71st OREGON LEGISLATIVE ASSEMBLY--2001 Regular Session
 
SA to RC to A-Eng. HB 2609
 
LC 666/HB 2609-A2
 
            SENATE AMENDMENTS TO RESOLVE CONFLICTS TO
                   A-ENGROSSED HOUSE BILL 2609
 
                    By COMMITTEE ON JUDICIARY
 
                             April 2
 
  On page 133 of the printed A-engrossed bill, after line 28,
insert:
  '  { +  SECTION 181a. + }  { + If House Bill 2241 becomes law,
section 181 of this 2001 Act (amending ORS 442.015) is repealed
and ORS 442.015, as amended by section 1, chapter ___, Oregon
Laws 2001 (Enrolled House Bill 2241), is amended to read: + }
  ' 442.015. As used in ORS chapter 441 and this chapter, unless
the context requires otherwise:
  '  { +  (1) '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. + }
  '  { - (1) - }  { +  (2) + } 'Adjusted admission' means the sum
of all inpatient admissions divided by the ratio of inpatient
revenues to total patient revenues.
  '  { - (2) - }  { +  (3) + } '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) 'Ambulatory surgical center' means a facility that
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. + }
  '  { - (4) - }  { +  (5) + } 'Audited actual experience' means
data contained within financial statements examined by an
independent, certified public accountant in accordance with
generally accepted auditing standards.
  '  { - (5) - }  { +  (6) + } 'Budget' means the projections by
the hospital for a specified future time period of expenditures
and revenues with supporting statistical indicators.
  '  { - (6) - }  { +  (7) + } '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) - }  { +  (8) + } 'Council' means the Oregon Health
Council.
  '  { - (8) - }  { +  (9) + } 'Department' means the Department
of Human Services of the State of Oregon.
  '  { - (9) - }  { +  (10) + } '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.
  '  { - (10) - }  { +  (11) + } 'Director' means the Director of
Human Services.
  '  { - (11) - }  { +  (12) + } '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.
  '  { +  (13) 'Freestanding birthing center' means a facility
licensed for the primary purpose of performing low risk
deliveries. + }
  '  { - (12) - }  { +  (14) + } 'Governmental unit' means the
state, or any county, municipality or other political
subdivision, or any related department, division, board or other
agency.
  '  { - (13) - }  { +  (15) + } '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) - }   { + (16)(a) + } 'Health care facility' means
 { - : - }  { +  a hospital, a long term care facility, an
ambulatory surgical center, a freestanding birthing center or an
outpatient renal dialysis facility. + }
  '  { - (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. - }
  '  { - (d) An establishment furnishing primarily domiciliary
care is not a 'health care facility.' - }
  '  { - (e) - }  { +  (b) + }   { - A - }  'Health care
facility' does not mean { + :
  ' (A) + } 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 { + ; or
  ' (B) An establishment furnishing primarily domiciliary
care + }.
  '  { - (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) - }  { +  (17) + } '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) - }  { +  (18) + } '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.
  '  { +  (19) 'Hospital' means a facility 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, to provide treatment for the mentally ill or to
provide treatment in special inpatient care facilities. + }
  '  { - (17) - }  { +  (20) + } '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.
  '  { +  (21) 'Intermediate care facility' means a facility that
provides, on a regular basis, health-related care and services to
individuals who do not require the degree of care and treatment
that 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 that
can be made available to them only through institutional
facilities.
  ' (22) 'Long term care facility' means a 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 skilled nursing
facilities and intermediate care facilities but may not be
construed to include facilities licensed and operated pursuant to
ORS 443.400 to 443.455.
  ' (23) 'Major medical equipment' means medical equipment that
is used to provide medical and other health services and that
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. + }
  '  { - (18) - }  { +  (24) + } '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) - }  { +  (25) + } 'Net revenue' means gross
revenue minus deductions from revenue.
  '  { - (20) - }  { +  (26) + } '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) - }  { +  (27) + } '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 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) - }  { +  (28) + } '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) - }  { +  (29) + } 'Operating expenses' means the
sum of daily hospital service expenses, ambulatory service
expenses, ancillary expenses and other operating expenses,
excluding income taxes.
  '  { +  (30) 'Outpatient renal dialysis facility' means a
facility that provides renal dialysis services directly to
outpatients. + }
  '  { - (25) - }  { +  (31) + } '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.
  '  { +  (32) 'Skilled nursing facility' means a facility or a
distinct part of a facility, that is primarily engaged in
providing to inpatients skilled nursing care and related services
for patients who require medical or nursing care, or an
institution that provides rehabilitation services for the
rehabilitation of injured, disabled or sick persons.
  ' (33) 'Special inpatient care facility' means a facility with
permanent inpatient beds and other facilities designed and
utilized for special health care purposes, including but not
limited to a rehabilitation center, a college infirmary, a
chiropractic facility, a facility for the treatment of alcoholism
or drug abuse, an 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. + }
  '  { - (26) 'State agency' means the office of the Director of
Human Services. - }
  '  { - (27) - }  { +  (34) + } '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.'.
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