Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 503 - MAINE CERTIFICATE OF NEED PROCEDURES MANUAL FOR HEALTH CARE FACILITIES (OTHER THAN NURSING CARE FACILITIES) › Chapter 4 - THE SCOPE OF CERTIFICATE OF NEED - COVERED ACTIVITIES › Section 144-503-4-1 - Certificate of Need Required

Current through 2024-29, July 17, 2024
A. A person may not
				  enter into any commitment for financing a project that requires a Certificate
				  of Need or incur an expenditure for the project without having sought and
				  received a Certificate of Need, except that this prohibition does not apply to
				  obligations for financing conditioned upon the receipt of a Certificate of Need
				  or to obligations for predevelopment activities. 22 M.R.S.A. Sec.329.
B. A Certificate of Need from the Department
				  is required for:
1
Transfer of
				  ownership acquisition by lease, donation, transfer; acquisition of
				  control
. Any transfer of ownership or acquisition under lease or
				  comparable arrangement or through donation or any acquisition of control of a
				  health care facility under lease, management agreement or comparable
				  arrangement or through donation that would have required review if the transfer
				  or acquisition had been by purchase, except in emergencies when that
				  acquisition of control is at the direction of the Department ( 22 M.R.S.A.
				  Sec.329(1) );
2
Acquisitions
				  of major medical equipment
. The use of major medical equipment on a
				  temporary basis in the case of a natural disaster, major accident or equipment
				  failure and the use of replacement equipment does not require a Certificate of
				  Need. Beginning September 30, 2004 and annually thereafter, the threshold
				  amount for review must be updated by the Commissioner to reflect the change in
				  the Consumer Price Index medical index ( 22 M.R.S.A. Sec.329(2) );
3
Capital expenditures
. Except
				  as provided in subsection 6, the obligation by or on behalf of a health care
				  facility of any capital expenditure of $2,400,000 or more. Capital expenditures
				  in the case of a natural disaster, major accident or equipment failure for
				  replacement equipment or for parking lots and garages, information and
				  communication systems and physician office space do not require a Certificate
				  of Need; however, the capital cost of these items must be included in the total
				  capital expenditure for a project that otherwise requires a Certificate of
				  Need. Beginning September 30, 2004 and annually thereafter, the threshold
				  amount for review must be updated by the Commissioner to reflect the change in
				  the Consumer Price Index medical index ( 22 M.R.S.A. Sec.329(3) );
4
New health service
. The
				  offering or development of any new health service( 22 M.R.S.A. Sec.329(4)
				  );
5
Changes in bed
				  complement
. An increase in the existing licensed bed complement or an
				  increase in the licensed bed category of a health care facility, other than a
				  nursing facility, of greater than 10% ( 22 M.R.S.A. Sec.329(5) );
6
Nursing facilities
. The
				  obligation by a nursing facility, when related to nursing services provided by
				  the nursing facility, of any capital expenditures of $510,000 or more. A
				  Certificate of Need is not required for a nursing facility to convert beds used
				  for the provision of nursing services to beds to be used for the provision of
				  residential care services. If such a conversion occurs, public funds are not
				  obligated for payment of services provided in the converted beds ( 22 M.R.S.A.
				  Sec.329(6) );
7
Other
				  circumstances
. The following circumstances:
A. Any proposed use of major medical
				  equipment to serve inpatients of a hospital, if the equipment is not located in
				  a health care facility and was acquired without a Certificate of Need, except
				  acquisitions exempt from review under subsection 2 or 3; or
B. If a person adds a health service not
				  subject to review under subsection 4, paragraph A and not subject to review
				  under subsection 4, paragraph B at the time it was established and not reviewed
				  and approved prior to establishment at the request of the applicant, and its
				  actual 3rd fiscal year operating cost exceeds the expenditure minimum for
				  annual operating costs in the 3rd fiscal year of operation following addition
				  of these services ( 22 M.R.S.A. Sec.329(7) ); and
8
Related Projects
. Any projects
				  that the Department determines are related projects if such projects,
				  considered in the aggregate, would otherwise require a Certificate of Need
				  under this section. 22 M.R.S.A. Sec329(8).Projects will be deemed related if
				  the projects are (1) expected to be commenced by the same health care facility
				  within 12 months of each other, and (2) provide associated services within
				  outpatient or inpatient settings or financially impact like or similar cost
				  centers.