Page:United States Statutes at Large Volume 103 Part 3.djvu/80

 103 STAT. 2148 PUBLIC LAW 101-239—DEC. 19, 1989 Contracts. Ck>miuunication8 and telecommunications. 1866(a) and had not been found, on the basis of a survey under section 1864, to be in violation of any requirement to participate as a hospital under this title; "(C) has ceased, or agrees (upon the approval of such application) to cease, providing inpatient care (except as required under subpar^aph (F)); (D) in the case of a facility that is a member of a rural health network, has in effect an agreement to participate with other hospitals and facilities in the communications svstem of such network, including the network's system for the electronic sharing of patient data, including telemetry and medical records, if the network has in operation such a system; "(E) makes available 24-hour emergency care; "(F) provides not more than 6 inpatient beds (meeting such conditions as the Secretary may establish) for provid- ing inpatient care for a period not to exceed 72 hours (unless a longer period is required because transfer to a hospital is precluded because of inclement weather or other emergency conditions) to patients requiring stabilization before discharge or transfer to a hospital; "(G) meets such staffing requirements as would apply under section 1861(e) to a hospital located in a rural area, except that— "(i) the facility need not meet hospital standards relating to the number of hours during a day, or days during a week, in which the facility must be open, except insofar as the facility is required to provide emergency care on a 24-hour basis under subparagraph (E), "(ii) the facility may provide any services otherwise required to be provided by a full-time, on-site dietician, pharmacist, laboratory technician, medical tech- nologist, and radiological technologist on a part-time, off-site basis, and "(iii) the inpatient care described in subparagraph (F) may be provided by a physician's assistant or nurse practitioner, subject to the oversight of a physician; and "(H) meets the requirements of subparagraphs (C) through (J) of paragraph (2) of section 1861(aa) and of clauses (ii) and (iv) of the second sentence of that paragraph. "(2) PREFERENCE GIVEN TO HOSPITALS OR FACILITIES PARTICIPAT- ING IN RURAL HEALTH NETWORK. —In designating facilities as rural primary care hospitals under paragraph (1), the State shall give preference to hospitals or facilities participating in a rural health network. "(3) PEaiMITTING RURAL PRIMARY CARE HOSPFFALS TO MAINTAIN SWING BEDS.— Nothing in this subsection shall be construed to prohibit a State from designating a facility as a rural primary care hospital solely because the facility has entered into an agreement with the Secretary under section 1883 under which the facility's inpatient hospital facilities may be used for the furnishing of extended ccu*e services. "(g) RURAL HEALTH NETWORK DEFINED.— For purposes of this section, the term 'rural health network' means, with respect to a State, an organization—

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