Chapter 3701-59 Hospitals

As used in this chapter:

(A) “Active medical staff” means staff with clinical privileges who are designated as active pursuant to the bylaws or other governing prescript of the hospital.

(B) “Alcohol and drug hospital” means a hospital engaged primarily in providing specialized care to inpatients with alcoholism or chemical dependency rehabilitative service needs.

(C) “Alcohol or drug abuse rehabilitation bed” means a hospital bed that is staffed and equipped for care of inpatients whose primary diagnosis is alcoholism or other chemical dependency.

(D) “Associate medical staff” means staff with clinical privileges who are designated as associate pursuant to the bylaws or other governing prescript of the hospital.

(E) “Average daily census” means total patient days for a given calendar year divided by the number of days in the year.

(F) “Beds in use” means the sum of the number of beds staffed and available for patient care on the last day of each month of the calendar year, divided by twelve.

(G) “Board certified physician” means an individual licensed under Chapter 4731. of the Revised Code to practice medicine and surgery or osteopathic medicine and surgery who has passed an examination given by a medical specialty board and has been certified by that board as a specialist. “Board certified” does not include board eligible physicians. For physicians certified by more than one board, “board certified: includes only the primary certification board.

(H) “Burn care bed” means a hospital bed that is staffed and equipped for care of inpatients whose primary diagnosis is burn-related.

(I) “Burn care hospital” means a hospital engaged primarily in providing inpatient care to patients requiring specialized burn-related diagnostic or therapeutic services.

(J) “Children’s hospital” means a hospital as defined in division (V) of section 3702.51 of the Revised Code.

(K) “Department” means the department of health of the state of Ohio.

(L) “Direct care services” means any in-person patient contact where health care or personal care is provided in the hospital.

(M) “Director” means the director of health or the director’s designated representative.

(N) “Discharge” means a patient who is formally released from a hospital including deaths. Discharge does not include temporary transfers to other settings.

(O) “Full-time equivalent” means at least one thousand eight hundred and twenty hours per calendar year.

(P) “General hospital” means a hospital that primarily functions to furnish the array of diagnostic and therapeutic services needed to provide care for a variety of medical conditions, such as diagnostic X-ray, clinical laboratory, and operating room services.

(Q) “Hospice beds” means the inpatient beds of a hospice care program as defined in division (A) of section 3712.01 of the Revised Code.

(R) “Hospital” means an institution located as a single site engaged primarily in providing to inpatients, by or under the supervision of an organized medical staff of physicians licensed under Chapter 4731. of the Revised Code, diagnostic services and therapeutic services for medical diagnosis and treatment or rehabilitation of injured, disabled, or sick persons. “Hospital” does not mean an institution that is operated by the United States government or by the Ohio department of mental health.

(S) “Hospital bed” or “bed” means a bed in a hospital with the attendant physical space, fixtures, and equipment for use in caring primarily for inpatients. “Hospital bed” includes beds used in caring for patients who stay for less than twenty-four hours, but the primary use of such beds is for care of inpatients.

(T) “House staff” means interns, residents, and fellows receiving stipends from the hospital who are in training positions approved by the accreditation council of graduate medical education, the American osteopathic association, or the American dental association

(U) “Inpatient” means a patient whose length of stay is twenty-four hours or more.

(V) “Inpatient surgical operating room” means a room in a hospital used to perform any operative or manual procedure undertaken for the diagnosis or treatment of a disease or other disorder.

(W) “Long term acute care hospital” means a hospital that is classified as a long-term care hospital under 42 C.F.R. 412.23(e), that is engaged primarily in providing specialized acute hospital care for medically complex patients who are critically ill or have multi-system complications or failures, and that has an average length of stay of thirty days or less.

(X) “Long term acute care hospital bed” means a bed in a long term acute care hospital.

(Y) “Long term care bed” means a hospital bed within a unit when the unit has an average length of stay of more than thirty days. “Long term care bed” does not include beds in the following categories:

(1) Alcohol or drug abuse rehabilitation;

(2) Burn care;

(3) Hospice beds;

(4) Physical rehabilitation; or

(5) Psychiatric care.

(Z) “Maternity hospital” means a hospital providing inpatient care primarily to newborn infants and women during all or part of the maternity cycle.

(AA) “Medical/surgical bed” means a hospital bed in a medical or surgical unit where general medical/surgical services are provided.

(BB) “Multi-hospital system” means two or more hospitals that are subject to the control and direction of one common owner responsible for the operational decisions of the entire system or that have integrated administrative functions and medical staff that report to one governing body as the result of a formal legal or contractual obligation.

(CC) “Number of admissions” means the number of patients accepted for inpatient service of twenty-four hours or more, including transfers by a service within the hospital.

(DD) “Number of inpatient surgical cases” means number of patients treated on an inpatient basis after surgery in an operating room.

(EE) “Other special hospital” means any hospital not specifically listed in section (A)(8)(b)(i) through (A)(8)(b)(vii) of rule 3701-59-05 of the Administrative Code that is engaged primarily in providing inpatient services to patients with specialized care needs.

(FF) “Outpatient” means a patient whose length of stay is less than twenty-four hours.

(GG) “Outpatient surgical operating room” means a room in a hospital designed to perform an operative or manual procedure undertaken for the diagnosis or treatment of a disease or other disorder on non-inpatients.

(HH) “Patient” means an individual who receives diagnostic or therapeutic services for medical diagnosis treatment, or rehabilitation. “Patient” also includes an individual receiving palliative care.

(II) “Patient days of care” means annual total number of inpatients in a hospital on a daily count at a specific uniform time of day.

(JJ) “Physical rehabilitation bed” means a hospital bed that is staffed and equipped for care of inpatients requiring intensive, multi-disciplinary physical restorative services.

(KK) “Physical rehabilitation hospital” means a hospital engaged primarily in providing specialized care to inpatients with intensive, multi-disciplinary physical restorative service needs.

(LL) “Psychiatric care bed” means a hospital bed that is staffed and equipped for care of inpatients whose primary diagnosis in mental illness.

(MM) “Psychiatric hospital” means a hospital engaged primarily in providing specialized care to inpatients diagnosed with mental illness.

(NN) “Register” means to report to the department on an annual basis information required under section 3701.07 of the Revised Code and rule 3701-59-05 of the Administrative Code.

(OO) “Satellite unit” means a unit owned and operated by a hospital that is providing outpatient diagnostic, therapeutic, or rehabilitative services in a geographically separate location from the hospital that owns and operates it. “Satellite unit” does not include facilities that are licensed under section 3702.30 of the Revised Code.

(PP) “Special care bed” means a hospital bed in which special medical/surgical services, beyond general medical/surgical care and including intensive care or coronary care, are provided.

(QQ) “Special hospital” means a hospital that primarily functions to furnish the limited diagnostic and therapeutic services needed to provide care for inpatients who have specialized medical conditions, both surgical and non-surgical.

(RR) “Total number of beds” means the total number of beds in which patient care may be provided, whether or not the bed is staffed and available. Beds in temporarily closed units are included in the total. Beds that are temporarily unavailable as the result of building renovations are included in the total. A temporary increase in the number of beds in use that is caused by unusually high volumes of admissions is not included in the total, where “temporary increase” means the average daily census exceeds registered capacity for less than forty-five days in any six month period.

R.C. 119.032 review dates: 05/11/2006 and 01/10/2010

Promulgated Under: 119.03

Statutory Authority: 3701.07

Rule Amplifies: 3701.07

Prior Effective Dates: 7/24/1978, 9/28/78, 5/6/80, 1/13/88 (Emer.), 5/16/88, 12/16/89 (Emer.), 12/31/90, 6/21/2004

Rescinded eff 6-21-04

(A) No person and no political subdivision, agency, or instrumentality of this state shall operate a hospital as defined in section 3727.01 of the Revised Code, unless it is certified under Title XVIII of the Social Security Act 49 Stat. 620 (1935), 42 U.S.C. 301, as amended or is accredited by the “Joint Commission on Accreditation of Healthcare Organizations” or the “American Osteopathic Association.”

(B) Each hospital defined in section 3727.01 of the Revised Code shall: Annually report to the department its accreditation and certification status on a form or in a format prescribed by the director.

(2)

(C) Any hospital defined in section 3727.01 of the Revised Code that voluntarily withdraws or is involuntarily terminated from certification or accreditation as required in paragraph (A) of this rule shall notify the director of health in writing within ten days after the effective date of such withdrawal or termination.

R.C. 119.032 review dates: 01/10/2005 and 01/10/2010

Promulgated Under: 119.03

Statutory Authority: 3727.03

Rule Amplifies: 3727.03

Prior Effective Dates: 12/3/1983, 6/9/2000

(A) The director of health shall make an investigation of any hospital or health facility to determine if there is a violation of section 3727.02 of the Revised Code and rule 3701-59-03 of the Administrative Code whenever he has reason to believe that there may be a violation of section 3727.02 of the Revised Code or rule 3701-59-03 of the Adm. Code.

(B) If the Director ascertains that there is a violation of section 3727.02 of the Revised Code or rule 3701-59-03 of the Administrative Code, he shall petition the court of common pleas of the county in which the hospital or health facility is located for an order enjoining such violation or shall institute legal proceedings under section 3727.99 of the Revised Code, or both, as appropriate.

R.C. 119.032 review dates: 01/10/2005 and 01/10/2010

Promulgated Under: 119.03

Statutory Authority: 3727.03

Rule Amplifies: 3727.03

Prior Effective Dates: 12/3/1983

Every hospital, public or private, shall, by the first of March of each year, register with and report to the department of health the following information for the previous calendar year in a manner prescribed by the director:

(A) Information needed to identify and classify the hospital, include the following: (1) Hospital identifying information, including name, address, mailing address if different than address, county, telephone number, e-mail address, hospital number assigned by the department, and corporate name, if different than hospital name;

(2) Name and title of president/chief executive officer;

(3) Name, title, and telephone number of individual responsible for submitting hospital registration information to the department;

(4) Accreditation/certification status;

(5) Name, address, county, and zip code of satellite units;

(6) Type of entity that controls operation of the hospital, such as not-for-profit, for profit, government, or other;

(7) Name of multi-hospital system of which the hospital is a part, if applicable; and

(8) Primary hospital classification from one of the following categories:

(a) General hospital; or

(b) Special hospital, including:

(i) Alcohol and drug hospital;

(ii) Burn care hospital;

(iii) Children’s hospital;

(iv) Long term acute care hospital;

(v) Maternity hospital;

(vi) Physical rehabilitation hospital;

(vii) Psychiatric hospital; or

(viii) Other special hospital.

(B) Information on the type and volume of services provided by the hospital, including but not limited to the following:

(1) Number of inpatient surgical cases;

(2) Number of outpatient surgical cases;

(3) Number of surgical operating rooms in the following categories;

(a) Inpatient;

(b) Outpatient; and

(c) Dual purpose (inpatient and outpatient);

(4) Number of patients treated in the emergency room and released;

(5) Number of patients treated in the emergency room who were admitted to the hospital;

(6) Level designation, if institution is a trauma center verified by the American college of surgeons; and

(7) Level designation, if institution is a pediatric trauma center verified by the American college of surgeons

(C) Information on the type and volume of services provided by the satellite units, including the following:

(1) Types of services provided; and

(2) Total number of patients treated (on an outpatient basis) for each type of service provided.

(D) The total number of beds listed by category of inpatient care provided. Report number of admissions (including individuals transferred from another unit within the hospital), number of patient days of care, and number of beds in use for each category of care listed in this paragraph. Beds shall be reported in the following categories:

(1) Alcohol or drug abuse rehabilitation;

(2) Burn care;

(3) Hospice;

(4) Level I newborn care service nursery (Level I nursery care beds established in 3701-59-05 2 Chapter 3701-84 of the Administrative Code);

(5) Level II newborn care service intermediate care nursery (Level II intermediate care nursery beds established in Chapter 3701-84 of the Administrative Code);

(6) Level III newborn care service intensive care nursery (Level III neonatal intensive care unit beds established in Chapter 3701-84 of the Administrative Code);

(7) Level I obstetric care service (Level I obstetric care service beds established in Chapter 3701-84 of the Administrative Code);

(8) Level II obstetric care service (Level II obstetric care service beds established in Chapter 3701-84 of the Administrative Code);

(9) Level III obstetric care service (Level III obstetric care service beds established in Chapter 3701-84 of the Administrative Code;

(10) Long term acute care;

(11) Long term, reported in the following categories;

(a) Skilled nursing facility beds certified under Title XVIII of the Social Security Act, 49 Stat. 620 (1935), 42 U.S.C. 301, as amended and licensed under Chapter 3721. of the Revised Code, excluding beds reported in paragraph (D)(18) of this rule;

(b) Nursing facility beds certified under Title XIX of the Social Security Act, 49 Stat. 620 (1935), 42 U.S.C. 301, as amended and licensed under Chapter 3721. of the Revised Code;

(c) Nursing facility beds certified under Title XVIII of the Social Security Act, 49 Stat. 620 (1935), 42 U.S.C. 301, as amended and Title XIX of the Social Security Act, 49 Stat. 620 (1935), 42 U.S.C. 301, as amended and licensed under Chapter 3721. of the Revised Code;

(d) Skilled nursing facility beds certified under Title XVIII of the Social Security Act, 49 Stat. 620 (1935), 42 U.S.C. 301, as amended and which are not licensed under Chapter 3721. of the Revised Code;

(e) Nursing facility beds certified under Title XIX of the Social Security Act, 49 Stat. 620 (1935), 42 U.S.C. 301, as amended and which are not licensed under Chapter 3721. of the Revised Code;

(f) Nursing facility beds certified under Title XVIII of the Social Security Act, 49 Stat. 620 (1935), 42 U.S.C. 301, as amended and Title XIX of the Social Security Act, 49 Stat. 620 (1935), 42 U.S.C. 301, as amended and which are not licensed under Chapter 3721. of the Revised Code; or

(g) Long term care beds.

(12) Medical/surgical – General;

(13) Pediatric intensive care, (beds in a pediatric intensive care unit as defined in paragraph (BB) of rule 3701-84-01 of the Administrative Code);

(14) Pediatric – General (services for patients less than twenty-two years of age are provided);

(15) Physical rehabilitation;

(16) Psychiatric care;

(17) Special care;

(18) Special skilled nursing (beds certified as skilled nursing facility beds under Title XVIII of the Social Security Act, 49 Stat. 620 (1935), 42 U.S.C. 301, as amended, for which a certificate of need was granted under division (R)(7)(d) of section 3702.51 of the Revised Code and rule 3701-12-233 of the Administrative Code that were in effect on May 20, 1991); or

(19) Swing bed (hospital beds with an average length of stay of thirty days or less than may also be used for long term care as certified under Title XVIII of the Social Security Act, 49 Stat. 620 (1935), 42 U.S.C. 301, as amended).

(E) The number of inpatient discharges for each of the following categories:

(1) Discharges to home, without referral to home care or hospice services;

(2) Discharges to home, with a referral to home care services;

(3) Discharges to home, with a referral to hospice care program;

(4) Transfers to inpatient service of a hospice care program;

(5) Transfers to other hospitals;

(6) Transfers to a home licensed as a nursing home under Chapter 3721. of the Revised Code or a facility certified under Title XVIII of the Social Security Act, 49 Stat. 620 (1935), 42 U.S.C. 301, as amended;

(7) Total patients expired in the hospital; and

(8) Total patients discharged.

(F) The number of employees, including contract employees, by employee type within each of the hospital service categories listed below. Report the number of employees in each type providing patient care services. Report the number of employees as total number of employees and total full-time equivalents.

(1) Physician services including interns, residents, salaried physicians, and contracted physicians;

(2) Dental services including dentists and dental residents;

(3) Nursing services including registered nurses, certified nurse practitioners, clinical nurse specialists, certified nurse-midwifes, certified registered nurse anesthetists (CRNA), licensed practical nurses, and nursing assistants;

(4) Pharmacy services including pharmacists and pharmacy technicians;

(5) Clinical laboratory including medical technologists, medical technicians and other licensed or certified laboratory personnel;

(6) Dietary services including registered or licensed dietitians and dietetic technicians;

(7) Radiological services including technologists, technicians, and other licensed or certified radiological personnel;

(8) Therapeutic services including occupational therapists, physical therapists, physician assistants, respiratory therapists, speech/audiology therapists and medical social workers;

(9) Mental health services including psychologists and psychiatric social workers; and

(10) All other services to include certified or licensed health professional and technical personnel.

(G) Numbers of medical staff delineated by primary area of specialization and category as follows:

(1) Area of specialization:

(a) Medical: Allergy/immunology, anesthesiology, cardiology, dentistry, dermatology, emergency medicine, family practice, gastroenterology, internal medicine, general practice, hematology, neonatology neurology, nuclear medicine, obstetrics and gynecology, oncology, ophthalmology, otorhinolaryngology, pathology, pediatrics, physical medicine, podiatry, psychiatry, radiology, rheumatology, urology, general medicine rotation program, and any other medical specialty; or

(b) Surgical: Cardiovascular, colon and rectal, general neurological, orthopedic, plastic, thoracic, surgery rotation program, and any other surgical specialty.

(2) Categories:

(a) Active and associate medical staff;

(b) Active and associate medical staff who are board certified;

(c) House staff;

(d) House staff who are in training positions approved by the accreditation council of graduate medical education or the American osteopathic association; and

(e) House staff who are in training positions approved by the American dental association.

(H) County (or state if other than Ohio) of resident of patients at the time of admission, reported in the aggregate.

R.C. 119.032 review dates: 05/11/2006 and 01/10/2010

Promulgated Under: 119.03

Statutory Authority: 3701.07

Rule Amplifies: 3701.07

Prior Effective Dates: 9/28/1978, 5/5/80, 1/13/88 (Emer.), 5/16/88, 12/16/89 (Emer.), 12/31/90, 6/21/2004