Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart D - Health Planning › Chapter 401 - CERTIFICATE OF NEED PROGRAM › Section 401.4 - Criteria for Certificate of Need review

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The following criteria, and standards
				  applicable to each criterion, shall be used to review each application for a
				  certificate of need. A certificate of need shall be recommended, approved and
				  issued when the application substantially meets the following criteria provided
				  that each decision, except in circumstances which pose a threat to public
				  health, shall be consistent with the State Health Plan (SHP):
(1) Whether the relationship of the
				  application to the applicable Health Systems Plan (HSP) and annual
				  implementation plan has been considered.
(2) Whether the services are compatible with
				  the long-range development plan of the applicant.
(3) Whether there is a need by the population
				  served or to be served by the services or facility. Particular consideration
				  shall be given to whether the proposed new institutional health service meets
				  or contributes to the health related needs of members of medically underserved
				  groups.
(4) Whether there is any
				  appropriate, less costly or more effective alternative method of providing the
				  services available.
(5) Whether the
				  service or facility is economically feasible, considering anticipated volume of
				  care, the capability of the service or facility and the availability of
				  reasonable financing.
(6) Whether
				  the proposed service or facility is financially feasible both on an
				  intermediate and long term basis, and whether the impact on the cost of and
				  charges for providing services by the applicant is appropriate.
(7) Whether the proposed service or facility
				  is compatible with the existing health care system in the area. Consideration
				  shall be given to efficiency and appropriateness of the existing services and
				  facilities similar to those proposed.
(8) Whether the service or facility is
				  justified by community need and within the financial capabilities of the
				  institution both on an intermediate and long term basis and whether it will
				  have an inappropriate, adverse impact on the overall cost of providing health
				  services in the area.
(9) Whether
				  there are available resources, including health manpower, management personnel
				  and funds for capital and operating needs to the applicant for the provision of
				  the services proposed to be provided, and whether there is a greater need for
				  alternative uses for such resources for the provision of other health services.
				  The effect on the clinical needs of health professional training programs in
				  the medical service area, the extent to which health professional schools in
				  the medical service area will have access to the services for training purposes
				  and the extent to which the proposed service will be accessible to all the
				  residents of the area to be served by such services shall also be considered in
				  determining resources.
(10) Whether
				  the proposed service or facility will have available to it appropriate
				  ancillary and support services and an appropriate organizational relationship
				  to such services.
(11) Whether the
				  proposed services are consistent with the special needs and circumstances of
				  those entities which provide services or resources both within and without the
				  health service area in which the proposed services are to be located, including
				  medical and other health professional schools, multidisciplinary clinics and
				  specialty centers.
(12) Whether the
				  proposed services are not incompatible with any biomedical or behavioral
				  research projects designed for national need for which local conditions offer
				  special advantages.
(13)
				  Consideration of the need and availability in the community for services and
				  facilities for allopathic and osteopathic physicians and their patients; and
				  the religious orientation of the facility and the religious needs of the
				  community to be served. This paragraph is not intended to create duplicative
				  systems of care.
(14) Whether
				  competitive factors relating to the supply of the health services being
				  reviewed have been considered. Particular attention shall be given to the
				  existence and capacity of market conditions, current or potential, in advancing
				  the purposes of quality assurance, cost containment, and responsiveness to
				  consumer preference. Particular attention shall also be given to the existence
				  and capacity of utilization review programs and other public and private cost
				  control measures to give effect to consumer preferences and to establish
				  appropriate incentives for capital allocations.
(15) Whether consideration has been given to
				  improvements or innovations in the financing and delivery of health services
				  which would foster competition and serve to promote quality assurance, cost
				  effectiveness, and responsiveness to consumer preferences.
(16) Whether, in the case of existing
				  services for facilities, the quality of care provided by services or facilities
				  in the past have been considered.
(17) Whether the special circumstances of
				  applications with respect to the need for conserving energy have been
				  considered.