333-550-0000 Categories that Are “Subject” or “Exempt” (1) Any person not excluded under section (2) or (3) of this rule, or not excluded pursuant to ORS 441.065, that proposes to offer or develop a new hospital, as defined in ORS 442.015(17) and OAR 333-550-0010(2) or offer or develop a new long-term care facility or service, as defined in ORS 442.015(18) and OAR 333-550-0010(3) is subject to certificate of need review by the division. Persons subject to review under ORS 442.315 include: (a) Hospitals, including special inpatient care facilities; and (b) Long-term care facilities (nursing homes). (2) Pursuant to ORS 442.325(1) and (2), a certificate of need shall be required when an HMO proposes to develop or establish a health care facility, or proposes health services normally subject to review under OAR 333-550-0010. However, any activity of an HMO which does not involve the direct delivery of health services, but, instead, consists of arrangements for indirect delivery of health services through contracts with providers, shall be exempt from the certificate of need law. (3)(a) Except as required in ORS 442.315(1) and OAR 333-550-0010(1) through (3) for a new hospital or new skilled nursing or intermediate care service or facility not operating as a Medicare swing bed program, rural hospitals as defined in ORS 442.470(5)(a)(A) and (B) and OAR 333-545-0020(27) and (28) are exempt from certificate of need requirements; (b) Rural hospitals which are exempt from review under subsection (a) of this section are required to report any action taken by the hospital that would have required a certificate of need if this exemption did not exist. Within 90 days of undertaking any project that would have otherwise been subject to certificate of need, the hospital shall notify the Public Health Division in writing. This notification shall include a detailed description of the project to be undertaken and include at least the following information: (A) The amount of capital expenditure involved; (B) A budget forecast for the first three years of operation showing gross revenues, direct expenses, indirect expenses and deductions from revenue; and (C) The units of service per year for the first three years of operation. (4) The division shall review all components of a project for which a health service related linkage exists, including any project components which, if they were to be done independently, would not be subject to review. Section (6) of this rule will be used to determine whether a health service related linkage exists. (5) A project which includes multiple “subject” components as integral parts shall be reviewed according to the schedules and procedures applicable to the component or part, or combination of these, which requires the most stringent review. (6) A series of projects having a health service related linkage which in the aggregate exceeds any of the certificate of need thresholds described in OAR 333-550-0010 is subject to the certificate of need law as a single proposal when 12 months or less can be expected to elapse or have elapsed between the completion of the first component of the project and the start of the next component of the project. A health service related linkage exists between any projects which affect a single health service, patient care unit, or area within the facility; or a series of projects which cannot be independently constructed: (a) The start date of a project component shall be considered to be the earliest of the following dates: (A) The date on which construction or remodeling work associated with the project begins; or (B) The date that any new service, area, or facility associated with the project begins to treat patients. (b) The completion date shall be considered to be the date on which the new service, area, or facility begins to treat patients. (7) Where a particular health service is involved, the division shall apply the appropriate need methodology for that service adopted in administrative rule, if any. Statutory/Other Authority: ORS 431.120(6), 442.015, 442.315, 442.325 & 442.347 Statutes/Other Implemented: ORS 431.120(6), 442.315, 442.325 & 442.347 History: OHD 11-1998, f. & cert. ef. 10-22-98 HD 13-1994, f. & cert. ef. 4-22-94