Page 33 - Aegion PPO SPDs
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2. Surgery;
3. Therapy Services or rehabilitation.
Ambulatory Surgical Facility - A Provider that:
1. is licensed as such, where required;
2. is equipped mainly to do Surgery;
3. has the services of a Physician and a Registered Nurse (R.N.) at all times when a patient is
present;
4. is not an office maintained by a Physician for the general practice of medicine or dentistry; and
5. is equipped and ready to initiate Emergency procedures with personnel who are certified in
Advanced Cardiac Lifesaving Skills.
Birthing Center - a Provider, other than a Hospital, where births take place following normal,
uncomplicated pregnancies. Such centers must be:
1. constituted, licensed, and operated as set forth in the laws that apply;
2. equipped to provide low-risk maternity care;
3. adequately staffed with qualified personnel who:
a. provide care at childbirth;
b. are practicing within the scope of their training and experience; and
c. are licensed if required; and
4. equipped and ready to initiate Emergency procedures in life threatening events to mother and
baby by personnel who are certified in Advanced Cardiac Life-Saving Skills.
Certified Registered Nurse Anesthetist - Any individual licensed as a Registered Nurse by the
state in which he or she practices, who holds a certificate of completion of a course in anesthesia
approved by the American Association of Nurse Anesthetists or a course approved by that state's
appropriate licensing board and who maintains certification through a recertification process
administered by the Council on Recertification of Nurse Anesthetists.
Home Health Care Agency - A public or private agency or organization licensed in the state in
which it is located to provide Home Health Care Services.
Hospice - A coordinated plan of home, Inpatient and Outpatient care which provides palliative and
supportive medical and other health services to terminally ill patients. An interdisciplinary team
provides a program of planned and continuous care, of which the medical components are under
the direction of a Physician. Care will be available 24 hours a day, seven days a week. The
Hospice must meet the licensing requirements of the state or locality in which it operates.
Hospital - A Provider constituted, licensed, and operated as set forth in the laws that apply to
Hospitals, which:
1. provides room and board and nursing care for its patients;
2. has a staff with one or more Physicians available at all times;
3. provides 24-hour nursing service;
4. maintains on its premises all the Facilities needed for the diagnosis, medical care, and
treatment of an illness or injury; and
5. is fully accredited by the Joint Commission on Accreditation of Health Care Organizations.
The term Hospital does not include a Provider, or that part of a Provider, used mainly for:
1. nursing care;
2. rest care;
3. convalescent care;
4. care of the aged;
5. custodial care;
6. educational care;
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3. Therapy Services or rehabilitation.
Ambulatory Surgical Facility - A Provider that:
1. is licensed as such, where required;
2. is equipped mainly to do Surgery;
3. has the services of a Physician and a Registered Nurse (R.N.) at all times when a patient is
present;
4. is not an office maintained by a Physician for the general practice of medicine or dentistry; and
5. is equipped and ready to initiate Emergency procedures with personnel who are certified in
Advanced Cardiac Lifesaving Skills.
Birthing Center - a Provider, other than a Hospital, where births take place following normal,
uncomplicated pregnancies. Such centers must be:
1. constituted, licensed, and operated as set forth in the laws that apply;
2. equipped to provide low-risk maternity care;
3. adequately staffed with qualified personnel who:
a. provide care at childbirth;
b. are practicing within the scope of their training and experience; and
c. are licensed if required; and
4. equipped and ready to initiate Emergency procedures in life threatening events to mother and
baby by personnel who are certified in Advanced Cardiac Life-Saving Skills.
Certified Registered Nurse Anesthetist - Any individual licensed as a Registered Nurse by the
state in which he or she practices, who holds a certificate of completion of a course in anesthesia
approved by the American Association of Nurse Anesthetists or a course approved by that state's
appropriate licensing board and who maintains certification through a recertification process
administered by the Council on Recertification of Nurse Anesthetists.
Home Health Care Agency - A public or private agency or organization licensed in the state in
which it is located to provide Home Health Care Services.
Hospice - A coordinated plan of home, Inpatient and Outpatient care which provides palliative and
supportive medical and other health services to terminally ill patients. An interdisciplinary team
provides a program of planned and continuous care, of which the medical components are under
the direction of a Physician. Care will be available 24 hours a day, seven days a week. The
Hospice must meet the licensing requirements of the state or locality in which it operates.
Hospital - A Provider constituted, licensed, and operated as set forth in the laws that apply to
Hospitals, which:
1. provides room and board and nursing care for its patients;
2. has a staff with one or more Physicians available at all times;
3. provides 24-hour nursing service;
4. maintains on its premises all the Facilities needed for the diagnosis, medical care, and
treatment of an illness or injury; and
5. is fully accredited by the Joint Commission on Accreditation of Health Care Organizations.
The term Hospital does not include a Provider, or that part of a Provider, used mainly for:
1. nursing care;
2. rest care;
3. convalescent care;
4. care of the aged;
5. custodial care;
6. educational care;
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