Mississippi Administrative Code › Title 15 - Mississippi Department of Health › Part 8 - Office of Health Policy and Planning › Subpart 90 - Planning and Resource Development › Chapter 05 - Acute Care Facilities and Services Overview › Section 15-8-90-05-502 - Certificate of Need Criteria and Standards for General Acute Care Facilities › Section 15-8-90-05-502.03 - Certificate of Need Criteria and Standards for Construction, Renovation, Expansion, Capital Improvements, Replacement of Health Care Facilities, and Addition of Hospital Beds

Current through June 25, 2024
MSDH will review applications for a Certificate of Need
						for the addition of beds to a health care facility and projects for
						construction, renovation, expansion, or capital improvement involving a capital
						expenditure in excess of $5,000,000 (for clinical health services) or
						$10,000,000 (for nonclinical health services). MSDH will further review
						applications under the applicable statutory requirements of Sections
						41-7-173,
						41-7-191, and
						41-7-193, Mississippi Code 1972,
						as amended. MSDH will also review applications for Certificate of Need
						according to the general criteria listed in the
Mississippi Certificate
						of Need Review Manual
; all adopted rules, procedures, and plans of the
						MSDH; and the specific criteria and standards listed below.
The construction, development, or other establishment of
						a new health care facility, the replacement and/or relocation of a health care
						facility or portion thereof, and changes of ownership of existing health care
						facilities are reviewable regardless of capital expenditure.
Need Criterion 1: Acute Care Bed Need
a.
Projects which do not involve the
					 addition of any acute care beds
The applicant shall document the need for the proposed
						project. Documentation may consist of, but is not limited to, citing of
						licensure or regulatory code deficiencies, institutional long-term plans (duly
						adopted by the governing board), recommendations made by consultant firms, and
						deficiencies cited by accreditation agencies (JCAHO, CAP, etc.). In addition,
						for projects which involve construction, renovation, or expansion of emergency
						department facilities, the applicant shall include a statement indicating
						whether the hospital will participate in the statewide trauma system and
						describe the level of participation, if any.
b.
Projects which involve the addition
					 of beds
The applicant shall document the need for the proposed
						project. In addition to the documentation required as stated in Need Criterion
						(1) (a), the applicant shall document that the facility in question has
						maintained an occupancy rate of at least sixty percent (60%) for the most
						recent two (2) years or has maintained an occupancy rate of at least seventy
						percent (70%) for the most recent two (2) years according to the below
						formula:
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Note: *An observation patient day is a patient that has
						NOT been admitted as an inpatient, but occupies an acute care bed (observation
						bed) and is provided observation services in a licensed, acute care hospital.
						Hospitals shall follow strict guidelines set forth by The Centers for Medicare
						& Medicaid Services, health insurance companies, and others in reporting
						observation bed data to the Department. For definitions that correspond with
						the above referenced item, please refer to the Glossary included in the
						Plan.
Need Criterion 2: Bed Service
						Transfer/Reallocation/Relocation
Applications proposing the transfer, reallocation, and/or
						relocation of a specific category or sub-category of bed/service from another
						facility as part of a renovation, expansion, or replacement project shall
						document that the applicant will meet all regulatory/licensure requirements for
						the type of bed/service being transferred/reallocated/relocated.
Need Criterion 3: Charity/Indigent
						Care
The application shall affirm that the applicant will
						provide a "reasonable amount" of indigent/charity care as described in Chapter
						1 of this
Plan
.
Need Criterion 4: Cost of Project
The application shall demonstrate that the cost of the
						proposed project, including equipment, is reasonable in comparison with the
						cost of similar projects in the state.
a. The applicant shall document that the cost
					 per square foot (per bed if applicable) does not exceed the median construction
					 costs, as determined by the MSDH, for similar projects in the state within the
					 most recent 12-month period by more than fifteen percent (15%). The Glossary of
					 this
Plan
provides the formulas to be used by MSDH staff in
					 calculating the cost per square foot for construction and/or
					 construction/renovation projects.
b. If equipment costs for the project exceed
					 the median costs for equipment of similar quality by more than fifteen percent
					 (15%), the applicant shall provide justification for the excessive costs. The
					 median costs shall be based on projects submitted during the most recent
					 six-month period and/or estimated prices provided by acceptable vendors.
Need Criterion 5: Project
						Specifications
The applicant shall specify the floor areas and space
						requirements, including the following factors:
a. The gross square footage of the proposed
					 project in comparison to state and national norms for similar
					 projects.
b. The architectural
					 design of the existing facility if it places restraints on the proposed
					 project.
c. Special considerations
					 due to local conditions.
Need Criterion 6: Renovation/Expansion
						Justification
If the cost of the proposed renovation or expansion
						project exceeds eighty-five percent (85%) of the cost of a replacement
						facility, the applicant shall document their justification for rejecting the
						option of replacing said facility.
Need Criterion 7: Need for Service
The applicant shall document the need for a specific
						service (i.e. perinatal, ambulatory care, psychiatric, etc.) using the
						appropriate service specific criteria as presented in this and other sections
						of the
Plan
.
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