Compilation of Rules and Regulations of the State of Georgia › Department 111 - RULES OF DEPARTMENT OF COMMUNITY HEALTH › Chapter 111-2 - HEALTH PLANNING › Subject 111-2-2 - CERTIFICATE OF NEED › Rule 111-2-2-.03 - Exemptions from Review

Current through Rules and Regulations filed through June 27, 2024
The following shall not be subject to Certificate of Need
				  review and shall be exempted from the provisions of these Rules regarding
				  Certificate of Need Review except as otherwise provided:
(1) infirmaries operated by educational
				institutions for the sole and exclusive benefit of students, faculty members,
				officers, or employees thereof;
(2)
				infirmaries or facilities operated by businesses for the sole and exclusive
				benefit of officers or employees thereof, provided that such infirmaries or
				facilities make no provision for overnight stay by persons receiving their
				services;
(3) institutions operated
				exclusively by the federal government or by any of its agencies;
(4) offices of private physicians or
				dentists, as determined in the sole discretion of the Department, whether for
				individual or group practice except as otherwise provided in Ga. Comp. R. &
				Regs. r. 111-2-2-.01(54) and
				Ga. Comp. R. & Regs. r.
				111-2-2-.01(42)(f).
				Simple ownership of a facility by a practitioner or a group of practitioners of
				the healing arts does not, in and of itself, exempt such facility from the
				scope of these Rules. Seeking licensure of a place, building, or facility as a
				health care institution is inconsistent with an assertion that such place,
				building, or facility is being occupied exclusively as the office of private
				physicians or dentists. Therefore, any person who seeks licensure as a health
				care facility must secure a Certificate of Need if a new institutional health
				service is being offered or developed;
(5) Religious, nonmedical health care
				institutions as defined in 42 U.S.C. Section
				1395x(ss)(1), listed and
				certified by a national accrediting organization;
(6) site acquisitions for health care
				facilities or preparation or development costs for such sites prior to filing a
				Certificate of Need application
;
(7) expenditures related to adequate
				preparation and development of an application for a Certificate of
				Need;
(8) the commitment of funds
				conditioned upon the obtaining of a Certificate of Need;
(9) transfers from one health care facility
				to another such facility of major medical equipment previously approved under
				or exempted from Certificate of Need review, except where such transfer results
				in the institution of a new clinical health service for which a Certificate of
				Need is required in the facility acquiring said equipment, provided that such
				transfers are recorded at net book value of the medical equipment as recorded
				on the books of the transferring facility;
(10) expenditures for the restructuring or
				acquisition of existing health care facilities by stock or asset purchase,
				merger, consolidation, or other lawful means;
(11) the purchase of a closing hospital or of
				a hospital that has been closed for no more than twelve (12) months by a
				hospital in a contiguous county to repurpose the facility as a
				micro-hospital;
(12) capital
				expenditures otherwise covered by this Chapter required solely to eliminate or
				prevent safety hazards as defined by federal, state or local fire, building,
				environmental occupational health, or life safety codes of regulations, to
				comply with licensing requirements of the Healthcare Facility Regulation
				Division, or to comply with accreditation standards of the Joint Commission or
				another nationally recognized health care accreditation body;
(13) except as otherwise provided in this
				subsection, all cost overruns are excluded from prior Certificate of Need
				review and approval. For purposes of this subsection, a cost overrun that is
				subject to prior Certificate of Need review and approval (i.e., a reviewable
				cost overrun) is defined as meaning any cost overrun which is in excess of the
				current capital or diagnostic, therapeutic, or other imaging equipment
				threshold, or in excess of ten percent (10%) of the approved capital
				expenditure amount, whichever is less. However, in no event shall an additional
				expenditure of less than $300,000 be deemed a reviewable cost overrun.
				Reviewable cost overruns will be reviewed by the Department in accordance with
				the following provisions:
(a) A reviewable
				cost overrun associated with ongoing construction or renovation activity which
				has not been incurred prior to a Certificate of Need approval and is solely
				related to an unanticipated engineering, major fixed equipment or other
				construction problem, or federal, state or local fire requirements which were
				adopted or became effective after the issuance of the Certificate of Need but
				prior to the completion of construction or renovation, will receive favorable
				review consideration if the applicant demonstrates that the overrun will have
				no impact or a minimal impact on costs and/or charges per patient day or
				procedure; and
(b) A reviewable
				cost overrun which is the result of subsequent project bidding prior to any
				contractual obligation for construction and/or renovation work will not receive
				favorable review consideration by the Department but will require the entire
				project to be reviewed as an entirely new project subject to all the applicable
				criteria, standards and plans; and
(c) A reviewable cost overrun which is due to
				delays of project construction and/or renovation activity resulting from an
				appeal proceeding, when such delay has been in excess of one year, and where
				the Department has suspended the time periods until the issues are resolved,
				will be given favorable consideration as long as the project has not changed in
				scope, square footage, services or number of new beds proposed.
(d) For projects involving either
				construction or renovation, but not both, a reviewable cost overrun which
				increases the square footage beyond five percent (5%) of the originally
				approved project's total new square footage will require the entire project to
				be submitted as a new application and the new application will be subject to
				all the applicable criteria, standards and plans.
(e) For projects involving construction and
				renovation, a reviewable cost overrun which increases the square footage beyond
				five percent (5%) of the sum of the new construction square footage and
				renovated square footage will require the entire project to be submitted as a
				new application and the new application will be subject to all the applicable
				criteria, standards and plans.
(f)
				Regardless of cost, during implementation of the project, any increase in the
				scope of the original project or any change in the number of beds (i.e., the
				subtraction, addition, replacement or conversion of different number of beds
				than authorized in the original Certificate of Need) will invalidate the
				original project and the Department will deem the original project to have been
				withdrawn unless prior written approval is obtained from the
				Department;