H.B. 272

1

HEALTH FACILITY LICENSURE AMENDMENTS
2 1997 GENERAL SESSION
3 STATE OF UTAH
4 Sponsor: Mary Carlson
5 AN ACT RELATING TO HEALTH; AMENDING HEALTH CARE FACILITIES
6 PROVISIONS; AMENDING "RESIDENTIAL-ASSISTED LIVING FACILITY"
7 DEFINITIONS; AMENDING HEALTH FACILITY COMMITTEE DUTIES; AMENDING
8 DEPARTMENT OF HEALTH DUTIES; h AND h AMENDING LICENSING PROCEDURES
8a h [; AND ] . h
9 h [REQUIRING CRIMINAL BACKGROUND CHECKS OF THOSE IN SPECIFIED
10 POSITIONS OF DUTY OR AUTHORITY. ] h
11 This act affects sections of Utah Code Annotated 1953 as follows:
12 AMENDS:
13 26-18-3.7, as last amended by Chapter 250, Laws of Utah 1996
14 26-21-1, as last amended by Chapter 114, Laws of Utah 1990
15 26-21-2, as last amended by Chapter 79, Laws of Utah 1996
16 26-21-2.1, as enacted by Chapter 114, Laws of Utah 1990
17 26-21-3, as last amended by Chapter 243, Laws of Utah 1996
18 26-21-5, as last amended by Chapter 28, Laws of Utah 1995
19 26-21-6, as last amended by Chapters 4 and 234, Laws of Utah 1993
20 26-21-8, as last amended by Chapter 201, Laws of Utah 1993
21 26-21-11, as last amended by Chapter 114, Laws of Utah 1990
22 26-21-12, as last amended by Chapter 114, Laws of Utah 1990
23 26-21-16, as last amended by Chapter 241, Laws of Utah 1991
24 26-21-20, as last amended by Chapter 114, Laws of Utah 1990
25 26-35-103, as enacted by Chapter 170, Laws of Utah 1992
26 26-36-104, as last amended by Chapter 209, Laws of Utah 1995
27 59-12-102, as last amended by Chapters 126, 170, 232, 274, 287 and 342, Laws of Utah 1996

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1 62A-3-202, as last amended by Chapter 176, Laws of Utah 1993
2 78-30-4.13, as enacted by Chapter 168, Laws of Utah 1995
3 REPEALS:
4 26-21-10, as last amended by Chapter 114, Laws of Utah 1990
5 Be it enacted by the Legislature of the state of Utah:
6 Section 1. Section 26-18-3.7 is amended to read:
7 26-18-3.7. Prepaid health care delivery systems.
8 (1) (a) Before July 1, 1996, the division shall submit to the Health Care Financing
9 Administration within the United States Department of Health and Human Services, an
10 amendment to the state's freedom of choice waiver. That amendment shall provide that the
11 following persons who are eligible for services under the state plan for medical assistance, who
12 reside in Salt Lake, Utah, Davis, or Weber counties, shall enroll in the recipient's choice of a health
13 care delivery system that meets the requirements of Subsection (2):
14 (i) by July 1, 1994, 40% of eligible persons;
15 (ii) by July 1, 1995, 65% of eligible persons; and
16 (iii) by July 1, 1996, 100% of eligible persons.
17 (b) The division may not enter into any agreements with mental health providers that
18 establish a prepaid capitated delivery system for mental health services that were not in existence
19 prior to July 1, 1993, until the application of the Utah Medicaid Hospital Provider Temporary
20 Assessment Act with regard to a specialty hospital as defined in [Subsection 26-21-2(19)] Section
21 26-21-2 that may be engaged exclusively in rendering psychiatric or other mental health treatment
22 is repealed.
23 (c) The following are exempt from the requirements of Subsection (a):
24 (i) persons who:
25 (A) receive medical assistance for the first time after July 1, 1996;
26 (B) have a mental illness, as that term is defined in Section 62A-12-202; and
27 (C) are receiving treatment for that mental illness. The division, when appropriate, shall
28 enroll these persons in a health care delivery system that meets the requirements of this section;
29 (ii) persons who are institutionalized in a facility designated by the division as a nursing
30 facility or an intermediate care facility for the mentally retarded; or
31 (iii) persons with a health condition that requires specialized medical treatment that is not

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1 available from a health care delivery system that meets the requirements of this section.
2 (2) In submitting the amendment to the state's freedom of choice waiver under Subsection
3 (1), the division shall ensure that the proposed health care delivery systems have at least the
4 following characteristics, so that the system:
5 (a) is financially at risk, for a specified continuum of health care services, for a defined
6 population, and has incentives to balance the patient's need for care against the need for cost
7 control;
8 (b) follows utilization and quality controls developed by the department;
9 (c) is encouraged to promote the health of patients through primary and preventive care;
10 (d) coordinates care to avoid unnecessary duplication and services;
11 (e) conserves health care resources; and
12 (f) if permissible under the waiver, utilizes private insurance plans including health
13 maintenance organizations and other private health care delivery organizations.
14 (3) Subsection (2) does not prevent the division from contracting with other health care
15 delivery organizations if the division determines that it is advantageous to do so.
16 (4) Health care delivery systems that meet the requirements of this section may provide
17 all services otherwise available under the state plan for medical assistance, except prescribed
18 drugs.
19 (5) The division shall periodically report to the Legislative Health and Environment and
20 Human Services Interim Committees regarding the development and implementation of the
21 amendment to the state's freedom of choice waiver required under this section.
22 Section 2. Section 26-21-1 is amended to read:
23 26-21-1. Title.
24 This chapter is known as the "Health Care Facility [Licensure] Licensing and Inspection
25 Act."
26 Section 3. Section 26-21-2 is amended to read:
27 26-21-2. Definitions.
28 As used in this chapter:
29 (1) "Abortion clinic" means a facility, other than a general acute or specialty hospital, that
30 performs abortions and provides abortion services during the second trimester of pregnancy.
31 (2) "Activities of daily living" means essential activities including:

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1 (a) dressing;
2 (b) eating;
3 (c) grooming;
4 (d) bathing;
5 (e) toileting;
6 (f) ambulation;
7 (g) transferring; and
8 (h) self-administration of medication.
9 [(2)] (3) "Ambulatory surgical facility" means a freestanding facility, which provides
10 surgical services to patients not requiring hospitalization.
11 [(3) "Assisted living facility" means a residential facility with a home-like setting that
12 provides an array of coordinated supportive personal and health care services, available 24 hours
13 per day, to residents who have been assessed under division rule to need any of these services.
14 Each resident shall have a service plan based on the assessment, which may include:]
15 [(a) specified services of intermittent nursing care;]
16 [(b) administration of medication; and]
17 [(c) support services promoting residents' independence and self sufficiency.]
18 (4) "Assistance with activities of daily living" means providing of or arranging for the
19 provision of assistance with activities of daily living.
20 [(4)] (5) "Birthing center" means a freestanding facility, receiving maternal clients and
21 providing care during pregnancy, delivery, and immediately after delivery.
22 [(5)] (6) "Committee" means the Health Facility Committee created in Section 26-1-7.
23 [(6)] (7) "Consumer" means any person not primarily engaged in the provision of health
24 care to individuals or in the administration of facilities or institutions in which such care is
25 provided and who does not hold a fiduciary position, or have a fiduciary interest in any entity
26 involved in the provision of health care, and does not receive, either directly or through his spouse,
27 more than 1/10 of his gross income from any entity or activity relating to health care.
28 [(7)] (8) "End stage renal disease facility" means a facility which furnishes staff-assisted
29 kidney dialysis services, self-dialysis services, or home-dialysis services on an outpatient basis.
30 [(8)] (9) "Freestanding" means existing independently or physically separated from
31 another health care facility by fire walls and doors and administrated by separate staff with

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1 separate records.
2 [(9)] (10) "General acute hospital" means a facility which provides diagnostic, therapeutic,
3 and rehabilitative services to both inpatients and outpatients by or under the supervision of
4 physicians.
5 [(10)] (11) "Governmental unit" means the state, or any county, municipality, or other
6 political subdivision or any department, division, board, or agency of the state, a county,
7 municipality, or other political subdivision.
8 [(11)] (12) (a) "Health care facility" means general acute hospitals, specialty hospitals,
9 home health agencies, hospices, nursing care facilities, residential [health care facilities,] assisted
10 living facilities, birthing centers, ambulatory surgical facilities, small health care facilities, abortion
11 clinics, facilities owned or operated by health maintenance organizations, end stage renal disease
12 facilities, and any other health care facility which the committee designates by rule.
13 (b) "Health care facility" does not include the offices of private physicians or dentists,
14 whether for individual or group practice.
15 [(12)] (13) "Health maintenance organization" means an organization, organized under the
16 laws of any state which:
17 (a) is a qualified health maintenance organization under Section 1310 (d) of the Public
18 Health Service Act; or
19 (b) (i) provides or otherwise makes available to enrolled participants at least the following
20 basic health care services: usual physician services, hospitalization, laboratory, x-ray, emergency,
21 and preventive services and out-of-area coverage;
22 (ii) is compensated, [(]except for copayments[)], for the provision of the basic health
23 services listed in Subsection [(12)] (13)(b)(i) to enrolled participants by a payment which is paid
24 on a periodic basis without regard to the date the health services are provided and which is fixed
25 without regard to the frequency, extent, or kind of health services actually provided; and
26 (iii) provides physicians' services primarily directly through physicians who are either
27 employees or partners of such organizations, or through arrangements with individual physicians
28 or one or more groups of physicians organized on a group practice or individual practice basis.
29 [(13)] (14) (a) "Home health agency" means an agency, organization, or facility or a
30 subdivision of an agency, organization, or facility [employing] which employs two or more direct
31 care staff persons [which provides] who provide licensed nursing services h [ [] , []] [ . ] h

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1 h [(b) A home health agency may provide, in addition to the services required under
2 Subsection (14)(a), the ] h therapeutic services [(] of physical therapy, speech therapy, occupational
3 therapy, medical social services, or home health aide services[), or both,] on a visiting basis.
4 h [[] (b) "Home []] [ (c) A home ] h health agency h [[] " []] h does not [include] mean an
4a individual who
5 provides services under the authority of a private license.
6 [(14)] (15) "Hospice" means a program of care for the terminally ill and their families
7 which occurs in a home or in a health care facility and which provides medical, palliative,
8 psychological, spiritual, and supportive care and treatment.
9 [(15)] (16) "Nursing care facility" means a health care facility, other than a general acute
10 or specialty hospital, constructed, licensed, and operated to provide patient living accommodations,
11 24-hour staff availability, and at least two of the following patient services:
12 (a) a selection of patient care services, under the direction and supervision of a registered
13 nurse, ranging from continuous medical, skilled nursing, psychological, or other professional
14 therapies to intermittent health-related or paraprofessional personal care services;
15 (b) a structured, supportive social living environment based on a professionally designed
16 and supervised treatment plan, oriented to the individual's habilitation or rehabilitation needs; or
17 (c) a supervised living environment that provides support, training, or assistance with
18 individual activities of daily living.
19 [(16)] (17) "Person" means any individual, firm, partnership, corporation, company,
20 association, or joint stock association, and the legal successor thereof.
21 [(17) "Residential health care facility" means a facility providing assistance with activities
22 of daily living and social care to two or more residents who require protected living arrangements.]
23 (18) "Resident" means a person 21 years of age or older who:
24 (a) as a result of physical or mental limitations or age requires or requests services
25 provided in a residential-assisted living setting; and
26 (b) does not require intensive medical or nursing services as provided in a hospital or
27 nursing home.
28 (19) "Residential-assisted living facility" means a home or facility of any size:
29 (a) operated as a family, congregate, or apartment style facility;
30 (b) having two or more residents 21 years of age or older who are not related to the facility
31 owner or administrator;

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1 (c) providing a social setting and not a medical institutional setting;
2 (d) where meals, housing, and assistance with activities of daily living, or supportive care,
3 or both, are provided by the owners or operators of the facility;
4 (e) operated either for profit or not for profit; and
5 (f) as may be further defined by rule.
6 [(18)] (20) "Small health care facility" means a four to sixteen bed facility that provides
7 licensed health care programs and services to residents who generally do not need continuous
8 nursing care or supervision.
9 [(19)] (21) "Specialty hospital" means a facility which provides specialized diagnostic,
10 therapeutic, or rehabilitative services in the recognized specialty or specialties for which the
11 hospital is licensed.
12 (22) "Substantial compliance" means in a department survey of a licensee, the department
13 determines there is an absence of deficiencies which would harm the physical health, mental
14 health, safety, or welfare of patients or residents of a licensee.
15 (23) "Supportive care" means providing or arranging for the provision of any one or more
16 of the following for a person:
17 (a) supervision and protective oversight;
18 (b) structured social and recreational activities;
19 (c) provision of or arrangement for health services; or
20 (d) assistance with activities of daily living.
21 Section 4. Section 26-21-2.1 is amended to read:
22 26-21-2.1. Services.
23 (1) General acute hospitals and specialty hospitals shall remain open and be continuously
24 ready to receive patients 24 hours of every day in a year and have an attending medical staff
25 consisting of one or more physicians licensed to practice medicine and surgery under Title 58,
26 Chapter [12] 67, Utah Medical Practice Act, or Title 58, Chapter 68, Utah Osteopathic [Medicine
27 Licensing] Medical Practice Act.
28 (2) A specialty hospital shall provide on-site all basic services required of a general acute
29 hospital that are needed for the diagnosis, therapy, or rehabilitation offered to or required by
30 patients admitted to or cared for in the facility.
31 (3) (a) A home health agency shall provide at least licensed nursing services h [ [ ] or [ ] ]
31a [ , and may ] h

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1 h [in addition provide ] h therapeutic services directly through the agency employees.
2 (b) A home health agency may provide additional services itself or under arrangements
3 with another agency, organization, facility, or individual.
4 Section 5. Section 26-21-3 is amended to read:
5 26-21-3. Health Facility Committee -- Members -- Terms -- Organization --
6 Meetings.
7 (1) The Health Facility Committee created by Section 26-1-7 [shall consist] consists of
8 13 members appointed by the governor with the consent of the senate. No more than seven
9 members [shall] may be from the same political party. The appointed members shall be
10 knowledgeable about health care facilities and issues. The membership of the committee [shall
11 be composed of] is:
12 (a) one physician, licensed to practice medicine and surgery under Title 58, Chapter [12]
13 67, Utah Medical Practice Act, or Title 58, Chapter 68, Utah Osteopathic [Medicine Licensing]
14 Medical Practice Act, who is a graduate of a regularly chartered medical school;
15 (b) one hospital administrator;
16 (c) one hospital trustee;
17 (d) one representative of the nursing care facility industry;
18 (e) one [licensed] registered nurse, licensed to practice under Title 58, Chapter 31, Nurse
19 Practice Act;
20 (f) one professional in the field of mental retardation not affiliated with a nursing care
21 facility;
22 (g) one licensed architect or engineer with expertise in health care facilities;
23 (h) two representatives of health care facilities, other than nursing care facilities or
24 hospitals, licensed under this chapter; and
25 (i) four consumers, one of whom [shall have] has an interest in or expertise in geriatric
26 care.
27 (2) (a) Except as required by Subsection (b), members shall be appointed for a term of four
28 years.
29 (b) Notwithstanding the requirements of Subsection (a), the governor shall, at the time of
30 appointment or reappointment, adjust the length of terms to ensure that the terms of committee
31 members are staggered so that approximately half of the committee is appointed every two years.

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1 (c) When a vacancy occurs in the membership for any reason, the replacement shall be
2 appointed for the unexpired term by the governor, giving consideration to recommendations made
3 by the committee, with the consent of the Senate.
4 (d) [No] A member [shall] may not serve more than two consecutive full terms or ten
5 consecutive years, whichever is less. However, a member may continue to serve as a member until
6 he is replaced.
7 (e) The committee shall annually elect from its membership a chair and vice chair [during
8 the second quarter of each year].
9 (f) The committee shall meet at least quarterly, or more frequently as determined by the
10 chair or five members of the committee.
11 (g) Seven members constitute a quorum. A vote of the majority of the members present
12 constitutes action of the committee.
13 Section 6. Section 26-21-5 is amended to read:
14 26-21-5. Duties of committee.
15 [(1)] The committee shall:
16 [(a)] (1) make rules in accordance with Title 63, Chapter 46a, Utah Administrative
17 Rulemaking Act:
18 [(i)] (a) for the licensing [and revoking licenses for] of health-care facilities; and
19 [(ii) governing the entry of agents of the department into health-care facilities for
20 inspections;]
21 [(iii) governing public hearings conducted under this chapter;]
22 [(iv) governing appeals related to licensure decisions of the department; and]
23 [(v)] (b) requiring the submission of architectural plans and specifications for any
24 proposed new health-care facility or renovation to the department for review;
25 [(b) define] (2) approve the information [that must be submitted to the department with
26 an application] for applications for [a license] licensure pursuant to Section 26-21-9;
27 [(c) establish fees for licenses issued to health-care facilities under this chapter in
28 accordance with Section 63-38-3.2;]
29 [(d)] (3) advise the department as requested concerning the interpretation and enforcement
30 of the rules established under this chapter; and
31 [(e) conduct hearings on appeals from enforcement actions of the department as provided

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1 in this chapter;]
2 [(f) compel the attendance of witnesses and the production of documents and evidence,
3 administer oaths, and take testimony concerning appeals as provided in this chapter;]
4 [(g) appoint a hearings officer who is empowered to act in its behalf in hearings and
5 appeals as provided in this chapter; an appointed hearings officer has the same powers as the
6 committee in the conduct of the hearings; and]
7 [(h)] (4) advise, consult, cooperate with, and provide technical assistance to other agencies
8 of the state and federal government, and other states and affected groups or persons in carrying out
9 the purposes of this chapter.
10 [(2) Rules made by the committee under Subsection (1)(a)(v) are subject to Utah Fire
11 Prevention Board rules governing residential health-care facilities made under Section 53-7-204.]
12 Section 7. Section 26-21-6 is amended to read:
13 26-21-6. Duties of department.
14 (1) The department shall:
15 (a) enforce rules established [by the committee] pursuant to this chapter;
16 (b) authorize an agent of the department to conduct inspections of health-care facilities
17 pursuant to [rules of the committee] this chapter;
18 (c) collect information authorized by the committee that may be necessary to ensure that
19 adequate health-care facilities are available to the public;
20 (d) collect and credit fees for licenses as free revenue;
21 (e) collect and credit fees for conducting plan reviews as dedicated credits;
22 (f) designate an executive secretary from within the department to assist the committee in
23 carrying out its powers and responsibilities; and
24 (g) provide necessary administrative and staff support to the committee[;].
25 (2) The department may:
26 [(h)] (a) exercise all incidental powers necessary to carry out the purposes of this chapter;
27 [and]
28 [(i)] (b) review architectural plans and specifications of proposed health-care facilities or
29 renovations of health-care facilities to ensure that the plans and specifications conform to rules
30 established by the committee[.]; and
31 (c) make rules as necessary to implement the provisions of this chapter, except as authority

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1 is specifically delegated to the committee.
2 [(2) The rules established by the committee under Subsection (1)(i) are subject to the rules
3 of the Utah Fire Prevention Board made pursuant to Section 53-7-204.]
4 Section 8. Section 26-21-8 is amended to read:
5 26-21-8. License required -- Not assignable or transferable -- Posting -- Expiration
6 and renewal -- Time for compliance by operating facilities.
7 (1) (a) A person or governmental unit acting severally or jointly with any other person or
8 governmental unit, may not establish, conduct, or maintain a health care facility in this state
9 without receiving a license from the department as provided by this chapter and the rules of the
10 committee.
11 (b) This subsection does not apply to those facilities exempted under Section 26-21-7.
12 (2) A license issued under this chapter is not assignable or transferable.
13 (3) The current license shall at all times be posted in each health care facility in a place
14 readily visible and accessible to the public.
15 (4) (a) Each license expires at midnight on the last day of the month, 12 months from date
16 of issuance, unless previously revoked by the department.
17 (b) The license shall be renewed annually upon completion of the application
18 requirements, unless the department finds the health care facility has not complied with the
19 provisions of this chapter or the rules adopted pursuant to [Section 26-21-5] this chapter.
20 (5) A license may be issued under this section only for the operation of a specific facility
21 at a specific site by a specific person.
22 (6) Any health care facility in operation at the time of adoption of any applicable rules as
23 provided under this chapter shall be given a reasonable time for compliance as determined by the
24 committee.
25 Section 9. Section 26-21-11 is amended to read:
26 26-21-11. Violations -- Denial or revocation of license -- Restricting or prohibiting
27 new admissions -- Monitor.
28 If the department finds a violation [is found under Section 26-21-10] of this chapter or any
29 rules adopted pursuant to this chapter the department may take one or more of the following
30 actions:
31 (1) [Serve] serve a written statement of violation requiring corrective action, which shall

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1 include time frames for correction of all violations[.];
2 (2) [Deny, suspend,] deny or revoke a license if it finds [that]:
3 (a) there has been a failure to comply with the rules established [by the committee; or, it
4 finds] pursuant to this chapter;
5 (b) evidence of aiding, abetting, or permitting the commission of any illegal act[,]; or [it
6 finds]
7 (c) conduct adverse to the public health, morals, welfare, and safety of the people of the
8 state[.];
9 (3) [Restrict] restrict or prohibit new admissions to a health care facility or revoke [or
10 suspend] the license of a health care facility for:
11 (a) violation of any rule adopted under this chapter; or
12 (b) permitting, aiding, or abetting the commission of any illegal act in the health care
13 facility[.];
14 (4) [Place] place a department representative as a monitor in the facility until [such time
15 as] corrective action is completed[.];
16 (5) [Assess] assess to the facility the cost incurred by the department in placing [the] a
17 monitor[.];
18 (6) assess an administrative penalty as allowed by Subsection 26-23-6(1)(a); or
19 (7) issue a cease and desist order to the facility.
20 Section 10. Section 26-21-12 is amended to read:
21 26-21-12. Issuance of new license after revocation -- Restoration.
22 (1) If a license is revoked, [a new license may be issued only after the department verifies
23 by inspection that the conditions upon which revocation was based have been corrected] the
24 department may issue a new license only after it determines by inspection that the facility has
25 corrected the conditions that were the basis of revocation and that the facility complies with all
26 provisions of this chapter and applicable rules.
27 [(2) Suspension of a license may be for a definite or indefinite period. The Department
28 shall completely or partially restore a suspended license upon a determination that the conditions
29 upon which suspension was based have been completely or partially corrected and that the interests
30 of the public will not be jeopardized by restoration of the license. ]
31 [(3) If a license is not renewed] (2) If the department does not renew a license because of

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1 noncompliance with the provisions of this chapter or the rules adopted under [Section 26-21-5, a
2 new license may be issued] this chapter, the department may issue a new license only after the
3 facility complies with all renewal requirements and the department determines that the interests
4 of the public will not be jeopardized.
5 Section 11. Section 26-21-16 is amended to read:
6 26-21-16. Operating facility in violation of chapter or rules a misdemeanor.
7 (1) Any person owning, establishing, conducting, maintaining, managing, or operating a
8 health care facility in violation of this chapter or rules of the committee is guilty of a class [B] A
9 misdemeanor.
10 (2) This section takes precedence over Section 26-23-6.
11 Section 12. Section 26-21-20 is amended to read:
12 26-21-20. Requirement for hospitals to provide statements of itemized charges to
13 patients.
14 (1) Each hospital, as defined in [Subsections 26-21-2 (8) and (18)] Section 26-21-2, shall
15 provide a statement of itemized charges to any patient receiving medical care or other services
16 from that hospital.
17 (2) The statement shall be provided to the patient or his personal representative or agent
18 at the hospital's expense, either personally or by mail, at the time any statement is provided to any
19 person or entity for billing purposes. If the statement is not provided to a third party, it shall be
20 provided to the patient as soon as possible and practicable.
21 (3) The statement shall itemize each of the charges actually provided by the hospital to the
22 patient.
23 (4) The statement may not include charges of physicians who bill separately.
24 (5) The requirements of this section do not apply to patients who receive services from a
25 hospital under Title XIX of the Social Security Act.
26 (6) A statement of charges to be paid by a third party and related information provided to
27 a patient pursuant to this section shall be marked in bold: "DUPLICATE: DO NOT PAY" or other
28 appropriate language.
29 Section 13. Section 26-35-103 is amended to read:
30 26-35-103. Definitions.
31 As used in this chapter:

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1 (1) (a) "Nursing facility" means a health care facility described in [Subsection
2 26-21-2(14)] Section 26-21-2 or an intermediate care facility for the mentally retarded that is
3 licensed under Section 26-21-13.5.
4 (b) "Nursing facility" does not include the Utah State Developmental Center or the Utah
5 State Hospital.
6 (2) "Patient day" means each calendar day in which an individual patient is admitted to
7 the nursing facility during a calendar month, even if on a temporary leave of absence from the
8 facility.
9 Section 14. Section 26-36-104 is amended to read:
10 26-36-104. Definitions.
11 As used in this chapter:
12 (1) "Adjusted inpatient days" for any hospital during a particular measuring period means
13 the number of inpatient days for a hospital during a measuring period times a fraction, the
14 numerator of which is the total patient revenue of the hospital during a measuring period and the
15 denominator of which is the total inpatient revenue of the hospital during a measuring period.
16 (2) "Assessment" means the Medicaid hospital provider temporary assessment established
17 by this chapter.
18 (3) "Federal act" means the Medicaid Voluntary Contribution and Provider-Specific Tax
19 Amendments of 1991, Public Law 102-234, enacted December 12, 1991.
20 (4) "Freestanding ambulatory surgical facility" means an urban or rural nonhospital based
21 or nonhospital affiliated licensed facility as defined in [Subsection 26-21-2(2)] Section 26-21-2
22 as an ambulatory surgical facility, with an organized professional staff that provides surgical
23 services to patients who do not require an inpatient bed.
24 (5) "Gross revenue" for any hospital during a particular measuring period means standard,
25 nondiscounted charges for all services rendered to patients by the hospital during a measuring
26 period.
27 (6) "Hospital" means:
28 (a) any general acute hospital operating in the state of Utah as defined in [Subsection
29 26-21-2(9)] Section 26-21-2.
30 (b) "Hospital" does not include residential care or treatment facilities as defined in
31 Subsections 62A-2-101(17), (18), and (20), Health Maintenance Organization owned service

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1 facilities, the Utah State Hospital or any rural hospital that operates outside of a metropolitan
2 statistical area, a metropolitan area, or an urbanized area as designated by the U.S. Bureau of
3 Census, or any specialty hospital operating in this state as defined in [Subsection 26-21-2(19)]
4 Section 26-21-2 that may be engaged exclusively in rendering psychiatric or other mental health
5 treatment.
6 (7) "Hospital-based ambulatory surgical facility" means an urban or rural on hospital
7 campus or hospital affiliated licensed facility with an organized professional staff that provides
8 surgical services to patients who do not require an inpatient bed.
9 (8) "Inpatient" means a patient of a hospital who is admitted on an overnight basis.
10 (9) "Inpatient day" means, with respect to each hospital patient excluding patients in the
11 nursery, skilled nursing and labor room, each 24-hour period during which a patient is an inpatient
12 of the hospital.
13 (10) "Inpatient services" means all services rendered by a hospital to an inpatient.
14 (11) "Outpatient" means any patient of a hospital other than an inpatient.
15 (12) "Outpatient services" means all services rendered by a hospital other than inpatient
16 services.
17 (13) "Patient encounter" as applied to any freestanding ambulatory surgical facility or
18 hospital-based ambulatory surgical facility means one or more outpatient surgery procedures
19 performed on one outpatient during the course of one outpatient visit for which a charge is
20 incurred. The patient encounter as defined in this act includes ancillary services incident to the
21 surgical procedures performed during the surgical visit.
22 (14) "Total inpatient revenue" for any hospital during a particular measuring period means
23 total gross revenue derived by the hospital from inpatient services rendered during a measuring
24 period.
25 (15) "Total outpatient revenue" for any hospital during a particular measuring period
26 means total gross revenue derived by the hospital from all outpatient services rendered, minus
27 those revenues derived from a hospital-based ambulatory surgical facility, during a measuring
28 period.
29 (16) "Total patient revenue" means the sum of total inpatient revenue and total outpatient
30 revenue.
31 Section 15. Section 59-12-102 is amended to read:

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1 59-12-102. Definitions.
2 As used in this chapter:
3 (1) (a) "Admission or user fees" includes season passes.
4 (b) "Admission or user fees" does not include annual membership dues to private
5 organizations.
6 (2) "Authorized carrier" means:
7 (a) in the case of vehicles operated over public highways, the holder of credentials
8 indicating that the vehicle is or will be operated pursuant to both the International Registration
9 Plan (IRP) and the International Fuel Tax Agreement (IFTA);
10 (b) in the case of aircraft, the holder of a Federal Aviation Administration (FAA) operating
11 certificate or air carrier's operating certificate; or
12 (c) in the case of locomotives, freight cars, railroad work equipment, or other rolling stock,
13 the holder of a certificate issued by the United States Interstate Commerce Commission.
14 (3) (a) For purposes of Subsection 59-12-104(44), "coin-operated amusement device"
15 means:
16 (i) a coin-operated amusement, skill, or ride device;
17 (ii) that is not controlled through vendor-assisted, over-the-counter, sales of tokens; and
18 (iii) includes a music machine, pinball machine, billiard machine, video game machine,
19 arcade machine, and a mechanical or electronic skill game or ride.
20 (b) For purposes of Subsection 59-12-104(44), "coin-operated amusement device" does
21 not mean a coin-operated amusement device possessing a coinage mechanism that:
22 (i) accepts and registers multiple denominations of coins; and
23 (ii) allows the vendor to collect the sales and use tax at the time an amusement device is
24 activated and operated by a person inserting coins into the device.
25 (4) "Commercial use" means the use of gas, electricity, heat, coal, fuel oil, or other fuels
26 that does not constitute industrial use under Subsection (10) or residential use under Subsection
27 (16).
28 (5) "Common carrier" means a person engaged in or transacting the business of
29 transporting passengers, freight, merchandise, or other property for hire within this state.
30 (6) "Component part" includes:
31 (a) poultry, dairy, and other livestock feed, and their components;

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1 (b) baling ties and twine used in the baling of hay and straw;
2 (c) fuel used for providing temperature control of orchards and commercial greenhouses
3 doing a majority of their business in wholesale sales, and for providing power for off-highway type
4 farm machinery; and
5 (d) feed, seeds, and seedlings.
6 (7) "Construction materials" means any tangible personal property that will be converted
7 into real property.
8 (8) (a) "Fundraising sales" means sales:
9 (i) (A) made by a public or private elementary or secondary school; or
10 (B) made by a public or private elementary or secondary school student, grades
11 kindergarten through 12;
12 (ii) that are for the purpose of raising funds for the school to purchase equipment,
13 materials, or provide transportation; and
14 (iii) that are part of an officially sanctioned school activity.
15 (b) For purposes of Subsection (8)(a)(iii), "officially sanctioned school activity" means
16 a school activity:
17 (i) that is conducted in accordance with a formal policy adopted by the school or school
18 district governing the authorization and supervision of fundraising activities;
19 (ii) that does not directly or indirectly compensate an individual teacher or other
20 educational personnel by direct payment, commissions, or payment in kind; and
21 (iii) the net or gross revenues from which are deposited in a dedicated account controlled
22 by the school or school district.
23 (9) (a) "Home medical equipment and supplies" means equipment and supplies that:
24 (i) a licensed physician prescribes or authorizes in writing as necessary for the treatment
25 of a medical illness or injury or as necessary to mitigate an impairment resulting from illness or
26 injury;
27 (ii) are used exclusively by the person for whom they are prescribed to serve a medical
28 purpose; and
29 (iii) are listed as eligible for payment under Title 18 of the federal Social Security Act or
30 under the state plan for medical assistance under Title 19 of the federal Social Security Act.
31 (b) "Home medical equipment and supplies" does not include:

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1 (i) equipment and supplies purchased by, for, or on behalf of any health care facility, as
2 defined in Subsection (9)(c), doctor, nurse, or other health care provider for use in their
3 professional practice;
4 (ii) eyeglasses, contact lenses, or equipment to correct impaired vision; or
5 (iii) hearing aids or hearing aid accessories.
6 (c) For purposes of Subsection (9)(b)(i), "health care facility" includes:
7 (i) a clinic;
8 (ii) a doctor's office; and
9 (iii) a health care facility as defined in [Subsection 26-21-2(11)(a)] Section 26-21-2.
10 (10) "Industrial use" means the use of natural gas, electricity, heat, coal, fuel oil, or other
11 fuels in:
12 (a) mining or extraction of minerals;
13 (b) agricultural operations to produce an agricultural product up to the time of harvest or
14 placing the agricultural product into a storage facility, including:
15 (i) commercial greenhouses;
16 (ii) irrigation pumps;
17 (iii) farm machinery;
18 (iv) implements of husbandry as defined in Subsection 41-1a-102(23) that are not
19 registered under Title 41, Chapter 1a, Part 2, Registration; and
20 (v) other farming activities; and
21 (c) manufacturing tangible personal property at an establishment described in SIC Codes
22 2000 to 3999 of the 1987 Standard Industrial Classification Manual of the federal Executive Office
23 of the President, Office of Management and Budget.
24 (11) "Manufactured home" means any manufactured home or mobile home as defined in
25 Title 58, Chapter 56, Utah Uniform Building Standards Act.
26 (12) (a) "Medicine" means:
27 (i) insulin, syringes, and any medicine prescribed for the treatment of human ailments by
28 a person authorized to prescribe treatments and dispensed on prescription filled by a registered
29 pharmacist, or supplied to patients by a physician, surgeon, or podiatric physician;
30 (ii) any medicine dispensed to patients in a county or other licensed hospital if prescribed
31 for that patient and dispensed by a registered pharmacist or administered under the direction of a

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1 physician; and
2 (iii) any oxygen or stoma supplies prescribed by a physician or administered under the
3 direction of a physician or paramedic.
4 (b) "Medicine" does not include:
5 (i) any auditory, prosthetic, ophthalmic, or ocular device or appliance; or
6 (ii) any alcoholic beverage.
7 (13) (a) "Other fuels" means products that burn independently to produce heat or energy.
8 (b) "Other fuels" includes oxygen when it is used in the manufacturing of tangible personal
9 property.
10 (14) "Person" includes any individual, firm, partnership, joint venture, association,
11 corporation, estate, trust, business trust, receiver, syndicate, this state, any county, city,
12 municipality, district, or other local governmental entity of the state, or any group or combination
13 acting as a unit.
14 (15) "Purchase price" means the amount paid or charged for tangible personal property or
15 any other taxable item or service under Subsection 59-12-103(1), excluding only cash discounts
16 taken or any excise tax imposed on the purchase price by the federal government.
17 (16) "Residential use" means the use in or around a home, apartment building, sleeping
18 quarters, and similar facilities or accommodations.
19 (17) (a) "Retail sale" means any sale within the state of tangible personal property or any
20 other taxable item or service under Subsection 59-12-103(1), other than resale of such property,
21 item, or service by a retailer or wholesaler to a user or consumer.
22 (b) "Retail sale" includes sales by any farmer or other agricultural producer of poultry,
23 eggs, or dairy products to consumers if the sales have an average monthly sales value of $125 or
24 more.
25 (c) "Retail sale" does not include, and no additional sales or use tax shall be assessed
26 against, those transactions where a purchaser of tangible personal property pays applicable sales
27 or use taxes on its initial nonexempt purchases of property and then enters into a sale-leaseback
28 transaction by which title to such property is transferred by the purchaser-lessee to a lessor for
29 consideration, provided:
30 (i) the transaction is intended as a form of financing for the property to the
31 purchaser-lessee; and

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1 (ii) pursuant to generally accepted accounting principles, the purchaser-lessee is required
2 to capitalize the subject property for financial reporting purposes, and account for the lease
3 payments as payments made under a financing arrangement.
4 (18) (a) "Retailer" means any person engaged in a regularly organized retail business in
5 tangible personal property or any other taxable item or service under Subsection 59-12-103(1), and
6 who is selling to the user or consumer and not for resale.
7 (b) "Retailer" includes commission merchants, auctioneers, and any person regularly
8 engaged in the business of selling to users or consumers within the state.
9 (c) "Retailer" includes any person who engages in regular or systematic solicitation of a
10 consumer market in this state by the distribution of catalogs, periodicals, advertising flyers, or
11 other advertising, or by means of print, radio or television media, by mail, telegraphy, telephone,
12 computer data base, cable, optic, microwave, or other communication system.
13 (d) "Retailer" does not include farmers, gardeners, stockmen, poultrymen, or other growers
14 or agricultural producers producing and doing business on their own premises, except those who
15 are regularly engaged in the business of buying or selling for a profit.
16 (e) For purposes of this chapter the commission may regard as retailers the following if
17 they determine it is necessary for the efficient administration of this chapter: salesmen,
18 representatives, peddlers, or canvassers as the agents of the dealers, distributors, supervisors, or
19 employers under whom they operate or from whom they obtain the tangible personal property sold
20 by them, irrespective of whether they are making sales on their own behalf or on behalf of these
21 dealers, distributors, supervisors, or employers, except that:
22 (i) a printer's facility with which a retailer has contracted for printing shall not be
23 considered to be a salesman, representative, peddler, canvasser, or agent of the retailer; and
24 (ii) the ownership of property that is located at the premises of a printer's facility with
25 which the retailer has contracted for printing and that consists of the final printed product, property
26 that becomes a part of the final printed product, or copy from which the printed product is
27 produced, shall not result in the retailer being deemed to have or maintain an office, distribution
28 house, sales house, warehouse, service enterprise, or other place of business, or to maintain a stock
29 of goods, within this state.
30 (19) "Sale" means any transfer of title, exchange, or barter, conditional or otherwise, in
31 any manner, of tangible personal property or any other taxable item or service under Subsection

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1 59-12-103(1), for a consideration. It includes:
2 (a) installment and credit sales;
3 (b) any closed transaction constituting a sale;
4 (c) any sale of electrical energy, gas, services, or entertainment taxable under this chapter;
5 (d) any transaction if the possession of property is transferred but the seller retains the title
6 as security for the payment of the price; and
7 (e) any transaction under which right to possession, operation, or use of any article of
8 tangible personal property is granted under a lease or contract and the transfer of possession would
9 be taxable if an outright sale were made.
10 (20) (a) "Sales relating to schools" means sales by a public school district or public or
11 private elementary or secondary school, grades kindergarten through 12, that are directly related
12 to the school's or school district's educational functions or activities and include:
13 (i) the sale of textbooks, textbook fees, laboratory fees, laboratory supplies, and safety
14 equipment;
15 (ii) the sale of clothing that:
16 (A) a student is specifically required to wear as a condition of participation in a
17 school-related event or activity; and
18 (B) is not readily adaptable to general or continued usage to the extent that it takes the
19 place of ordinary clothing;
20 (iii) sales of food if the net or gross revenues generated by the food sales are deposited into
21 a school district fund or school fund dedicated to school meals; and
22 (iv) transportation charges for official school activities.
23 (b) "Sales relating to schools" does not include:
24 (i) gate receipts;
25 (ii) special event admission fees;
26 (iii) bookstore sales of items that are not educational materials or supplies; and
27 (iv) except as provided in Subsection (20)(a)(ii), clothing.
28 (21) "State" means the state of Utah, its departments, and agencies.
29 (22) "Storage" means any keeping or retention of tangible personal property or any other
30 taxable item or service under Subsection 59-12-103(1), in this state for any purpose except sale
31 in the regular course of business.

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1 (23) (a) "Tangible personal property" means:
2 (i) all goods, wares, merchandise, produce, and commodities;
3 (ii) all tangible or corporeal things and substances which are dealt in or capable of being
4 possessed or exchanged;
5 (iii) water in bottles, tanks, or other containers; and
6 (iv) all other physically existing articles or things, including property severed from real
7 estate.
8 (b) "Tangible personal property" does not include:
9 (i) real estate or any interest or improvements in real estate;
10 (ii) bank accounts, stocks, bonds, mortgages, notes, and other evidence of debt;
11 (iii) insurance certificates or policies;
12 (iv) personal or governmental licenses;
13 (v) water in pipes, conduits, ditches, or reservoirs;
14 (vi) currency and coinage constituting legal tender of the United States or of a foreign
15 nation; and
16 (vii) all gold, silver, or platinum ingots, bars, medallions, or decorative coins, not
17 constituting legal tender of any nation, with a gold, silver, or platinum content of not less than
18 80%.
19 (24) (a) "Use" means the exercise of any right or power over tangible personal property
20 under Subsection 59-12-103(1), incident to the ownership or the leasing of that property, item, or
21 service.
22 (b) "Use" does not include the sale, display, demonstration, or trial of that property in the
23 regular course of business and held for resale.
24 (25) "Vehicle" means any aircraft, as defined in Section 2-1-1; any vehicle, as defined in
25 Section 41-1a-102; any off-highway vehicle, as defined in Section 41-22-2; and any vessel, as
26 defined in Section 41-1a-102; that is required to be titled, registered, or both. "Vehicle" for
27 purposes of Subsection 59-12-104(37) only, also includes any locomotive, freight car, railroad
28 work equipment, or other railroad rolling stock.
29 (26) "Vehicle dealer" means a person engaged in the business of buying, selling, or
30 exchanging vehicles as defined in Subsection (25).
31 (27) (a) "Vendor" means:

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1 (i) any person receiving any payment or consideration upon a sale of tangible personal
2 property or any other taxable item or service under Subsection 59-12-103(1), or to whom such
3 payment or consideration is payable; and
4 (ii) any person who engages in regular or systematic solicitation of a consumer market in
5 this state by the distribution of catalogs, periodicals, advertising flyers, or other advertising, or by
6 means of print, radio or television media, by mail, telegraphy, telephone, computer data base,
7 cable, optic, microwave, or other communication system.
8 (b) "Vendor" does not mean a printer's facility described in Subsection (18)(e).
9 Section 16. Section 62A-3-202 is amended to read:
10 62A-3-202. Definitions.
11 As used in this part:
12 (1) "Elderly resident" means an adult 60 years of age or older who because of physical,
13 economic, social, or emotional problems cannot function normally on an independent basis, and
14 who resides in a long-term care facility.
15 (2) "Government agency" means any department, division, office, bureau, board,
16 commission, authority, or any other agency or instrumentality created by the state, or to which the
17 state is a party, or created by any county or municipality, which is responsible for the regulation,
18 visitation, inspection, or supervision of facilities, or which provides services to patients, residents,
19 or clients of facilities.
20 (3) "Long-term care facility" means any skilled nursing facility, intermediate care facility,
21 nursing home, [residential care] residential-assisted living facility, adult foster care home, or any
22 living arrangement in the community through which room and personal care services are provided
23 for elderly residents.
24 (4) "Ombudsman" means the administrator of the long-term care ombudsman program,
25 created pursuant to Section 62A-3-203.
26 Section 17. Section 78-30-4.13 is amended to read:
27 78-30-4.13. Notice of adoption proceedings.
28 (1) An unmarried biological father, by virtue of the fact that he has engaged in a sexual
29 relationship with a woman, is deemed to be on notice that a pregnancy and an adoption proceeding
30 regarding that child may occur, and has a duty to protect his own rights and interests. He is
31 therefore entitled to actual notice of a birth or an adoption proceeding with regard to that child only

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1 as provided in this section.
2 (2) Notice of an adoption proceeding shall be served on each of the following persons:
3 (a) any person or agency whose consent or relinquishment is required under Section
4 78-30-4.14 unless that right has been terminated by waiver, relinquishment, consent, or judicial
5 action;
6 (b) any person who has initiated a paternity proceeding and filed notice of that action with
7 the state registrar of vital statistics within the Department of Health, in accordance with Subsection
8 (3);
9 (c) any legally appointed custodian or guardian of the adoptee;
10 (d) the petitioner's spouse, if any, only if he has not joined in the petition;
11 (e) the adoptee's spouse, if any;
12 (f) any person who is recorded on the birth certificate as the child's father, with the
13 knowledge and consent of the mother;
14 (g) any person who is openly living in the same household with the child at the time the
15 consent is executed or relinquishment made, and who is holding himself out to be the child's
16 father; and
17 (h) any person who is married to the child's mother at the time she executes her consent
18 to the adoption or relinquishes the child for adoption.
19 (3) (a) In order to preserve any right to notice and consent, an unmarried biological father
20 may initiate proceedings to establish paternity under Title 78, Chapter 45a, Uniform Act on
21 Paternity, and file a notice of the initiation of those proceedings with the state registrar of vital
22 statistics within the Department of Health prior to the mother's execution of consent or her
23 relinquishment to an agency. That action and notice may also be filed prior to the child's birth.
24 (b) The Department of Health shall provide forms for the purpose of filing the notice
25 described in Subsection (a), and make those forms available in the office of the county clerk in
26 each county, every health care facility, as defined in [Subsection 26-21-2(11)] Section 26-21-2,
27 and licensed child-placing agency.
28 (4) Notice provided in accordance with this section need not disclose the name of the
29 mother of the child who is the subject of an adoption proceeding.
30 (5) The notice required by this section may be served immediately after relinquishment
31 or execution of consent, but shall be served at least 30 days prior to the final dispositional hearing.

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1 The notice shall specifically state that the person served must respond to the petition within 30
2 days of service if he intends to intervene in or contest the adoption.
3 (6) (a) Any person who has been served with notice of an adoption proceeding and who
4 wishes to contest the adoption shall file a motion in the adoption proceeding within 30 days after
5 service. The motion shall set forth specific relief sought and be accompanied by a memorandum
6 specifying the factual and legal grounds upon which the motion is based.
7 (b) Any person who fails to file a motion for relief within 30 days after service of notice
8 waives any right to further notice in connection with the adoption, forfeits all rights in relation to
9 the adoptee, and is barred from thereafter bringing or maintaining any action to assert any interest
10 in the adoptee.
11 (7) Service of notice under this section shall be made as follows:
12 (a) With regard to a person whose consent is necessary under Section 78-30-4.14, service
13 shall be in accordance with the provisions of the Utah Rules of Civil Procedure. If service is by
14 publication, the court shall designate the content of the notice regarding the identity of the parties.
15 The notice may not include the name of the person or persons seeking to adopt the adoptee.
16 (b) As to any other person for whom notice is required under this section, service by
17 certified mail, return receipt requested, is sufficient. If that service cannot be completed after two
18 attempts, the court may issue an order providing for service by publication, posting, or by any
19 other manner of service.
20 (c) Notice to a person who has initiated a paternity proceeding and filed notice of that
21 action with the state registrar of vital statistics in the Department of Health in accordance with the
22 requirements of Subsection (3), shall be served by certified mail, return receipt requested, at the
23 last address filed with the registrar.
24 (8) The notice required by this section may be waived in writing by the person entitled to
25 receive notice.
26 (9) Proof of service of notice on all persons for whom notice is required by this section
27 shall be filed with the court before the final dispositional hearing on the adoption.
28 (10) Notwithstanding any other provision of law, neither the notice of an adoption
29 proceeding nor any process in that proceeding is required to contain the name of the person or
30 persons seeking to adopt the adoptee.
31 (11) Except as to those persons whose consent to an adoption is required under Section

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1 78-30-4.14, the sole purpose of notice under this section is to enable the person served to intervene
2 in the adoption and present evidence to the court relevant to the best interest of the child.
3 Section 18. Repealer.
4 This act repeals:
5 Section 26-21-10, Violations -- Committee review.




Legislative Review Note
as of 1-22-97 2:20 PM

A limited legal review of this bill raises no obvious constitutional or statutory concerns.

Office of Legislative Research and General Counsel

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