(7) Specialty hospital (A) In general For purposes of this section, except as provided in subparagraph (B), the term “specialty hospital” means a subsection (d) hospital (as defined in section 1395ww(d)(1)(B) of this title ) that is primarily or exclusively engaged in the care and treatment of one of the following categories: (i) Patients with a cardiac condition. (ii) Patients with an orthopedic condition. (iii) Patients receiving a surgical procedure. (iv) Any other specialized category of services that the Secretary designates as inconsistent with the purpose of permitting physician ownership and investment interests in a hospital under this section. (B) Exception For purposes of this section, the term “specialty hospital” does not include any hospital— (i) determined by the Secretary— (I) to be in operation before November 18, 2003 ; or (II) under development as of such date; (ii) for which the number of physician investors at any time on or after such date is no greater than the number of such investors as of such date; (iii) for which the type of categories described in subparagraph (A) at any time on or after such date is no different than the type of such categories as of such date; (iv) for which any increase in the number of beds occurs only in the facilities on the main campus of the hospital and does not exceed 50 percent of the number of beds in the hospital as of November 18, 2003 , or 5 beds, whichever is greater; and (v) that meets such other requirements as the Secretary may specify.