Section 216-RICR-40-10-13.3 - DefinitionsA. Wherever used in these rules and regulations the following terms shall be construed to mean: 1. "Accreditation agency" means an entity, approved by the Director, which grants accreditation to physician ambulatory surgery centers and podiatry ambulatory surgery centers. Accreditation agencies approved by the Director include: the Joint Commission on Accreditation of Healthcare Organizations, the American Association for Accreditation of Ambulatory Surgery Facilities, Inc., and the Accreditation Association for Ambulatory Health Care, Inc.2. "Anesthesiologist" means a physician licensed in Rhode Island who is board certified, or becoming so, in anesthesia and has privileges to administer anesthesia in a Rhode Island licensed health care facility.3. "Certified registered nurse anesthetist" means a registered nurse who has successfully met the requirements for licensure which are set forth in the "Rules and Regulations for Licensing of Nurses and Standards for the Approval of Basic Nursing Education Programs".4. "The practice of certified registered nurse anesthesia" means providing certain health care services under the supervision of anesthesiologists, licensed physicians, or licensed dentists, in accordance with R.I. Gen. Laws § 5-31.1-1(g) which requires substantial specialized knowledge, judgement and skill related to the administration of anesthesia, including pre-operative and post-operative assessment of patients; administration of anesthetics; monitoring patients during anesthesia; management of fluid in intravenous therapy and respiratory care.5. "Conscious sedation" means a drug-induced depression of consciousness during which patients respond purposefully (reflex withdrawal from a painful stimulus is not considered a purposeful response) to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate. Cardiovascular function is usually maintained.6. "Director" means the Director of the Rhode Island Department of Health.7. "Employee", as used in §13.4.1(E) of this Part, means an individual who is required to comply with instructions about when, where, and how to work, both as to the final results and as to the details of when, where, and how the work is to be done. The employer need not actually exercise this control; it is sufficient that he has the right to do so. When the employer does not possess this control, the individual involved is not an employee, but an independent contractor.8. "Exempt procedures" means: a. Minor surgical procedures such as excision of skin lesions, moles, warts, lipomas and repair of lacerations, incision and drainage of superficial abscesses, or surgery limited to the skin and subcutaneous tissue performed under topical or local anesthesia not involving drug induced alteration of consciousness other than minimal pre-operative tranquilization of the patient;b. Procedures not requiring or using conscious sedation techniques or pre-operative medications other than minimal pre-operative tranquilization of the patient;c. Procedures requiring or using only local, topical, or no anesthesia.9. "General anesthesia" means a drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired.10. "The licensed capacity" of the physician ambulatory surgery center and/or podiatry ambulatory surgery center means the number of operating/procedure rooms that the physician ambulatory surgery center and/or podiatry ambulatory surgery center is licensed to operate.11. "Licensing agency" or "state agency" means the Rhode Island Department of Health.12. "Local anesthesia" means the injection of a local anesthetic agent (e.g., Lidocaine) into and around the operative site to achieve numbness in the area where a painful procedure is to be performed. This type of anesthesia does not involve any systemic sedation.13. "Operating room or procedure room" means the area of the office operatory wherein a surgical treatment is performed.14. "Person" means any individual, trust or estate, partnership, corporation (including associations, joint stock companies), limited liability company, state, or political subdivisions or instrumentality of a state.15. "Physician" means a person licensed to practice allopathic or osteopathic medicine in this state, pursuant to the provisions of R.I. Gen. Laws Chapter 5-37.16. "Physician ambulatory surgery center," means an office or portion thereof owned and/or operated by a physician-controlled professional services corporation as defined in R.I. Gen. Laws Chapter 7-5.1 or a private physician's office or group of physicians' offices (whether owned and/or operated by an individual practitioner, alone or as a member of a partnership, professional service corporation, organization, or association) which is utilized for the purpose of furnishing surgical services to said owner and/or operator's own patients on an ambulatory basis.17. "Podiatrist" means a person with a license to practice podiatric medicine and surgery in this state under the provisions of R.I. Gen. Laws Chapter 5-29.18. "Podiatry ambulatory surgery center" means an office or portion of an office owned and/or operated by a podiatrist controlled professional service corporation as defined in R.I. Gen. Laws Chapter 7-5.1 or a private podiatrist's office or group of the podiatrists' offices (whether owned and/or operated by an individual practitioner, alone or as a member of a partnership, professional service corporation, organization, or association) which is utilized for the purpose of furnishing surgical services to the owner and/or operator's own patients.19. "Regional anesthesia" means the use of local anesthetic agents to block nerves leading to the area where a painful procedure is to be done. There are many examples of regional anesthesia, including, but not limited to, spinal, interscalene, ankle, etc. Generally, regional anesthesia involves more of a physiological reaction because of the larger area blocked and/or the dose of local anesthesia. This type of anesthesia may or may not involve sedation.20. "Registered nurse" means a person licensed under the provisions of R.I. Gen. Laws Chapter 5-34.21. "Surgery" means the excision or resection partial/complete, destruction, incision or other structural alteration of human tissue by any means. Surgery shall have the same meaning as "operate."216 R.I. Code R. 216-RICR-40-10-13.3