A hospital is an institution accredited under the Hospital Accreditation Program of the Joint Commission and licensed by the state where it’s located. Any exception to this must be approved by the plan.
The term hospital does not include a convalescent nursing home or institution (or a part of one) that:
- Furnishes primarily domiciliary or custodial care.
- Is operated as a school.
- Is used principally as a convalescent facility, rest facility, nursing facility, or facility for the aged.