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As Reported by the House Health, Retirement and Aging Committee
122nd General Assembly
Regular Session
1997-1998 | Sub. H. B. No. 243 |
REPRESENTATIVES VAN VYVEN-BRADING-CORBIN-HAINES-SCHURING-
TAYLOR-TERWILLEGER-TIBERI-OLMAN-WACHTMANN-VESPER
A BILL
To amend sections 3702.51, 3727.01, and 4751.05 and to enact section 3702.40
of the Revised Code to establish
standards for using electronic signatures and computer-generated signature
codes in records of health care
facilities
and to extend existing exemptions from
hospital and nursing home regulations that apply to
Christian Science
sanitoriums to other institutions that meet similar
criteria.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
Section 1. That sections 3702.51, 3727.01, and 4751.05 be amended and section
3702.40 of the Revised Code be
enacted to read as follows:
Sec. 3702.40. (A) AS USED IN THIS SECTION:
(1) "ELECTRONIC
RECORD" MEANS A RECORD COMMUNICATED, RECEIVED, OR STORED BY ELECTRONIC,
MAGNETIC, OPTICAL, OR SIMILAR MEANS FOR STORAGE IN AN INFORMATION SYSTEM OR
TRANSMISSION FROM ONE INFORMATION SYSTEM TO ANOTHER. "ELECTRONIC RECORD"INCLUDES ELECTRONIC DATA INTERCHANGE, ELECTRONIC MAIL, FACSIMILE, AND
TELEX.
(2) "ELECTRONIC SIGNATURE" MEANS ANY LETTERS, CHARACTERS, NUMBERS, OR SYMBOLS
ATTACHED TO OR ASSOCIATED WITH AN ELECTRONIC RECORD AND EXECUTED OR ADOPTED BY
AN INDIVIDUAL TO AUTHENTICATE AN ELECTRONIC RECORD.
(3) "HEALTH CARE FACILITY" MEANS ANY OF
THE FOLLOWING:
(a) A HOSPITAL, AS DEFINED IN SECTION 3727.01 OF THE
REVISED CODE;
(b) AN AMBULATORY SURGICAL FACILITY, AS DEFINED IN SECTION
3702.30 OF
THE REVISED
CODE;
(c) A FREESTANDING BIRTHING CENTER;
(d) A FREESTANDING CARDIAC CATHETERIZATION FACILITY;
(e) A FREESTANDING OR MOBILE DIAGNOSTIC IMAGING CENTER;
(f) A FREESTANDING DIALYSIS CENTER;
(g) A FREESTANDING EMERGENCY FACILITY;
(h) AN URGENT CARE CENTER;
(i) A FREESTANDING EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY
CENTER;
(j) A FREESTANDING RADIATION THERAPY CENTER;
(k) A HOME HEALTH AGENCY;
(l) A HOSPICE CARE PROGRAM, AS DEFINED IN SECTION 3712.01 OF THE
REVISED CODE;
(m) A NURSING HOME, RESIDENTIAL CARE FACILITY, OR HOME FOR THE
AGING,
ALL AS DEFINED IN SECTION 3721.01 OF THE
REVISED CODE;
(n) AN ADULT CARE FACILITY, AS DEFINED IN SECTION 3722.01 OF THE
REVISED CODE;
(o) A NURSING FACILITY OR INTERMEDIATE CARE FACILITY FOR THE
MENTALLY
RETARDED, BOTH AS DEFINED IN SECTION 5111.20 OF THE
REVISED CODE;
(p) A FACILITY OR PORTION OF A FACILITY CERTIFIED AS A SKILLED
NURSING
FACILITY UNDER TITLE XVIII OF THE "SOCIAL
SECURITY ACT," 49 STAT. 620 (1935), 42
U.S.C.A.
301, AS AMENDED;
(q) A STATE INSTITUTION FOR THE CARE AND TREATMENT OF MENTALLY ILL
PERSONS, OPERATED BY THE DEPARTMENT OF MENTAL HEALTH PURSUANT TO SECTION
5119.02 OF THE REVISED CODE;
(r) A COMMUNITY MENTAL HEALTH FACILITY, AS DEFINED IN SECTION
5119.01
OF THE REVISED CODE;
(s) A RESIDENTIAL FACILITY, AS DEFINED IN SECTION 5119.22 OF THE
REVISED CODE;
(t) A COMMUNITY-BASED CLINIC, AS DEFINED IN SECTION 5111.17 OF THE
REVISED CODE;
(u) AN OUTPATIENT HEALTH FACILITY, AS DEFINED IN SECTION 5111.04 OF THE
REVISED CODE;
(v) AN ALCOHOL AND DRUGADDICTION PROGRAM, AS
DEFINED IN SECTION 3793.01 OF THE REVISED CODE;
(w) THE PRIVATE OFFICE OF ANY HEALTH CARE PROFESSIONAL,
INCLUDING:
(i) PHYSICIANS AUTHORIZED UNDER
CHAPTER 4731. OF THE
REVISED CODE
TO PRACTICE MEDICINE AND SURGERY OR OSTEOPATHIC MEDICINE AND SURGERY;
(ii) REGISTERED NURSES AND LICENSED PRACTICAL NURSES LICENSED
UNDER CHAPTER 4723. OF THE
REVISED
CODE;
(iii) PHYSICIAN ASSISTANTS AUTHORIZED TO PRACTICE UNDER
CHAPTER 4730. OF THE
REVISED
CODE;
(iv) DENTISTS AND DENTAL HYGIENIST LICENSED UNDER
CHAPTER 4715. OF THE
REVISED
CODE;
(v) PHYSICAL THERAPISTS LICENSED UNDER
CHAPTER 4755. OF THE
REVISED
CODE;
(vi) CHIROPRACTORS LICENSED UNDER
CHAPTER 4734. OF THE
REVISED
CODE;
(vii) OPTOMETRISTS LICENSED UNDER
CHAPTER 4725. OF THE
REVISED
CODE;
(viii) PODIATRISTS AUTHORIZED UNDER
CHAPTER 4731. OF THE
REVISED CODE
TO PRACTICE PODIATRY;
(ix) DIETITIANS LICENSED UNDER
CHAPTER 4759. OF THE
REVISED
CODE;
(x) PHARMACISTS REGISTERED UNDER
CHAPTER 4729. OF THE
REVISED
CODE.
(x) THE PRIVATE OFFICE OF A PSYCHOLOGIST LICENSED UNDER
CHAPTER
4372. OF THE REVISED CODE OR A COUNSELOR OR SOCIAL WORKER
LICENSED UNDER CHAPTER 4757. OF THE REVISED CODE;
(y) ANY OTHER HEALTH CARE FACILITY RECOGNIZED BY THE PUBLIC
HEALTH
COUNCIL BY RULE ADOPTED UNDER CHAPTER 119. OF THE REVISED
CODE.
(4) "HEALTH CARE RECORD" MEANS ANY DOCUMENT
OR COMBINATION OF DOCUMENTS PERTAINING TO A PATIENT'S MEDICAL HISTORY,
DIAGNOSIS, PROGNOSIS, OR MEDICAL CONDITION THAT IS GENERATED AND MAINTAINED IN
THE PROCESS OF THE PATIENT'S TREATMENT AT A HEALTH CARE FACILITY.
(B) ALL WRITTEN NOTES, ORDERS, AND OBSERVATIONS ENTERED INTO A
HEALTH CARE RECORD AT A HEALTH CARE FACILITY, INCLUDING ANY INTERPRETIVE
REPORTS
OF DIAGNOSTIC TESTS OR SPECIFIC TREATMENTS, SUCH AS RADIOLOGIC OR
ELECTROCARDIOGRAPHIC REPORTS, OPERATIVE REPORTS, REPORTS OF PATHOLOGIC
EXAMINATION OF TISSUE, AND SIMILAR REPORTS, SHALL BE AUTHENTICATED BY
THE INDIVIDUAL WHO MADE OR AUTHORIZED THE ENTRY. HEALTH CARE RECORD ENTRIES
MAY BE AUTHENTICATED BY HANDWRITTEN SIGNATURES OR
HANDWRITTEN INITIALS. THEY ALSO MAY BE AUTHENTICATED BY ELECTRONIC SIGNATURES
OR COMPUTER-GENERATED SIGNATURE CODES IF ALL OF THE FOLLOWING APPLY:
(1) THE HEALTH CARE FACILITY ADOPTS A
POLICY THAT PERMITS THE USE OF ELECTRONIC SIGNATURES OR COMPUTER-GENERATED
SIGNATURE CODES;
(2) THE FACILITY'S ELECTRONIC SIGNATURE
OR COMPUTER-GENERATED SIGNATURE CODE SYSTEM UTILIZES A TWO-LEVEL OR BIOMETRIC
ACCESS MECHANISM THAT ASSIGNS A UNIQUE IDENTIFIER TO EACH USER;
(3) THE FACILITY TAKES STEPS TO
SAFEGUARD AGAINST USE OF A UNIQUE IDENTIFIER BY ANY INDIVIDUAL OTHER THAN THE
ONE TO WHOM IT IS ASSIGNED;
(4) THE SYSTEM INCLUDES A PROCESS TO
VERIFY THAT THE INDIVIDUAL AFFIXING THE ELECTRONIC SIGNATURE OR
COMPUTER-GENERATED SIGNATURE CODE HAS REVIEWED THE CONTENTS OF THE ENTRY AND
DETERMINED THAT THEY ARE WHAT THAT INDIVIDUAL INTENDED;
(5) THE POLICY ADOPTED BY THE FACILITY
PURSUANT TO DIVISION (B)(1) OF THIS SECTION
PRESCRIBES ALL OF THE FOLLOWING:
(a) A PROCEDURE BY WHICH EACH USER OF THE SYSTEM MUST CERTIFY IN
WRITING
THAT THE USER WILL KEEP THE USER'S UNIQUE IDENTIFIER STRICTLY
CONFIDENTIAL;
(b) PENALTIES FOR MISUSING THE SYSTEM OR A
UNIQUE IDENTIFIER ALLOWING ACCESS TO IT;
(c) TRAINING THAT THE FACILITY MUST PROVIDE TO ALL USERS OF THE
SYSTEM AND
THAT INCLUDES AN EXPLANATION OF THE APPROPRIATE USE OF THE SYSTEM AND THE
CONSEQUENCES FOR
NONCOMPLIANCE WITH THE FACILITY'S CONFIDENTIALITY AND SECURITY POLICIES.
THE USE OF AN ELECTRONIC SIGNATURE OR COMPUTER-GENERATED SIGNATURE CODE
IN ACCORDANCE WITH THIS SECTION SHALL BE CONSIDERED FOR ALL LEGAL PURPOSES TO
BE THE SAME AS A HANDWRITTEN SIGNATURE OR HANDWRITTEN INITIALS.
(C) THE PUBLIC HEALTH COUNCIL SHALL ESTABLISH AND ADOPT PROTOCOLS
FOR
THEUSE OF ELECTRONIC SIGNATURE AND COMPUTER-GENERATED SIGNATURE
CODE SYSTEMS. THE COUNCIL SHALL CERTIFY A HEALTH CARE FACILITY'S ELECTRONIC
SIGNATURE OR COMPUTER-GENERATED SIGNATURE CODE SYSTEM IF IT COMPLIES WITH THE
PROTOCOL ADOPTED BY THE COUNCIL OR BY THE JOINT COMMISSION ON HEALTH CARE
ORGANIZATIONS.
(D) AN ELECTRONIC SIGNATURE GENERATED BY AN ELECTRONIC SIGNATURE OR
COMPUTER-GENERATED SIGNATURE CODE SYSTEM CERTIFIED BY THE COUNCIL SHALL BE
PRESUMED TO BE THE SIGNATURE OF THE INDIVIDUAL TO WHOM IT IS ASSIGNED AND TO
BE
AFFIXED TO AUTHENTICATE THE DOCUMENT.
Sec. 3702.51. As used in sections 3702.51 to 3702.62 of
the Revised Code:
(A) "Applicant" means any person that submits an
application for a certificate of need and who is designated in
the application as the applicant.
(B) "Person" means any individual, corporation, business
trust, estate, firm, partnership, association, joint stock
company, insurance company, government unit, or other entity.
(C) "Certificate of need" means a written approval granted
by the director of health to an applicant to authorize conducting
a reviewable activity.
(D) "Health service area" means a geographic region
designated by the director of health under section 3702.58 of the
Revised Code.
(E) "Health service" means a clinically related service,
such as a diagnostic, treatment, rehabilitative, or preventive
service.
(F) "Health service agency" means an agency designated to
serve a health service area in accordance with section 3702.58 of
the Revised Code.
(G) "Health care facility" means:
(1) A hospital registered under section 3701.07 of the
Revised Code;
(2) A nursing home licensed under section 3721.02 of the
Revised Code, or by a political subdivision certified under
section 3721.09 of the Revised Code;
(3) A county home or a county nursing home as defined in
section 5155.31 of the Revised Code that is certified under Title
XVIII or XIX of the "Social Security Act," 49 Stat. 620 (1935),
42 U.S.C.A. 301, as amended;
(4) A freestanding dialysis center;
(5) A freestanding inpatient rehabilitation facility;
(6) An ambulatory surgical facility;
(7) A freestanding cardiac catheterization facility;
(8) A freestanding birthing center;
(9) A freestanding or mobile diagnostic imaging center;
(10) A freestanding radiation therapy center.
A health care facility does not include the offices of
private physicians and dentists whether for individual or group
practice, Christian Science sanitoriums operated or listed and
certified by the First Church of Christ, Scientist, Boston,
Massachusetts, residential facilities licensed under section
5123.19 of the Revised Code, or habilitation centers certified by
the director of mental retardation and developmental disabilities
under section 5123.041 of the Revised Code, OR AN INSTITUTION FOR
THE SICK THAT IS OPERATED EXCLUSIVELY FOR PATIENTS WHO USE SPIRITUAL MEANS FOR
HEALING AND FOR WHOM THE ACCEPTANCE OF MEDICAL CARE IS INCONSISTENT WITH THEIR
RELIGIOUS BELIEFS, ACCREDITED BY A NATIONAL ACCREDITING ORGANIZATION, EXEMPT
FROM FEDERAL INCOME TAXATION UNDER SECTION 501 OF THE INTERNAL
REVENUE CODE OF 1986, 100 STAT. 2085, 26 U.S.C.A. 1,
AS
AMENDED, AND PROVIDING TWENTY-FOUR HOUR NURSING CARE PURSUANT TO THE EXEMPTION
IN DIVISION (G) OF SECTION 4723.32 of the Revised Code FROM THE LICENSING
REQUIREMENTS OF CHAPTER 4723. of the Revised Code.
(H) "Medical equipment" means a single unit of medical
equipment or a single system of components with related functions
that is used to provide health services.
(I) "Third-party payer" means a medical care corporation
or health care corporation licensed under Chapter 1737. or 1738.
of the Revised Code, a health maintenance organization, an
insurance company that issues sickness and accident insurance in
conformity with Chapter 3923. of the Revised Code, a
state-financed health insurance program under Chapter 3701.,
4123., or 5111. of the Revised Code, or any self-insurance plan.
(J) "Government unit" means the state and any county,
municipal corporation, township, or other political subdivision
of the state, or any department, division, board, or other agency
of the state or a political subdivision.
(K) "Health maintenance organization" means a public or
private organization organized under the law of any state that is
qualified under section 1310(d) of Title XIII of the "Public
Health Service Act," 87 Stat. 931 (1973), 42 U.S.C. 300e--9 or
that does all of the following:
(1) Provides or otherwise makes available to enrolled
participants health care services including at least the
following basic health care services: usual physician services,
hospitalization, laboratory, x-ray, emergency and preventive
services, and out-of-area coverage;
(2) Is compensated, except for copayments, for the
provision of basic health care services listed in division (K)(1)
of this section to enrolled participants by a payment that is
paid on a periodic basis without regard to the date the health
care services are provided and that is fixed without regard to
the frequency, extent, or kind of health service actually
provided;
(3) Provides physician services primarily either:
(a) Directly through physicians who are either employees
or partners of the organization;
(b) Through arrangements with individual physicians or one
or more groups of physicians organized on a group practice or
individual practice basis.
(L) "Existing health care facility" means a health care
facility that is licensed or otherwise approved to practice in
this state, in accordance with applicable law, is staffed and
equipped to provide health care services, and actively provides
health services or has not been actively providing health
services for less than twelve consecutive months.
(M) "State" means the state of Ohio, including, but not
limited to, the general assembly, the supreme court, the offices
of all elected state officers, and all departments, boards,
offices, commissions, agencies, institutions, and other
instrumentalities of the state of Ohio. "State" does not include
political subdivisions.
(N) "Political subdivision" means a municipal corporation,
township, county, school district, and all other bodies corporate
and politic responsible for governmental activities only in
geographic areas smaller than that of the state to which the
sovereign immunity of the state attaches.
(O) "Affected person" means:
(1) An applicant for a certificate of need, including an
applicant whose application was reviewed comparatively with the
application in question;
(2) The person that requested the reviewability ruling in question;
(3) Any person that resides or regularly uses health care
facilities within the geographic area served or to be served by
the health care services that would be provided under the
certificate of need or reviewability ruling in question;
(4) Any health care facility that is located in the health
service area where the health care services would be provided
under the certificate of need or reviewability ruling in question;
(5) Third-party payers that reimburse health care
facilities for services in the health service area where the
health care services would be provided under the certificate of need or
reviewability ruling in question;
(6) Any other person who testified at a public hearing
held under division (B) of section 3702.52 of the Revised Code or
submitted written comments in the course of review of the
certificate of need application in question.
(P) "Osteopathic hospital" means a hospital registered
under section 3701.07 of the Revised Code that advocates
osteopathic principles and the practice and perpetuation of
osteopathic medicine by doing any of the following:
(1) Maintaining a department or service of osteopathic
medicine or a committee on the utilization of osteopathic
principles and methods, under the supervision of an osteopathic
physician;
(2) Maintaining an active medical staff, the majority of
which is comprised of osteopathic physicians;
(3) Maintaining a medical staff executive committee that
has osteopathic physicians as a majority of its members.
(Q) "Ambulatory surgical facility" has the same meaning as in
section 3702.30 of the Revised Code.
(R) Except as otherwise provided in division (T) of this section, and until
the termination date specified in section 3702.511 of the Revised Code,
"reviewable activity" means any of the following:
(1) The addition
by any person of any of the following health
services, regardless of the amount of operating costs or capital
expenditures:
(a) A heart, heart-lung, lung, liver, kidney, bowel,
pancreas, or bone marrow transplantation service, a stem cell harvesting and
reinfusion service, or a service for transplantation
of any other organ unless transplantation of the organ is
designated by public health council rule not to be a reviewable
activity;
(b) A cardiac catheterization service;
(c) An open-heart surgery service;
(d) Any new, experimental medical technology
that is designated by rule of the public health council.
(2) The acceptance of high-risk patients, as defined in
rules adopted under section 3702.57 of the Revised Code, by any cardiac
catheterization service that was initiated without a certificate of
need pursuant to division
(R)(3)(b) of the version of this section in effect
immediately prior to April 20,
1995;
(3)(a) The establishment, development, or construction of a
new health care facility other than a new long-term care facility or a new
hospital;
(b) The establishment, development, or construction of a new hospital or
the relocation of an existing hospital;
(c) The relocation of hospital beds, other than long-term care,
perinatal, or pediatric intensive care beds, into or out of a rural
area.
(4)(a) The replacement of an existing hospital;
(b) The replacement of an existing hospital obstetric or
newborn care unit or freestanding birthing
center.
(5)(a) The renovation of a hospital
that involves
a capital expenditure, obligated on or after the effective date of
this amendment, of five million dollars or more,
not including expenditures for equipment, staffing, or operational costs. For
purposes of division (R)(5)(a) of this
section, a capital expenditure is obligated:
(i) When a contract enforceable under Ohio law is entered
into for the construction, acquisition, lease, or financing of a capital
asset;
(ii) When the governing body of a hospital takes formal action to
commit its own funds for a construction project undertaken by the hospital as
its own contractor;
(iii) In the case of donated property, on the date the gift is
completed under applicable Ohio law.
(b) The renovation of a hospital obstetric or newborn care
unit
or freestanding birthing center that involves a capital expenditure of five
million dollars or more, not including expenditures for equipment, staffing,
or operational costs.
(6) Any change in the health care services, bed capacity,
or site, or any other failure to conduct the reviewable activity
in substantial accordance with the approved application for which
a certificate of need was granted, if the change is made prior to
the date the activity for which the certificate was issued ceases to be a
reviewable activity;
(7) Any of the following changes in perinatal bed capacity or pediatric
intensive care bed capacity:
(a) An increase in bed capacity;
(b) A change in service or service-level
designation of newborn care beds or obstetric beds in a hospital or
freestanding birthing center, other than a change of service that is provided
within the service-level designation of newborn care or obstetric beds as
registered by the department of health;
(c) A relocation of perinatal or pediatric
intensive care beds from one physical facility or
site to another, excluding the relocation of beds within a
hospital or freestanding birthing
center or the relocation of beds among buildings of a
hospital or freestanding birthing
center at the same site.
(8) The expenditure of more than one hundred ten per cent
of the maximum expenditure specified in a certificate of need;
(9) Any transfer of a certificate of need issued prior to April
20, 1995, from the person
to whom it was issued to another person before the project that
constitutes a reviewable activity is completed, any agreement
that contemplates the transfer of a certificate of need issued prior to that
date upon
completion of the project, and any transfer of the controlling
interest in an entity that holds a certificate of need issued prior to that
date. However, the transfer of a certificate of need issued prior to that
date or agreement to
transfer such a certificate of need from the person to whom the
certificate of need was issued to an affiliated or related person
does not constitute a reviewable transfer of a certificate of
need for the purposes of this division, unless the transfer
results in a change in the person that holds the
ultimate controlling interest in the certificate of need.
(10)(a) The acquisition by any person of any of the following medical
equipment,
regardless of the amount of operating costs or capital expenditure:
(i) A cobalt radiation therapy unit;
(ii) A linear accelerator;
(iii) A gamma knife unit.
(b) The acquisition by any person of medical equipment with a
cost of two million dollars or more. The cost of acquiring medical equipment
includes the sum of the following:
(i) The greater of its fair market value or the cost of its lease
or purchase;
(ii) The cost of installation and any other activities essential
to the acquisition of the equipment and its placement into service.
(11) The addition of another cardiac
catheterization laboratory to an existing cardiac
catheterization service.
(S) Except as provided in division
(T) of this section,
"reviewable activity" also means any of the following
activities, none of which are subject to a termination date:
(1) The establishment, development, or construction of a
new long-term care facility;
(2) The replacement of an existing long-term care
facility;
(3) The renovation of a long-term care facility that
involves a capital expenditure of two million dollars or more,
not including expenditures for equipment, staffing, or
operational costs;
(4) Any of the following changes in long-term care bed
capacity:
(a) An increase in bed capacity;
(b) A relocation of beds from one
physical facility or site to another, excluding the relocation
of beds within a long-term care facility or among buildings of a
long-term care facility at the same site;
(c) A recategorization of hospital
beds registered under section 3701.07 of the
Revised
Code from another registration
category to skilled nursing beds or long-term care beds.
(5) Any change in the health services, bed capacity, or
site, or any other failure to conduct the reviewable activity in
substantial accordance with the approved application for which a
certificate of need concerning long-term care beds was granted,
if the change is made within five years after the implementation
of the reviewable activity for which the certificate was
granted;
(6) The expenditure of more than one hundred ten per cent
of the maximum expenditure specified in a certificate of need
concerning long-term care beds;
(7) Any transfer of a certificate of need that concerns
long-term care beds and was issued prior to
April 20, 1995, from the person
to whom it was issued to another person before the project that
constitutes a reviewable activity is completed, any agreement
that contemplates the transfer of such a certificate of need
upon completion of the project, and any transfer of the
controlling interest in an entity that holds such a certificate
of need. However, the transfer of a certificate of need that
concerns long-term care beds and was issued prior to
April 20, 1995, or agreement to
transfer such a certificate of need from the person to whom the
certificate was issued to an affiliated or related person does
not constitute a reviewable transfer of a certificate of need
for purposes of this division, unless the transfer results in a
change in the person that holds the ultimate controlling
interest in the certificate of need.
(T) "Reviewable activity" does not include any of the
following activities:
(1) Acquisition of computer hardware or software;
(2) Acquisition of a telephone system;
(3) Construction or acquisition of parking facilities;
(4) Correction of cited deficiencies that are in violation
of federal, state, or local fire, building, or safety laws and
rules and that constitute an imminent threat to public health or
safety;
(5) Acquisition of an existing health care facility that
does not involve a change in the number of the beds, by service,
or in the number or type of health services;
(6) Correction of cited deficiencies identified by
accreditation surveys of the joint commission on accreditation of
healthcare organizations or of the American osteopathic
association;
(7) Acquisition of medical equipment to replace the same
or similar equipment for which a certificate of need has been
issued if the replaced equipment is removed from service;
(8) Mergers, consolidations, or other corporate
reorganizations of health care facilities that do not involve a
change in the number of beds, by service, or in the number or
type of health services;
(9) Construction, repair, or renovation of bathroom
facilities;
(10) Construction of laundry facilities, waste disposal
facilities, dietary department projects, heating and air
conditioning projects, administrative offices, and portions of
medical office buildings used exclusively for physician services;
(11) Acquisition of medical equipment to conduct research
required by the United States food and drug administration or
clinical trials sponsored by the national institute of health.
Use of medical equipment that was acquired without a certificate
of need under division (T)(11) of this section and for
which
premarket approval has been granted by the United States food and
drug administration to provide services for which patients or
reimbursement entities will be charged shall be a reviewable
activity.
(12) Removal of asbestos from a health care facility.
Only that portion of a project that meets the requirements
of division (T) of this section is not a reviewable
activity.
(U) "Small rural hospital" means a hospital that is
located within a rural area, has fewer than
one hundred beds, and to which fewer than four thousand persons
were admitted during the most recent calendar year.
(V) "Children's hospital" means any of the following:
(1) A hospital registered under section 3701.07 of the
Revised Code that provides general pediatric medical and surgical
care, and in which at least seventy-five per cent of annual
inpatient discharges for the preceding two calendar years were
individuals less than eighteen years of age;
(2) A distinct portion of a hospital registered under
section 3701.07 of the Revised Code that provides general
pediatric medical and surgical care, has a total of at least one
hundred fifty registered pediatric special care and pediatric
acute care beds, and in which at least seventy-five per cent of
annual inpatient discharges for the preceding two calendar years
were individuals less than eighteen years of age;
(3) A distinct portion of a hospital, if the hospital is
registered under section 3701.07 of the Revised Code as a
children's hospital and the children's hospital meets all the
requirements of division (V)(1) of this section.
(W) "Long-term care facility" means any of the following:
(1) A nursing home licensed under section 3721.02 of the
Revised Code or by a political subdivision certified under section 3721.09 of
the Revised Code;
(2) The portion of any facility, including a county home or county
nursing home, that is certified as a skilled nursing facility or a nursing
facility under Title XVIII or XIX of the "Social Security Act";
(3) The portion of any hospital that contains beds registered under
section 3701.07 of the Revised Code as skilled nursing beds or long-term care
beds.
(X) "Long-term care bed" means a bed in a long-term care facility.
(Y) "Perinatal bed" means a bed in a hospital that is registered under
section 3701.07 of the Revised Code as a newborn care bed or obstetric bed, or
a bed in a freestanding birthing center.
(Z) "Freestanding birthing center" means any facility in which
deliveries routinely occur, regardless of whether
the facility is located on the campus of another health care facility, and
which is not licensed under Chapter 3711. of
the Revised
Code as a level one, two, or three maternity
unit or a limited maternity unit.
(AA)(1) "Reviewability ruling" means a ruling issued by the
director of health under division (A) of section 3702.52 of the Revised Code
as to whether a particular proposed project is or is not a
reviewable activity.
(2) "Nonreviewability ruling" means a ruling issued under
that division that a particular proposed project is not a reviewable
activity.
(BB)(1) "Metropolitan
statistical area" means an area of this state designated a
metropolitan statistical area or primary metropolitan
statistical area in United
States office of management and
budget bulletin No. 93-17,
June 30, 1993, and its
attachments.
(2) "Rural area" means any area of this state not located
within a metropolitan statistical area.
Sec. 3727.01. As used in this section, "health maintenance
organization" means a public or private organization organized
under the law of any state that is qualified under section
1310(d) of Title XIII of the "Public Health Service Act," 87
Stat. 931 (1973), 42 U.S.C. 300e-9, or that does all of the
following:
(A) Provides or otherwise makes available to enrolled
participants health care services including at least the
following basic health care services: usual physician services,
hospitalization, laboratory, x-ray, emergency and preventive
service, and out-of-area coverage;
(B) Is compensated, except for copayments, for the
provision of basic health care services to enrolled participants
by a payment that is paid on a periodic basis without regard to
the date the health care services are provided and that is fixed
without regard to the frequency, extent, or kind of health
service actually provided;
(C) Provides physician services primarily in either of the
following ways:
(1) Directly through physicians who are either employees
or partners of the organization;
(2) Through arrangements with individual physicians or one
or more groups of physicians organized on a group practice or
individual practice basis.
As used in this chapter, "hospital" means an institution
classified as a hospital under section 3701.07 of the Revised
Code in which are provided to inpatients diagnostic, medical,
surgical, obstetrical, psychiatric, or rehabilitation care for a
continuous period longer than twenty-four hours; a tuberculosis
hospital; or a hospital operated by a health maintenance
organization. "Hospital" does not include a facility licensed
under Chapter 3721. of the Revised Code, a health care facility
operated by the department of mental health or the department of
mental retardation and developmental disabilities, a health
maintenance organization that does not operate a hospital, the
office of any private licensed health care professional, whether
organized for individual or group practice, a Christian Science
sanatorium operated or listed and certified by the First Church
of Christ, Scientist, Boston, Massachusetts, or a clinic that
provides ambulatory patient services and where patients are not
regularly admitted as inpatients. NOR DOES "HOSPITAL" INCLUDE AN
INSTITUTION FOR
THE SICK THAT IS OPERATED EXCLUSIVELY FOR PATIENTS WHO USE SPIRITUAL MEANS FOR
HEALING AND FOR WHOM THE ACCEPTANCE OF MEDICAL CARE IS INCONSISTENT WITH THEIR
RELIGIOUS BELIEFS, ACCREDITED BY A NATIONAL ACCREDITING ORGANIZATION, EXEMPT
FROM FEDERAL INCOME TAXATION UNDER SECTION 501 OF THE INTERNAL
REVENUE CODE OF 1986, 100 STAT. 2085, 26 U.S.C.A. 1,
AS
AMENDED, AND PROVIDING TWENTY-FOUR HOUR NURSING CARE PURSUANT TO THE EXEMPTION
IN DIVISION (G) OF SECTION 4723.32 of the Revised Code FROM THE LICENSING
REQUIREMENTS OF CHAPTER 4723. of the Revised Code.
Sec. 4751.05. (A) The board of examiners of nursing home
administrators shall admit to examination for licensure as a
nursing home administrator any candidate who:
(1) Pays the application fee of fifty dollars;
(2) Submits evidence of good moral character and
suitability;
(3) Is at least eighteen years of age;
(4) Has completed educational requirements and work
experience satisfactory to the board;
(5) Submits an application on forms prescribed by the
board;
(6) Pays the examination fee of one hundred fifty dollars.
(B) Nothing in Chapter 4751. of the Revised Code or the rules
adopted thereunder shall be construed to require an applicant for
licensure or a temporary license, who is certified EMPLOYED by
a recognized church or religious denomination which teaches
reliance on spiritual means alone for healing and has been
approved to administer institutions certified by such church or
denomination AN INSTITUTION for the care and treatment of the sick
in accordance
with its teachings, to demonstrate proficiency in any medical
techniques or to meet any medical educational qualifications or
medical standards not in accord with the remedial care and
treatment provided in such institutions BY THE INSTITUTION IF THE
INSTITUTION IS ALL OF THE FOLLOWING:
(1) OPERATED EXCLUSIVELY FOR PATIENTS WHO USE SPIRITUAL MEANS FOR
HEALING AND FOR WHOM THE ACCEPTANCE OF MEDICAL CARE IS INCONSISTENT WITH THEIR
RELIGIOUS BELIEFS;
(2) ACCREDITED BY A NATIONAL ACCREDITING ORGANIZATION;
(3) EXEMPT FROM FEDERAL INCOME TAXATION UNDER SECTION 501 OF THE
INTERNAL
REVENUE CODE OF 1986, 100 STAT. 2085, 26 U.S.C.A. 1,
AS AMENDED;
(4) PROVIDING TWENTY-FOUR HOUR NURSING CARE PURSUANT TO THE EXEMPTION
IN DIVISION (G) OF SECTION 4723.32 of the Revised Code FROM THE LICENSING
REQUIREMENTS OF CHAPTER 4723. of the Revised Code.
(B)(C) If a person fails three times to attain a passing
grade on the examination, said person, before he THE PERSON may
again be admitted to examination, shall meet such additional education or
experience requirements, or both, as may be prescribed by the
board.
Section 2. That existing sections 3702.51, 3727.01, and 4751.05 of the Revised
Code are hereby repealed.
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