Page:United States Statutes at Large Volume 111 Part 1.djvu/395

 PUBLIC LAW 105-33—AUG. 5, 1997 111 STAT. 371 "(iii) provides not more than 15 (or, in the case of a facility under an agreement described in subsection (f), 25) acute care inpatient beds (meeting such standards as the Secretary may establish) for providing inpatient care for a period not to exceed 96 hours (unless a longer period is required because transfer to a hospital is precluded because of inclement weather or other emergency conditions), except that a peer review organization or equivalent entity may, on request, waive the 96-hour restriction on a case-by- case basis; "(iv) 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 and fully staffed, except insofar as the facility is required to make available emergency care services as determined under clause (ii) and must have nursing services available on a 24-hour basis, but need not otherwise staff the facility except when an inpatient is present; "(II) the facility may provide any services otherwise required to be provided by a full-time, on site dietitian, pharmacist, laboratory technician, medical technologist, and radiological technologist on a part-time, off site basis under arrangements as defined in section 1861(w)(l); and "(III) the inpatient care described in clause (iii) may be provided by a physician assistant, nurse practitioner, or clinical nurse specialist subject to the oversight of a physician who need not be present in the facility; and "(v) meets the requirements of section 1861(aa)(2)(I). " (d) DEFINITION OF RURAL HEALTH NETWORK. — "(1) IN GENERAL.—In this section, the term 'rural health network' means, with respect to a State, an organization consisting of— "(A) at least 1 facility that the State has designated or plans to designate as a critical access hospital; and "(B) at least 1 hospital that furnishes acute care services. " (2) AGREEMENTS.— "(A) IN GENERAL.— Each critical access hospital that is a member of a rural health network shall have an agreement with respect to each item described in subparagraph (B) with at least 1 hospital that is a member of the network. "(B) ITEMS DESCRIBED.— The items described in this subparagraph are the following: "(i) Patient referral and transfer, "(ii) The development and use of communications systems including (where feasible)— "(I) telemetry systems; and

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