71st OREGON LEGISLATIVE ASSEMBLY--2001 Regular Session
Enrolled
House Bill 2241
Ordered printed by the Speaker pursuant to House Rule 12.00A (5).
Presession filed (at the request of Governor John A. Kitzhaber,
M.D., for Department of Human Services)
CHAPTER ................
AN ACT
Relating to renal dialysis facilities; amending ORS 441.020 and
442.015.
Be It Enacted by the People of the State of Oregon:
SECTION 1. ORS 442.015 is amended to read:
442.015. As used in ORS chapter 441 and this chapter, unless
the context requires otherwise:
(1) 'Adjusted admission' means the sum of all inpatient
admissions divided by the ratio of inpatient revenues to total
patient revenues.
(2) 'Affected persons' has the same meaning as given to '
party' in ORS 183.310 (6).
(3) 'Acquire' or 'acquisition' refers to obtaining equipment,
supplies, components or facilities by any means, including
purchase, capital or operating lease, rental or donation, with
intention of using such equipment, supplies, components or
facilities to provide health services in Oregon. When equipment
or other materials are obtained outside of this state,
acquisition is considered to occur when the equipment or other
materials begin to be used in Oregon for the provision of health
services or when such services are offered for use in Oregon.
(4) 'Audited actual experience' means data contained within
financial statements examined by an independent, certified public
accountant in accordance with generally accepted auditing
standards.
(5) 'Budget' means the projections by the hospital for a
specified future time period of expenditures and revenues with
supporting statistical indicators.
(6) 'Case mix' means a calculated index for each hospital,
based on financial accounting and case mix data collection as set
forth in ORS 442.425, reflecting the relative costliness of that
hospital's mix of cases compared to a state or national mix of
cases.
(7) 'Council' means the Oregon Health Council.
(8) 'Department' means the Department of Human Services of the
State of Oregon.
(9) 'Develop' 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, as
defined under applicable state law, in relation to the offering
of such a health service.
Enrolled House Bill 2241 (HB 2241-INTRO) Page 1
(10) 'Director' means the Director of Human Services.
(11) 'Expenditure' or 'capital expenditure' means the actual
expenditure, an obligation to an expenditure, lease or similar
arrangement in lieu of an expenditure, and the reasonable value
of a donation or grant in lieu of an expenditure but not
including any interest thereon.
(12) 'Governmental unit' means the state, or any county,
municipality or other political subdivision, or any related
department, division, board or other agency.
(13) 'Gross revenue' means the sum of daily hospital service
charges, ambulatory service charges, ancillary service charges
and other operating revenue. 'Gross revenue' does not include
contributions, donations, legacies or bequests made to a hospital
without restriction by the donors.
(14) 'Health care facility' means:
(a) A 'hospital' with an organized medical staff, with
permanent facilities that include inpatient beds, and with
medical services, including physician services and continuous
nursing services under the supervision of registered nurses, to
provide diagnosis and medical or surgical treatment primarily for
but not limited to acutely ill patients and accident victims, or
to provide treatment for the mentally ill or to provide treatment
in special inpatient care facilities. A 'special inpatient care
facility' is a facility with permanent inpatient beds and other
facilities designed and utilized for special health care
purposes, to include but not limited to: Rehabilitation center,
college infirmary, chiropractic facility, facility for the
treatment of alcoholism or drug abuse, or inpatient care facility
meeting the requirements of ORS 441.065, and any other
establishment falling within a classification established by the
division, after determination of the need for such classification
and the level and kind of health care appropriate for such
classification.
(b) A 'long term care facility' with permanent facilities that
include inpatient beds, providing medical services, including
nursing services but excluding surgical procedures except as may
be permitted by the rules of the director, to provide treatment
for two or more unrelated patients. 'Long term care facility '
includes the terms 'skilled nursing facility' and 'intermediate
care facility,' but such definition shall not be construed to
include facilities licensed and operated pursuant to ORS 443.400
to 443.455. Such definitions shall include:
(A) A 'skilled nursing facility' whether an institution or a
distinct part of an institution, which is primarily engaged in
providing to inpatients skilled nursing care and related services
for patients who require medical or nursing care, or
rehabilitation services for the rehabilitation of injured,
disabled or sick persons.
(B) An 'intermediate care facility' which provides, on a
regular basis, health-related care and services to individuals
who do not require the degree of care and treatment which a
hospital or skilled nursing facility is designed to provide, but
who because of their mental or physical condition require care
and services above the level of room and board which can be made
available to them only through institutional facilities.
(c) An 'ambulatory surgical center' means a health care
facility which performs outpatient surgery not routinely or
customarily performed in a physician's or dentist's office, and
is able to meet health facility licensure requirements.
Enrolled House Bill 2241 (HB 2241-INTRO) Page 2
(d) An establishment furnishing primarily domiciliary care is
not a 'health care facility. '
(e) A 'health care facility' does not mean an establishment
furnishing residential care or treatment not meeting federal
intermediate care standards, not following a primarily medical
model of treatment, prohibited from admitting persons requiring
24-hour nursing care and licensed or approved under the rules of
the Mental Health and Developmental Disability Services Division,
Senior and Disabled Services Division, State Office for Services
to Children and Families, Department of Corrections or Vocational
Rehabilitation Division.
(f) A 'freestanding birthing center' means a health care
facility licensed for the primary purpose of performing low risk
deliveries.
{ + (g) An 'outpatient renal dialysis facility' that provides
renal dialysis services directly to outpatients. + }
(15) 'Health maintenance organization' or 'HMO' means a public
organization or a private organization organized under the laws
of any state which:
(a) Is a qualified HMO under section 1310 (d) of the U.S.
Public Health Services Act; or
(b)(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
services, and out-of-area coverage;
(B) Is compensated, except for copayments, for the provision of
the basic health care services listed in subparagraph (A) of this
paragraph to enrolled participants on a predetermined periodic
rate basis; and
(C) Provides physicians' services primarily directly through
physicians who are either employees or partners of such
organization, or through arrangements with individual physicians
or one or more groups of physicians organized on a group practice
or individual practice basis.
(16) 'Health services' means clinically related diagnostic,
treatment or rehabilitative services, and includes alcohol, drug
or controlled substance abuse and mental health services that may
be provided either directly or indirectly on an inpatient or
ambulatory patient basis.
(17) 'Institutional health services' means health services
provided in or through health care facilities and includes the
entities in or through which such services are provided.
(18) 'Medically indigent' means a person who has insufficient
resources or assets to pay for needed medical care without
utilizing resources required to meet basic needs for shelter,
food and clothing.
(19) 'Net revenue' means gross revenue minus deductions from
revenue.
(20) 'New hospital' means a facility that did not offer
hospital services on a regular basis within its service area
within the prior 12-month period and is initiating or proposing
to initiate such services. 'New hospital' also includes any
replacement of an existing hospital that involves a substantial
increase or change in the services offered.
(21) 'New skilled nursing or intermediate care service or
facility' means a service or facility that did not offer long
term care services on a regular basis by or through the facility
within the prior 12-month period and is initiating or proposing
to initiate such services. A 'new skilled nursing or intermediate
Enrolled House Bill 2241 (HB 2241-INTRO) Page 3
care service or facility' also includes the rebuilding of a long
term care facility, the relocation of buildings which are a part
of a long term care facility, the relocation of long term care
beds from one facility to another or an increase in the number of
beds of more than 10 or 10 percent of the bed capacity, whichever
is the lesser, within a two-year period.
(22) 'Major medical equipment' means medical equipment which is
used to provide medical and other health services and which costs
more than $1 million. 'Major medical equipment' does not include
medical equipment acquired by or on behalf of a clinical
laboratory to provide clinical laboratory services, if the
clinical laboratory is independent of a physician's office and a
hospital and has been determined under Title XVIII of the Social
Security Act to meet the requirements of paragraphs (10) and (11)
of section 1861(s) of that Act.
(23) 'Offer' means that the health care facility holds itself
out as capable of providing, or as having the means for the
provision of, specified health services.
(24) 'Operating expenses' means the sum of daily hospital
service expenses, ambulatory service expenses, ancillary expenses
and other operating expenses, excluding income taxes.
(25) 'Person' means an individual, a trust or estate, a
partnership, a corporation (including associations, joint stock
companies and insurance companies), a state, or a political
subdivision or instrumentality, including a municipal
corporation, of a state.
(26) 'State agency' means the office of the Director of Human
Services.
(27) 'Total deductions from gross revenue' or 'deductions from
revenue' means reductions from gross revenue resulting from
inability to collect payment of charges. Such reductions include
bad debts; contractual adjustments; uncompensated care;
administrative, courtesy and policy discounts and adjustments and
other such revenue deductions. The deduction shall be net of the
offset of restricted donations and grants for indigent care.
SECTION 2. ORS 441.020 is amended to read:
441.020. (1) Licenses for health care facilities except long
term care facilities, as defined in ORS 442.015, shall be
obtained from the Health Division.
(2) Licenses for long term care facilities shall be obtained
from the Senior and Disabled Services Division.
(3) Applications shall be upon such forms and shall contain
such information as the appropriate division may reasonably
require, which may include affirmative evidence of ability to
comply with such reasonable standards and rules as may lawfully
be prescribed under ORS 441.055.
(4) Each application shall be accompanied by the license fee.
If the license is denied, the fee shall be refunded to the
applicant. If the license is issued, the fee shall be paid into
the State Treasury to the credit of the appropriate division for
carrying out the functions under ORS 441.015 to 441.063 and
431.607 to 431.619.
(5) Except as otherwise provided in subsection (6) of this
section, for hospitals with:
(a) Fewer than 26 beds, the annual license fee shall be $750.
(b) Twenty-six beds or more but fewer than 50 beds, the annual
license fee shall be $1,000.
(c) Fifty or more beds but fewer than 100 beds, the annual
license fee shall be $1,900.
Enrolled House Bill 2241 (HB 2241-INTRO) Page 4
(d) One hundred beds or more but fewer than 200 beds, the
annual license fee shall be $2,900.
(e) Two hundred or more beds, the annual license fee shall be
$3,400.
(6) For long term care facilities with:
(a) Fewer than 16 beds, the annual license fee shall be up to
$120.
(b) Sixteen beds or more but fewer than 50 beds, the annual
license fee shall be up to $175.
(c) Fifty beds or more but fewer than 100 beds, the annual
license fee shall be up to $350.
(d) One hundred beds or more but fewer than 200 beds, the
annual license fee shall be up to $450.
(e) Two hundred beds or more, the annual license fee shall be
up to $580.
(7) For special inpatient care facilities with:
(a) Fewer than 26 beds, the annual license fee shall be $750.
(b) Twenty-six beds or more but fewer than 50 beds, the annual
license fee shall be $1,000.
(c) Fifty beds or more but fewer than 100 beds, the annual
license fee shall be $1,900.
(d) One hundred beds or more but fewer than 200 beds, the
annual license fee shall be $2,900.
(e) Two hundred beds or more, the annual license fee shall be
$3,400.
(8) For ambulatory surgical centers, the annual license fee
shall be $1,000.
(9) For birthing centers, the annual license fee shall be $250.
{ + (10) For outpatient renal dialysis facilities, the annual
license fee shall be $1,500. + }
{ - (10) - } { + (11) + } During the time the licenses
remain in force holders thereof are not required to pay
inspection fees to any county, city or other municipality.
{ - (11) - } { + (12) + } Any health care facility license
may be indorsed to permit operation at more than one location. In
such case the applicable license fee shall be the sum of the
license fees which would be applicable if each location were
separately licensed.
{ - (12) - } { + (13) + } Licenses for health maintenance
organizations shall be obtained from the Director of the
Department of Consumer and Business Services pursuant to ORS
731.072.
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Enrolled House Bill 2241 (HB 2241-INTRO) Page 5
Passed by House February 13, 2001
...........................................................
Chief Clerk of House
...........................................................
Speaker of House
Passed by Senate April 3, 2001
...........................................................
President of Senate
Enrolled House Bill 2241 (HB 2241-INTRO) Page 6
Received by Governor:
......M.,............., 2001
Approved:
......M.,............., 2001
...........................................................
Governor
Filed in Office of Secretary of State:
......M.,............., 2001
...........................................................
Secretary of State
Enrolled House Bill 2241 (HB 2241-INTRO) Page 7