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There is a more recent version of this section in the official Social Security Act Statute Compilation, u.ggg, u.ggg. A such u.ggg is located in a rural area and the supply of hospital services in such area is not sufficient to meet the needs of individuals residing therein. B the failure of such institution to qualify as a hospital would seriously reduce the availability of such services u.ggg such individuals, and. C such institution has made and continues to make a good faith effort to comply with this paragraph, u.ggg, but such compliance is impeded by the lack of qualified nursing personnel in such area.

The term "spell of illness" with respect to any individual means a period of consecutive days-. The term "inpatient hospital services" means the following items and services furnished to an inpatient of a hospital and except as provided in paragraph 3 by the hospital-. Paragraph 4 shall not apply to services provided in a hospital by-. The term "inpatient psychiatric hospital services" means inpatient hospital services furnished to an inpatient of a psychiatric hospital. The term "supplier" means, unless the context otherwise requires, a physician or other practitioner, a facility, or other entity other than a provider of services that furnishes items or services under this subchapter. The term "hospital" except for purposes of sections f d , f f , and n b of this title , subsection a 2 of this section, paragraph 7 of this subsection, and subsection i of this section means an institution which-. A such institution is located in a rural area and the supply of hospital services in such area is not sufficient to meet the needs of individuals residing therein,.

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For purposes of the preceding sentence, items and services shall be deemed to have been furnished to an individual after transfer from a hospital , and he shall be deemed to have been an inpatient in the hospital immediately before transfer therefrom, if he is admitted to the skilled nursing facility A within 30 days after discharge from such hospital , or B within such time as it would be medically appropriate to begin an active course of treatment, in the case of an individual whose condition is such that skilled nursing facility care would not be medically appropriate within 30 days after discharge from a hospital ; and an individual shall be deemed not to have been discharged from a skilled nursing facility if, within 30 days after discharge therefrom, he is admitted to such facility or any other skilled nursing facility. With respect to a seat-lift chair, such term includes only the seat-lift mechanism and does not include the chair. For the purposes of section y a 4 of this title and subject to the limitations and conditions provided in the previous sentence, such term includes a doctor of one of the arts, specified in such previous sentence, legally authorized to practice such art in the country in which the inpatient hospital services referred to in such section y a 4 of this title are furnished. The Secretary shall establish quality measurement reporting requirements for rural emergency hospitals , which may include the use of a small number of claims-based outcomes measures or surveys of patients with respect to their experience in the rural emergency hospital , in accordance with the succeeding provisions of this paragraph. With respect to each year beginning with , or each year beginning on or after the date that is one year after one or more measures are first specified under subparagraph C , a rural emergency hospital shall submit data to the Secretary in accordance with clause ii. With respect to each such year, a rural emergency hospital shall submit to the Secretary data on quality measures specified under subparagraph C. Such data shall be submitted in a form and manner, and at a time, specified by the Secretary for purposes of this subparagraph. Subject to clause ii , any measure specified by the Secretary under this subparagraph must have been endorsed by the entity with a contract under section aaa a of this title. In the case of a specified area or medical topic determined appropriate by the Secretary for which a feasible and practical measure has not been endorsed by the entity with a contract under section aaa a of this title , the Secretary may specify a measure that is not so endorsed as long as due consideration is given to measures that have been endorsed or adopted by a consensus organization identified by the Secretary. The Secretary shall, in the selection of measures specified under this subparagraph, take into consideration ways to account for rural emergency hospitals that lack sufficient case volume to ensure that the performance rates for such measures are reliable.

I for cost reporting periods beginning during fiscal u.gggby 12 percent of such amount otherwise allowable;, u.ggg.

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B physical or occupational therapy, or speech-language pathology services,. The Secretary may waive the requirement of a surety bond under paragraph 7 in the case of an agency or organization that provides a comparable surety bond under State law. G antigens subject to quantity limitations prescribed in regulations by the Secretary prepared by a physician, as defined in subsection r 1 , for a particular patient, including antigens so prepared which are forwarded to another qualified person including a rural health clinic for administration to such patient, from time to time, by or under the supervision of another such physician;. T In determining such reasonable costs for hospitals, no reduction in copayments under section t 8 B shall be treated as a bad debt and the amount of bad debts otherwise treated as allowable costs which are attributable to the deductibles and coinsurance amounts under this title shall be reduced—. Such regulations shall i take into account both direct and indirect costs of providers of services excluding therefrom any such costs, including standby costs, which are determined in accordance with regulations to be unnecessary in the efficient delivery of services covered by the insurance programs established under this subchapter in order that, under the methods of determining costs, the necessary costs of efficiently delivering covered services to individuals covered by the insurance programs established by this subchapter will not be borne by individuals not so covered, and the costs with respect to individuals not so covered will not be borne by such insurance programs, and ii provide for the making of suitable retroactive corrective adjustments where, for a provider of services for any fiscal period, the aggregate reimbursement produced by the methods of determining costs proves to be either inadequate or excessive. J Cardiovascular screening blood tests as defined in subsection xx 1. Amendment by section a 2 of Pub. C Where a hospital has an arrangement with a medical school under which the faculty of such school provides services at such hospital, an amount not in excess of the reasonable cost of such services to the medical school shall be included in determining the reasonable cost to the hospital of furnishing services—. H diagnostic services, and. V In determining such reasonable costs for skilled nursing facilities and beginning with respect to cost reporting periods beginning during fiscal year for covered skilled nursing services described in section e 2 A furnished by hospital providers of extended care services as described in section [] , the amount of bad debts otherwise treated as allowed costs which are attributable to the coinsurance amounts under this title for individuals who are entitled to benefits under part A and—. F other items and services that the Secretary determines are appropriate but in no event to include meals or transportation. B after discharge from a skilled nursing facility in which the individual was provided post- hospital extended care services if such home health services were initiated within 14 days after the date of such discharge. B i In administering this subsection and section i—5 of this title , the Secretary shall not subject a religious nonmedical health care institution or its personnel to any medical supervision, regulation, or control, insofar as such supervision, regulation, or control would be contrary to the religious beliefs observed by the institution or such personnel. E medical supplies including drugs and biologicals and the use of medical appliances, while under such a plan,.

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J Cardiovascular screening blood tests as defined in subsection xx 1. D an individual with primary hyperparathyroidism; or. II If a hospital has a unit which is a skilled nursing facility, the payment rate referred to in clause i for the hospital is a rate equal to the lesser of the rate described in subclause I or the allowable costs in effect under this subchapter for extended care services provided to patients of such unit. The Public Health Service Act , referred to in subsec. B meets such other conditions relating to the health and safety of individuals with respect to whom such tests are performed as the Secretary may find necessary. The Secretary may not approve an indication under subparagraph B for any individual unless a blood test for such is recommended by the United States Preventive Services Task Force. II triglycerides;. G meets such other requirements as the Secretary may find necessary in the interest of the health and safety of the individuals who are provided care and services by such agency or organization. Effective Date of Amendment Pub. H In determining such reasonable cost with respect to home health agencies, the Secretary may not include—. A individual and group therapy with physicians or psychologists or other mental health professionals to the extent authorized under State law ,. N and O and added subpar. A the physician who is managing the individual's diabetic condition i documents that the individual has peripheral neuropathy with evidence of callus formation, a history of pre-ulcerative calluses, a history of previous ulceration, foot deformity, or previous amputation, or poor circulation, and ii certifies that the individual needs such shoes under a comprehensive plan of care related to the individual's diabetic condition;.