Rhode Island Code of Regulations › Title 216 - Department of health › Chapter 40 - Professional licensing and facility regulation › Subchapter 10 - Facility regulation › Part 13 - Licensure of Physician Ambulatory Surgery Centers and Podiatry Ambulatory Surgery Centers (216-RICR-40-10-13) › Section 216-RICR-40-10-13.3 - Definitions

Current through June 14, 2024
A. Wherever used in these rules and
				  regulations the following terms shall be construed to mean:
1. "Accreditation agency" means an entity,
				  approved by the Director, which grants accreditation to physician ambulatory
				  surgery centers and podiatry ambulatory surgery centers. Accreditation agencies
				  approved by the Director include: the Joint Commission on Accreditation of
				  Healthcare Organizations, the American Association for Accreditation of
				  Ambulatory Surgery Facilities, Inc., and the Accreditation Association for
				  Ambulatory Health Care, Inc.
2.
				  "Anesthesiologist" means a physician licensed in Rhode Island who is board
				  certified, or becoming so, in anesthesia and has privileges to administer
				  anesthesia in a Rhode Island licensed health care facility.
3. "Certified registered nurse anesthetist"
				  means a registered nurse who has successfully met the requirements for
				  licensure which are set forth in the "Rules and Regulations for Licensing of
				  Nurses and Standards for the Approval of Basic Nursing Education
				  Programs".
4. "The practice of
				  certified registered nurse anesthesia" means providing certain health care
				  services under the supervision of anesthesiologists, licensed physicians, or
				  licensed dentists, in accordance with R.I. Gen. Laws §
											5-31.1-1(g) 
				  which requires substantial specialized knowledge, judgement and skill related
				  to the administration of anesthesia, including pre-operative and post-operative
				  assessment of patients; administration of anesthetics; monitoring patients
				  during anesthesia; management of fluid in intravenous therapy and respiratory
				  care.
5. "Conscious sedation" means
				  a drug-induced depression of consciousness during which patients respond
				  purposefully (reflex withdrawal from a painful stimulus is not considered a
				  purposeful response) to verbal commands, either alone or accompanied by light
				  tactile stimulation. No interventions are required to maintain a patent airway,
				  and spontaneous ventilation is adequate. Cardiovascular function is usually
				  maintained.
6. "Director" means the
				  Director of the Rhode Island Department of Health.
7. "Employee", as used in §13.4.1(E) of
				  this Part, means an individual who is required to comply with instructions
				  about when, where, and how to work, both as to the final results and as to the
				  details of when, where, and how the work is to be done. The employer need not
				  actually exercise this control; it is sufficient that he has the right to do
				  so. When the employer does not possess this control, the individual involved is
				  not an employee, but an independent contractor.
8. "Exempt procedures" means:
a. Minor surgical procedures such as excision
				  of skin lesions, moles, warts, lipomas and repair of lacerations, incision and
				  drainage of superficial abscesses, or surgery limited to the skin and
				  subcutaneous tissue performed under topical or local anesthesia not involving
				  drug induced alteration of consciousness other than minimal pre-operative
				  tranquilization of the patient;
b.
				  Procedures not requiring or using conscious sedation techniques or
				  pre-operative medications other than minimal pre-operative tranquilization of
				  the patient;
c. Procedures
				  requiring or using only local, topical, or no anesthesia.
9. "General anesthesia" means a drug-induced
				  loss of consciousness during which patients are not arousable, even by painful
				  stimulation. The ability to independently maintain ventilatory function is
				  often impaired. Patients often require assistance in maintaining a patent
				  airway, and positive pressure ventilation may be required because of depressed
				  spontaneous ventilation or drug-induced depression of neuromuscular function.
				  Cardiovascular function may be impaired.
10. "The licensed capacity" of the physician
				  ambulatory surgery center and/or podiatry ambulatory surgery center means the
				  number of operating/procedure rooms that the physician ambulatory surgery
				  center and/or podiatry ambulatory surgery center is licensed to
				  operate.
11. "Licensing agency" or
				  "state agency" means the Rhode Island Department of Health.
12. "Local anesthesia" means the injection of
				  a local anesthetic agent (e.g., Lidocaine) into and around the operative site
				  to achieve numbness in the area where a painful procedure is to be performed.
				  This type of anesthesia does not involve any systemic sedation.
13. "Operating room or procedure room" means
				  the area of the office operatory wherein a surgical treatment is
				  performed.
14. "Person" means any
				  individual, trust or estate, partnership, corporation (including associations,
				  joint stock companies), limited liability company, state, or political
				  subdivisions or instrumentality of a state.
15. "Physician" means a person licensed to
				  practice allopathic or osteopathic medicine in this state, pursuant to the
				  provisions of R.I. Gen. Laws Chapter 5-37.
16. "Physician ambulatory surgery center,"
				  means an office or portion thereof owned and/or operated by a
				  physician-controlled professional services corporation as defined in R.I. Gen.
				  Laws Chapter 7-5.1 or a private physician's office or group of physicians'
				  offices (whether owned and/or operated by an individual practitioner, alone or
				  as a member of a partnership, professional service corporation, organization,
				  or association) which is utilized for the purpose of furnishing surgical
				  services to said owner and/or operator's own patients on an ambulatory
				  basis.
17. "Podiatrist" means a
				  person with a license to practice podiatric medicine and surgery in this state
				  under the provisions of R.I. Gen. Laws Chapter 5-29.
18. "Podiatry ambulatory surgery center"
				  means an office or portion of an office owned and/or operated by a podiatrist
				  controlled professional service corporation as defined in R.I. Gen. Laws
				  Chapter 7-5.1 or a private podiatrist's office or group of the podiatrists'
				  offices (whether owned and/or operated by an individual practitioner, alone or
				  as a member of a partnership, professional service corporation, organization,
				  or association) which is utilized for the purpose of furnishing surgical
				  services to the owner and/or operator's own patients.
19. "Regional anesthesia" means the use of
				  local anesthetic agents to block nerves leading to the area where a painful
				  procedure is to be done. There are many examples of regional anesthesia,
				  including, but not limited to, spinal, interscalene, ankle, etc. Generally,
				  regional anesthesia involves more of a physiological reaction because of the
				  larger area blocked and/or the dose of local anesthesia. This type of
				  anesthesia may or may not involve sedation.
20. "Registered nurse" means a person
				  licensed under the provisions of R.I. Gen. Laws Chapter 5-34.
21. "Surgery" means the excision or resection
				  partial/complete, destruction, incision or other structural alteration of human
				  tissue by any means. Surgery shall have the same meaning as
				  "operate."