Senate Bill sb1472c2

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    Florida Senate - 2005                    CS for CS for SB 1472

    By the Committees on Health and Human Services Appropriations;
    Health Care; and Senator Peaden




    603-2066-05

  1                      A bill to be entitled

  2         An act relating to hospitals; amending s.

  3         395.002, F.S.; redefining the term "hospital"

  4         to exclude designated critical access hospitals

  5         from certain requirements; redefining the term

  6         "intensive residential treatment programs for

  7         children and adolescents"; amending s. 395.003,

  8         F.S.; extending by 1 year the moratorium on

  9         approving additional emergency departments

10         located off the premises of a licensed

11         hospital; amending s. 408.061, F.S.; conforming

12         a cross-reference; amending s. 408.07, F.S.;

13         defining the term "critical access hospital";

14         redefining the term "rural hospital" to delete

15         certain requirements applicable to the

16         designation of a critical access hospital;

17         amending ss. 458.345 and 459.021, F.S.;

18         conforming cross-references; providing an

19         effective date.

20  

21  Be It Enacted by the Legislature of the State of Florida:

22  

23         Section 1.  Subsections (13), (16), and (24) of section

24  395.002, Florida Statutes, are amended to read:

25         395.002  Definitions.--As used in this chapter:

26         (13)  "Hospital" means any establishment that:

27         (a)  Offers services more intensive than those required

28  for room, board, personal services, and general nursing care,

29  and offers facilities and beds for use beyond 24 hours by

30  individuals requiring diagnosis, treatment, or care for

31  

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 1  illness, injury, deformity, infirmity, abnormality, disease,

 2  or pregnancy; and

 3         (b)  Regularly makes available at least clinical

 4  laboratory services, diagnostic X-ray services, and treatment

 5  facilities for surgery or obstetrical care, or other

 6  definitive medical treatment of similar extent, except that a

 7  critical access hospital, as defined in s. 408.07, is not

 8  required to make available treatment facilities for surgery,

 9  obstetrical care, or similar services as long as it maintains

10  its designation as a critical access hospital, but must make

11  such facilities available if it ceases to be designated as a

12  critical access hospital.

13  

14  However, the provisions of this chapter do not apply to any

15  institution conducted by or for the adherents of any

16  well-recognized church or religious denomination that depends

17  exclusively upon prayer or spiritual means to heal, care for,

18  or treat any person.  For purposes of local zoning matters,

19  the term "hospital" includes a medical office building located

20  on the same premises as a hospital facility, provided the land

21  on which the medical office building is constructed is zoned

22  for use as a hospital; provided the premises were zoned for

23  hospital purposes on January 1, 1992.

24         (16)  "Intensive residential treatment programs for

25  children and adolescents" means a specialty hospital

26  accredited by an accrediting organization the Joint Commission

27  on Accreditation of Healthcare Organizations which provides

28  24-hour care and which has the primary functions of diagnosis

29  and treatment of patients under the age of 18 having

30  psychiatric disorders in order to restore such patients to an

31  optimal level of functioning.

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 1         (24)  "Premises" means those buildings, beds, and

 2  equipment located at the address of the licensed facility and

 3  all other buildings, beds, and equipment for the provision of

 4  hospital, ambulatory surgical, or mobile surgical care located

 5  in such reasonable proximity to the address of the licensed

 6  facility as to appear to the public to be under the dominion

 7  and control of the licensee. For any licensee that is a

 8  teaching hospital as defined in s. 408.07(45) s. 408.07(44),

 9  reasonable proximity includes any buildings, beds, services,

10  programs, and equipment under the dominion and control of the

11  licensee that are located at a site with a main address that

12  is within 1 mile of the main address of the licensed facility;

13  and all such buildings, beds, and equipment may, at the

14  request of a licensee or applicant, be included on the

15  facility license as a single premises.

16         Section 2.  Paragraph (b) of subsection (1) and

17  paragraphs (e) and (f) of subsection (2) of section 395.003,

18  Florida Statutes, are amended to read:

19         395.003  Licensure; issuance, renewal, denial,

20  modification, suspension, and revocation.--

21         (1)

22         (b)1.  It is unlawful for a person to use or advertise

23  to the public, in any way or by any medium whatsoever, any

24  facility as a "hospital," "ambulatory surgical center," or

25  "mobile surgical facility" unless such facility has first

26  secured a license under the provisions of this part.

27         2.  This part does not apply to veterinary hospitals or

28  to commercial business establishments using the word

29  "hospital," "ambulatory surgical center," or "mobile surgical

30  facility" as a part of a trade name if no treatment of human

31  beings is performed on the premises of such establishments.

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 1         3.  By December 31, 2004, the agency shall submit a

 2  report to the President of the Senate and the Speaker of the

 3  House of Representatives recommending whether it is in the

 4  public interest to allow a hospital to license or operate an

 5  emergency department located off the premises of the hospital.

 6  If the agency finds it to be in the public interest, the

 7  report shall also recommend licensure criteria for such

 8  medical facilities, including criteria related to quality of

 9  care and, if deemed necessary, the elimination of the

10  possibility of confusion related to the service capabilities

11  of such facility in comparison to the service capabilities of

12  an emergency department located on the premises of the

13  hospital. Until July 1, 2006 2005, additional emergency

14  departments located off the premises of licensed hospitals may

15  not be authorized by the agency.

16         (2)

17         (e)  The agency shall, at the request of a licensee

18  that is a teaching hospital as defined in s. 408.07(45) s.

19  408.07(44), issue a single license to a licensee for

20  facilities that have been previously licensed as separate

21  premises, provided such separately licensed facilities, taken

22  together, constitute the same premises as defined in s.

23  395.002(24). Such license for the single premises shall

24  include all of the beds, services, and programs that were

25  previously included on the licenses for the separate premises.

26  The granting of a single license under this paragraph shall

27  not in any manner reduce the number of beds, services, or

28  programs operated by the licensee.

29         (f)  Intensive residential treatment programs for

30  children and adolescents which have received accreditation

31  from an accrediting organization the Joint Commission on

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 1  Accreditation of Healthcare Organizations and which meet the

 2  minimum standards developed by rule of the agency for such

 3  programs shall be licensed by the agency under this part.

 4         Section 3.  Subsection (4) of section 408.061, Florida

 5  Statutes, is amended to read:

 6         408.061  Data collection; uniform systems of financial

 7  reporting; information relating to physician charges;

 8  confidential information; immunity.--

 9         (4)  Within 120 days after the end of its fiscal year,

10  each health care facility, excluding continuing care

11  facilities and nursing homes as defined in s. 408.07(14) and

12  (37) (36), shall file with the agency, on forms adopted by the

13  agency and based on the uniform system of financial reporting,

14  its actual financial experience for that fiscal year,

15  including expenditures, revenues, and statistical measures.

16  Such data may be based on internal financial reports which are

17  certified to be complete and accurate by the provider.

18  However, hospitals' actual financial experience shall be their

19  audited actual experience. Every nursing home shall submit to

20  the agency, in a format designated by the agency, a

21  statistical profile of the nursing home residents. The agency,

22  in conjunction with the Department of Elderly Affairs and the

23  Department of Health, shall review these statistical profiles

24  and develop recommendations for the types of residents who

25  might more appropriately be placed in their homes or other

26  noninstitutional settings.

27         Section 4.  Section 408.07, Florida Statutes, is

28  amended to read:

29         408.07  Definitions.--As used in this chapter, with the

30  exception of ss. 408.031-408.045, the term:

31  

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 1         (1)  "Accepted" means that the agency has found that a

 2  report or data submitted by a health care facility or a health

 3  care provider contains all schedules and data required by the

 4  agency and has been prepared in the format specified by the

 5  agency, and otherwise conforms to applicable rule or Florida

 6  Hospital Uniform Reporting System manual requirements

 7  regarding reports in effect at the time such report was

 8  submitted, and the data are mathematically reasonable and

 9  accurate.

10         (2)  "Adjusted admission" means the sum of acute and

11  intensive care admissions divided by the ratio of inpatient

12  revenues generated from acute, intensive, ambulatory, and

13  ancillary patient services to gross revenues.  If a hospital

14  reports only subacute admissions, then "adjusted admission"

15  means the sum of subacute admissions divided by the ratio of

16  total inpatient revenues to gross revenues.

17         (3)  "Agency" means the Agency for Health Care

18  Administration.

19         (4)  "Alcohol or chemical dependency treatment center"

20  means an organization licensed under chapter 397.

21         (5)  "Ambulatory care center" means an organization

22  which employs or contracts with licensed health care

23  professionals to provide diagnosis or treatment services

24  predominantly on a walk-in basis and the organization holds

25  itself out as providing care on a walk-in basis.  Such an

26  organization is not an ambulatory care center if it is wholly

27  owned and operated by five or fewer health care providers.

28         (6)  "Ambulatory surgical center" means a facility

29  licensed as an ambulatory surgical center under chapter 395.

30         (7)  "Audited actual data" means information contained

31  within financial statements examined by an independent,

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 1  Florida-licensed, certified public accountant in accordance

 2  with generally accepted auditing standards, but does not

 3  include data within a financial statement about which the

 4  certified public accountant does not express an opinion or

 5  issues a disclaimer.

 6         (8)  "Birth center" means an organization licensed

 7  under s. 383.305.

 8         (9)  "Cardiac catheterization laboratory" means a

 9  freestanding facility that employs or contracts with licensed

10  health care professionals to provide diagnostic or therapeutic

11  services for cardiac conditions such as cardiac

12  catheterization or balloon angioplasty.

13         (10)  "Case mix" means a calculated index for each

14  health care facility or health care provider, based on patient

15  data, reflecting the relative costliness of the mix of cases

16  to that facility or provider compared to a state or national

17  mix of cases.

18         (11)  "Clinical laboratory" means a facility licensed

19  under s. 483.091, excluding:  any hospital laboratory defined

20  under s. 483.041(6); any clinical laboratory operated by the

21  state or a political subdivision of the state; any blood or

22  tissue bank where the majority of revenues are received from

23  the sale of blood or tissue and where blood, plasma, or tissue

24  is procured from volunteer donors and donated, processed,

25  stored, or distributed on a nonprofit basis; and any clinical

26  laboratory which is wholly owned and operated by physicians

27  who are licensed pursuant to chapter 458 or chapter 459 and

28  who practice in the same group practice, and at which no

29  clinical laboratory work is performed for patients referred by

30  any health care provider who is not a member of that same

31  group practice.

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 1         (12)  "Comprehensive rehabilitative hospital" or

 2  "rehabilitative hospital" means a hospital licensed by the

 3  agency as a specialty hospital as defined in s. 395.002;

 4  provided that the hospital provides a program of comprehensive

 5  medical rehabilitative services and is designed, equipped,

 6  organized, and operated solely to deliver comprehensive

 7  medical rehabilitative services, and further provided that all

 8  licensed beds in the hospital are classified as "comprehensive

 9  rehabilitative beds" pursuant to s. 395.003(4), and are not

10  classified as "general beds."

11         (13)  "Consumer" means any person other than a person

12  who administers health activities, is a member of the

13  governing body of a health care facility, provides health

14  services, has a fiduciary interest in a health facility or

15  other health agency or its affiliated entities, or has a

16  material financial interest in the rendering of health

17  services.

18         (14)  "Continuing care facility" means a facility

19  licensed under chapter 651.

20         (15)  "Critical access hospital" means a hospital that

21  meets the requirements in 42 U.S.C. s. 1395i-4 under the

22  Social Security Act and is certified by the United States

23  Secretary of Health and Human Services as a critical access

24  hospital.

25         (16)(15)  "Cross-subsidization" means that the revenues

26  from one type of hospital service are sufficiently higher than

27  the costs of providing such service as to offset some of the

28  costs of providing another type of service in the hospital.

29  Cross-subsidization results from the lack of a direct

30  relationship between charges and the costs of providing a

31  particular hospital service or type of service.

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 1         (17)(16)  "Deductions from gross revenue" or

 2  "deductions from revenue" means reductions from gross revenue

 3  resulting from inability to collect payment of charges.  For

 4  hospitals, such reductions include contractual adjustments;

 5  uncompensated care; administrative, courtesy, and policy

 6  discounts and adjustments; and other such revenue deductions,

 7  but also includes the offset of restricted donations and

 8  grants for indigent care.

 9         (18)(17)  "Diagnostic-imaging center" means a

10  freestanding outpatient facility that provides specialized

11  services for the diagnosis of a disease by examination and

12  also provides radiological services. Such a facility is not a

13  diagnostic-imaging center if it is wholly owned and operated

14  by physicians who are licensed pursuant to chapter 458 or

15  chapter 459 and who practice in the same group practice and no

16  diagnostic-imaging work is performed at such facility for

17  patients referred by any health care provider who is not a

18  member of that same group practice.

19         (19)(18)  "FHURS" means the Florida Hospital Uniform

20  Reporting System developed by the agency.

21         (20)(19)  "Freestanding" means that a health facility

22  bills and receives revenue which is not directly subject to

23  the hospital assessment for the Public Medical Assistance

24  Trust Fund as described in s. 395.701.

25         (21)(20)  "Freestanding radiation therapy center" means

26  a facility where treatment is provided through the use of

27  radiation therapy machines that are registered under s. 404.22

28  and the provisions of the Florida Administrative Code

29  implementing s. 404.22.  Such a facility is not a freestanding

30  radiation therapy center if it is wholly owned and operated by

31  physicians licensed pursuant to chapter 458 or chapter 459 who

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 1  practice within the specialty of diagnostic or therapeutic

 2  radiology.

 3         (22)(21)  "GRAA" means gross revenue per adjusted

 4  admission.

 5         (23)(22)  "Gross revenue" means the sum of daily

 6  hospital service charges, ambulatory service charges,

 7  ancillary service charges, and other operating revenue.  Gross

 8  revenues do not include contributions, donations, legacies, or

 9  bequests made to a hospital without restriction by the donors.

10         (24)(23)  "Health care facility" means an ambulatory

11  surgical center, a hospice, a nursing home, a hospital, a

12  diagnostic-imaging center, a freestanding or hospital-based

13  therapy center, a clinical laboratory, a home health agency, a

14  cardiac catheterization laboratory, a medical equipment

15  supplier, an alcohol or chemical dependency treatment center,

16  a physical rehabilitation center, a lithotripsy center, an

17  ambulatory care center, a birth center, or a nursing home

18  component licensed under chapter 400 within a continuing care

19  facility licensed under chapter 651.

20         (25)(24)  "Health care provider" means a health care

21  professional licensed under chapter 458, chapter 459, chapter

22  460, chapter 461, chapter 463, chapter 464, chapter 465,

23  chapter 466, part I, part III, part IV, part V, or part X of

24  chapter 468, chapter 483, chapter 484, chapter 486, chapter

25  490, or chapter 491.

26         (26)(25)  "Health care purchaser" means an employer in

27  the state, other than a health care facility, health insurer,

28  or health care provider, who provides health care coverage for

29  her or his employees.

30         (27)(26)  "Health insurer" means any insurance company

31  authorized to transact health insurance in the state, any

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 1  insurance company authorized to transact health insurance or

 2  casualty insurance in the state that is offering a minimum

 3  premium plan or stop-loss coverage for any person or entity

 4  providing health care benefits, any self-insurance plan as

 5  defined in s. 624.031, any health maintenance organization

 6  authorized to transact business in the state pursuant to part

 7  I of chapter 641, any prepaid health clinic authorized to

 8  transact business in the state pursuant to part II of chapter

 9  641, any multiple-employer welfare arrangement authorized to

10  transact business in the state pursuant to ss. 624.436-624.45,

11  or any fraternal benefit society providing health benefits to

12  its members as authorized pursuant to chapter 632.

13         (28)(27)  "Home health agency" means an organization

14  licensed under part IV of chapter 400.

15         (29)(28)  "Hospice" means an organization licensed

16  under part VI of chapter 400.

17         (30)(29)  "Hospital" means a health care institution

18  licensed by the Agency for Health Care Administration as a

19  hospital under chapter 395.

20         (31)(30)  "Lithotripsy center" means a freestanding

21  facility that employs or contracts with licensed health care

22  professionals to provide diagnosis or treatment services using

23  electro-hydraulic shock waves.

24         (32)(31)  "Local health council" means the agency

25  defined in s. 408.033.

26         (33)(32)  "Market basket index" means the Florida

27  hospital input price index (FHIPI), which is a statewide

28  market basket index used to measure inflation in hospital

29  input prices weighted for the Florida-specific experience

30  which uses multistate regional and state-specific price

31  measures, when available.  The index shall be constructed in

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 1  the same manner as the index employed by the Secretary of the

 2  United States Department of Health and Human Services for

 3  determining the inflation in hospital input prices for

 4  purposes of Medicare reimbursement.

 5         (34)(33)  "Medical equipment supplier" means an

 6  organization that provides medical equipment and supplies used

 7  by health care providers and health care facilities in the

 8  diagnosis or treatment of disease.

 9         (35)(34)  "Net revenue" means gross revenue minus

10  deductions from revenue.

11         (36)(35)  "New hospital" means a hospital in its

12  initial year of operation as a licensed hospital and does not

13  include any facility which has been in existence as a licensed

14  hospital, regardless of changes in ownership, for over 1

15  calendar year.

16         (37)(36)  "Nursing home" means a facility licensed

17  under s. 400.062 or, for resident level and financial data

18  collection purposes only, any institution licensed under

19  chapter 395 and which has a Medicare or Medicaid certified

20  distinct part used for skilled nursing home care, but does not

21  include a facility licensed under chapter 651.

22         (38)(37)  "Operating expenses" means total expenses

23  excluding income taxes.

24         (39)(38)  "Other operating revenue" means all revenue

25  generated from hospital operations other than revenue directly

26  associated with patient care.

27         (40)(39)  "Physical rehabilitation center" means an

28  organization that employs or contracts with health care

29  professionals licensed under part I or part III of chapter 468

30  or chapter 486 to provide speech, occupational, or physical

31  therapy services on an outpatient or ambulatory basis.

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 1         (41)(40)  "Prospective payment arrangement" means a

 2  financial agreement negotiated between a hospital and an

 3  insurer, health maintenance organization, preferred provider

 4  organization, or other third-party payor which contains, at a

 5  minimum, the elements provided for in s. 408.50.

 6         (42)(41)  "Rate of return" means the financial

 7  indicators used to determine or demonstrate reasonableness of

 8  the financial requirements of a hospital.  Such indicators

 9  shall include, but not be limited to:  return on assets,

10  return on equity, total margin, and debt service coverage.

11         (43)(42)  "Rural hospital" means an acute care hospital

12  licensed under chapter 395, having 100 or fewer licensed beds

13  and an emergency room, and which is:

14         (a)  The sole provider within a county with a

15  population density of no greater than 100 persons per square

16  mile;

17         (b)  An acute care hospital, in a county with a

18  population density of no greater than 100 persons per square

19  mile, which is at least 30 minutes of travel time, on normally

20  traveled roads under normal traffic conditions, from another

21  acute care hospital within the same county;

22         (c)  A hospital supported by a tax district or

23  subdistrict whose boundaries encompass a population of 100

24  persons or fewer per square mile;

25         (d)  A hospital with a service area that has a

26  population of 100 persons or fewer per square mile.  As used

27  in this paragraph, the term "service area" means the fewest

28  number of zip codes that account for 75 percent of the

29  hospital's discharges for the most recent 5-year period, based

30  on information available from the hospital inpatient discharge

31  

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 1  database in the State Center for Health Statistics at the

 2  Agency for Health Care Administration; or

 3         (e)  A hospital designated as A critical access

 4  hospital by the Department of Health in accordance with

 5  federal regulations and state requirements.

 6  

 7  Population densities used in this subsection must be based

 8  upon the most recently completed United States census. A

 9  hospital that received funds under s. 409.9116 for a quarter

10  beginning no later than July 1, 2002, is deemed to have been

11  and shall continue to be a rural hospital from that date

12  through June 30, 2012, if the hospital continues to have 100

13  or fewer licensed beds and an emergency room, or meets the

14  criteria of s. 395.602(2)(e)4. An acute care hospital that has

15  not previously been designated as a rural hospital and that

16  meets the criteria of this subsection shall be granted such

17  designation upon application, including supporting

18  documentation, to the Agency for Health Care Administration.

19         (44)(43)  "Special study" means a nonrecurring

20  data-gathering and analysis effort designed to aid the agency

21  in meeting its responsibilities pursuant to this chapter.

22         (45)(44)  "Teaching hospital" means any Florida

23  hospital officially affiliated with an accredited Florida

24  medical school which exhibits activity in the area of graduate

25  medical education as reflected by at least seven different

26  graduate medical education programs accredited by the

27  Accreditation Council for Graduate Medical Education or the

28  Council on Postdoctoral Training of the American Osteopathic

29  Association and the presence of 100 or more full-time

30  equivalent resident physicians. The Director of the Agency for

31  

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 1  Health Care Administration shall be responsible for

 2  determining which hospitals meet this definition.

 3         Section 5.  Subsection (1) of section 458.345, Florida

 4  Statutes, is amended to read:

 5         458.345  Registration of resident physicians, interns,

 6  and fellows; list of hospital employees; prescribing of

 7  medicinal drugs; penalty.--

 8         (1)  Any person desiring to practice as a resident

 9  physician, assistant resident physician, house physician,

10  intern, or fellow in fellowship training which leads to

11  subspecialty board certification in this state, or any person

12  desiring to practice as a resident physician, assistant

13  resident physician, house physician, intern, or fellow in

14  fellowship training in a teaching hospital in this state as

15  defined in s. 408.07(45) s. 408.07(44) or s. 395.805(2), who

16  does not hold a valid, active license issued under this

17  chapter shall apply to the department to be registered and

18  shall remit a fee not to exceed $300 as set by the board.  The

19  department shall register any applicant the board certifies

20  has met the following requirements:

21         (a)  Is at least 21 years of age.

22         (b)  Has not committed any act or offense within or

23  without the state which would constitute the basis for refusal

24  to certify an application for licensure pursuant to s.

25  458.331.

26         (c)  Is a graduate of a medical school or college as

27  specified in s. 458.311(1)(f).

28         Section 6.  Subsection (1) of section 459.021, Florida

29  Statutes, is amended to read:

30         459.021  Registration of resident physicians, interns,

31  and fellows; list of hospital employees; penalty.--

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 1         (1)  Any person who holds a degree of Doctor of

 2  Osteopathic Medicine from a college of osteopathic medicine

 3  recognized and approved by the American Osteopathic

 4  Association who desires to practice as a resident physician,

 5  assistant resident physician, house physician, intern, or

 6  fellow in fellowship training which leads to subspecialty

 7  board certification in this state, or any person desiring to

 8  practice as a resident physician, assistant resident

 9  physician, house physician, intern, or fellow in fellowship

10  training in a teaching hospital in this state as defined in s.

11  408.07(45) s. 408.07(44) or s. 395.805(2), who does not hold

12  an active license issued under this chapter shall apply to the

13  department to be registered, on an application provided by the

14  department, within 30 days of commencing such a training

15  program and shall remit a fee not to exceed $300 as set by the

16  board.

17         Section 7.  This act shall take effect upon becoming a

18  law.

19  

20          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
21                          CS for SB 1472

22                                 

23  The committee substitute changes the accreditation
    requirements from the Joint Commission on Accreditation of
24  Healthcare Organizations to any accrediting organization.

25  

26  

27  

28  

29  

30  

31  

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