§ 19a-490 — (Formerly Sec. 19-576). Licensing of institutions. Definitions.

Connecticut § 19a-490

• Jurisdiction: Connecticut
• Title 19a: Public Health and Well-Being
• Ch. 368v: Health Care Institutions

Text

As used in this chapter, unless the context otherwise requires: (a) “Institution” means a hospital, short-term hospital special hospice, hospice inpatient facility, residential care home, nursing home facility, home health care agency, home health aide agency, behavioral health facility, assisted living services agency, substance abuse treatment facility, outpatient surgical facility, outpatient clinic, clinical laboratory, blood collection facility, source plasma donation center, birth center, an infirmary operated by an educational institution for the care of students enrolled in, and faculty and employees of, such institution; a facility engaged in providing services for the prevention, diagnosis, treatment or care of human health conditions, including facilities operated and maintained by any state agency; and a residential facility for persons with intellectual disability licensed pursuant to section 17a-227 and certified to participate in the Title XIX Medicaid program as an intermediate care facility for individuals with intellectual disability. “Institution” does not include any facility for the care and treatment of persons with mental illness or substance use disorder operated or maintained by any state agency, except Whiting Forensic Hospital and the hospital and psychiatric residential treatment facility units of the Albert J. Solnit Children's Center; (b) “Hospital” means an establishment for the lodging, care and treatment of persons suffering from disease or other abnormal physical or mental conditions and includes inpatient psychiatric services in general hospitals; (c) “Residential care home” or “rest home” means a community residence that furnishes, in single or multiple facilities, food and shelter to two or more persons unrelated to the proprietor and, in addition, provides services that meet a need beyond the basic provisions of food, shelter and laundry and may qualify as a setting that allows residents to receive home and community-based services funded by state and federal programs; (d) “Home health care agency” means a public or private organization, or a subdivision thereof, engaged in providing professional nursing services and the following services, available twenty-four hours per day, in the patient's home or a substantially equivalent environment: Home health aide services as defined in this section, physical therapy, speech therapy, occupational therapy or medical social services. The agency shall provide professional nursing services and at least one additional service directly and all others directly or through contract. An agency shall be available to enroll new patients seven days a week, twenty-four hours per day; (e) “Home health aide agency” means a public or private organization, except a home health care agency, which provides in the patient's home or a substantially equivalent environment supportive services which may include, but are not limited to, assistance with personal hygiene, dressing, feeding and incidental household tasks essential to achieving adequate household and family management. Such supportive services shall be provided under the supervision of a registered nurse and, if such nurse determines appropriate, shall be provided by a social worker, physical therapist, speech therapist or occupational therapist. Such supervision may be provided directly or through contract; (f) “Home health aide services” as defined in this section shall not include services provided to assist individuals with activities of daily living when such individuals have a disease or condition that is chronic and stable as determined by a physician licensed in the state; (g) “Behavioral health facility” means any facility that provides mental health services to persons eighteen years of age or older or substance use disorder services to persons of any age in an outpatient treatment or residential setting to ameliorate mental, emotional, behavioral or substance use disorder issues; (h) “Clinical laboratory” means any facility or other area used for microbiological, serological, chemical, hematological, immunohematological, biophysical, cytological, pathological or other examinations of human body fluids, secretions, excretions or excised or exfoliated tissues for the purpose of providing information for the (1) diagnosis, prevention or treatment of any human disease or impairment, (2) assessment of human health, or (3) assessment of the presence of drugs, poisons or other toxicological substances; (i) “Person” means any individual, firm, partnership, corporation, limited liability company or association; (j) “Commissioner” means the Commissioner of Public Health or the commissioner's designee; (k) “Home health agency” means an agency licensed as a home health care agency or a home health aide agency; (l) “Assisted living services agency” means an agency that provides chronic and stable individuals with services that include, but need not be limited to, nursing services and assistance with activities of daily living and may have a dementia special care unit or program as defined in section 19a-562 ; (m) “Outpatient clinic” means an organization operated by a municipality or a corporation, other than a hospital, that provides (1) ambulatory medical care, including preventive and health promotion services, (2) dental care, or (3) mental health services in conjunction with medical or dental care for the purpose of diagnosing or treating a health condition that does not require the patient's overnight care; (n) “Multicare institution” means a hospital that provides outpatient behavioral health services or other health care services, psychiatric outpatient clinic for adults, free-standing facility for the care or treatment of substance abusive or dependent persons, hospital for psychiatric disabilities, as defined in section 17a-495 , or a general acute care hospital that provides outpatient behavioral health services that (1) is licensed in accordance with this chapter, (2) has more than one facility or one or more satellite units owned and operated by a single licensee, and (3) offers complex patient health care services at each facility or satellite unit. For purposes of this subsection, “satellite unit” means a location where a segregated unit of services is provided by the multicare institution; (o) “Nursing home” or “nursing home facility” means (1) any chronic and convalescent nursing home or any rest home with nursing supervision that provides nursing supervision under a medical director twenty-four hours per day, or (2) any chronic and convalescent nursing home that provides skilled nursing care under medical supervision and direction to carry out nonsurgical treatment and dietary procedures for chronic diseases, convalescent stages, acute diseases or injuries; (p) “Outpatient dialysis unit” means (1) an out-of-hospital out-patient dialysis unit that is licensed by the department to provide (A) services on an out-patient basis to persons requiring dialysis on a short-term basis or for a chronic condition, or (B) training for home dialysis, or (2) an in-hospital dialysis unit that is a special unit of a licensed hospital designed, equipped and staffed to (A) offer dialysis therapy on an out-patient basis, (B) provide training for home dialysis, and (C) perform renal transplantations; (q) “Hospice agency” means a public or private organization that provides home care and hospice services to terminally ill patients; (r) “Psychiatric residential treatment facility” means a nonhospital facility with a provider agreement with the Department of Social Services to provide inpatient services to Medicaid-eligible individuals under the age of twenty-one; (s) “Chronic disease hospital” means a long-term hospital having facilities, medical staff and all necessary personnel for the diagnosis, care and treatment of chronic diseases; (t) “Blood collection facility” means a facility that performs blood component collection activities where blood is removed from a human being for the purpose of administering such blood or any of its components to any human being. “Blood collection facility” does not include a facility that performs blood component collection activities to collect source plasma or perform testing that would require licensure as a clinical laboratory. For the purposes of this subsection, “source plasma” means the liquid portion of human blood collected by plasmapheresis and intended as source material for further manufacturing use and does not include single donor plasma products intended for intravenous use, and “plasmapheresis” means a procedure in which blood is removed from a blood donor, the plasma is separated from the formed elements and at least the red blood cells are returned to the blood donor at the time of the donation; (u) “Source plasma donation center” means a facility where source plasma is collected by plasmapheresis. For the purposes of this subsection, “source plasma” means the liquid portion of human blood collected by plasmapheresis and intended as source material for further manufacturing use and does not include single donor plasma products intended for intravenous use, and “plasmapheresis” means a procedure in which blood is removed from a blood donor, the plasma is separated from the formed elements and at least the red blood cells are returned to the blood donor at the time of the donation; and (v) “Birth center” means a freestanding facility that is licensed by the department (1) to provide perinatal, labor, delivery and postpartum care during and immediately after delivery to persons presenting with a low-risk pregnancy and healthy newborns for a period typically less than twenty-four hours, and (2) that is not a hospital licensed pursuant to the provisions of this chapter, or attached to or located in such a hospital. For the purposes of this subsection, “low-risk pregnancy” means an uncomplicated, singleton pregnancy that has vertex presentation and is at low risk for developing complications during labor and birth, as determined by an evaluation and examination conducted by a licensed health care provider acting within the scope of such provider's practice.

Legislative History

(1953, 1955, S. 2051d; 1957, P.A. 217, S. 2; 455, S. 1; 586, S. 6; 1959, P.A. 188; February, 1965, P.A. 161; 1969, P.A. 713; P.A. 74-137, S. 12, 21; P.A. 77-569, S. 4; 77-601, S. 2, 11; P.A. 78-60, S. 1, 2; P.A. 79-46, S. 1, 3; 79-610, S. 22; P.A. 80-186, S. 1, 2; 80-483, S. 87, 186; P.A. 87-107; P.A. 88-357, S. 5; P.A. 89-350, S. 5; P.A. 90-230, S. 30, 101; June Sp. Sess. P.A. 91-8, S. 18, 63; P.A. 92-80, S. 1, 3; May Sp. Sess. P.A. 92-16, S. 38, 89; P.A. 93-381, S. 9, 39; 93-415, S. 1, 2; P.A. 95-79, S. 63, 189; 95-160, S. 10, 69; 95-257, S. 12, 21, 58; 95-271, S. 34, 40; P.A. 96-139, S. 12, 13; 96-268, S. 6, 34; P.A. 97-112, S. 2; P.A. 01-57, S. 1; P.A. 03-274, S. 2; P.A. 05-280, S. 60; P.A. 06-195, S. 42; P.A. 07-252, S. 12, 13, 68; P.A. 10-117, S. 32; P.A. 13-139, S. 15; 13-208, S. 4, 25, 77; P.A. 14-211, S. 1; P.A. 15-242, S. 39; P.A. 16-66, S. 5; P.A. 17-146, S. 2; 17-202, S. 71; P.A. 18-86, S. 5; P.A. 19-97, S. 2–4; 19-118, S. 6; P.A. 21-121, S. 45; June Sp. Sess. P.A. 21-2, S. 29, 30; P.A. 22-58, S. 1; P.A. 23-31, S. 1; 23-147, S. 1; P.A. 24-68, S. 57.) History: 1959 act made technical changes, included as institutions in Subdiv. (c)(2) hospitals for mentally ill or retarded persons and substituted “any state agency” for “the commission on tuberculosis and other chronic illness” in the same subdivision; 1965 act added reference to “nursing home” and “rest home”; 1969 act redefined “institution” to include infirmaries operated by educational institutions, health facilities operated by commercial or industrial establishments for their employees and facilities operated by corporations or municipalities providing medical services on outpatient basis; P.A. 74-137 deleted health facilities operated by commercial or industrial establishments for their employees from “institution” definition; Sec. 19-32 transferred to Sec. 19-576 in 1977; P.A. 77-569 included health care facilities for the handicapped in “institution” definition; P.A. 77-601 included home health care, homemaker-home health aide and coordination, assessment and monitoring agencies in “institution” definition and included exceptions to definition which had been listed elsewhere in section and defined “home health care agency”, “homemaker-home health aide agency” and “coordination, assessment and monitoring agency”; P.A. 78-60 rephrased definition of “homemaker-home health care agency” and included social workers; P.A. 79-46 deleted exception for institutions otherwise required by law to be licensed by the state in “institution” definition, included subdivisions of organizations in “home health care agency” definition and deleted “primarily” as modifier of “engaged” and rephrased “homemaker-home health aide agency”; P.A. 79-610 included mental health facilities in “institution” definition and defined “mental health facility” and “alcohol or drug treatment facility”; P.A. 80-186 and P.A. 80-483 included alcohol or drug treatment facilities in “institution” definition; Sec. 19-576 transferred to Sec. 19a-490 in 1983; P.A. 87-107 inserted definition of “homemaker-home health aide services” as Subdiv. (f), relettering prior Subdivs. as necessary; P.A. 88-357 redefined “institution”; P.A. 89-350 added Subdiv. (k), defining “commissioner”; P.A. 90-230 made technical change in Subdiv. (a); June Sp. Sess. P.A. 91-8 redefined “institution” to include residential facilities for the mentally retarded which are certified to participate in Title XIX Medicaid program; P.A. 92-80 redefined “mental health facility” to exclude family care homes after October 1, 1993; May Sp. Sess. P.A. 92-16 added Subdiv. (l) defining “home health agency”; P.A. 93-381 replaced commissioner of health services with commissioner of public health and addiction services, effective July 1, 1993; P.A. 93-415 amended the definition of “home health care agency” in Subdiv. (d) to specify provision of twenty-four-hour care and round-the-clock, seven-day-a-week enrollment and redefined “coordination, assessment and monitoring agency” in Subdiv. (g) to require targeting of patients with chronic conditions; P.A. 95-79 redefined “person” to include a limited liability company, effective May 31, 1995; P.A. 95-160 replaced “coordination, assessment and monitoring agency” with “access agency” in definitions of “institution” and “home health agency” and deleted former Subdiv. (g), which had defined said term, relettering remaining Subdivs. as necessary, effective July 1, 1995; P.A. 95-257 replaced Commissioner and Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July 1, 1995; P.A. 95-271 added new Subdiv. (l) defining “assisted living services agencies”; P.A. 96-139 changed effective date of P.A. 95-160 but without affecting this section; P.A. 96-268 deleted reference to access agencies in definition of “institution”, effective July 1, 1996 (Revisor's note: The word “in” was inserted editorially by the Revisors in Subdiv. (a) in the phrase “... operated by an educational institution for the care of students in, and faculty and employees of, ...”); P.A. 97-112 replaced “home for the aged” with “residential care home”; P.A. 01-57 amended Subdiv. (g) by making a technical change and adding provision re mental health outpatient treatment facility that provides treatment to persons 16 years of age or older who are receiving services from the Department of Mental Health and Addiction Services; P.A. 03-274 amended Subdiv. (a) by adding outpatient surgical facility to definition of “institution”, effective July 1, 2003; P.A. 05-280 extended applicability of definitions to Secs. 17b-261e, 19a-487 to 19a-487b, inclusive, 38a-498b and 38a-525b and added Subdiv. (m) defining “critical access hospital”, effective July 1, 2005; P.A. 06-195 redefined “mental health facility” in Subdiv. (g) to include any facility for the care or treatment of mentally ill or emotionally disturbed persons, rather than adults, effective June 7, 2006; P.A. 07-252 amended Subdiv. (a) to redefine “institution” to include assisted living services agencies, amended Subdiv. (l) to redefine “assisted living services agency” to include an “agency”, rather than an “institution”, that provides nursing services and assistance with daily living activities and, effective July 12, 2007, amended Subdiv. (m) to substitute “mobile field hospital” for “critical access hospital” and expand definition to include modular, transportable facilities used for providing medical services at a mass gathering or providing surge capacity for a hospital during a mass casualty event or infrastructure failure; P.A. 10-117 deleted former Subdiv. (m) re definition of “mobile field hospital” and made technical changes; P.A. 13-139 amended Subdiv. (a) to redefine “institution” by substituting “persons with intellectual disability” or “individuals with intellectual disabilities” for “the mentally retarded”; P.A. 13-208 amended Subdiv. (c) by making technical changes, effective July 1, 2013, amended Subdiv. (a) to redefine “institution” by including short-term hospital special hospice and hospice inpatient facility, effective October 1, 2013, and further amended Subdiv. (a) to redefine “institution” by including outpatient clinic and added Subdiv. (m) defining “outpatient clinic”, effective January 1, 2014; P.A. 14-211 added Subdiv. (n) defining “multicare institution”; P.A. 15-242 amended Subdiv. (n) by redesignating Subparas. (A) to (C) as Subparas. (1) to (3); P.A. 16-66 amended Subdiv. (a) to redefine “institution” by replacing “nursing home” with “nursing home facility”, deleting “rest home,” and replacing “mental health facility” with “behavioral health facility”, amended Subdiv. (c) to delete “nursing home” and redefine “residential care home” or “rest home” by replacing “an establishment” with “a community residence” and adding provision re qualifying as setting that allows residents to receive home and community-based services funded by state and federal programs, amended Subdiv. (g) to replace “Mental health facility” with “Behavioral health facility” and define same, amended Subdiv. (j) to add reference to commissioner's designee and added Subdiv. (o) defining “nursing home” or “nursing home facility”; P.A. 17-146 added Subsec. (p) defining “outpatient dialysis unit” and made technical changes; P.A. 17-202 amended Subsec. (a) to redefine “institution” by deleting “health care facility for the handicapped”; P.A. 18-86 amended Subsec. (a) by deleting provision re exception for facilities for care or treatment of mentally ill persons or persons with substance abuse problems, adding provision re “institution” not to include facility for care and treatment of persons with mental illness or substance use disorder operated or maintained by state agency, except Whiting Forensic Hospital, and making technical changes, effective June 4, 2018; P.A. 19-97 amended Subsec. (a) by replacing “homemaker-home health aide agency” with “home health aide agency”, amended Subsec. (d) by replacing “Homemaker-home health aide services” with “Home health aide services”, amended Subsec. (e) by replacing “Homemaker-home health aide agency” with “Home health aide agency”, amended Subsec. (f) by replacing “Homemaker-home health aide services” with “Home health aide services” and making a technical change and amended Subsec. (k) by replacing “homemaker-home health aide agency” with “home health aide agency”, effective July 1, 2019; P.A. 19-118 amended Subsec. (n) by redefining “multicare institution” and adding provision defining “satellite unit”, effective July 1, 2019; P.A. 21-121 amended Subsec. (a) by redefining “institution,”, amended Subsec. (l) by redefining “assisted living services agency”, added Subsec. (q) re definition of “hospice agency” and made conforming changes, effective July 1, 2021; June Sp. Sess. P.A. 21-2 amended Subsec (a) by adding reference to the hospital and psychiatric residential treatment facility units of the Albert J. Solnit Children's Center and added Subsec. (q), codified by the Revisors as Subsec. (r), defining “psychiatric residential treatment facility”; P.A. 22-58 added provision re applicability of definitions to Ch. 368v, amended Subsec. (a) by redefining “institution”, amending Subsec. (h) by deleting definition of “alcohol and drug treatment facility” and defining “clinical laboratory”, added Subsec. (s) defining “chronic disease hospital”, and made technical and conforming changes; (Revisor's note: In 2023, the changes made by P.A. 21-121, S. 45, were incorporated editorially by the Revisors in the version of Subsec. (a), as amended by June Sp. Sess. P.A. 21-2, S. 29, that became effective on October 1, 2022); P.A. 23-31 amended Subsec. (a) by adding references to blood collection facility and source plasma donation center, amended Subsec. (l) by redefining “assisted living services agency”, added Subsec. (t) defining “blood collection facility”, added Subsec. (u) defining “source plasma donation center”, and made conforming changes; P.A. 23-147 amended Subsec. (a) by adding “birth center”, added Subsec. (t), codified by the Revisors as Subsec. (v), defining “birth center” and made conforming changes, effective January 1, 2024; P.A. 24-68 amended Subsec. (l) by making a technical change. Annotations to former section 19-576: Constitutionality of former statute upheld. 140 C. 478. Difference between public and private hospitals discussed. 21 CS 55. Annotations to present section: Cited. 214 C. 321; 219 C. 657.