32.1-102.1 - Definitions.
§ 32.1-102.1. Definitions.
As used in this article, unless the context indicates otherwise:
"Certificate" means a certificate of public need for a project required bythis article.
"Clinical health service" means a single diagnostic, therapeutic,rehabilitative, preventive or palliative procedure or a series of suchprocedures that may be separately identified for billing and accountingpurposes.
"Health planning region" means a contiguous geographical area of theCommonwealth with a population base of at least 500,000 persons which ischaracterized by the availability of multiple levels of medical careservices, reasonable travel time for tertiary care, and congruence withplanning districts.
"Medical care facility," as used in this title, means any institution,place, building or agency, whether or not licensed or required to be licensedby the Board or the Department of Behavioral Health and DevelopmentalServices, whether operated for profit or nonprofit and whether privatelyowned or privately operated or owned or operated by a local governmentalunit, (i) by or in which health services are furnished, conducted, operatedor offered for the prevention, diagnosis or treatment of human disease, pain,injury, deformity or physical condition, whether medical or surgical, of twoor more nonrelated mentally or physically sick or injured persons, or for thecare of two or more nonrelated persons requiring or receiving medical,surgical or nursing attention or services as acute, chronic, convalescent,aged, physically disabled or crippled or (ii) which is the recipient ofreimbursements from third-party health insurance programs or prepaid medicalservice plans. For purposes of this article, only the following medical carefacilities shall be subject to review:
1. General hospitals.
2. Sanitariums.
3. Nursing homes.
4. Intermediate care facilities, except those intermediate care facilitiesestablished for individuals with mental retardation that have no more than 12beds and are in an area identified as in need of residential services forindividuals with mental retardation in any plan of the Department ofBehavioral Health and Developmental Services.
5. Extended care facilities.
6. Mental hospitals.
7. Mental retardation facilities.
8. Psychiatric hospitals and intermediate care facilities establishedprimarily for the medical, psychiatric or psychological treatment andrehabilitation of individuals with substance abuse.
9. Specialized centers or clinics or that portion of a physician's officedeveloped for the provision of outpatient or ambulatory surgery, cardiaccatheterization, computed tomographic (CT) scanning, stereotacticradiosurgery, lithotripsy, magnetic resonance imaging (MRI), magnetic sourceimaging (MSI), positron emission tomographic (PET) scanning, radiationtherapy, stereotactic radiotherapy, proton beam therapy, nuclear medicineimaging, except for the purpose of nuclear cardiac imaging, or such otherspecialty services as may be designated by the Board by regulation.
10. Rehabilitation hospitals.
11. Any facility licensed as a hospital.
The term "medical care facility" shall not include any facility of (i) theDepartment of Behavioral Health and Developmental Services; (ii) anynonhospital substance abuse residential treatment program operated by orcontracted primarily for the use of a community services board under theDepartment of Behavioral Health and Developmental Services' ComprehensiveState Plan; (iii) an intermediate care facility for individuals with mentalretardation that has no more than 12 beds and is in an area identified as inneed of residential services for people with mental retardation in any planof the Department of Behavioral Health and Developmental Services; (iv) aphysician's office, except that portion of a physician's office describedabove in subdivision 9 of the definition of "medical care facility"; (v)the Woodrow Wilson Rehabilitation Center of the Department of RehabilitativeServices; or (vi) the Department of Corrections. "Medical care facility"shall also not include that portion of a physician's office dedicated toproviding nuclear cardiac imaging.
"Project" means:
1. Establishment of a medical care facility;
2. An increase in the total number of beds or operating rooms in an existingmedical care facility;
3. Relocation of beds from one existing facility to another; provided that"project" shall not include the relocation of up to 10 beds or 10 percentof the beds, whichever is less, (i) from one existing facility to anotherexisting facility at the same site in any two-year period, or (ii) in anythree-year period, from one existing nursing home facility to any otherexisting nursing home facility owned or controlled by the same person that islocated either within the same planning district, or within another planningdistrict out of which, during or prior to that three-year period, at least 10times that number of beds have been authorized by statute to be relocatedfrom one or more facilities located in that other planning district and atleast half of those beds have not been replaced; provided further that,however, a hospital shall not be required to obtain a certificate for the useof 10 percent of its beds as nursing home beds as provided in § 32.1-132;
4. Introduction into an existing medical care facility of any new nursinghome service, such as intermediate care facility services, extended carefacility services, or skilled nursing facility services, regardless of thetype of medical care facility in which those services are provided;
5. Introduction into an existing medical care facility of any new cardiaccatheterization, computed tomographic (CT) scanning, stereotacticradiosurgery, lithotripsy, magnetic resonance imaging (MRI), magnetic sourceimaging (MSI), medical rehabilitation, neonatal special care, obstetrical,open heart surgery, positron emission tomographic (PET) scanning,psychiatric, organ or tissue transplant service, radiation therapy,stereotactic radiotherapy, proton beam therapy, nuclear medicine imaging,except for the purpose of nuclear cardiac imaging, substance abuse treatment,or such other specialty clinical services as may be designated by the Boardby regulation, which the facility has never provided or has not provided inthe previous 12 months;
6. Conversion of beds in an existing medical care facility to medicalrehabilitation beds or psychiatric beds;
7. The addition by an existing medical care facility of any medical equipmentfor the provision of cardiac catheterization, computed tomographic (CT)scanning, stereotactic radiosurgery, lithotripsy, magnetic resonance imaging(MRI), magnetic source imaging (MSI), open heart surgery, positron emissiontomographic (PET) scanning, radiation therapy, stereotactic radiotherapy,proton beam therapy, or other specialized service designated by the Board byregulation. Replacement of existing equipment shall not require a certificateof public need;
8. Any capital expenditure of $15 million or more, not defined as reviewablein subdivisions 1 through 7 of this definition, by or in behalf of a medicalcare facility. However, capital expenditures between $5 and $15 million shallbe registered with the Commissioner pursuant to regulations developed by theBoard. The amounts specified in this subdivision shall be revised effectiveJuly 1, 2008, and annually thereafter to reflect inflation using appropriatemeasures incorporating construction costs and medical inflation; or
9. Conversion in an existing medical care facility of psychiatric inpatientbeds approved under § 32.1-102.3:2 to nonpsychiatric inpatient beds.
"Regional health planning agency" means the regional agency, including theregional health planning board, its staff and any component thereof,designated by the Virginia Health Planning Board to perform the healthplanning activities set forth in this chapter within a health planning region.
"State Medical Facilities Plan" means the planning document adopted by theBoard of Health which shall include, but not be limited to, (i) methodologiesfor projecting need for medical care facility beds and services; (ii)statistical information on the availability of medical care facilities andservices; and (iii) procedures, criteria and standards for review ofapplications for projects for medical care facilities and services.
(1982, c. 388; 1983, c. 533; 1984, c. 740; 1985, c. 513; 1989, c. 517; 1991,c. 561; 1992, c. 612; 1993, c. 704; 1995, c. 524; 1996, c. 1050; 1997, c.600; 1998, c. 289; 1999, cc. 899, 920, 922; 2000, cc. 850, 920; 2004, c. 75;2007, c. 502; 2008, c. 664; 2009, cc. 67, 175, 813, 840.)