124 STAT. 686 PUBLIC LAW 111–148—MAR. 23, 2010 ‘‘(i) The percentage of the total value of the owner- ship or investment interests held in the hospital, or in an entity whose assets include the hospital, by physi- cian owners or investors in the aggregate does not exceed such percentage as of the date of enactment of this subsection. ‘‘(ii) Any ownership or investment interests that the hospital offers to a physician owner or investor are not offered on more favorable terms than the terms offered to a person who is not a physician owner or investor. ‘‘(iii) The hospital (or any owner or investor in the hospital) does not directly or indirectly provide loans or financing for any investment in the hospital by a physician owner or investor. ‘‘(iv) The hospital (or any owner or investor in the hospital) does not directly or indirectly guarantee a loan, make a payment toward a loan, or otherwise subsidize a loan, for any individual physician owner or investor or group of physician owners or investors that is related to acquiring any ownership or invest- ment interest in the hospital. ‘‘(v) Ownership or investment returns are distrib- uted to each owner or investor in the hospital in an amount that is directly proportional to the ownership or investment interest of such owner or investor in the hospital. ‘‘(vi) Physician owners and investors do not receive, directly or indirectly, any guaranteed receipt of or right to purchase other business interests related to the hospital, including the purchase or lease of any prop- erty under the control of other owners or investors in the hospital or located near the premises of the hospital. ‘‘(vii) The hospital does not offer a physician owner or investor the opportunity to purchase or lease any property under the control of the hospital or any other owner or investor in the hospital on more favorable terms than the terms offered to an individual who is not a physician owner or investor. ‘‘(E) PATIENT SAFETY.— ‘‘(i) Insofar as the hospital admits a patient and does not have any physician available on the premises to provide services during all hours in which the hos- pital is providing services to such patient, before admit- ting the patient— ‘‘(I) the hospital discloses such fact to a patient; and ‘‘(II) following such disclosure, the hospital receives from the patient a signed acknowledgment that the patient understands such fact. ‘‘(ii) The hospital has the capacity to— ‘‘(I) provide assessment and initial treatment for patients; and ‘‘(II) refer and transfer patients to hospitals with the capability to treat the needs of the patient involved.
