Effective: 12-12-00
59C-1.002 Definitions (4 pages)
(1) "Acute
care bed" means a patient accommodation or space licensed by the agency
pursuant to Chapter 395, Part I, F.S., and regulated under Rule 59C-1.038,
F.A.C. Acute care beds exclude neonatal intensive care beds, comprehensive
medical rehabilitation beds, hospital inpatient psychiatric beds, hospital
inpatient substance abuse beds, beds in distinct part skilled nursing units,
and beds in long term care hospitals licensed pursuant to Chapter 395, Part I,
F.S.
(2) "Applicant"
means any individual, partnership, corporation, or governmental entity which
has filed an application for a certificate of need with the agency.
(3) "Application"
means the forms supplied by the agency to an applicant which are to be
completed in order to be eligible to be considered for a certificate of need.
(4) "Audited
financial statement" means all pages of the financial statements of the
applicant that have been examined by an independent certified public accountant
in accordance with generally accepted auditing standards as set forth in
Statements on Auditing Standards published by the American Institute of
Certified Public Accountants, on which the certified public accountant
expresses an opinion as to the fairness with which the financial statements
present financial position, results of operations, and changes in financial
position in conformity with generally accepted accounting principles as
established by the American Institute of Certified Public Accountants and the
Financial Accounting Standards Board.
(5) "Batching
Cycle" means the grouping for comparative review of Certificate of Need
applications submitted for beds, services or programs having a like Certificate
of Need need methodology or licensing category in the same planning horizon and
the same applicable district or subdistrict.
(6) "By
or on behalf of" means any action taken directly or indirectly by a health
care facility or health maintenance organization which will result in any
leasehold or ownership interest for the health care facility or health
maintenance organization.
(7) "Capital
project" means a project, whether subject to or not subject to certificate
of need review, which involves a capital expenditure as defined in subsection
408.032(2), Florida Statutes, and which the applicant has approved via
authorization to execute. For projects
subject to certificate of need review, a capital project approved by the
applicant also means:
(a) A
project involving a capital expenditure for which a notice of intent to grant a
certificate of need has been issued; or
(b) A
project involving a capital expenditure for which a notice of intent to deny a
certificate of need is in litigation, or could still be litigated within any
remaining part of the 21-day period provided by s. 408.039(5)(a), F.S.
(8) "Combination"
means the combination within one nursing home facility of the beds or services
authorized by two or more Certificates of Need issued in the same planning
subdistrict.
(9) "Community
nursing home beds" means nursing home beds, other than sheltered nursing
home beds, regulated under Rule 59C-1.036.
(10) "Comparative
hearing" means a single hearing, conducted pursuant to s. 120.57 F.S. and
s.59C-1.012, F.A.C., held to review all pending applications in the same
batching cycle and comparatively reviewed by the agency.
(11) "Comparative
review" means the process by which Certificate of Need applications,
submitted in the same batching cycle for beds, services or programs for the
same planning area, as defined by applicable rules, are competitively evaluated
by the agency through final agency action for purposes of awarding a
Certificate of Need.
(12) "Comprehensive
Medical Rehabilitation Inpatient Beds" means beds designated for the
exclusive use for comprehensive medical rehabilitation inpatient services
regulated under Rule 59C-1.039, F.A.C.
(13) "Conversion
from one type of health care facility to another" means the
reclassification of one licensed facility type to another licensed facility
type, including reclassification from a general acute care hospital to a long
term care hospital or specialty hospital, or from a long term care hospital or
specialty hospital to a general acute care hospital.
(14) "Conversion
of beds" means the reclassification of licensed beds from one category to
another, for facilities licensed under Chapter 395, F.S., including conversion
to or from acute care beds, neonatal intensive care beds, hospital inpatient psychiatric
beds, comprehensive medical rehabilitation beds, hospital inpatient substance
abuse beds, distinct part skilled nursing facility beds, or beds in a long term
care hospital; and, for facilities licensed under Chapter 400, Part I, F.S.,
conversion to or from sheltered beds and community beds.
(15) "Division"
means the division into two or more nursing home facilities of beds or services
authorized by one Certificate of Need issued in the same planning subdistrict.
(16) "Established
program" means a program for the provision of a certificate of need
regulated institutional health service which has a valid certificate of need
for the program or existed prior to the requirement for a certificate of need
and has been continuously in operation, and has performed at least one
institutional health service.
(17) "Exemption"
means the process by which a proposal that would otherwise require a
certificate of need may proceed without a certificate of need.
(18) "Existing
health care facility" means a licensed health care facility.
(19) "Fixed
Need Pool" means the identified numerical need, as published in the
Florida Administrative Weekly, for new beds or services for the applicable
planning horizon established by the agency in accordance with need methodologies
which are in effect by rule at the time of publication of the fixed need pools
for the applicable batching cycle.
(20) "Health
care provider" means an individual who delivers health services or who is
a member of an organization that delivers health services. Health care providers include but are not
limited to physicians, medical doctors, osteopaths, dentists, podiatrists,
nurses, chiropractors, physician assistants, dental assistants, mental health
professionals and other allied health professionals, administrators and
employees of health care institutions.
(21) "Health
care purchaser" means an individual who is responsible for or an
authorized member of an organization or agency which is responsible for the
purchase of health services for a group of 25 or more individuals either
directly or through acquisition of health insurance coverage. Health care purchasers as described above
include, but are not limited to representatives of individual businesses, employer
coalitions, governmental units, labor organizations, consumer groups and health
insurers.
(22) "Hospital
inpatient psychiatric beds" means beds designated for the exclusive use of
hospital inpatient psychiatric services regulated under Rule 59C-1.040, F.A.C.
(23) "Hospital
inpatient substance abuse beds" means beds designated for the exclusive
use of hospital inpatient substance abuse services regulated under Rule
59C-1.041, F.A.C.
(24)
"Identifiable portion" means a reduction in the scope of a project
proposed that does not involve a change in the type of project.
(25) "Letter
of Intent" means a written communication respecting the development of a
certificate of need proposal, submitted to the agency in accordance with the
provisions in Rule 59C-1.008, F.A.C., and subsection 408.039(2), F.S.
(26) "License"
means the granting of a privilege, by the agency, to operate any facility,
service or agency for which the agency has regulatory responsibility and is
evidenced by the document titled "license" issued by the agency
pursuant to its statutory authority.
(27) "Local
Health Council" means a public or private nonprofit health planning agency
established consistent with s. 408.033, F.S., which serves the counties of a
district of the agency as defined in s. 408.032(5), F.S.
(28) "Long
term care hospital" means a hospital licensed under Chapter 395, Part I,
F.S., which meets the requirements of Part 412, subpart B, paragraph 412.23(e),
Code of Federal Regulations (1994), and seeks exclusion from the Medicare
prospective payment system for inpatient hospital services.
(29) "Mental
health services" means inpatient services provided in a hospital licensed under
chapter 395, F.S., and listed on the hospital license as psychiatric beds for
adults; psychiatric beds for children and adolescents; intensive residential
treatment beds for children and adolescents; substance abuse beds for adults;
or substance abuse beds for children and adolescents.
(30) "Mobile
unit" means an object with the ability by structure, function or design to
move or be moved from one health care facility to another, such that upon
arriving at a facility the object is not permanently fixed but is temporarily
secured for the purpose of providing a health service to inpatients.
(31) "Nongovernmental
health care consumer" means an individual who is not a health care
provider or a health care purchaser as defined in subsections (20) and (21) of
this section. Nongovernmental health
care consumers include but are not limited to elected government officials,
members of the general public and representatives of consumer organizations.
(32) "Nursing
home" means a health care facility licensed under Chapter 400, Part I,
F.S.
(33) "Operate"
means to have the legal responsibility, pursuant to the appropriate licensure
statute where licensure is required, for the proper functioning of all aspects
of a health care facility or service.
(34) "Shared
service" means a health service which is operated by or on behalf of two
or more health care facilities or health care providers.
(35) "Shared
service project" means the act of two or more health care facilities or
health care providers entering into an arrangement to jointly offer an
existing, approved or proposed health service for a pre-determined period of
time.
(36) "Sheltered
nursing home beds" mean nursing home beds configured into a nursing home
facility licensed pursuant to Chapter 400, Part I, F.S., which are located
within a continuing care retirement community
certified under Chapter 651, F.S., for which a certificate of need has
been issued as sheltered beds, and which are regulated under Rule 59C-1.037,
F.A.C.
(37) "State
Agency Action Report" means the single written document prepared by the
agency after reviewing a Certificate of Need application, or applications where
more than 1 Certificate of Need application is accepted by the agency in the
same batching cycle, which sets forth the evaluation of the agency with respect
to the application or applications.
(38) "Subdistricts"
mean a subdivision of a district designated by the local health council as
established under Rules 59C-2.100 and 59C-2.200, F.A.C.
(39) "Substantial
change in health services" means:
(a) The
offering by a health care facility, through conversion of beds or other means,
of a new institutional health service or a health service which has not been
offered on a continuing basis by or on behalf of the health care facility
within the 12-month period prior to the time such service would be offered,
excluding obstetrical services; or
(b) The
designation of acute care beds in a health care facility as beds regulated
under Rule 59C-1.036, F.A.C., or the redesignation of such beds back to acute
care beds; or
(c) The
conversion of a general acute care or specialty hospital licensed under Chapter
395, Part I, F.S., to a long term care hospital.
(40) "Termination
of an inpatient health service" means the cessation of a health service
which currently requires a certificate of need. It does not include the temporary cessation of a service lasting
6 months or less.
(41) "Tertiary
health service" means a health service which, due to its high level of
intensity, complexity, specialized or limited applicability, and cost, should
be limited to, and concentrated in, a limited number of hospitals to ensure the
quality, availability, and cost effectiveness of such service. Examples of such service include, but are
not limited to, organ transplantation, specialty burn units, neonatal intensive
care units, comprehensive rehabilitation, and medical or surgical services
which are experimental or developmental in nature to the extent that the
provision of such services is not yet contemplated within the commonly accepted
course of diagnosis or treatment for the condition addressed by a given
service. The types of tertiary services
to be regulated under the Certificate of Need Program in addition to those
listed in Florida Statutes include:
(a) Heart
transplantation;
(b) Kidney
transplantation;
(c) Liver
transplantation;
(d) Bone
marrow transplantation;
(e) Lung
transplantation;
(f) Pancreas
and islet cells transplantation;
(g) Heart/lung
transplantation;
(h) Adult
open heart surgery;
(i) Neonatal
and pediatric cardiac and vascular surgery; and
(j) Pediatric
oncology and hematology.
In
order to determine whether services should be added or deleted, the listing
shall be reviewed annually by the agency.
(42) "Transfer
of a certificate of need" means the conveyance of a certificate of need
which has been issued and remains valid from one person to another person.
(43) "Transfer
costs" means any expense actually incurred by the transferor, and, as
provided for in s. 408.042 F.S., the expense was incurred in obtaining the
initial Certificate of Need which authorized the project. Costs incurred in implementing the Certificate
of Need subsequent to its award are project costs, not transfer costs.
Specific
Authority: 408.034(5),
408.15(8), F.S.
Law
Implemented: 408.033(1)(a),
408.036(1)(2), F.S.
408.037(1),
408.039(1)(2),
651.118,
F.S.
History: New 1-1-77,
Joint Administrative Procedures
Committee
Objection Filed See F.A.W. Volume
3
No. 10 March 11, 1977. Amended 11-1-77,
9-1-78,
6-5-79, 4-25-80, 2-1-81, 3-31-82,
7-29-82,
12-23-82. Formerly 10-5.02. Amended
11-17-87,
12-5-90, 1-31-91, 1-1-92. Formerly
10-5.002. Amended 12-14-92, 2-27-94, 6-23-94,
10-18-95,
10-8-97, 12-12-00.
