§291o Definitions

Summary

Gives plain meanings for words used in this part of the law. "State" includes Puerto Rico, Guam, American Samoa, the Trust Territory of the Pacific Islands, the Virgin Islands, and the District of Columbia. "Federal share" is the part of a project's cost the federal government will pay. For projects paid from an allotment under section 291a, the State agency sets the amount but it cannot be more than 66 2/3 percent or the State’s allotment percentage, whichever is lower; if the allotment percentage is under 50 percent, it is treated as 50 percent for this rule. Before approving the first project each fiscal year, the State agency must tell the Secretary in writing the maximum Federal share for that year and how it will figure the actual share, and it cannot change those after approval. The State agency may add an extra incentive percent for certain projects so long as the total does not exceed 90 percent; those projects serve people in areas the Secretary calls rural or urban poverty areas or aim to cut health costs by sharing services, cooperating between facilities, or building or modernizing free‑standing outpatient centers. "Hospital" covers general, tuberculosis, and other hospitals and related parts like labs, outpatient departments, nurses’ homes, extended care, home‑health program facilities, self‑care units, central service facilities, and training for health workers, but not hospitals that mainly give domiciliary care. "Public health center" means a publicly owned place that provides public health services and related labs, clinics, or offices. "Nonprofit" means owned and run by nonprofit groups whose net earnings do not go to private owners. "Outpatient facility" is a place, in or apart from a hospital, that diagnoses or treats patients who don't stay overnight and is either run with a hospital, supervised by licensed doctors or dentists, or offers multiple specialties and a broad set of services. "Rehabilitation facility" mainly helps disabled people recover with medical and psychological, social, or vocational programs mostly on site, and is either connected to a hospital or directed by licensed physicians. "Facility for long‑term care" provides inpatient skilled nursing and medical services for convalescent or chronic patients, is a hospital or linked to one (not mainly for the mentally ill or tuberculosis), or has nursing and medical care prescribed or overseen by licensed physicians. "Construction" means new buildings, expansions, remodels, major changes, and initial equipment (including medical transport) and equipment to deliver new services; it includes architects' fees but not off‑site work, and except for public health centers it does not include buying land. "Cost" for construction or modernization is the amount the Surgeon General finds necessary, except that certain modernization grants under section 291b(a)(2) exclude amounts tied to adding beds. "Modernization" means alteration, major repair (as rules allow), remodeling, replacement, renovation, initial equipment, and replacing obsolete built‑in equipment. "Title" to a project site means owning the land outright or having another interest (including a lease with rent no more than 4 percent of the land value) that the Surgeon General finds will assure at least 50 years of undisturbed use and possession.