Iowa Admin. Code r. 481-2202.1

Current through Register Vol. 47, No. 10, November 13, 2024

Rule 481-2202.1 - Definitions

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 a new 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.

Iowa Admin. Code r. 481-2202.1

ARC 7932C, IAB 5/1/24, effective 6/5/2024; Editorial change: IAC Supplement 9/4/2024