Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 100.000 - Determination of Need › Section 100.715 - Substantial Capital Expenditure and Substantial Change in Service

Current through Register 1525, July 5, 2024
Pursuant to M.G.L. c. Ill, § 25C, no Person may make a
				Substantial Capital Expenditure or a Substantial Change in Service, unless the
				Department has first issued a Notice of Determination of Need.
(A)
Substantial Capital
			 Expenditure
. Effective October 1,2019, an Application for
			 Substantial Capital Expenditure must be submitted when the total of any Capital
			 Expenditures, excluding those Capital Expenditures consisting of construction
			 defined as a Conservation Project, by a Health Care Facility, as that term is
			 defined in
			 105 CMR 100.100, for
			 any construction that requires Department approval, either through a Notice of
			 Determination of Need or through the submission and approval of architectural
			 plans and specifications as required by M.G.L. c. Ill, §51, reasonably
			 forseeable during the course of a single Federal Fiscal Year, exceed, or may be
			 reasonably regarded as likely to exceed, the Expenditure Minimum with Respect
			 to Substantial Capital Expenditures when consolidated over the course of a
			 single Federal Fiscal Year. Such Applications must also include all proposed
			 Substantial Changes in Service consolidated over the same Federal Fiscal Year.
			 An Applicant may separately submit an Application for those Capital
			 Expenditures consisting solely of construction defined as a Conservation
			 Project that, when consolidated over the course of a single Federal Fiscal
			 Year, exceed the Expenditure Minimum with Respect to Substantial Capital
			 Expenditures.
A Hospital or comprehensive cancer center, as that term is
				defined in M.G.L. c. 118E, § 8A, may separately submit an Application for
				Substantial Capital Expenditure for those Capital Expenditures concerned solely
				with outpatient services other than Ambulatory Surgery and not otherwise
				defined by the Department as DoN-required Equipment or DoN-required Services;
				provided that such an Application includes all such reasonably foreseeable
				Capital Expenditures across all locations on the Health Care Facility License
				that exceed the Expenditure Minimum with Respect to Substantial Capital
				Expenditures when consolidated over the course of a single Federal Fiscal Year.
				Such Applications must also include all planned Substantial Changes in Service
				consolidated over the same Federal Fiscal Year.
(B)
Substantial Change in
			 Service
. Effective October 1, 2019, a Health Care Facility, as
			 that term is defined in
			 105 CMR 100.100, that
			 is not required to submit an application under
			 105
			 CMR 100.715(A)  but proposes
			 any reasonably foreseeable Substantial Change in Service over the course of a
			 single Federal Fiscal Year, must submit an Application for any Substantial
			 Change in Service that consolidates all such Substantial Changes in Service at
			 the Health Care Facility over that Federal Fiscal Year.
A Hospital or comprehensive cancer center, as that term is
				defined in M.G.L. c. 118E, § 8A, may separately submit an Application for
				Substantial Change in Service for outpatient services; provided that such an
				Application consolidates all such reasonably foreseeable Substantial Changes in
				Service across all locations on the Health Care Facility License over the
				course of a single Federal Fiscal Year.
(1)
DoN-required Services and
			 DoN-required Equipment
.
(a)
			 Maintenance or replacement of existing equipment defined as a DoN-required
			 Equipment shall not require a Notice of Determination of Need.
(b) When considering a proposed Addition,
			 Expansion, or Conversion of an existing DoN-required Service or DoN-required
			 Equipment, the Department shall first deem that such services or equipment were
			 established or acquired pursuant to a properly issued Notice of Determination
			 of Need.