reglab/statecodes huggingface dataset:
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 216 - METHODOLOGY TO MEASURE EFFICIENCY AND PRODUCTIVITY OF HEALTH CARE INSTITUTIONS › Section 12VAC5-216-20 - Filing

Current through Register Vol. 40, No. 24, July 15, 2024
Each health care institution, except where otherwise
				  indicated, will submit an annual historical performance filing. Each health
				  care institution will submit an annual historical performance filing as
				  prescribed in § 32.1-276.7 of the Code of Virginia. This filing will be
				  used to collect audited financial information and other information for all of
				  the categories listed in
				  12VAC5-216-40. It will provide the
				  basis for the evaluation by the board. The annual historical performance filing
				  shall be received by the board within 120 days after the close of the health
				  care institution's fiscal year.
Statutory Authority
§§ 32.1-12 and 32.1-276.2 of the Code of
					 Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 216 - METHODOLOGY TO MEASURE EFFICIENCY AND PRODUCTIVITY OF HEALTH CARE INSTITUTIONS › Section 12VAC5-216-30 - Eliminating duplication in reporting

Current through Register Vol. 40, No. 24, July 15, 2024
In compliance with § 32.1-276.4B of the Code of
				  Virginia, information that is collected by other public and private entities
				  that is used by the board in its evaluation of efficiency and productivity
				  shall be received by the board directly from the appropriate agency or entity.
				  Data will also be drawn from the Virginia Patient Level Data System and from
				  other available data bases.
Statutory Authority
§§ 32.1-12 and 32.1-276.2 of the Code of
					 Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 216 - METHODOLOGY TO MEASURE EFFICIENCY AND PRODUCTIVITY OF HEALTH CARE INSTITUTIONS › Section 12VAC5-216-40 - Categories of information

Current through Register Vol. 40, No. 24, July 15, 2024
Information concerning charges, costs, elements of costs,
				  productivity, resource utilization, financial viability, and community support
				  services will be assembled from the filings made pursuant to this
				  chapter.
Statutory Authority
§§ 32.1-12 and 32.1-276.2 of the Code of
					 Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 216 - METHODOLOGY TO MEASURE EFFICIENCY AND PRODUCTIVITY OF HEALTH CARE INSTITUTIONS › Section 12VAC5-216-50 - Efficiency and productivity indicators

Current through Register Vol. 40, No. 24, July 15, 2024
Individual data elements from the general categories
				  identified in
				  12VAC5-216-40 will be used to form
				  ratio indicators. These indicators will be used to evaluate health care
				  institutions and rank health care institutions in relation to their
				  peers.
1. Case mix index. Each acute
				care hospital shall provide the board with a case mix index for all inpatients
				and designated categories of inpatients when it submits its annual historical
				performance filing. The Medicare DRG grouper process shall be utilized by the
				board.
2. Each nursing facility
				that has received a Patient Intensity Rating System (PIRS) Service Intensity
				Index (SII) number from the Virginia Department of Medical Assistance Services
				shall report the four quarterly final PIRS SII scores associated with its
				fiscal year. These scores are to be reported on the institution's annual
				historical performance filing.
Statutory Authority
§§ 32.1-12 and 32.1-276.2 of the Code of
					 Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 216 - METHODOLOGY TO MEASURE EFFICIENCY AND PRODUCTIVITY OF HEALTH CARE INSTITUTIONS › Section 12VAC5-216-60 - Electronic submission of data

Current through Register Vol. 40, No. 24, July 15, 2024
A.
				Information shall be submitted electronically.
B. Information shall be submitted using
				software developed by the board for the use of health institutions in
				submitting filings.
C. Any health
				care institution that does not have the computer equipment to submit
				electronically may apply to the board for an exemption to subsection B of this
				section. A fee commensurate with the cost of data entry will be assessed by the
				board.
Statutory Authority
§§ 32.1-12 and 32.1-276.2 of the Code of
					 Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 216 - METHODOLOGY TO MEASURE EFFICIENCY AND PRODUCTIVITY OF HEALTH CARE INSTITUTIONS › Section 12VAC5-216-70 - Public access to data

Current through Register Vol. 40, No. 24, July 15, 2024
The board will publish an annual report which will
				  incorporate the data collected and analysis of the data including, but not
				  limited to, an evaluation of the relative efficiency and productivity of health
				  care institutions. An electronic data base is open to the
				  public.
Statutory Authority
§§ 32.1-12 and 32.1-276.2 of the Code of
					 Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 216 - METHODOLOGY TO MEASURE EFFICIENCY AND PRODUCTIVITY OF HEALTH CARE INSTITUTIONS › Section 12VAC5-216-80 - Initial measurement

Current through Register Vol. 40, No. 24, July 15, 2024
The performance of each health care institution will be
				  measured using the indicators referenced in
				  12VAC5-216-50.
Statutory Authority
§§ 32.1-12 and 32.1-276.2 of the Code of
					 Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 216 - METHODOLOGY TO MEASURE EFFICIENCY AND PRODUCTIVITY OF HEALTH CARE INSTITUTIONS › Section 12VAC5-216-90 - Ranking; other peer groupings

Current through Register Vol. 40, No. 24, July 15, 2024
A.
				Unless exempted as provided for in
				12VAC5-216-100, each health care
				institution will be subject to a ranking procedure.
1. Geographical peer grouping. Similar types
				of health care institutions (e.g., all hospitals or all nursing homes) will be
				grouped into geographical peer groups and ranked in relation to other
				institutions within their peer group.
2. Ranking procedure. Each health care
				institution will be ranked on each indicator and given a quartile score on each
				indicator. Each quartile represents 25% of institutions within the peer group.
				Each institution will be given a score of 1, 2, 3, or 4 on each indicator
				depending upon the quartile in which it falls. A quartile score of 1 on an
				indicator means that an institution ranked in the top quartile (top 25%) on
				that indicator. Quartile scores are summed over all indicators. The total is
				divided by the number of indicators to get an average quartile score. The top
				performers will be selected by using the average quartile score and
				identifying, to the extent possible, the top 25% of the institutions within
				each peer group.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 216 - METHODOLOGY TO MEASURE EFFICIENCY AND PRODUCTIVITY OF HEALTH CARE INSTITUTIONS › Section 12VAC5-216-100 - Exemptions from the ranking procedure

Current through Register Vol. 40, No. 24, July 15, 2024
Until such time as a resource utilization adjustor, similar
				  to the case mix index for acute care hospitals referenced in subdivision 1 of
				  12VAC5-216-50 is developed and
				  adopted by the board, some institutions will be exempt from the ranking
				  procedure as described below:
1.
				Psychiatric hospitals.
2.
				Rehabilitation hospitals.
3.
				Ambulatory surgery hospitals.
4.
				Continuing care retirement communities.
5. Children's specialty hospitals.
6. Subacute care hospitals.
Statutory Authority
§§ 32.1-12 and 32.1-276.2 of the Code of
					 Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 216 - METHODOLOGY TO MEASURE EFFICIENCY AND PRODUCTIVITY OF HEALTH CARE INSTITUTIONS › Form - FORMS (12VAC5-216)

Current through Register Vol. 40, No. 24, July 15, 2024
Hospital Historical Filing, 03-01 (rev. 4/30/96).
Indicator Definitions - Acute Care Hospitals (rev.
				  10/15/96).
Special Services Utilization Calculations
Ambulatory Surgical Hospital Historical Filing, 03-02 (rev.
				  4/30/96).
Indicator Definitions - Ambulatory Surgery Hospitals (rev.
				  10/15/96).
Nursing Home Historical Filing, 03-03 (rev. 4/30/96).
Indicator Definitions - Nursing Homes (rev. 10/15/96).
Psychiatric Hospital Historical Filing, 03-05 (rev.
				  4/30/96).
Indicator Definitions - Psychiatric Hospitals (rev.
				  10/15/96).
Rehabilitation Hospital Historical Filing, 03-06 (rev.
				  4/30/96).
Indicator Definitions - Rehabilitation Hospitals (rev.
				  10/15/96).
Income Statement Reconciliation Worksheet, 04-04 (rev.
				  4/30/96).
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 217 - REPORTING REQUIREMENTS FOR PATIENT LEVEL DATA ELEMENTS › Section 12VAC5-217-10 - Definitions

Current through Register Vol. 40, No. 24, July 15, 2024
The following words and terms, when used in this chapter,
				  shall have the following meanings:
"Board" means the Virginia Board of Health.
"Complete filing" means that patient level data of at least
				  99% of a hospital's inpatient discharges for a calendar year quarter are
				  submitted.
"Inpatient hospital" means a hospital providing inpatient
				  care and licensed pursuant to Article 1 (§ 32.1-123 et seq.) of Chapter 5
				  of Title 32.1 of the Code of Virginia, a hospital licensed pursuant to Article
				  2 (§ 37.2-403 et seq.) of Chapter 4 of Title 37.2 of the Code of Virginia,
				  a hospital operated by the Department of Behavioral Health and Developmental
				  Services for the care and treatment of individuals with mental illness, or a
				  hospital operated by the University of Virginia or Virginia Commonwealth
				  University Health System Authority.
"Nonprofit organization" means a nonprofit, tax-exempt health
				  data organization with the characteristics, expertise, and capacity to execute
				  the powers and duties set forth for such entity in Chapter 7.2 (§
				  32.1-276.2 et seq.) of Title 32.1 of the Code of Virginia and with which the
				  Commissioner of Health has entered into a contract as required by §
				  32.1-276.4 of the Code of Virginia.
"Processed, verified data" means data on inpatient records
				  that fulfill the requirements specified in 12VAC5-217-15.
Statutory Authority: §§ 32.1-12 and 32.1-276.6 of
					 the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 217 - REPORTING REQUIREMENTS FOR PATIENT LEVEL DATA ELEMENTS › Section 12VAC5-217-15 - Requirements of processed, verified data

Current through Register Vol. 40, No. 24, July 15, 2024
Inpatient hospitals shall submit only processed, verified
				  data from inpatient records. To be considered processed and verified, a
				  complete filing of all records that are submitted by an inpatient hospital in
				  aggregate per calendar year quarter must be free of error at a prescribed
				  minimum rate. The prescribed minimum accuracy rate shall be 95% overall, with
				  patient identifier separately calculated at 95%. The accuracy rate shall be
				  calculated on only those fields designated in
				  12VAC5-217-20. Inpatient records
				  containing invalid codes or blank fields for any of the data elements shall be
				  designated as error records.
Statutory Authority: §§ 32.1-12 and 32.1-276.6 of
					 the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 217 - REPORTING REQUIREMENTS FOR PATIENT LEVEL DATA ELEMENTS › Section 12VAC5-217-30

Current through Register Vol. 40, No. 24, July 15, 2024
Statutory Authority: §§ 32.1-12 and 32.1-276.6 of
					 the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 217 - REPORTING REQUIREMENTS FOR PATIENT LEVEL DATA ELEMENTS › Section 12VAC5-217-40 - Options for submission

Current through Register Vol. 40, No. 24, July 15, 2024
Each inpatient hospital shall submit the patient level data
				  to the board for processing and verification. If data is submitted in this
				  fashion, the board will transmit it to the nonprofit organization along with
				  any fees submitted by the hospital to the board for the processing and
				  verification of such data.
As an alternative to submitting the patient level data to
				  the board, an inpatient hospital may submit the patient level data to the
				  office of the nonprofit organization for processing and verification.
If a hospital chooses this alternative it shall notify the
				  board and the nonprofit organization of its intent to follow this
				  procedure.
In lieu of submitting the patient level data to the board or
				  to the nonprofit organization, an inpatient hospital may submit already
				  processed, verified data to the nonprofit organization. If an inpatient
				  hospital chooses this alternative for submission of patient level data, it
				  shall notify the board and the nonprofit organization of its intent to utilize
				  this procedure.
If an inpatient hospital decides to change the option it has
				  chosen, it shall notify the board of its decision 30 days prior to the due date
				  for the next submission of patient level data.
Statutory Authority
§§ 32.1-12 and 32.1-276.2 of the Code of
					 Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 217 - REPORTING REQUIREMENTS FOR PATIENT LEVEL DATA ELEMENTS › Section 12VAC5-217-50 - Contact person

Current through Register Vol. 40, No. 24, July 15, 2024
Each hospital shall notify in writing the board and the
				  nonprofit organization of the name, address, telephone number and fax number of
				  a contact person. If a hospital's contact person changes, the board and the
				  nonprofit organization shall be notified in writing as soon as possible of the
				  name of the new person who shall be the contact person for that
				  hospital.
Statutory Authority
§§ 32.1-12 and 32.1-276.2 of the Code of
					 Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 217 - REPORTING REQUIREMENTS FOR PATIENT LEVEL DATA ELEMENTS › Section 12VAC5-217-60 - Frequency of submission

Current through Register Vol. 40, No. 24, July 15, 2024
A.
				Inpatient hospitals shall submit patient level data for inpatients at least on
				a calendar year quarterly basis.
B.
				If the data is submitted to the board or to the nonprofit organization for
				processing and verification, it shall be received at the office of the board or
				the office of the nonprofit organization within 45 days after the end of each
				calendar year quarter.
C. If
				inpatient hospitals choose to submit processed, verified data directly to the
				nonprofit organization, it shall be received at the office of the nonprofit
				organization within 120 days after the end of each calendar year
				quarter.
Statutory Authority
§§ 32.1-12 and 32.1-276.2 of the Code of
					 Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 217 - REPORTING REQUIREMENTS FOR PATIENT LEVEL DATA ELEMENTS › Section 12VAC5-217-70 - Establishment of annual fee

Current through Register Vol. 40, No. 24, July 15, 2024
The board shall not assess any fee against any health care
				  provider that submits data under this chapter that is processed, verified, and
				  timely in accordance with standards established by the board. The board shall
				  prescribe a reasonable fee not to exceed $1.00 per discharge for each inpatient
				  hospital submitting patient level data pursuant to this chapter that is not
				  processed, verified, or timely to cover the cost of the reasonable expenses in
				  processing and verifying such data. The fee shall be established and reviewed
				  annually by the board.
Statutory Authority: §§ 32.1-12 and 32.1-276.6 of
					 the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 217 - REPORTING REQUIREMENTS FOR PATIENT LEVEL DATA ELEMENTS › Section 12VAC5-217-80

Current through Register Vol. 40, No. 24, July 15, 2024
Statutory Authority: §§ 32.1-12 and 32.1-276.6 of
					 the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 217 - REPORTING REQUIREMENTS FOR PATIENT LEVEL DATA ELEMENTS › Section 12VAC5-217-90

Current through Register Vol. 40, No. 24, July 15, 2024
Statutory Authority: §§ 32.1-12 and 32.1-276.6 of
					 the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 217 - REPORTING REQUIREMENTS FOR PATIENT LEVEL DATA ELEMENTS › Section 12VAC5-217-100 - Late charge

Current through Register Vol. 40, No. 24, July 15, 2024
A late charge of $25 per working day shall be paid to the
				  board by an inpatient hospital that does not submit, in aggregate, a complete
				  filing of the patient level data required by
				  12VAC5-217-20 for all inpatients
				  discharged in a calendar year quarter pursuant to the times established in
				  12VAC5-217-60. This requirement
				  may be waived by the board if an inpatient hospital can show that an
				  extenuating circumstance exists. Examples of an extenuating circumstance
				  include, but are not limited to, the installation of a new computerized billing
				  system, a bankruptcy proceeding, closure of the institution, change of
				  ownership in the institution, or the institution is a new facility that has
				  recently opened.
Statutory Authority
§§ 32.1-12 and 32.1-276.2 of the Code of
					 Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 218 - RULES AND REGULATIONS GOVERNING OUTPATIENT HEALTH DATA REPORTING › Section 12VAC5-218-25 - Requirements of outpatient processed verified data

Current through Register Vol. 40, No. 24, July 15, 2024
To be considered processed and verified, a complete filing
				  of outpatient surgical procedures specified by the board submitted by a
				  reporting entity in aggregate per calendar year quarter must be free of error
				  at a prescribed rate. The prescribed minimum accuracy rate shall be 95%
				  overall, with patient identifier separately calculated at 95%. The accuracy
				  rate shall be calculated on only those fields designated in
				  12VAC5-218-20. Outpatient records
				  containing invalid codes or all blank fields for any of the data elements shall
				  be designated as error records.
Statutory Authority: §§ 32.1-12 and 32.1-276.6
					 of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 218 - RULES AND REGULATIONS GOVERNING OUTPATIENT HEALTH DATA REPORTING › Section 12VAC5-218-30

Current through Register Vol. 40, No. 24, July 15, 2024
Statutory Authority: §§ 32.1-12 and 32.1-276.6
					 of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 218 - RULES AND REGULATIONS GOVERNING OUTPATIENT HEALTH DATA REPORTING › Section 12VAC5-218-40 - Options for submission

Current through Register Vol. 40, No. 24, July 15, 2024
A. Each
				reporting entity shall submit outpatient level data in one of the following
				methods:
1. A reporting entity may submit the
				outpatient patient level data to the board for processing and verification. If
				data is submitted in this fashion, the board shall transmit it to the nonprofit
				organization along with any fees submitted for the processing and verification
				of such data. Fees shall not exceed $ .75 per record. Fees shall not be applied
				to state agencies reporting data.
2. A reporting entity may submit the
				outpatient patient level data along with any fees to the office of the
				nonprofit organization for processing and verification. If this alternative is
				chosen, the reporting entity shall notify the board and the nonprofit
				organization of its intent to follow this procedure.
3. A reporting entity may submit processed,
				verified data to the nonprofit organization. In the event that processed,
				verified data is submitted no fees shall be applied. If a reporting entity
				chooses this alternative for submission of patient level data, it shall notify
				the board and the nonprofit organization of its intent to utilize this
				procedure.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 218 - RULES AND REGULATIONS GOVERNING OUTPATIENT HEALTH DATA REPORTING › Section 12VAC5-218-50 - Contact person

Current through Register Vol. 40, No. 24, July 15, 2024
Each reporting entity shall notify the board and the
				  nonprofit organization in writing of the name, address, telephone number, email
				  (where available) and fax number (where available) of a contact person. If the
				  contact person changes, the board and the nonprofit organization shall be
				  notified in writing as soon as possible of the name of the new contact person
				  for that reporting entity.
Statutory Authority: §§ 32.1-12 and 32.1-276.6
					 of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 218 - RULES AND REGULATIONS GOVERNING OUTPATIENT HEALTH DATA REPORTING › Section 12VAC5-218-60 - Frequency of submission

Current through Register Vol. 40, No. 24, July 15, 2024
A.
				Reporting entities shall submit the data required by
				12VAC5-218-20 at least on a
				calendar-year quarterly basis.
B.
				If the data is submitted to the board or to the nonprofit organization for
				processing and verification, it shall be received at the office of the board or
				the office of the nonprofit organization within 45 days after the end of each
				calendar year quarter.
C. If a
				reporting entity chooses to submit processed, verified data directly to the
				nonprofit organization, it shall be received at the office of the nonprofit
				organization within 120 days after the end of each calendar year
				quarter.
Statutory Authority
§§ 32.1-12 and 32.1-276.6 of the Code of
					 Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 218 - RULES AND REGULATIONS GOVERNING OUTPATIENT HEALTH DATA REPORTING › Form - FORMS (12VAC5-218)

Current through Register Vol. 40, No. 24, July 15, 2024
National
				  Uniform Billing Committee Uniform Billing Form UB-04 (undated)
Centers
				  for Medicare and Medicaid Health Insurance Claim Form, Sample Form, CMS 1500
				  (approved 2/12)
Statutory Authority: §§ 32.1-12 and 32.1-276.6
					 of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part I - Definitions › Section 12VAC5-220-95 - Fee schedule

Current through Register Vol. 40, No. 24, July 15, 2024
A. Unless
				  otherwise provided, fees established by the board in this chapter shall not be
				  refundable.
B. The fee for any
				  application that requests a certificate of public need shall be 1.0% of the
				  proposed expenditure for the project but not less than $1,000 and no more than
				  $60,000.
C. The fee for any
				  application that requests registration of certain capital expenditures under
				  12VAC5-220-110
				  shall be $70.
D. The fee for any
				  application that requests registration of the addition of medical equipment and
				  services shall be $70.
E. The fee
				  for any application that requests registration of replacement of existing
				  medical equipment shall be $70.
Statutory Authority: §§ 32.1-12 and 32.1-102.2
						of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part II - General Information › Section 12VAC5-220-20 - Authority for regulations

Current through Register Vol. 40, No. 24, July 15, 2024
The Virginia Medical Care Facilities Certificate of Public
					 Need Law, which is codified as Article 1.1 (§ 32.1-102.1 et seq.) of
					 Chapter 4 of Title 32.1 of the Code of Virginia, requires the owners or
					 sponsors of medical care facility projects to secure a certificate of public
					 need from the State Health Commissioner prior to initiating such projects.
					 Sections 32.1-102.2 and 32.1-12 of the Code of Virginia direct the Board of
					 Health to promulgate and prescribe such rules and regulations as are deemed
					 necessary to effectuate the purposes of this statute.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part II - General Information › Section 12VAC5-220-30 - Purpose of chapter

Current through Register Vol. 40, No. 24, July 15, 2024
The board has promulgated this chapter to set forth an
					 orderly administrative process for making public need
					 decisions.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part II - General Information › Section 12VAC5-220-40 - Administration of chapter

Current through Register Vol. 40, No. 24, July 15, 2024
This chapter is administered by the following:
1. The Board of Health is the governing body
				  of the Virginia Department of Health. The Board of Health has the authority to
				  promulgate and prescribe such rules and regulations as it deems necessary to
				  effectuate the purposes of the Act.
2. The State Health Commissioner is the
				  executive officer of the Virginia Department of Health. The commissioner is the
				  designated decision maker in the process of determining public need under the
				  Act.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part II - General Information › Section 12VAC5-220-50 - Public meetings and public hearings

Current through Register Vol. 40, No. 24, July 15, 2024
All meetings and hearings convened to consider any
					 certificate of public need application shall be open to the public in
					 accordance with the provisions of the Virginia Freedom of Information Act
					 (§ 2.1-340 et seq.) of the Code of Virginia.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part II - General Information › Section 12VAC5-220-60 - Official records

Current through Register Vol. 40, No. 24, July 15, 2024
Written information including staff evaluations and
					 reports and correspondence developed or utilized or received by the
					 commissioner during the review of a medical care facility project shall become
					 part of the official project record maintained by the Department of Health and
					 shall be made available to the applicant, competing applicant and review
					 bodies. Other persons may obtain a copy of the project record upon request. All
					 records are subject to the Virginia Freedom of Information
					 Act.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part II - General Information › Section 12VAC5-220-70 - Application of chapter

Current through Register Vol. 40, No. 24, July 15, 2024
This chapter has general applicability throughout the
					 Commonwealth. The requirements of the Virginia Administrative Process Act
					 (§ 9-6.14:1 et seq.) of the Code of Virginia apply to their
					 promulgation.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part II - General Information › Section 12VAC5-220-80 - Powers and procedures of chapter not exclusive

Current through Register Vol. 40, No. 24, July 15, 2024
The commissioner and the board reserve the right to
					 authorize any procedure for the enforcement of this chapter that is not
					 inconsistent with the provisions set forth herein and the provisions of Article
					 1.1 (§ 32.1-102.1 et seq.) of Chapter 4 of Title 32.1 of the Code of
					 Virginia.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part II - General Information › Section 12VAC5-220-90 - Annual report

Current through Register Vol. 40, No. 24, July 15, 2024
Pursuant to § 32.1-102.12 of the Code of Virginia,
					 the commissioner shall annually report to the Governor and the General Assembly
					 on the status of Virginia's certificate of public need program.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part III - Mandatory Requirements › Section 12VAC5-220-100 - Requirements for reviewable medical care facility projects; exceptions

Current through Register Vol. 40, No. 24, July 15, 2024
A. Prior to
				  initiating a reviewable medical care facility project the owner or sponsor
				  shall obtain a certificate of public need from the commissioner. In the case of
				  an acquisition of an existing medical care facility, the notification
				  requirement set forth in
				  12VAC5-220-120
				  shall be met.
B. Projects involving
				  a temporary increase in the total number of beds in an existing hospital or
				  nursing home shall be exempt from the requirement for a certificate, for a
				  period of no more than 30 days, if the commissioner has determined that a
				  natural or man-made disaster has caused the evacuation of a hospital or nursing
				  home and that a public health emergency exists due to a shortage of hospital or
				  nursing home beds.
Statutory Authority: §§
												32.1-12
						and
						32.1-102.2 of the
						Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part III - Mandatory Requirements › Section 12VAC5-220-105 - Requirements for registration of the replacement of existing medical equipment

Current through Register Vol. 40, No. 24, July 15, 2024
Within 30 days of any person contracting to make, or
					 otherwise legally obligating to make, a capital expenditure for the replacement
					 of medical equipment or otherwise acquiring replacement medical equipment for
					 the provision of services listed in subdivision 7 of the definition of
					 "project" in
					 12VAC5-220-10, the
					 person shall register in writing such equipment replacement with the
					 commissioner and the appropriate regional health planning agency. Such
					 registration shall be made on forms provided by the department. The
					 registration shall identify the specific unit of equipment to be replaced and
					 the estimated capital cost of the replacement , shall include documentation
					 that the equipment to be replaced has previously been authorized or exempted as
					 allowed by law, and shall include the fee prescribed by subsection E of
					 12VAC5-220-95.
Statutory Authority: §§ 32.1-12 and 32.1-102.2
						of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part III - Mandatory Requirements › Section 12VAC5-220-110 - Requirements for registration of certain capital expenditures

Current through Register Vol. 40, No. 24, July 15, 2024
A. At least 30 days
				  before any person contracts to make or is otherwise legally obligated to make a
				  capital expenditure by or on behalf of a medical care facility as defined in
				  this chapter that has not been previously authorized by the commissioner, such
				  expenditure shall be registered in writing with the commissioner. The threshold
				  amount for capital expenditure project registration shall be determined using
				  the formula contained in subsection B of this section.
B. The threshold contained in subsection A of
				  this section shall be adjusted annually using the percentage increase listed in
				  the Consumer Price Index for All Urban Consumers (CPI-U) for the most recent
				  year as follows:
A x (1 + B)
where:
A = the capital expenditure threshold amount for the
					 previous year
and
B = the percent increase for the expense category "Medical
					 Care" listed in the most recent year available of the CPI-U of the U.S. Bureau
					 of Labor Statistics.
C. The
				  application requesting registration shall include information concerning the
				  purpose of such expenditure , the projected impact that the expenditure will
				  have upon the charges for services, and the fee prescribed by subsection C of
				  12VAC5-220-95. For purposes of registration, the owner shall include any person
				  making the affected capital expenditure. See definition of "project."
D. Annually, the department shall (i) publish
				  the threshold amount in the General Notices section of the Virginia Register of
				  Regulations and (ii) post the threshold amount on its website.
Statutory Authority: §§ 32.1-12 and 32.1-102.2
						of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part III - Mandatory Requirements › Section 12VAC5-220-120 - Requirement for notification of proposed acquisition of medical care facility

Current through Register Vol. 40, No. 24, July 15, 2024
At least 30 days before any person is contractually
					 obligated to acquire an existing medical care facility, the cost of which is
					 $600,000 or more, that person shall provide written notification to the
					 commissioner and the regional health planning agency that serves the area in
					 which the facility is located. Such notification shall identify the name of the
					 medical care facility, the current and proposed owner, the cost of the
					 acquisition, the services to be added or deleted, the number of beds to be
					 added or deleted, and the projected impact that the cost of the acquisition
					 will have upon the charges of the services to be provided in the medical care
					 facility. The commissioner shall provide written notification to the person who
					 plans to acquire the medical care facility within 30 days of receipt of the
					 required notification. If the commissioner finds that a reviewable clinical
					 health service or beds are to be added as a result of the acquisition, the
					 commissioner may require the proposed new owner to obtain a certificate prior
					 to the acquisition. If such certificate is required, an application will be
					 considered under an appropriate batch group which will be identified at the
					 time of written notification by the commissioner to the applicant for such
					 acquisition.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part III - Mandatory Requirements › Section 12VAC5-220-130 - Significant change limitation

Current through Register Vol. 40, No. 24, July 15, 2024
No significant change in a project for which a certificate
					 of public need has been issued shall be made without prior written approval of
					 the commissioner. Such request for a significant change shall be made in
					 writing by the owner to the commissioner with a copy to the appropriate
					 regional health planning agency. The owner shall also submit the application
					 fee to the department if applicable at the time the written request is made.
					 The written request shall identify the nature and purpose of the change. The
					 regional health planning agency shall review the proposed change and notify the
					 commissioner of its recommendation with respect to the change within 30 days
					 from receipt of the request by both the department and the regional health
					 planning agency. Failure of the regional health planning agency to notify the
					 commissioner within the 30-day period shall constitute a recommendation of
					 approval. The commissioner shall act on the significant change request within
					 35 days of receipt. A public hearing during the review of a proposed
					 significant change request is not required unless determined necessary by the
					 commissioner. The commissioner shall not approve a significant change in cost
					 for a project which exceeds the authorized capital expenditure by more than
					 20%. The commissioner shall not extend the schedule for completion of a project
					 beyond three years from the date of issuance of the certificate or beyond the
					 time period approved by the commissioner at the date of certificate issuance,
					 whichever is greater, except when delays in completion of a project have been
					 caused by events beyond the control of the owner and the owner has made
					 substantial and continuing progress toward completion of the project.
Exception: The commissioner may approve a significant
					 change in cost for an approved project that exceeds the authorized capital
					 expenditure by more than 20%, provided the applicant has demonstrated that the
					 cost increases are reasonable and necessary under all the circumstances and do
					 not result from any material expansion for the project as
					 approved.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part III - Mandatory Requirements › Section 12VAC5-220-140 - Requirements for health maintenance organizations (HMO)

Current through Register Vol. 40, No. 24, July 15, 2024
An HMO must obtain a certificate of public need prior to
					 initiating a project. Such HMO must also adhere to the requirements for the
					 acquisition of medical care facilities if appropriate. See definition of
					 "project" and
					 12VAC5-220-10.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part III - Mandatory Requirements › Section 12VAC5-220-155 - Requirements for the reporting of charity care

Current through Register Vol. 40, No. 24, July 15, 2024
Every medical care facility subject to the requirements of
					 Article 1.1 (§
										32.1-102.1 et seq.)
					 of Chapter 4 of Title 32.1 of the Code of Virginia, other than a nursing home,
					 that is not a medical care facility for which a certificate with conditions
					 imposed pursuant to §
										32.1-102.4F
					 of the Code of Virginia has been issued and that provides charity care, as
					 defined in §
										32.1-102.1 of the
					 Code of Virginia, shall annually report to the commissioner the amount of
					 charity care provided.
Statutory Authority: §§
												32.1-12
						and
						32.1-102.2 of the
						Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part IV - Determination of Public Need (Required Considerations) › Section 12VAC5-220-160 - Required considerations

Current through Register Vol. 40, No. 24, July 15, 2024
In determining whether a public need exists for a proposed
					 project, the applicable requirements of § 32.1-102.2:1 of the Code of
					 Virginia will be considered.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part V - Standard Review Process › Section 12VAC5-220-170 - Preconsultation

Current through Register Vol. 40, No. 24, July 15, 2024
Each regional health planning agency and the department
					 shall provide upon request advice and assistance concerning community health
					 resources needs to potential applicants. Such advice and assistance shall be
					 advisory only and shall not be a commitment on behalf of the regional health
					 planning agency or the commissioner.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part V - Standard Review Process › Section 12VAC5-220-180 - Application forms

Current through Register Vol. 40, No. 24, July 15, 2024
A. Letter of
				  intent. An applicant shall file a letter of intent with the commissioner to
				  request appropriate application forms, and submit a copy of that letter to the
				  appropriate regional health planning agency, by the later of (i) 30 days prior
				  to the submission of an application for a project included within a particular
				  batch group or (ii) 10 days after the first letter of intent is filed for a
				  project within a particular batch group for the same or similar services and
				  facilities which are proposed for the same planning district or medical service
				  area. The letter shall identify the owner, the type of project for which an
				  application is requested, and the proposed scope (size) and location of the
				  proposed project. The department shall transmit application forms to the
				  applicant within seven days of the receipt of the letter of intent. A letter of
				  intent filed with the department shall be considered void one year after the
				  date of receipt of such letter. (See
				  12VAC5-220-310
				  C.)
B. Application fees. The
				  department shall collect application fees for applications that request a
				  certificate of public need. The applicant shall pay the fee prescribed by
				  subsection B of 12VAC5-220-95 for any application that requests a certificate
				  of public need.
No application will be deemed to be complete for review
					 until the required application fee is paid. (See
					 12VAC5-220-310
					 C.)
C. Filing application
				  forms. Applications must be submitted at least 40 days prior to the first day
				  of a scheduled review cycle to be considered for review in the same cycle. In
				  order to verify the date of the department's and the appropriate regional
				  health planning agency's receipt of the application, the applicant shall
				  transmit the document electronically, or prepare in triplicate two copies to be
				  submitted to the department and one copy to be submitted to the appropriate
				  regional health planning agency and sent by certified mail or a delivery
				  service, return receipt requested, or by hand, with a signed receipt to be
				  provided. No application shall be deemed to have been submitted until required
				  copies have been received by the department and the appropriate regional health
				  planning agency. (See
				  12VAC5-220-200.)
Statutory Authority: §§ 32.1-12 and 32.1-102.2
						of the Code of Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part V - Standard Review Process › Section 12VAC5-220-190 - Review for completeness

Current through Register Vol. 40, No. 24, July 15, 2024
The applicant shall be notified by the department within
					 15 days following receipt of the application if additional information is
					 required to complete the application or the application is complete as
					 submitted. No application shall be reviewed until the department has determined
					 that it is complete. To be complete, all questions must be answered to the
					 satisfaction of the commissioner and all requested documents supplied, when
					 applicable and the application fee submitted. Additional information required
					 to complete an application shall be submitted to the department and the
					 appropriate regional health planning agency at least five days prior to the
					 first day of a review cycle to be considered complete for review in the same
					 review cycle. (See
					 12VAC5-220-200.)
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.
Virginia Administrative Code › Title 12 - HEALTH › Agency 5 - DEPARTMENT OF HEALTH › Chapter 220 - VIRGINIA MEDICAL CARE FACILITIES CERTIFICATE OF PUBLIC NEED RULES AND REGULATIONS › Part V - Standard Review Process › Section 12VAC5-220-210 - Requests for application (RFA)

Current through Register Vol. 40, No. 24, July 15, 2024
The commissioner may request the submission of applications
					 for his consideration which address a specific need for services and facilities
					 as identified in the State Medical Facilities Plan. The department shall give
					 notice of such RFA in a newspaper of general circulation in the locality or the
					 planning district where the specific services or facility is requested. Such
					 notice shall be published at least 120 days prior to the first day of the
					 appropriate review cycle for the type of project being requested. A written
					 copy of an RFA shall also be available upon request from the department and the
					 regional health planning agency in the appropriate geographic area. The process
					 for adoption of an RFA by the commissioner for projects listed in §
					 32.1-102.3:2A, B, and C of the Code of Virginia are set forth in
					 12VAC5-220-335.
Statutory Authority
§§ 32.1-12 and 32.1-102.2 of the Code of
						Virginia.