An Act
ENROLLED 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.
SUBJECT: Hospitals
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY 63 O.S. 2021, Se ction 1-701, is
amended to read as follows:
Section 1-701. For the purposes of Sectio n 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 o f patients admitted for overnight stay
or longer in order to obtain medical care, surgical care,
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 d uration of their stay. The term
"hospital" includes general medical surgical hospitals, specialized
ENR. S. B. NO. 293 Page 2
hospitals, critical access and emergency hospitals, emergency
hospitals, rural emergency hospitals , and birthing centers;
2. "General medical surgical ho spital" 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 mainta ined 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 pr ovides
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;
6. "Rural emergency hospital" means a hospital that provides
emergency treatment and stabilizati on 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 prima rily for the purpose of
providing services of a certified midwife or licensed m edical 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 175.2 0 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
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providing to inpatients the following care by or under
the supervision of physicians:
(1) diagnostic services and therapeutic service s for
medical diagnosis, treatment and care of injured,
disabled or sick persons, or
(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 p roviding inpatient hospital
services to inpatients of a hospital, the Department
shall evaluate the total facility operation s and
consider multiple factors as provided in subparagraph s
c and d of this subsection.
c. In evaluating the total facility operat ions, 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 needs 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,
(5) the number of provider -based emergency
departments for the entity,
ENR. S. B. NO. 293 Page 4
(6) the number of inpatient beds related to the 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 ove r the past
twelve (12) months. A critical access hospital sh all
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 tha n (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.
If a first survey finds nonco mpliance with the ADC and
ALOS, a second survey may be requir ed by the
Department to demonst rate compliance with state
licensure.
SECTION 2. This act shall become effective October 1, 2023.
ENR. S. B. NO. 293 Page 5
Passed the Senate the 2nd day of March, 2023.
Presiding Officer of the Senate
Passed the House of Rep resentatives the 20th day of April, 2023.
Presiding Officer of the House
of Representatives
OFFICE OF THE GOVERNOR
Received by the Office of the Governor this _______ _____________
day of _________________ __, 20_______, at _______ o'clock _______ M.
By: _______________________________ __
Approved by the Governor of the State of Oklahoma this _____ ____
day of _________________ __, 20_______, at _______ o'clock _______ M.
_________________________________
Governor of the State of Oklahoma
OFFICE OF THE SECRETARY OF STATE
Received by the Office of the Secretary of State this _______ ___
day of __________________, 20 _______, at _______ o'clock _______ M.
By: _______________________________ __