SB293 HFLR Page 1 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 HOUSE OF REPRESENTATIVES - FLOOR VERSION STATE OF OKLAHOMA 1st Session of the 59th Legislature (2023) ENGROSSED SENATE BILL NO. 293 By: Hall of the Senate and Burns of the House An Act relating to hospitals; amending 63 O.S. 2021, Section 1-701, which relates to definitions; modifying and adding definitions; updating statutory reference; and providing an effective date. BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: SECTION 1. AMENDATORY 63 O.S. 2021, S ection 1-701, is amended to read as follows: Section 1-701. For the purposes of Section 1 -701 et seq. of this title: 1. "Hospital" means any institution, place, building or agency, public or private, whether organized for profit or not, primarily engaged in the maintenance and operation o f facilities for the diagnosis, treatment or care of patie nts admitted for overnight stay or longer in order to obtain medical care, surgical care, SB293 HFLR Page 2 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 obstetrical care, or nursing care for illness, disease, injury, infirmity, or deformity. Except as otherwis e provided by paragraph 5 of this subsection paragraph 7 of this section, places where pregnant females are admitted and receive care incident to pregnancy, abortion or delivery shall be considered to be a "hospital" within the meaning of this article, regardless of the number of patients received or the duration of their stay. The term "hospital" includes general medical surgical hospitals, specialized hospitals, critical access and emergency hospitals, emergency hospitals, rural emergency hospitals , and birthing centers; 2. "General medical surgical hospital " means a hospital maintained for the purpose of providing hospital care in a broad category of illness and injury; 3. "Specialized hospital " means a hospital maint ained for the purpose of providing hospital care in a certain category, or categories, of illness and injury; 4. "Critical access hospital " means a hospital determined by the State Department of He alth to be a necessary provider of health care services to residents of a rural community; 5. "Emergency hospital" means a hospital that provides emergency treatment and stabilization services on a twenty -four-hour basis that has the ability to admit and treat patients for short periods of time; SB293 HFLR Page 3 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 6. "Rural emergency hospital" means a hospital that provides emergency treatment and stabilization services for an average length of stay of twenty-four hours or less; 7. "Birthing center" means any facility, pla ce or institution, which is maintained or established prim arily for the purpose of providing services of a certified midwife or licensed medical doctor to assist or attend a woman in delivery and birth, and where a woman is scheduled in advance to give bir th following a normal, uncomplicated, low-risk pregnancy. Provided, however, lice nsure for a birthing center shall not be compulsory; 7. 8. "Day treatment program" means nonresidential, partial hospitalization programs, day treatment programs, and day ho spital programs as defined by subsection A of Section 175. 20 of Title 10 of the Oklahoma Statutes; and 8. 9. a. "Primarily engaged" means a hospital shall be primarily engaged, defined by this section and as determined by the State Department of Health, in providing to inpatients the following care by or under the supervision of physicians: (1) diagnostic services and therapeutic services for medical diagnosis, treatment and care of injured, disabled or sick persons, or SB293 HFLR Page 4 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 (2) rehabilitation services for the r ehabilitation of injured, disabled or sick persons. b. In reaching a determination as to whether an entity is primarily engaged in providing inpatient hospital services to inpatients of a hospital, the Department shall evaluate the total facility operation s and consider multiple factors as provided in subparagrap hs c and d of this subsection. c. In evaluating the total facility operations, the Department shall review the actual provision of care and services to two or more inpatients, and the effects of that care, to assess whether the care provided meets the need s of individual patients by wa y of patient outcomes. d. The factors that the Department shall consider for determination of whether an entity meets the definition of primarily engaged include, but a re not limited to: (1) a minimum of four inpatient beds, (2) the entity's average daily census (ADC), (3) the average length of stay (ALOS), (4) the number of off-site campus outpatient locations, SB293 HFLR Page 5 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 (5) the number of provider -based emergency departments for the entity, (6) the number of inpatient beds related to th e size of the entity and the s cope of the services offered, (7) the volume of outpatient surg ical procedures compared to the inpatient surgical procedures, if surgical services are provided, (8) staffing patterns, and (9) patterns of ADC by day of the week . e. Notwithstanding any other provision of this section, an entity shall be considered prima rily engaged in providing inpatient hospital services to inpatients if the hospital has had an ADC of at least two (2) and an ALOS of at least two (2) midnights ov er the past twelve (12) months. A critical access hospital shall be exempt from the ADC and ALOS determination. ADC shall be calculated by adding the midnight daily census for each day of the twel ve-month period and then dividing the total number by days in the year. A facility that has been operating for less than (12) months at the time of th e survey shall calculate its ADC based on the number of months the facility has been operational, but not less than three (3) months. SB293 HFLR Page 6 BOLD FACE denotes Committee Amendments. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 If a first survey finds nonc ompliance with the ADC and ALOS, a second survey may be required by the Department to demonst rate compliance with state licensure. SECTION 2. This act shall become effective October 1, 2023. COMMITTEE REPORT BY: COMMITTEE ON APPROPRIATION S AND BUDGET, dated 04/13/2023 - DO PASS.