Pennsylvania Code › Title 28 - HEALTH AND SAFETY › Part IV - Health Facilities › Subpart D - Health Planning › Chapter 401 - CERTIFICATE OF NEED PROGRAM › Section 401.3 - New institutional health services

Current through Register Vol. 54, No. 28, July 13, 2024
(a) No person shall offer, develop, construct
				  or otherwise establish or undertake to establish within the State a new
				  institutional health service without first obtaining a certificate of need from
				  the Department.
(b) A new
				  institutional health service shall mean the following:
(1) The construction, development or other
				  establishment of a health care facility or health maintenance
				  organization.
(2) An expenditure by
				  or on behalf of a health care facility or Health Maintenance Organization (HMO)
				  in excess of the minimum capital expenditure threshold established by Federal
				  law or regulation which, under generally accepted accounting principles,
				  consistently applied is a capital expenditure. For the purpose of this
				  subsection, any expenditure which is not properly chargeable under generally
				  accepted accounting principles as an expense of operation and maintenance shall
				  be deemed a capital expenditure. An acquisition of a building, property, or
				  equipment by or on behalf of a health care facility or a HMO under lease or
				  comparable arrangement, or through donation, which would have required review
				  if the acquisition had been by purchase, shall be deemed a capital expenditure
				  subject to review.
(3) An
				  expenditure by or on behalf of a health care facility or a health maintenance
				  organization in excess of the minimum capital expenditure threshold established
				  by Federal law or regulation made in preparation for the offering or
				  development of a new institutional health service and any binding arrangement
				  or commitment by either of them for financing the offering or development of
				  the new institutional health service.
(4) Expenditures for the acquisition of an
				  existing health care facility or health maintenance organization shall not be
				  subject to review if notice has been provided to the Department under
				  subsection (c), and the Department finds within 30 days of receipt of the
				  notice that the services or bed capacity of the facility to be acquired will
				  not be changed in being acquired within 1 year from the date of the change of
				  ownership. This does not prohibit facilities from increasing, redistributing,
				  or relocating beds by 10 beds or 10%, whichever is less, of the bed capacity as
				  allowed by paragraph (6).
(5) The
				  acquisition of major medical equipment not owned by or located in a health care
				  facility if the equipment will be used to provide service for inpatients of a
				  health care facility, or if notice has not been provided to the Department
				  under subsection (c).
(6) The
				  obligation of any capital expenditure by or on behalf of a health care facility
				  which results in the addition of a health service not provided in or through
				  the facility in the previous 12 months or which increases the total number of
				  beds, or redistributes beds among various categories other than levels of care
				  in a nursing home, or relocates such beds from one physical facility or site to
				  another, by more than 10 beds or 10% of total bed capacity, whichever is less,
				  over a 2-year period. For purposes of this paragraph, categories of beds in a
				  hospital are those categories of beds established and defined in the
				  instructions and definitions of the Department's Annual Hospital Questionnaire.
				  Although dialysis stations are not defined as beds in the annual hospital
				  questionnaire, facilities with dialysis stations may increase the number of
				  stations in accordance with this subsection, except that the 10 beds or 10%
				  rule will apply to the number of dialysis stations only. The total bed capacity
				  of the hospital if the dialysis unit is located in a hospital, is separate and
				  distinct from dialysis stations. The 2-year periods shall begin on the date of
				  licensure. Increases not added during a 2-year period cannot be accumulated and
				  carried over to another period, nor will a change in ownership allow increases
				  of more than 10 beds or 10% of total capacity in a 2-year period.
(7) The addition of a health service which is
				  offered in or through a health care facility having an annual operating expense
				  in excess of the minimum operating expense threshold established by Federal law
				  or regulation and which was not offered on a regular basis in or through the
				  health care facility within the 12-month period prior to the time such services
				  would be offered. A health service shall be considered to be offered by or
				  through a health care facility or a health maintenance organization if the
				  service is offered or made available on a regular basis to inpatients or
				  outpatients of a health care facility.