
Physical status classifications
-The
						evaluation of the patient's overall health as it would influence the conduct
						and outcome of anesthesia or surgery, or both. Physical status shall be defined
						within one of five assigned classes which are:
(i) Class 1 patients have no organic,
					 physiologic, biochemical, metabolic or psychiatric disturbance. The operation
					 to be performed is for a local pathologic process and has no systemic
					 effect.
(ii) Class 2 patients have
					 a systemic disturbance which may be of a mild to moderate degree but which is
					 either controlled or has not changed in its severity for some time.
(iii) Class 3 patients suffer from
					 significant systemic disturbance, although the degree to which it limits the
					 patient's functioning or causes disability may not be quantifiable.
(iv) Class 4 patients suffer from severe
					 systemic diseases that are already life-threatening and may or may not be
					 correctable by surgery.
(v) Class 5
					 patients are moribund and not expected to survive without surgery.
Physician
-A doctor of medicine or
						osteopathy who holds a current and valid license to practice in this
						Commonwealth.
Physician assistant
-A person who has
						been certified by the State Board of Medicine or the State Board of Osteopathic
						Medical Examiners to assist a physician or group of physicians under The
						Medical Practice Act of 1985 or The Osteopathic Medical Practice Act
						(63
						P. S. §§
												271.1-271.18).
Podiatrist
-A person licensed by the
						State Board of Podiatry Examiners to practice podiatry under The Podiatry Act
						of 1956 (63 P. S. §§
												42.1-42.21a).
Practitioner
-A licensed physician,
						dentist or podiatrist.
Preboard certification status
-A
						physician licensed to practice medicine or osteopathic medicine in this
						Commonwealth who has completed the requirements necessary to take a
						certification examination offered by a specialty board recognized by the
						American Board of Medical Specialties, the American Osteopathic Association or
						the foreign equivalent of either group, and who has been eligible to take the
						examination for no longer than 3 years.
Premises of a hospital
-Buildings,
						equipment and supplies licensed as a hospital to provide inpatient and
						outpatient services.
Professional nurse/registered nurse
-A
						person licensed to practice professional nursing under The Professional Nursing
						Law.
Provider
-An individual; a trust or
						estate; a partnership; a corporation including associations, joint stock
						companies, health maintenance organizations, professional health service plan
						corporations and insurance companies; the Commonwealth or a political
						subdivision or instrumentality thereof, including a municipal corporation or
						authority that operates an ambulatory surgical facility; and any other legal
						entity that operates an ambulatory surgical facility.
Secretary
-The Secretary of the
						Department.
Surgery
-The branch of medicine that
						diagnoses and treats diseases, disorders, malformations and injuries wholly or
						partially by operative procedures.
Survey
-The process of evaluation or
						reevaluation of the compliance of an ASF with this subpart.
This section cited in 28 Pa. Code §
													555.32 (relating to administration
						  of anesthesia).