135.61 DEFINITIONS.
As used in this division, unless the context otherwise requires:
1. "Affected persons" means, with respect to an application
for a certificate of need:
a. The person submitting the application.
b. Consumers who would be served by the new institutional
health service proposed in the application.
c. Each institutional health facility or health maintenance
organization which is located in the geographic area which would
appropriately be served by the new institutional health service
proposed in the application. The appropriate geographic service area
of each institutional health facility or health maintenance
organization shall be determined on a uniform basis in accordance
with criteria established in rules adopted by the department.
d. Each institutional health facility or health maintenance
organization which, prior to receipt of the application by the
department, has formally indicated to the department pursuant to this
division an intent to furnish in the future institutional health
services similar to the new institutional health service proposed in
the application.
e. Any other person designated as an affected person by rules
of the department.
f. Any payer or third-party payer for health services.
2. "Birth center" means a facility or institution, which is
not an ambulatory surgical center or a hospital or in a hospital, in
which births are planned to occur following a normal, uncomplicated,
low-risk pregnancy.
3. "Consumer" means any individual whose occupation is other
than health services, who has no fiduciary obligation to an
institutional health facility, health maintenance organization or
other facility primarily engaged in delivery of services provided by
persons in health service occupations, and who has no material
financial interest in the providing of any health services.
4. "Council" means the state health facilities council
established by this division.
5. "Department" means the Iowa department of public health.
6. "Develop", when used in connection with health services,
means to undertake those activities which on their completion will
result in the offer of a new institutional health service or the
incurring of a financial obligation in relation to the offering of
such a service.
7. "Director" means the director of public health, or the
director's designee.
8. "Financial reporting" means reporting by which hospitals
and health care facilities shall respectively record their revenues,
expenses, other income, other outlays, assets and liabilities, and
units of services.
9. "Health care facility" means health care facility as
defined in section 135C.1.
10. "Health care provider" means a person licensed or
certified under chapter 147, 148, 148A, 148C, 149, 151, 152, 153,
154, 154B, 154F, or 155A to provide in this state professional health
care service to an individual during that individual's medical care,
treatment, or confinement.
11. "Health maintenance organization" means health
maintenance organization as defined in section 514B.1, subsection 6.
12. "Health services" means clinically related diagnostic,
curative, or rehabilitative services, and includes alcoholism, drug
abuse, and mental health services.
13. "Hospital" means hospital as defined in section 135B.1,
subsection 3.
14. "Institutional health facility" means any of the
following, without regard to whether the facilities referred to are
publicly or privately owned or are organized for profit or not or
whether the facilities are part of or sponsored by a health
maintenance organization:
a. A hospital.
b. A health care facility.
c. An organized outpatient health facility.
d. An outpatient surgical facility.
e. A community mental health facility.
f. A birth center.
15. "Institutional health service" means any health service
furnished in or through institutional health facilities or health
maintenance organizations, including mobile health services.
16. "Mobile health service" means equipment used to provide a
health service that can be transported from one delivery site to
another.
17. "Modernization" means the alteration, repair, remodeling,
replacement or renovation of existing buildings or of the equipment
previously installed therein, or both.
18. "New institutional health service" or "changed
institutional health service" means any of the following:
a. The construction, development or other establishment of a
new institutional health facility regardless of ownership.
b. Relocation of an institutional health facility.
c. Any capital expenditure, lease, or donation by or on
behalf of an institutional health facility in excess of one million
five hundred thousand dollars within a twelve-month period.
d. A permanent change in the bed capacity, as determined by
the department, of an institutional health facility. For purposes of
this paragraph, a change is permanent if it is intended to be
effective for one year or more.
e. Any expenditure in excess of five hundred thousand dollars
by or on behalf of an institutional health facility for health
services which are or will be offered in or through an institutional
health facility at a specific time but which were not offered on a
regular basis in or through that institutional health facility within
the twelve-month period prior to that time.
f. The deletion of one or more health services, previously
offered on a regular basis by an institutional health facility or
health maintenance organization or the relocation of one or more
health services from one physical facility to another.
g. Any acquisition by or on behalf of a health care provider
or a group of health care providers of any piece of replacement
equipment with a value in excess of one million five hundred thousand
dollars, whether acquired by purchase, lease, or donation.
h. Any acquisition by or on behalf of a health care provider
or group of health care providers of any piece of equipment with a
value in excess of one million five hundred thousand dollars, whether
acquired by purchase, lease, or donation, which results in the
offering or development of a health service not previously provided.
A mobile service provided on a contract basis is not considered to
have been previously provided by a health care provider or group of
health care providers.
i. Any acquisition by or on behalf of an institutional health
facility or a health maintenance organization of any piece of
replacement equipment with a value in excess of one million five
hundred thousand dollars, whether acquired by purchase, lease, or
donation.
j. Any acquisition by or on behalf of an institutional health
facility or health maintenance organization of any piece of equipment
with a value in excess of one million five hundred thousand dollars,
whether acquired by purchase, lease, or donation, which results in
the offering or development of a health service not previously
provided. A mobile service provided on a contract basis is not
considered to have been previously provided by an institutional
health facility.
k. Any air transportation service for transportation of
patients or medical personnel offered through an institutional health
facility at a specific time but which was not offered on a regular
basis in or through that institutional health facility within the
twelve-month period prior to the specific time.
l. Any mobile health service with a value in excess of one
million five hundred thousand dollars.
m. Any of the following:
(1) Cardiac catheterization service.
(2) Open heart surgical service.
(3) Organ transplantation service.
(4) Radiation therapy service applying ionizing radiation for the
treatment of malignant disease using megavoltage external beam
equipment.
19. "Offer", when used in connection with health services,
means that an institutional health facility, health maintenance
organization, health care provider, or group of health care providers
holds itself out as capable of providing, or as having the means to
provide, specified health services.
20. "Organized outpatient health facility" means a facility,
not part of a hospital, organized and operated to provide health care
to noninstitutionalized and nonhomebound persons on an outpatient
basis; it does not include private offices or clinics of individual
physicians, dentists or other practitioners, or groups of
practitioners, who are health care providers.
21. "Outpatient surgical facility" means a facility which as
its primary function provides, through an organized medical staff and
on an outpatient basis to patients who are generally ambulatory,
surgical procedures not ordinarily performed in a private physician's
office, but not requiring twenty-four hour hospitalization, and which
is neither a part of a hospital nor the private office of a health
care provider who there engages in the lawful practice of surgery.
"Outpatient surgical facility" includes a facility certified or
seeking certification as an ambulatory surgical center, under the
federal Medicare program or under the medical assistance program
established pursuant to chapter 249A.
22. "Technologically innovative equipment" means equipment
potentially useful for diagnostic or therapeutic purposes which
introduces new technology in the diagnosis or treatment of disease,
the usefulness of which is not well enough established to permit a
specific plan of need to be developed for the state.
135.61 DEFINITIONS.
As used in this division, unless the context otherwise requires:
1. "Affected persons" means, with respect to an application
for a certificate of need:
a. The person submitting the application.
b. Consumers who would be served by the new institutional
health service proposed in the application.
c. Each institutional health facility or health maintenance
organization which is located in the geographic area which would
appropriately be served by the new institutional health service
proposed in the application. The appropriate geographic service area
of each institutional health facility or health maintenance
organization shall be determined on a uniform basis in accordance
with criteria established in rules adopted by the department.
d. Each institutional health facility or health maintenance
organization which, prior to receipt of the application by the
department, has formally indicated to the department pursuant to this
division an intent to furnish in the future institutional health
services similar to the new institutional health service proposed in
the application.
e. Any other person designated as an affected person by rules
of the department.
f. Any payer or third-party payer for health services.
2. "Birth center" means a facility or institution, which is
not an ambulatory surgical center or a hospital or in a hospital, in
which births are planned to occur following a normal, uncomplicated,
low-risk pregnancy.
3. "Consumer" means any individual whose occupation is other
than health services, who has no fiduciary obligation to an
institutional health facility, health maintenance organization or
other facility primarily engaged in delivery of services provided by
persons in health service occupations, and who has no material
financial interest in the providing of any health services.
4. "Council" means the state health facilities council
established by this division.
5. "Department" means the Iowa department of public health.
6. "Develop", when used in connection with health services,
means to undertake those activities which on their completion will
result in the offer of a new institutional health service or the
incurring of a financial obligation in relation to the offering of
such a service.
7. "Director" means the director of public health, or the
director's designee.
8. "Financial reporting" means reporting by which hospitals
and health care facilities shall respectively record their revenues,
expenses, other income, other outlays, assets and liabilities, and
units of services.
9. "Health care facility" means health care facility as
defined in section 135C.1.
10. "Health care provider" means a person licensed or
certified under chapter 147, 148, 148A, 148C, 149, 151, 152, 153,
154, 154B, 154F, or 155A to provide in this state professional health
care service to an individual during that individual's medical care,
treatment, or confinement.
11. "Health maintenance organization" means health
maintenance organization as defined in section 514B.1, subsection 6.
12. "Health services" means clinically related diagnostic,
curative, or rehabilitative services, and includes alcoholism, drug
abuse, and mental health services.
13. "Hospital" means hospital as defined in section 135B.1,
subsection 3.
14. "Institutional health facility" means any of the
following, without regard to whether the facilities referred to are
publicly or privately owned or are organized for profit or not or
whether the facilities are part of or sponsored by a health
maintenance organization:
a. A hospital.
b. A health care facility.
c. An organized outpatient health facility.
d. An outpatient surgical facility.
e. A community mental health facility.
f. A birth center.
15. "Institutional health service" means any health service
furnished in or through institutional health facilities or health
maintenance organizations, including mobile health services.
16. "Mobile health service" means equipment used to provide a
health service that can be transported from one delivery site to
another.
17. "Modernization" means the alteration, repair, remodeling,
replacement or renovation of existing buildings or of the equipment
previously installed therein, or both.
18. "New institutional health service" or "changed
institutional health service" means any of the following:
a. The construction, development or other establishment of a
new institutional health facility regardless of ownership.
b. Relocation of an institutional health facility.
c. Any capital expenditure, lease, or donation by or on
behalf of an institutional health facility in excess of one million
five hundred thousand dollars within a twelve-month period.
d. A permanent change in the bed capacity, as determined by
the department, of an institutional health facility. For purposes of
this paragraph, a change is permanent if it is intended to be
effective for one year or more.
e. Any expenditure in excess of five hundred thousand dollars
by or on behalf of an institutional health facility for health
services which are or will be offered in or through an institutional
health facility at a specific time but which were not offered on a
regular basis in or through that institutional health facility within
the twelve-month period prior to that time.
f. The deletion of one or more health services, previously
offered on a regular basis by an institutional health facility or
health maintenance organization or the relocation of one or more
health services from one physical facility to another.
g. Any acquisition by or on behalf of a health care provider
or a group of health care providers of any piece of replacement
equipment with a value in excess of one million five hundred thousand
dollars, whether acquired by purchase, lease, or donation.
h. Any acquisition by or on behalf of a health care provider
or group of health care providers of any piece of equipment with a
value in excess of one million five hundred thousand dollars, whether
acquired by purchase, lease, or donation, which results in the
offering or development of a health service not previously provided.
A mobile service provided on a contract basis is not considered to
have been previously provided by a health care provider or group of
health care providers.
i. Any acquisition by or on behalf of an institutional health
facility or a health maintenance organization of any piece of
replacement equipment with a value in excess of one million five
hundred thousand dollars, whether acquired by purchase, lease, or
donation.
j. Any acquisition by or on behalf of an institutional health
facility or health maintenance organization of any piece of equipment
with a value in excess of one million five hundred thousand dollars,
whether acquired by purchase, lease, or donation, which results in
the offering or development of a health service not previously
provided. A mobile service provided on a contract basis is not
considered to have been previously provided by an institutional
health facility.
k. Any air transportation service for transportation of
patients or medical personnel offered through an institutional health
facility at a specific time but which was not offered on a regular
basis in or through that institutional health facility within the
twelve-month period prior to the specific time.
l. Any mobile health service with a value in excess of one
million five hundred thousand dollars.
m. Any of the following:
(1) Cardiac catheterization service.
(2) Open heart surgical service.
(3) Organ transplantation service.
(4) Radiation therapy service applying ionizing radiation for the
treatment of malignant disease using megavoltage external beam
equipment.
19. "Offer", when used in connection with health services,
means that an institutional health facility, health maintenance
organization, health care provider, or group of health care providers
holds itself out as capable of providing, or as having the means to
provide, specified health services.
20. "Organized outpatient health facility" means a facility,
not part of a hospital, organized and operated to provide health care
to noninstitutionalized and nonhomebound persons on an outpatient
basis; it does not include private offices or clinics of individual
physicians, dentists or other practitioners, or groups of
practitioners, who are health care providers.
21. "Outpatient surgical facility" means a facility which as
its primary function provides, through an organized medical staff and
on an outpatient basis to patients who are generally ambulatory,
surgical procedures not ordinarily performed in a private physician's
office, but not requiring twenty-four hour hospitalization, and which
is neither a part of a hospital nor the private office of a health
care provider who there engages in the lawful practice of surgery.
"Outpatient surgical facility" includes a facility certified or
seeking certification as an ambulatory surgical center, under the
federal Medicare program or under the medical assistance program
established pursuant to chapter 249A.
22. "Technologically innovative equipment" means equipment
potentially useful for diagnostic or therapeutic purposes which
introduces new technology in the diagnosis or treatment of disease,
the usefulness of which is not well enough established to permit a
specific plan of need to be developed for the state.
135.61 DEFINITIONS.
As used in this division, unless the context otherwise requires:
1. "Affected persons" means, with respect to an application
for a certificate of need:
a. The person submitting the application.
b. Consumers who would be served by the new institutional
health service proposed in the application.
c. Each institutional health facility or health maintenance
organization which is located in the geographic area which would
appropriately be served by the new institutional health service
proposed in the application. The appropriate geographic service area
of each institutional health facility or health maintenance
organization shall be determined on a uniform basis in accordance
with criteria established in rules adopted by the department.
d. Each institutional health facility or health maintenance
organization which, prior to receipt of the application by the
department, has formally indicated to the department pursuant to this
division an intent to furnish in the future institutional health
services similar to the new institutional health service proposed in
the application.
e. Any other person designated as an affected person by rules
of the department.
f. Any payer or third-party payer for health services.
2. "Birth center" means a facility or institution, which is
not an ambulatory surgical center or a hospital or in a hospital, in
which births are planned to occur following a normal, uncomplicated,
low-risk pregnancy.
3. "Consumer" means any individual whose occupation is other
than health services, who has no fiduciary obligation to an
institutional health facility, health maintenance organization or
other facility primarily engaged in delivery of services provided by
persons in health service occupations, and who has no material
financial interest in the providing of any health services.
4. "Council" means the state health facilities council
established by this division.
5. "Department" means the Iowa department of public health.
6. "Develop", when used in connection with health services,
means to undertake those activities which on their completion will
result in the offer of a new institutional health service or the
incurring of a financial obligation in relation to the offering of
such a service.
7. "Director" means the director of public health, or the
director's designee.
8. "Financial reporting" means reporting by which hospitals
and health care facilities shall respectively record their revenues,
expenses, other income, other outlays, assets and liabilities, and
units of services.
9. "Health care facility" means health care facility as
defined in section 135C.1.
10. "Health care provider" means a person licensed or
certified under chapter 147, 148, 148A, 148C, 149, 151, 152, 153,
154, 154B, 154F, or 155A to provide in this state professional health
care service to an individual during that individual's medical care,
treatment, or confinement.
11. "Health maintenance organization" means health
maintenance organization as defined in section 514B.1, subsection 6.
12. "Health services" means clinically related diagnostic,
curative, or rehabilitative services, and includes alcoholism, drug
abuse, and mental health services.
13. "Hospital" means hospital as defined in section 135B.1,
subsection 3.
14. "Institutional health facility" means any of the
following, without regard to whether the facilities referred to are
publicly or privately owned or are organized for profit or not or
whether the facilities are part of or sponsored by a health
maintenance organization:
a. A hospital.
b. A health care facility.
c. An organized outpatient health facility.
d. An outpatient surgical facility.
e. A community mental health facility.
f. A birth center.
15. "Institutional health service" means any health service
furnished in or through institutional health facilities or health
maintenance organizations, including mobile health services.
16. "Mobile health service" means equipment used to provide a
health service that can be transported from one delivery site to
another.
17. "Modernization" means the alteration, repair, remodeling,
replacement or renovation of existing buildings or of the equipment
previously installed therein, or both.
18. "New institutional health service" or "changed
institutional health service" means any of the following:
a. The construction, development or other establishment of a
new institutional health facility regardless of ownership.
b. Relocation of an institutional health facility.
c. Any capital expenditure, lease, or donation by or on
behalf of an institutional health facility in excess of one million
five hundred thousand dollars within a twelve-month period.
d. A permanent change in the bed capacity, as determined by
the department, of an institutional health facility. For purposes of
this paragraph, a change is permanent if it is intended to be
effective for one year or more.
e. Any expenditure in excess of five hundred thousand dollars
by or on behalf of an institutional health facility for health
services which are or will be offered in or through an institutional
health facility at a specific time but which were not offered on a
regular basis in or through that institutional health facility within
the twelve-month period prior to that time.
f. The deletion of one or more health services, previously
offered on a regular basis by an institutional health facility or
health maintenance organization or the relocation of one or more
health services from one physical facility to another.
g. Any acquisition by or on behalf of a health care provider
or a group of health care providers of any piece of replacement
equipment with a value in excess of one million five hundred thousand
dollars, whether acquired by purchase, lease, or donation.
h. Any acquisition by or on behalf of a health care provider
or group of health care providers of any piece of equipment with a
value in excess of one million five hundred thousand dollars, whether
acquired by purchase, lease, or donation, which results in the
offering or development of a health service not previously provided.
A mobile service provided on a contract basis is not considered to
have been previously provided by a health care provider or group of
health care providers.
i. Any acquisition by or on behalf of an institutional health
facility or a health maintenance organization of any piece of
replacement equipment with a value in excess of one million five
hundred thousand dollars, whether acquired by purchase, lease, or
donation.
j. Any acquisition by or on behalf of an institutional health
facility or health maintenance organization of any piece of equipment
with a value in excess of one million five hundred thousand dollars,
whether acquired by purchase, lease, or donation, which results in
the offering or development of a health service not previously
provided. A mobile service provided on a contract basis is not
considered to have been previously provided by an institutional
health facility.
k. Any air transportation service for transportation of
patients or medical personnel offered through an institutional health
facility at a specific time but which was not offered on a regular
basis in or through that institutional health facility within the
twelve-month period prior to the specific time.
l. Any mobile health service with a value in excess of one
million five hundred thousand dollars.
m. Any of the following:
(1) Cardiac catheterization service.
(2) Open heart surgical service.
(3) Organ transplantation service.
(4) Radiation therapy service applying ionizing radiation for the
treatment of malignant disease using megavoltage external beam
equipment.
19. "Offer", when used in connection with health services,
means that an institutional health facility, health maintenance
organization, health care provider, or group of health care providers
holds itself out as capable of providing, or as having the means to
provide, specified health services.
20. "Organized outpatient health facility" means a facility,
not part of a hospital, organized and operated to provide health care
to noninstitutionalized and nonhomebound persons on an outpatient
basis; it does not include private offices or clinics of individual
physicians, dentists or other practitioners, or groups of
practitioners, who are health care providers.
21. "Outpatient surgical facility" means a facility which as
its primary function provides, through an organized medical staff and
on an outpatient basis to patients who are generally ambulatory,
surgical procedures not ordinarily performed in a private physician's
office, but not requiring twenty-four hour hospitalization, and which
is neither a part of a hospital nor the private office of a health
care provider who there engages in the lawful practice of surgery.
"Outpatient surgical facility" includes a facility certified or
seeking certification as an ambulatory surgical center, under the
federal Medicare program or under the medical assistance program
established pursuant to chapter 249A.
22. "Technologically innovative equipment" means equipment
potentially useful for diagnostic or therapeutic purposes which
introduces new technology in the diagnosis or treatment of disease,
the usefulness of which is not well enough established to permit a
specific plan of need to be developed for the state.
