For purposes of this part, the following definitions apply:

1. (1) “Abortion complication” means any harmful event or adverse outcome with respect to a patient related to an abortion that is performed on the patient and that is diagnosed or treated by a physician or at a healthcare facility, including but not limited to:

   1. (A) Shock;
   2. (B) Uterine perforation;
   3. (C) Cervical laceration;
   4. (D) Hemorrhage;
   5. (E) Aspiration;
   6. (F) Allergic response;
   7. (G) Infection;
   8. (H) Sepsis;
   9. (I) Death;
   10. (J) Incomplete abortion;
   11. (K) Damage to the uterus; and
   12. (L) An infant born alive after an abortion;

2. (2)

   1. (A) “Ambulatory surgery center” means a facility:

      1. (i) In which surgical services are offered that require the use of general or intravenous anesthetics; and
      2. (ii) Where, in the opinion of the attending physician, hospitalization is not necessary.

   2. (B) “Ambulatory surgery center” does not include a:

      1. (i) Medical office owned and operated by a physician or more than one (1) physician licensed by the Arkansas State Medical Board, if the medical office does not bill facility fees to a third-party payor; or
      2. (ii) Dental office that has a Facility Permit for Moderate Sedation or a Facility Permit for General/Deep Sedation issued by the Arkansas State Board of Dental Examiners;
3. (3) “Administrator” means the person responsible for the management of any facility requiring licensure under this part;
4. (4) “Alcohol and drug abuse inpatient treatment center” means a distinct unit within a hospital facility in which services are provided for the diagnosis, treatment, and rehabilitation of alcohol and drug abuse;

5. (5)

   1. (A) “Basic hospital services” means the services that all licensed hospitals must provide.

   2. (B) “Basic hospital services” consist of:

      1. (i) Governing body;
      2. (ii) Medical staff;
      3. (iii) General administration;
      4. (iv) Patient care;
      5. (v) Health information;
      6. (vi) Pharmacy;
      7. (vii) Food and nutrition;
      8. (viii) Infection prevention and control;
      9. (ix) Laboratory;
      10. (x) Radiology;
      11. (xi) Respiratory therapy;
      12. (xii) Emergency; and
      13. (xiii) Physical facility maintenance;

6. (6)

   1. (A) “Critical access hospital” (CAH) means a hospital located in a rural area that:

      1. (i) Is located more than a thirty-five-mile drive or, in the case of mountainous terrain or in areas with only secondary roads available, a fifteen-mile drive, from a hospital;
      2. (ii) Provides twenty-four-hour emergency care services as determined necessary for ensuring access to emergency care in each area served by a CAH;
      3. (iii) Provides staffing according to this part;
      4. (iv) Meets Centers for Medicare & Medicaid Services Conditions of Participation for Critical Access Hospitals; or
      5. (v) Was operating as a licensed critical access hospital in Arkansas as of April 2007.

   2. (B) Note.

      1. (i) When a hospital converts to a CAH and then at a later date decides to return to a full service with no limits on bed or length of stay, the hospital shall be surveyed using the Life Safety Code under which the hospital entered into the CAH program.
      2. (ii) The hospital shall be able to show that it has continued to be licensed and complied consistently with the Life Safety Code as a CAH;
7. (7) “Department” means the Department of Health;
8. (8) “Emergency services facility” means a facility originally operated as a licensed hospital that has discontinued inpatient services but is licensed to continue to provide emergency services;

9. (9) “General hospital” means any facility used for the purpose of providing short-term inpatient diagnostic care and treatment, including:

   1. (A) General medical care;
   2. (B) Surgical care;
   3. (C) Obstetrical care; and
   4. (D) Specialized services or specialized treatment;
10. (10) “Infirmary” means any facility used for the purpose of offering temporary medical care and/or treatment exclusively for persons residing on a designated premise, e.g., schools, reformatories, prisons, etc., and where the persons are kept for twenty-four (24) hours or more;

11. (11)

    1. (A) “Institution” means, for the purpose of this part, a facility that requires a license.

    2. (B) “Institution” does not include an establishment:

       1. (i) Operated by the federal government or by any of its agencies; or
       2. (ii) Licensed or certified by the Division of Aging, Adult, and Behavioral Health Services of the Department of Human Services as an alcohol and drug abuse inpatient treatment center;

12. (12) “Licensee” means the person to whom a license is issued for the purpose of operating the institution described in the application for licensure, who shall be responsible for maintaining approved standards for:

    1. (A) The institution of any state, county, or local government unit; and
    2. (B) Any division, board, or agency thereof;

13. (13)

    1. (A) “Observation” means a designated patient status as opposed to a designated area.

    2. (B) Patients in observation status are those patients requiring periodic monitoring and assessment necessary to:

       1. (i) Evaluate the patient’s condition; or
       2. (ii) Determine the need for possible admission to the hospital in an inpatient status.
    3. (C) Usually observation status shall be for forty-eight (48) hours or less;
14. (14) “Off-campus emergency department” means an emergency services department located offsite from the main hospital campus but functioning as a fully integrated department of the parent hospital;

15. (15)

    1. (A) “Outpatient psychiatric center” means a facility in which psychiatric services are offered for a period of eight (8) to sixteen (16) hours a day, and where, in the opinion of the attending psychiatrist, hospitalization as defined in the present licensure law is not necessary.
    2. (B) This definition shall not include community mental health clinics and centers as they now exist;
16. (16) “Psychiatric hospital” means any facility or a distinct part of a facility used for the purpose of providing inpatient diagnostic care and treatment for persons having mental disorders;

17. (17)

    1. (A) “Recuperation center” means any facility or distinct part of a facility that includes:

       1. (i) Inpatient beds with an organized medical staff; and
       2. (ii) Medical services that include physician services and continuous nursing services to provide treatment for patients who are not in an acute phase of illness, but who currently require primarily convalescent or restorative services, usually postacute hospital care of relatively short duration.
    2. (B) A facility that furnishes primarily domiciliary care is not within this definition;

18. (18)

    1. (A) “Rehabilitation hospital or facility” means, for the purpose of this part, an inpatient care facility or a distinct part of a facility that provides rehabilitation services for two (2) or more disabled persons not related to the proprietor for more than twenty-four (24) hours, through an integrated program of medical and other restorative services.
    2. (B) A disabled person shall be considered to be an individual who has a physical or mental condition that, if not treated, will probably result in limiting the performance or activity of the person to the extent of constituting a substantial physical, mental, or vocational handicap;

19. (19) “Rural emergency hospital” means a facility that:

    1. (A) Meets the eligibility requirements described in this part, including 20 CAR § 41-183;
    2. (B) Provides rural emergency hospital services;

    3. (C) Provides rural emergency services in the facility twenty-four (24) hours per day by maintaining an emergency department that is staffed twenty-four (24) hours per day and seven (7) days per week with a:

       1. (i) Physician;
       2. (ii) Nurse practitioner;
       3. (iii) Clinical nurse specialist; or
       4. (iv) Physician assistant;
    4. (D) Has a transfer agreement in effect with a Level I or Level II trauma center;
    5. (E) Provides other outpatient medical and health services in which the annual per-patient average length of stay does not exceed twenty-four (24) hours; and
    6. (F) Was a critical access hospital or a general hospital with not more than fifty (50) licensed beds located or deemed located in a rural area under the Social Security Act, 42 U.S.C. § 1886(d)(2)(D) or 42 U.S.C. § 1886(d)(2)(E), on or before December 27, 2020;

20. (20) “Rural emergency hospital services” means the following services provided by a rural emergency hospital that do not require more than twenty-four (24) hours on average in a rural emergency hospital:

    1. (A) Emergency department services, observation care; and

    2. (B) At the election of the rural emergency hospital, other medical and health services provided on an outpatient basis as:

       1. (i) Specified in regulations adopted by the United States Secretary of Health and Human Services; and
       2. (ii) Authorized by the Department of Health;
21. (21) “Shall” means mandatory;
22. (22) “State Health Officer” means the Secretary for the State Board of Health; and
23. (23) “Surgery and general medical care hospital” means any facility limited to providing short-term inpatient surgical and general medical diagnostic care and treatment.