New Jersey Administrative Code › Title 8 - HEALTH › Chapter 33 - CERTIFICATE OF NEED: APPLICATION AND REVIEW PROCESS › Subchapter 1 - GENERAL PROVISIONS › Section 8:33-1.3 - Definitions

Current through Register Vol. 56, No. 14, July 15, 2024
The following words and terms, when used in this chapter, shall
				  have the following meanings unless the context clearly indicates otherwise:
"Accepted for processing" means an application, subject to
				  N.J.A.C. 8:33-5, has been determined by the Department as eligible to be entered
				  into the applicable review cycle.
"Adolescent acute psychiatric beds" means licensed psychiatric
				  beds in a designated and separate unit of a licensed general, psychiatric or special
				  hospital, established for the provision of intensive treatment to persons generally
				  between the ages of 13 and 18 who are experiencing an acute episode of a primary
				  psychiatric disorder and have been medically evaluated to require the services of a
				  specifically designated unit.
"Adult acute psychiatric beds" means licensed psychiatric beds in
				  a designated and separate unit of a general, psychiatric or special hospital,
				  established for the provision of intensive evaluation, stabilization and treatment
				  of persons 18 years of age and older who are experiencing an acute episode of a
				  primary psychiatric disorder. Patients are admitted under voluntary status.
"Adult closed acute psychiatric beds" means licensed psychiatric
				  beds in a designated and separate unit of a general, psychiatric, or special
				  hospital for the provision of treatment services for persons experiencing an acute
				  episode of a psychiatric disorder. All such persons are referred by a designated
				  psychiatric screening center and may be admitted voluntarily or involuntarily if
				  they are determined to be mentally ill and dangerous to self or others.
"Adult intermediate psychiatric beds" means licensed psychiatric
				  beds in a separate and designated area in a general, psychiatric or special hospital
				  for the provision of intensive psychiatric evaluation and treatment services as part
				  of a comprehensive psychiatric and psychosocial rehabilitation program, and which
				  are appropriate for individuals aged 18 and above who are experiencing an acute
				  episode of a psychiatric disorder and who require a comprehensive and specialized
				  treatment program that cannot be fully provided within a short-term acute
				  psychiatric setting. Admissions to the intermediate psychiatric unit or facility
				  have an average length of stay which is generally greater than the average length of
				  stay for adult acute psychiatric units in New Jersey and less than 45 days.
"Advanced life support" (ALS) means an advanced level of
				  prehospital, interhospital, and emergency service care which includes basic life
				  support functions, cardiac monitoring, cardiac defibrillation, telemetered
				  electrocardiography, intravenous therapy, administration of specific medications,
				  drugs and solutions, use of adjunctive ventilation devices, trauma care, and other
				  techniques and procedures authorized by the Commissioner, pursuant to
				  26:2K-7.
"Ambulance service" means the provision of emergency or
				  non-emergency medical care and transportation by certified personnel in a vehicle,
				  which is designed and equipped to provide medical care at the scene and while
				  transporting sick and/or injured persons to or from a medical care facility or
				  provider.
"American Board of Internal Medicine" or "ABIM" means one of the
				  24 certifying boards under the American Board of Medical Specialties umbrella, which
				  sets the standards for physician certification in the United States and assists its
				  member boards in developing and implementing standards to evaluate and certify
				  physician specialists, and which is located at 510 Walnut Street, Suite 1700,
				  Philadelphia, PA 19106-3699, and can be reached by telephone at 1.800.441.ABIM, or
				  accessed through its website at:
www.abim.org
.
"Applicant" means an individual, a partnership, a limited
				  liability partnership, a corporation (including associations and joint-stock
				  companies), a limited liability corporation, a State, or a political subdivision or
				  instrumentality (including a municipal corporation) of a State that will be the
				  licensed operator of the proposed service, facility or equipment, which will have
				  overall responsibility for the health care service to be provided.
"Applicant hospital" means a hospital that has submitted a
				  certificate of need application to perform elective PCI in the State demonstration
				  project.
"Assisted living program" means the provision of or arrangement
				  for meals and assisted living services, when needed, to the tenants (also known as
				  residents) of publicly subsidized housing which because of any Federal, State, or
				  local housing laws, regulations or requirements cannot become licensed as an
				  assisted living residence. An assisted living program may also provide staff
				  resources and other services to a licensed assisted living residence and a licensed
				  comprehensive personal care home.
"Assisted living residence" means a facility that is licensed by
				  the Department to provide apartment-style housing and congregate dining and to
				  assure that assisted living services are available when needed, to four or more
				  adult persons unrelated to the proprietor. Apartment units offer, at a minimum, one
				  unfurnished room, a private bathroom, a kitchenette, and a lockable door on the unit
				  entrance.
"Atherectomy device" means a device (directional, rotational,
				  orbital or 360 degree, excisional laser, or as may be developed or used) to remove
				  the plaque burden within a coronary artery.
"Atlantic Cardiovascular Patient Outcomes Research Team trial" or
				  "Atlantic C-PORT-E trial" means the multi-state, randomized clinical trial being
				  conducted by the Atlantic Cardiovascular Patient Outcomes Research Team under the
				  direction of Thomas Aversano, M.D., Johns Hopkins Medical Institutions, comparing
				  outcomes of elective PCI at hospitals with and without on-site cardiac
				  surgery.
1. Atlantic C-PORT-E trial documents and other information can be
				  obtained by contacting Thomas Aversano, M.D., Medical Director, Atlantic C-PORT-E,
				  Johns Hopkins Medical Institutions, 5501 Hopkins Bayview Circle, JHAAC 1B.40,
				  Baltimore, Maryland 21224, (410) 550-9820,
				  http://www.cport.org/atlantic_cport_introduction_body.htm.
"Atlantic C-PORT-E Manual of Operations" means the manual of
				  operations that governed participation in the Atlantic C-PORT-E registry.
"Atlantic C-PORT-E registry" means the multi-state repository of
				  patient-specific elective angioplasty data in hospital settings that are without
				  on-site cardiac surgery conducted by the Atlantic Cardiovascular Patient Outcomes
				  Research Team under the direction of Thomas Aversano, M.D., Johns Hopkins Medical
				  Institutions, which compares outcomes of elective PCI at hospitals with and without
				  on-site cardiac surgery, and which terminated on or around December 31, 2014.
"Atlantic C-PORT-E Study" or "C-PORT-E Study" means the
				  multi-state, randomized clinical trial conducted by the Atlantic Cardiovascular
				  Patient Outcomes Research Team under the direction of Thomas Aversano, M.D., Johns
				  Hopkins Medical Institutions that compared outcomes of elective PCI at hospitals
				  with and without on-site cardiac surgery, the results of which were published in the
				  New England Journal of Medicine in 2012.
1. Number of beds by service;
2. Change in complement of major movable equipment, that is,
				  cardiac catheterization;
3. Array of services;
4. Service area;
5. Access or availability to the approved project;
6. Population served including the percentage of Medicaid and
				  medically indigent required to be served as a condition of certificate of need
				  approval; or
6. Population served including the percentage of Medicaid and
				  medically indigent required to be served as a condition of certificate of need
				  approval; or
"Bed capacity" means the total number of beds, listed by health
				  care service within the facility, which are recognized on the facility's current
				  license.
"Bloodless surgery" means the performance of surgery in a general
				  hospital without the use of blood transfusion, including, but not limited to, adult
				  cardiac surgery and exclusive of pediatric cardiac surgery, solid organ
				  transplantation, high risk perinatal, and trauma surgery.
"Burn center" means a general hospital that provides the same
				  comprehensive burn care services as required of a burn unit. In addition, a burn
				  center provides intensive and comprehensive in-service training and education for
				  all burn care personnel and includes a research component.
"Burn program" means a general hospital that provides therapy to
				  burn patients, which includes fluid resuscitation and electrolyte balance,
				  hydrotherapy, debridement, escharotomy, and shock prevention.
"Burn unit" means a general hospital that has beds committed
				  solely to burn care, a large and diversified physician staff and nursing staff that
				  rotate solely in this service. A burn unit shall provide
				  electrocardiograph-oscilloscope defibrillation, cardiac output monitoring, physical
				  therapy-hydrotherapy and occupational therapy.
"Cardiovascular Subspecialty Board of the American Board of
				  Internal Medicine" means the subspecialty board of the ABIM that confers physician
				  certification in Interventional Cardiology.
"Central service facility" means a health care facility, regulated
				  by the Department, providing essential administrative and clerical support service
				  to two or more direct providers of health care services in a region and which may
				  also include some direct provision of health care services.
"Change in cost" means any cost in excess of the total approved
				  cost in the most recent certificate of need approval for the project.
"Change in project scope" is defined as a deviation from the
				  approved certificate of need, which results in a change in any one of, but not
				  limited to, the following:
1. Number of beds by service;
2. Change in complement of major movable equipment, that is,
				  cardiac catheterization;
3. Array of services;
4. Service area;
5. Access or availability to the approved project;
6. Population served including the percentage of Medicaid and
				  medically indigent required to be served as a condition of certificate of need
				  approval; or
7. Square footage.
"Children's acute psychiatric beds" means licensed psychiatric
				  beds in a designated unit of a licensed general, psychiatric or special hospital,
				  for the provision of intensive treatment of persons generally under the age of 13
				  who are experiencing an acute episode of a psychiatric disorder and have been
				  medically evaluated to require acute psychiatric inpatient services.
"Commissioner" means the State Commissioner of Health.
"Community perinatal center" means a licensed hospital designated
				  within a Maternal and Child Health Service Region as one of the following:
1. "Community perinatal center--basic" means a licensed general
				  hospital that provides services to uncomplicated maternity and normal newborn
				  patients in accordance with the scope of functions delineated in its formal letter
				  of agreement with the regional perinatal center. This hospital is characterized by
				  physically separated facilities for labor, delivery, and newborn care, with cesarean
				  section capability within the perinatal suite. The hospital must also provide
				  supportive care for infants returned from regional or community perinatal
				  center--intensive care facilities. Such a facility shall provide care to patients
				  expected to deliver neonates greater than 2,499 grams and at least 36 weeks
				  gestational age.
2. "Community perinatal center--intermediate" means a licensed
				  general hospital which provides care to a minimum of 800 complicated maternity
				  patients and neonates in accordance with the scope of functions delineated in its
				  formal letter of agreement with the regional perinatal center. Such a facility shall
				  provide care to patients expected to deliver neonates greater than 1,499 grams and
				  at least 32 weeks gestational age.
3. "Community perinatal center--intensive" means a licensed
				  general hospital which provides care to complicated maternity patients and neonates
				  in accordance with the scope of functions delineated in its letter of agreement with
				  the hospital and the Regional Perinatal Center. Such a facility shall provide care
				  to patients expected to deliver neonates greater than 999 grams and at least 28
				  weeks gestational age.
"Comprehensive personal care home" means a facility that is
				  licensed by the Department to provide room and board and to assure that assisted
				  living services are available when needed, to four or more adults unrelated to the
				  proprietor. Residential units in comprehensive personal care homes house no more
				  than two residents and have a lockable door on the unit entrance.
"Comprehensive rehabilitation" means services offered by a
				  licensed rehabilitation hospital and characterized by the coordinated delivery of
				  multidisciplinary care intended to achieve the goal of maximizing the
				  self-sufficiency of the patient.
"Construction" means the erection, building, alteration,
				  reconstruction, improvement, renovation, extension or modification of a health care
				  facility, including fixed equipment, the inspection and supervision thereof; and the
				  studies, surveys, designs, plans, working drawings, specifications, procedures, and
				  other actions necessary thereto.
"Data Monitor" means an individual or entity that the Department
				  designates to:
1. Ensure quality and provide clinical oversight of the State
				  demonstration project;
2. Receive patient level data from each participating
				  hospital;
3. Monitor for adverse events;
4. Promptly report safety concerns to the Department; and
5. Assist the Department in evaluating the safety and efficacy of
				  the State demonstration project, and evaluating whether the results of the State
				  demonstration project are consistent with the results of the C-PORT-E Study.
"Deemed complete for processing" means an application, subject to
				  N.J.A.C. 8:33-4, that, determined to be complete by the Department, has been entered
				  into the applicable review cycle.
"Deferral" means a suspension of the review of a submitted
				  application for a limited period of time.
"Demonstration project" generally refers to a health care service,
				  technology, equipment or modality not currently available in the State or which
				  targets unique institutional circumstances or the needs of underserved populations.
				  A demonstration project requires a certificate of need as specified at
				  N.J.A.C.
				  8:33-3.11.
"Department" means the New Jersey Department of Health.
"Discontinuance" means any health care facility which has closed
				  or substantially ceased operation of any of its beds, facilities, services, or
				  equipment for a period of two succeeding years.
"Elective" means performed on a non-emergent basis.
"Elective angioplasty demonstration project" means the
				  demonstration project pertaining to elective angioplasty or percutaneous coronary
				  intervention (PCI) without coronary artery bypass graft (CABG) surgical back-up
				  on-site as part of the Atlantic C-PORT-E trial.
"Emergency medical service helicopter" means a service which
				  provides aeromedical emergency care and transportation by rotowing aircraft and is
				  licensed in accordance with N.J.A.C. 8:41.
"Expedited review cycle" means the period of time from the date
				  the application is submitted to the expedited review process through the date a
				  decision is rendered by the Commissioner.
"Expedited review process" means the review by the Department of a
				  certificate of need application meeting certain specified criteria. Such a review
				  process does not include a review by the State Health Planning Board.
"Fixed equipment" means equipment which is attached to the
				  physical plant of a facility.
"Full review cycle" means the period of time from the date the
				  application is submitted to the full review process through the date a decision is
				  rendered by the Commissioner.
"Full review process" means the review of an application by the
				  State Health Planning Board, as well as the Department.
"General hospital" means a hospital which maintains and operates
				  organized facilities and services as approved by the Department for the diagnosis,
				  treatment or care of persons suffering from acute illness, injury or deformity and
				  in which all diagnosis, treatment and care are administered by or performed under
				  the direction of persons licensed to practice medicine or osteopathy in the State of
				  New Jersey.
"General long-term care" means a long-term care bed for which
				  there is no restriction imposed by statute (for example, subacute long-term care),
				  certificate of need approval requirements (for example, pediatric long-term care,
				  specialized long-term ventilator care, specialized long-term care of patients with
				  severe behavior management problems) or stipulations and/or licensure standards that
				  would limit the type of nursing home patient who may occupy the bed or the type or
				  length of nursing home care which may be provided to the occupant of the bed.
"Health care facility" means the facility or institution, whether
				  public or private, engaged principally in providing services for health maintenance
				  organizations, diagnosis or treatment of human disease, pain, injury, deformity or
				  physical condition, including, but not limited to, a general hospital, special
				  hospital, mental hospital, public health center, diagnostic center, treatment
				  center, rehabilitation center, extended care facility, skilled nursing home,
				  intermediate care facility, assisted living residence, comprehensive personal care
				  facility, tuberculosis hospital, chronic disease hospital, maternity hospital,
				  outpatient clinic, dispensary, home health care agency, residential health care
				  facility and bioanalytical laboratories (except as specifically excluded hereunder)
				  or central services facility serving one or more such institutions but excluding
				  institutions that provide healing solely by prayer and excluding such bioanalytical
				  laboratories as are independently owned and operated, and are not owned, operated,
				  managed or controlled in whole or in part, directly or indirectly by any one or more
				  health care facilities and the predominant source of business of which is not by
				  contract with health care facilities within the State of New Jersey and which
				  solicit or accept specimens and operate predominantly in interstate commerce.
"Health care service" means the preadmission, outpatient,
				  inpatient, and postdischarge care provided in or by a health care facility, and such
				  other items or service as are necessary for such care, which are provided by or
				  under the supervision of a physician for the purpose of health maintenance or
				  diagnosis or treatment of human disease, pain, injury, disability, deformity, or
				  physical condition, including, but not limited to, nursing service, home care
				  nursing and other paramedical service, ambulance service, service provided by an
				  intern, resident in training or physician whose compensation is provided through
				  agreement with a health care facility, laboratory service, medical social service,
				  drugs, biologicals, supplies, appliances, equipment, bed and board, but excluding
				  services provided by a physician, nurse practitioner, clinical nurse specialist,
				  certified nurse midwife or physician assistant, in his or her private practice,
				  unless the service is the subject of a health planning regulation as defined in this
				  section, adopted by the Department of Health or involves the acquisition of major
				  moveable equipment as specified herein, and services provided by volunteer first
				  aid, rescue and ambulance squads as defined in the New Jersey Highway Safety Act of
				  1971, P.L. 1971, c.351.
"Home health agency" means a facility that is licensed by the
				  Department to provide preventive, rehabilitative, and therapeutic services to
				  patients in the patient's home or place of residence. All home health agencies shall
				  provide nursing, homemaker-home health aide, and physical therapy services.
"Hospital system" means a group of licensed general hospital
				  facilities owned or controlled by the same legal entity.
"Inner city cardiac satellite demonstration project" means a
				  cooperative expansion of invasive therapeutic cardiac services within a hospital
				  system, whereby a satellite hospital within the system is permitted to provide
				  invasive therapeutic cardiac services already provided by an inner city hospital
				  within the same hospital system and which meets all of the criteria set forth in
				  this chapter and N.J.A.C. 8:33E.
"Inner city hospital" means a general hospital which is located in
				  a city with a population which is greater than 50,000 (or in a city with population
				  greater than 10,000 located in a county with population density greater than 2,500
				  persons per square mile) and in which more than 10 percent of families in the city
				  have income levels which are below the Federal poverty line, as determined in
				  accordance with
				  42 U.S.C.
				  §
										9902(2).
"In-stent restenosis" means the recurrence of narrowing in a
				  coronary artery that previously had been opened with a stent.
"Interventionalist" means a physician who is privileged at a
				  participating hospital to perform PCI.
"Invasive cardiac services" means cardiac catheterization which is
				  the insertion of a thin, flexible tube (catheter) into a vein or artery and guiding
				  it into the heart for purposes of determining cardiac anatomy and function.
"Invasive therapeutic cardiac services" means the full array of
				  therapeutic cardiac interventional procedures that includes, but is not limited to,
				  coronary artery bypass graft (CABG), percutaneous transluminal coronary angioplasty
				  (PTCA), and complex electrophysiology studies (EPS).
"Long-term acute care hospital-within-a-hospital" means a
				  hospital established in accordance with the standards imposed by the United States
				  Department of Health and Human Services at 42 CFR Part 412 that occupies space in a
				  building also used by another hospital and is licensed as a special hospital in
				  accordance with N.J.A.C. 8:43G-38.
"Long-term acute care hospital-freestanding" means a hospital
				  established in accordance with the standards imposed by the United States Department
				  of Health and Human Services at 42 CFR Part 412 that is a physically separate
				  self-contained facility and is licensed as a special hospital in accordance with
				  N.J.A.C. 8:43G-38.
"Major moveable equipment" means cardiac catheterization
				  equipment.
"Maternal and child health consortium" means a nonprofit
				  organization that is licensed as a central service facility by the Department as
				  specified in N.J.A.C. 8:33C, and incorporated under Section 501(c)(3) of the United
				  States Internal Revenue Code.
"Medically underserved" means segments of the population whose
				  utilization of health care services is disproportionately low to their presence in
				  the population as adjusted to account for their need for such services. Medically
				  underserved includes, but is not limited to, racial and ethnic minority populations,
				  migrant workers, the handicapped, Medicaid recipients, and the medically indigent,
				  defined as those individuals lacking third party insurance coverage whose income is
				  less than or equal to 200 percent of the United States Department of Health and
				  Human Services Income Poverty Guidelines,
				  42 U.S.C.
				  §
										9902(2).
"Minor moveable equipment" means equipment which does not fall
				  within the definition of major moveable equipment stated herein.
"Mobile intensive care unit" (MICU) means a specialized emergency
				  medical service vehicle staffed by mobile intensive care paramedics or mobile
				  intensive care nurses trained in advanced life support nursing and operated for the
				  provision of advanced life support services under the direction of an authorized
				  hospital.
"Modernization/renovation" means the alteration, expansion, major
				  repair, remodeling, replacement, and renovation of existing buildings, and the
				  replacement of obsolete equipment of existing buildings.
"Null and void," "nullification," and "nullify" means the
				  revocation of a certificate of need by the Commissioner prior to the expiration of
				  the certificate.
"Operator" of a health care facility means the person or entity
				  which is the holder of the facility license and which has the ultimate
				  responsibility for the provision of health care services in the facility in
				  accordance with applicable legal and professional standards.
"Participating hospital" means a hospital that is licensed to
				  perform elective PCI in the State demonstration project.
"Pediatric intensive or critical care" means a general hospital
				  unit in which special equipment and skilled personnel are concentrated to provide
				  immediate and continuous attention to pediatric patients who, because of surgery,
				  shock, trauma, serious injury or life threatening conditions, require intensified
				  comprehensive observation, and care.
"Pediatric long-term care" means a facility, distinct nursing
				  unit, or program which is dedicated for occupancy by patients under age 20 who
				  require long-term care services.
"Pediatric service" means provision of services by a general
				  hospital to pediatric patients.
"Percutaneous Coronary Intervention" or "PCI" means angioplasty
				  or percutaneous coronary intervention as defined at
				  8:33E-1.2.
"Perinatal" means the period from the 20th week of gestation
				  through the neonatal period.
"Person" shall include a corporation, limited liability
				  corporation, company, association, society, firm, partnership, limited liability
				  partnership, and joint stock company, as well as an individual.
"Planning region" means the county(ies) where (a) facility(ies),
				  service(s), or bed(s) subject to CN is located and/or proposed to be located, in
				  accordance with the approved CN, and contiguous counties.
"Primary" means performed on an emergent basis.
"Principal" means any individual, partnership, or corporation with
				  an ownership interest in the operating entity of a health care facility or service,
				  or a general or managing partner in a limited partnership.
"Project cost" means costs submitted in those dollars which would
				  be needed to complete the project over the anticipated period of construction, if
				  construction were to begin at the time of certificate of need submission.
"Provider of health care" means an individual:
1. Who is a direct provider of health care service in that the
				  individual's primary activity is the provision of health care services to
				  individuals or the administration of health care facilities in which such care is
				  provided and, when required by State law, the individual has received professional
				  training in the provision of such services or in such administration; or
2. Who is an indirect provider of health care in that the
				  individual:
i. Holds a fiduciary position with, or has a fiduciary interest
				  in, any entity described in subparagraph 2ii(2) or subparagraph 2ii(4) below;
				  provided, however, that a member of the governing body of a county or any elected
				  official shall not be deemed to be a provider of health care unless he is a member
				  of the board of trustees of a health care facility or a member of a board, committee
				  or body with authority similar to that of a board of trustees, or unless he
				  participates in the direct administration of a health care facility; or
ii. Received, either directly or through his or her spouse, more
				  than one-tenth of his or her gross annual income for any one or more of the
				  following:
(1) Fees or other compensation for research into or instruction in
				  the provision of health care services;
(2) Entities engaged in the provision of health care services or
				  in research or instruction in the provision of health care services;
(3) Producing or supplying drugs or other articles for individuals
				  or entities for use in the provision of or in research into or instruction in the
				  provision of health care services; or
(4) Entities engaged in producing drugs or such other
				  articles.
"Psychiatric hospital" means a hospital licensed by the
				  Department which assures the provision of comprehensive specialized diagnosis, care,
				  treatment and rehabilitation where applicable on an inpatient basis for patients
				  with primary psychiatric diagnoses.
"Regional perinatal center" means a licensed general hospital
				  designated within a Maternal and Child Health Service Region which is required to
				  provide care to high risk mothers and neonates. Such a facility shall provide
				  consultation, referral, transport and consultation to its regional
				  affiliates.
"Rehabilitation hospital" means a hospital licensed by the
				  Department to provide comprehensive rehabilitation services to patients for the
				  alleviation or amelioration of the disabling effects of illness. Comprehensive
				  rehabilitation services are characterized by the coordinated delivery of
				  multidisciplinary care intended to achieve the goal of maximizing the
				  self-sufficiency of the patient. A rehabilitation hospital is a facility licensed to
				  provide only comprehensive rehabilitation services or is a distinct unit providing
				  only comprehensive rehabilitation services located within a licensed health care
				  facility.
"Research projects" are projects whose scope of inquiry and
				  activity are exclusively limited to the execution of a research protocol which when
				  it involves human subjects must be approved by an Institutional Review Board; whose
				  services and interventions are provided to approved study subjects alone; who do not
				  bill for or receive reimbursement for the services, equipment, or interventions
				  provided through the research; and whose services, equipment, or interventions are
				  not competing with and do not negatively impact upon licensed providers of health
				  care services in the State, as determined by the Commissioner.
"Satellite hospital" means, for purposes of N.J.A.C. 8:33E-3.11, a
				  general hospital that is not the inner city hospital which is the subject of an
				  inner city cardiac demonstration project, but which shall be a general hospital
				  within the same hospital system as the inner city hospital at issue.
"Service area" means a geographic area, generally a country within
				  which the facility or service is located. However, definitions of service areas
				  planning rules shall take precedence over this general definition.
"Special hospital" means a hospital which maintains and operates
				  organized facilities and services as approved by the Department for the diagnosis,
				  treatment or care of persons suffering from acute illness, injury or deformity in
				  which comprehensive specialized diagnosis, care, treatment and rehabilitation are
				  administered by or performed under the direction of persons licensed to practice
				  medicine or osteopathy in the State of New Jersey, where applicable, on an inpatient
				  basis for one or more specific categories of patients as approved by the
				  Department.
"Special psychiatric beds" means licensed psychiatric beds within
				  any separate unit or section of a licensed general, psychiatric or special hospital
				  which are utilized for the treatment of an identified target population of any age
				  demonstrated to require a specialized program of treatment for acute psychiatric
				  disorders. Examples include units designated to provide services to persons with
				  eating disorders, geriatric services and with dual psychiatric/substance abuse
				  diagnoses. Admissions to the unit or facility should have an average length of stay
				  that reflects the level of active medical care for each category of special
				  psychiatric beds and, as a guideline, does not exceed 60 days.
"Specialized long-term care" means a program of care provided in
				  licensed long-term care beds for patients who require technically complex treatment
				  with life supporting equipment or who have serious problems accessing appropriate
				  nursing home care due to the specialized treatment required by their medical
				  diagnoses and level of functional limitation.
"Specialty acute care children's hospital" means a general
				  hospital, designated by the Commissioner pursuant to a statutory mandate, that
				  provides diagnostic and specialty treatment services for children and is licensed in
				  accordance with N.J.A.C. 8:43G-22.
"State" means the State of New Jersey.
"State elective angioplasty demonstration project" or the "State
				  demonstration project" means the scientific and rigorous collection and analysis of
				  data that would expand the evidence base of the safety and efficacy outcomes of
				  elective PCI performed in New Jersey hospitals without on-site coronary artery
				  bypass graft (CABG) surgical back-up.
"State Health Planning Board" means the board established pursuant
				  to
				  26:2H-5.7,
				  to conduct certificate of need review activities.
"Statewide restricted admissions facility" means a non-profit
				  nursing home owned and operated by a religious or fraternal organization that serves
				  only members of that organization and their immediate families and meets the
				  specific requirements set forth in N.J.A.C. 8:33H.
"Subject of a health planning regulation" means any health care
				  service identified in the Appendix, Exhibit 1.
"Teaching hospital" means, for purposes of
				  8:33-3.11
				  (c), a general hospital engaged in a graduate medical education residency program in
				  cardiology approved by a nationally recognized credentialing organization.
"Termination" means a certificate of need is not extended by the
				  Commissioner beyond its expiration date.
"Total capital cost" means all costs associated with the proposed
				  project including studies and/or surveys; architect, engineer, legal fees; plans and
				  specifications; supervision and inspection of site and buildings; demolition,
				  renovation, construction; fixed and major moveable equipment, purchase of land and
				  buildings; lease and/or rentals; developmental and/or start up costs, but excluding
				  carrying and financing cost and/or fees, interest and debt service reserve fund.
				  Total capital cost excludes any contingency amounts.
"Trauma services" means the treatment of wounds or injuries of
				  sufficient severity to require treatment at a Level I or Level II trauma center, as
				  measured by the immediate threat of death imposed by the injury, the presence of
				  injuries to multiple systems, Injury Severity Score or other trauma scoring systems,
				  and/or the application of appropriate trauma triage decision criteria.
"Total project cost" means all costs associated with the proposed
				  project, including all capital costs, carrying and financing costs, net interest on
				  borrowings during construction, debt service reserve fund. Total project cost
				  excludes any contingency amounts.
"Withdrawal" means a voluntary written request by a certificate of
				  need applicant to the Department to cease any further review of a submitted
				  application submitted before the Commissioner acts on the application. Such a
				  request shall be considered final by the Department and no further consideration or
				  review shall be given to the "withdrawn" application.