N.M. Admin. Code § 8.370.13.7

Current through Register Vol. 35, No. 23, December 10, 2024

Section 8.370.13.7 - DEFINITIONS

A.Definitions beginning with "A":

(1)"Action plan" means the eligible facility's plan for conversion to an REH and the initiation of REH specific services including the provision of emergency department services, observation care and other medical and health services elected by the REH, submitted to the authority for recommended approval or denial pursuant to CMS COPs.

(2)"Amended license" means a change of administrator, name, location, capacity, classification of any units as listed in these requirements requires a new license:

(a) the application shall be on a form provided by the licensing authority;

(b) the application shall be accompanied by the required fee for an amended license; and

(c) the application shall be submitted at least 10 working days prior to the change.

(3)"Annual license" means a license issued for a one-year period to a hospital that has met all license prior to the initial state licensing survey, or when the licensing authority finds partial compliance with these requirements.

B.Definitions beginning with "B": [RESERVED]

C.Definitions beginning with "C": "Critical access hospital" means a hospital with special characteristics, duly certified as such by centers for medicare and medicaid services (CMS) and is in compliance with the conditions of participation for such facilities; such critical access hospitals are deemed as meeting the intent of these requirements and may be licensed accordingly by the licensing authority.

D.Definitions beginning with "D": [RESERVED]

E.Definitions beginning with "E": [RESERVED]

F.Definitions beginning with "F":

(1)"Facility" means:

(a) was a critical access hospital; or

(b) was a hospital as defined in 42 U.S.C. 1395ww(d)(1)(B) with not more than 50 beds located in a county (or equivalent unit of local government) in a rural area (as defined in 42 U.S.C. 1395ww(d)(2)(D) or was a hospital as so defined in 42 U.S.C. 1395ww(d)(8) (E) with not more than 50 beds that was treated as being located in a rural area.

(2)"Financial interest" means any equity, security, lease or debt interest in the hospital; financial interest also includes any equity, security, and lease or debt interest in any real property used by the hospital or in any entity that receives compensation arising from the use real property by the hospital.

G.Definitions beginning with "G": [RESERVED]

H.Definitions beginning with "H": "Hospital" means a facility offering in-patient services, nursing, overnight care on a 24-hour basis for diagnosing, treating, and providing medical, psychological or surgical care for three or more separate individuals who have a physical or mental illness, disease, injury, a rehabilitative condition or are pregnant; use of the term "hospital" for any facility not duly licensed according to these requirements is prohibited; any acute care hospital shall have emergency services, inpatient medical and nursing care for acute illness, injury, surgery, and obstetrics; any limited services hospital shall have emergency services, inpatient medical and nursing care for acute illness, injury and surgery; ancillary services such as pharmacy, clinical laboratory, radiology, and dietary are required for acute-care or limited service hospitals.

I.Definitions beginning with "I": [RESERVED]

J.Definitions beginning with "J": [RESERVED]

K.Definitions beginning with "K": [RESERVED]

L.Definitions beginning with "L":

(1)"Licensee" means the person(s) who, or organization which, has an ownership, leasehold, or similar interest in the hospital and in whose name a license has been issued and who is legally responsible for compliance with these requirements.

(2)"Licensing authority" means the agency within the authority vested with the authority to enforce these requirements.

M.Definitions beginning with "M": [RESERVED]

N. Definitions beginning with "N": [RESERVED]

O.Definitions beginning with "O": [RESERVED]

P.Definitions beginning with "P": [RESERVED]

Q.Definitions beginning with "Q": [RESERVED]

R.Definitions beginning with "R": [RESERVED]

(1)"Rural emergency hospital" or "REH" means a facility, as defined above, that:

(a) is enrolled under as defined in 42 U.S.C. 1395cc(j), which relates to the enrollment process for providers of services and suppliers, submits the additional information described in paragraph as defined in 42 U.S.C. 1395x(kkk)(4)(A) related to providing an action plan, describing any outpatient services offered and the proposed use of the additional facility payment to REHs, for purposes of such enrollment, and makes the detailed transition plan described in clause (i) of such paragraph available to the public, in a form and manner determined appropriate by the U.S. secretary of health & human services ("secretary");

(b) does not provide any acute care inpatient services, other than those as defined in 42 U. S. C. 1395x(kkk) (6)(A), related to a skilled nursing facility to furnish post-hospital extended care services;

(c) has in effect a transfer agreement with a level I or level II trauma center;

(d) meets:

(i) licensure requirements as described in 42 U.S.C. 1395x(kkk)(5);

(ii) the requirements of a staffed emergency department as described in 42 U.S.C. 1395x(kkk)(1)(B);

(iii) such staff training and certification requirements as the secretary may require;

(iv) conditions of participation applicable to critical access hospitals, with respect to emergency services under section as defined in 42 CFR 485.618 (or any successor regulation) and hospital emergency departments under this subchapter, as determined applicable by the secretary; as defined in 42 U.S.C. 1395x(kkk).

(e) is an entity that operates for the purpose of providing emergency department services, observation care, and other outpatient medical and health services specified by the Secretary in which the annual per patient average length of stay does not exceed 24 hours. 42 CFR Part 485, 485.502.

(2)"Rural emergency hospital services" means the following services furnished by a rural emergency hospital that do not exceed an annual per patient average of 24 hours in such rural emergency hospital:

(a) emergency department services and observation care; and

(b) At the election of the rural emergency hospital, with respect to services furnished on an outpatient basis, other medical and health services as specified by the secretary through rulemaking. 42 U.S.C. 1395x (kkk) (1).

S.Definitions beginning with "S": "Secretary" means the secretary of the New Mexico health care authority.

T.Definitions beginning with "T": [RESERVED]

U.Definitions beginning with "U": [RESERVED]

V.Definitions beginning with "V":"Variance" means an act on the part of the licensing authority to refrain from enforcing compliance with a portion or portions of these requirements for an unspecified period of time where the granting of a variance will not create a danger to the health, safety, or welfare of patients or staff of a hospital and is at the sole discretion of the licensing authority.

W.Definitions beginning with "W": "Waive/waiver" means to refrain from pressing or enforcing compliance with a portion or portions of these regulations for a limited period of time where the granting of a waiver will not create a danger to the health, safety, or welfare of patients or staff of a facility, and is at the sole discretion of the licensing authority.

X.Definitions beginning with "X": [RESERVED]

Y.Definitions beginning with "Y": [RESERVED]

Z.Definitions beginning with "Z": [RESERVED]

N.M. Admin. Code § 8.370.13.7

Adopted by New Mexico Register, Volume XXXV, Issue 12, June 25, 2024, eff. 7/1/2024