reglab/statecodes huggingface dataset:
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-07 - Certificate Of Need Rule › Section 65-7-13 - Stays and Extensions of Review Periods

Current through Register Vol. XLI, No. 28, July 12, 2024
13.1. At any time during the board's review
				of an application, the board may grant the applicant's request that the running
				of the review period be stayed. An application under review and stayed at the
				request of the applicant for a total period exceeding one hundred eighty (180)
				days during any review period is considered withdrawn, and the applicant shall
				file a new letter of intent and an application if the applicant desires to
				pursue the project.
13.2. Upon a
				finding by the board that it would not be practicable to complete the review of
				an application within the time provided by this rule, the board may extend the
				review process for up to an additional thirty (30) days.
13.3. Situations which would make it
				impracticable for the board to complete its review within the time provided by
				this rule include, but are not limited to the following:
13.3.a. A project is of such a comprehensive
				nature that to review it within the time provided by this rule would not do
				justice to the applicant or to the population which the proposed project would
				serve;
13.3.b. The board has
				requested additional information from the applicant and the applicant has
				failed to provide the information to the board in the time frame directed by
				the board; and
13.3.c. Weather
				conditions or other natural disasters have prevented the review process from
				taking place in a timely manner.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-07 - Certificate Of Need Rule › Section 65-7-14 - Decision

Current through Register Vol. XLI, No. 28, July 12, 2024
14.1. Except as
				provided later in this section, the board shall issue a certificate of need
				only if it makes the following written findings:
14.1.a. That the proposed new institutional
				health service is needed;
14.1.b.
				With the exception of emergency circumstances that pose a threat to the public
				health, that the new institutional health service is consistent with the State
				Health Plan. If the proposed new institutional health service is not discussed
				in the State Health Plan, the board shall not disapprove the application solely
				for that reason;
14.1.c. That
				superior alternatives to the services in terms of cost, efficiency and
				appropriateness do not exist and that the development of alternatives is not
				practicable;
14.1.d. Existing
				facilities providing similar services to those proposed are using those
				services in an appropriate and efficient manner;
14.1.e. In the case of new construction,
				alternatives to new construction have been considered and have been implemented
				to the maximum extent possible, including modernization and sharing
				arrangements;
14.1.f. Patients will
				experience serious problems in obtaining care of the type proposed in the
				absence of the proposed new service; and
14.1.g. In the case of a proposal for the
				addition of beds for the provision of skilled nursing or intermediate care
				services, the addition will be consistent with the plans of other agencies of
				the state responsible for the provision and financing of long-term care
				facilities or services including home health services.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-07 - Certificate Of Need Rule › Section 65-7-15 - Exemptions from Certificate of Need Program

Current through Register Vol. XLI, No. 28, July 12, 2024
15.1. Except for the acquisition of major
				medical equipment which costs in excess of two million dollars, the following
				projects are not subject to supervision, regulation or control by the board:
15.1.a. Any private office practice of one or
				more health professionals licensed pursuant to the provisions of Chapter 30 of
				the W. Va. Code. This exemption does not exempt from review the acquisition,
				offering or development of one or more health services, including ambulatory
				surgical facilities or centers, lithotripsy, magnetic resonance imaging or
				radiation therapy by one or more health professionals and as further defined in
				the Health Care Authority's legislative rule, "Health Services Offered by
				Health Professionals," 65 CSR 17;
15.1.b. Any dispensary or first-aid station
				located within a business or industrial establishment and maintained solely for
				the use of employees. The facility may not contain inpatient or resident beds
				for patients or employees who generally remain in the facility for more than
				twenty-four hours;
15.1.c. Any
				establishment, such as a motel, hotel or boarding house, which provides
				medical, nursing personnel and health related services;
15.1.d. The remedial care or treatment of
				residents or patients in any home or institution conducted only for those who
				rely solely upon treatment by prayer or spiritual means in accordance with the
				creed or tenets of any recognized church or religious denomination;
15.1.e. The creation of new primary care
				services located in communities that are underserved with respect to primary
				care services. This exemption is limited to applicants that are community-based
				nonprofit organizations with community boards that provide or will provide
				primary care services to people without regard to ability to pay. This
				exemption is further defined in the Health Care Authority's legislative rule,
				"Exemption for New Primary Care Services," 65CSR23; and
15.1.f. The creation of birthing centers by
				nonprofit primary care centers that have a community board and provide primary
				care services to people in their community without regard to ability to pay, or
				by nonprofit hospitals with less than one hundred licensed acute care beds.
				This exemption is further defined in the Health Care Authority's legislative
				rule, "Exemption for Birthing Centers," 65CSR24.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-07 - Certificate Of Need Rule › Section 65-7-17 - Reconsideration of Final Board Decision

Current through Register Vol. XLI, No. 28, July 12, 2024
17.1. Any person may request, in writing,
				reconsideration of a decision rendered by the board on a certificate of need
				application. If the request for reconsideration establishes good cause for
				reconsideration, then the board shall grant the request. Upon request, the
				board may grant a public hearing to consider the request for
				reconsideration.
17.2. A request
				for reconsideration is considered to have shown good cause if, in a detailed
				statement, it:
17.2.a. Presents significant,
				relevant information not previously considered by the board, and demonstrates
				that with reasonable diligence the information could not have been presented
				before the board made its decision;
17.2.b. Demonstrates that there have been
				significant changes in factors or circumstances relied upon by the board in
				reaching its decision;
17.2.c.
				Demonstrates that the board has materially failed to follow its adopted
				procedures in reaching its decision; or
17.2.d. Provides any other basis for a public
				hearing as the board determines constitutes good cause.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-07 - Certificate Of Need Rule › Section 65-7-19 - Judicial Review

Current through Register Vol. XLI, No. 28, July 12, 2024
19.1. Any final
				decision of the Office of Judges granting, denying or withdrawing a certificate
				of need or exemption may be appealed to the Circuit Court of Kanawha County or
				to the circuit court of the county in which the petitioner or any of the
				petitioners reside or do business. The appellant shall file an appeal within
				thirty (30) days after the date the appellant received notice of the decision
				of the Office of Judges.
19.2. Any
				party adversely affected by the Office of Judges review has standing to file an
				appeal. For the purposes of this section, a "person adversely affected by the
				review" means the board and any person who meets the definition of "affected
				person" under section 2 of the Act.
19.3. For the purposes of this section, no
				decision of the board is considered final until it is reviewed by the Office of
				Judges pursuant to section 18 of this rule or until the time for an appeal has
				elapsed. No circuit court has jurisdiction to consider a decision of the board
				if the petitioner has failed to file a request for review with the Office of
				Judges within the time permitted under section 18 of this rule, or, if a
				request for review was filed, the person requesting the review has failed to
				pursue the review and the Office of Judges has dismissed the request for review
				with prejudice.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-07 - Certificate Of Need Rule › Section 65-7-20 - Progress Reports/Extension of Certificate of Need

Current through Register Vol. XLI, No. 28, July 12, 2024
20.1. Any person holding a certificate of
				need or who has been granted an exemption shall submit to the board, in
				writing, a report on the progress being made toward completion of the approved
				project according to the timetable contained in the application. The progress
				report must contain a verification signed by the Chief Executive Officer and
				shall be submitted at least forty-five (45) days prior to the expiration of the
				certificate of need or exemption, or at any other time directed by the board.
				The report shall include, at a minimum, the following:
20.1.a. The current status of the project in
				relation to the timetable in the application;
20.1.b. The projected date of
				completion;
20.1.c. The cause or
				causes of any delays encountered;
20.1.d. Changes in the project, including any
				proposed changes for which a request is made for the board to determine whether
				the proposed change is reviewable as a substantial change or that an exemption
				previously granted should be withdrawn and the applicant be required to obtain
				a certificate of need for failure to meet the requirements of the
				exemption;
20.1.e. The projected
				total cost; and
20.1.f. Compliance
				with any conditions of certification.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-07 - Certificate Of Need Rule › Section 65-7-21 - Substantial Changes to Project After Issuance of Certificate of Need

Current through Register Vol. XLI, No. 28, July 12, 2024
21.1. In
				determining whether changes proposed to an approved project for which a
				certificate of need or exemption has been issued are substantial, the board
				shall consider the following as prima facie evidence of a substantial change.
21.1.a. A change in the location of the
				approved project which reduces the accessibility of patients who otherwise have
				no alternative to the services reasonably available or the change in location
				would adversely affect or impact an existing health care facility;
21.1.b. A change in the service area of the
				approved project;
21.1.c. A change
				in the location of the approved project to a county that was not significantly
				impacted by the proposal when it was originally approved;
21.1.d. An addition in the number of beds or
				a change in the types of beds;
21.1.e. The acquisition of major medical
				equipment not described in the application as part of the project or a capital
				expenditure for major medical equipment in excess of ten percent (10%) over the
				approved capital expenditure for medical equipment;
21.1.f. The addition of health
				services;
21.1.g. An increase or
				decrease in square footage in excess of 10% of the originally approved footage
				or 1,000 square feet, whichever is greater; and
21.1.h. An unapproved capital expenditure, or
				an increase in the approved capital expenditure which is in excess of the
				expenditure minimum or in excess of 20% of the originally approved capital
				expenditure, whichever is less.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-07 - Certificate Of Need Rule › Section 65-7-22 - Transferability

Current through Register Vol. XLI, No. 28, July 12, 2024
22.1. A certificate
				of need is nontransferable. A transfer includes the sale, lease, transfer of
				stock or partnership shares, or other comparable arrangement which has the
				effect of transferring the control of the owner of the certificate of
				need.
22.2. If the board finds that
				a certificate of need has been transferred, the board shall withdraw the
				certificate.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-07 - Certificate Of Need Rule › Section 65-7-23 - Substantial Compliance Review

Current through Register Vol. XLI, No. 28, July 12, 2024
23.1. The board shall conduct a substantial
				compliance review of all new institutional health services for which it has
				issued a certificate of need or for which it has granted an exemption. No later
				than forty-five (45) days prior to licensure or the undertaking of the activity
				for which a certificate of need was issued or an exemption granted, the
				applicant shall request, in writing, that the board undertake a substantial
				compliance review. The request shall contain a verification signed by the Chief
				Executive Officer.
23.2. The board
				shall issue its findings as to substantial compliance within forty-five (45)
				days of its receipt of a request for the review. If the board finds that the
				project is not in substantial compliance with its certificate of need or
				exemption, the board may withdraw the certificate or exemption and the board
				may direct that any license to operate the new service be revoked or denied, or
				the board may impose appropriate fines and/or seek an injunction against the
				use or operation of the new service.
23.3. If the board determines that it would
				be impracticable for the applicant to prepare and submit final cost figures for
				the project prior to the time the project is ready to be licensed or ready to
				undertake the activity for which a certificate of need was issued, the board
				may issue a conditional notice of substantial compliance, authorizing the
				licensure or the undertaking of the activity, for up to twelve (12) months. The
				applicant shall prepare and submit documented final cost figures within the
				time designated by the board in its notice of substantial compliance. The board
				may withdraw a certificate of need if the applicant fails to submit the final
				cost figures within the time designated by the board. The board may impose
				appropriate fines and seek an injunction against the further use or operation
				of the new service.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-07 - Certificate Of Need Rule › Section 65-7-24 - Withdrawal of Certificate of Need

Current through Register Vol. XLI, No. 28, July 12, 2024
24.1. The board may withdraw a certificate of
				need for any of the following reasons:
24.1.a. Insufficient progress in meeting the
				timetable specified in the approved application for the certificate and for not
				making a good faith effort to meet it in developing the project;
24.1.b. Noncompliance with any conditions of
				certification;
24.1.c. A
				substantial change in an approved new institutional health service for which
				the board has not issued a certificate of need;
24.1.d. A material misrepresentation by an
				applicant upon which the board relied in making its decision; or
24.1.e. Other reasons contained in the Act or
				this rule.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-07 - Certificate Of Need Rule › Section 65-7-26 - Public Access To Information

Current through Register Vol. XLI, No. 28, July 12, 2024
The board shall make available for public inspection and
				  examination all applications filed with the board and all other pertinent
				  written materials filed with the board and essential to its review process. The
				  board shall make copies of the applications or documents available to the
				  public upon request. The board may charge its reasonable and customary fees for
				  making the copies.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-07 - Certificate Of Need Rule › Section 65-7-27 - Applicability

Current through Register Vol. XLI, No. 28, July 12, 2024
The board shall consider any application for which a review
				  cycle has been established prior to the effective date of this rule under the
				  rules in effect at the time the review cycle was established.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-07 - Certificate Of Need Rule › Section 65-7-28 - Addition of Health Services

Current through Register Vol. XLI, No. 28, July 12, 2024
28.1.
				The addition of the following health services offered by or on behalf of a
				health care facility or a health maintenance organization which were not
				offered on a regular basis within the twelve month period prior to the time the
				services would be offered is subject to certificate of need review pursuant to
				section 3(b)(5) of the Act:
28.1.a. Alcohol
				and other drug treatment and rehabilitation if offered in a discrete
				unit;
28.1.b. Ambulatory surgical
				facilities, ambulatory surgical centers and diagnostic services;
28.1.c. Cardiac catheterization;
28.1.d. Comprehensive medical rehabilitation
				on an inpatient basis;
28.1.e.
				End-stage renal dialysis stations and home training;
28.1.f. Intermediate care facilities for the
				mentally retarded (ICF-MR);
28.1.g.
				Discrete units for long term care nursing beds;
28.1.h. Lithotripsy;
28.1.i. Magnetic resonance imaging
				(MRI);
28.1.j. Medical or surgical
				beds;
28.1.k. Discrete obstetrical
				units;
28.1.l. Organ and tissue
				transplants;
28.1.m. Open heart
				surgery;
28.1.n. Discrete pediatric
				units;
28.1.o. Discrete inpatient
				psychiatric units;
28.1.p. Special
				care units for burns, intensive care, cardiac care, neonatal intensive care,
				neonatal intermediate care and pediatric intensive care;
28.1.q. Surgical services;
28.1.r. Radiation therapy;
28.1.s. Hospice;
28.1.t. Home health;
28.1.u. Positron emission tomography
				(PET);
28.1.v. In-home personal
				care services;
28.1.w. Outpatient
				behavioral health services; and
28.1.x. CT (computed tomography)
				scanning.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-08 - Legislative Rules For The Limitation On Hospital Gross Patient Revenue › Section 65-8-1 - General

Current through Register Vol. XLI, No. 28, July 12, 2024
1.1. Scope. --
				These legislative rules shall be used to determine hospital's compliance with
				the limitations placed on the rate of increase for each hospital's gross
				patient revenue during the period prior to the establishment of rate schedules
				by the Health Care Cost Revenue Authority. These legislative rules supplement
				Code section one, article twenty-nine-b, chapter sixteen et seq. and must be
				read in conjunction with it.
1.2.
				Authority. -- W. Va. Code ''16-29B-1 et seq., 16-5F-3, 29A-2-9, 29A-3-15 and
				29B-1-3.
1.3. Filing Date. -- April
				5, 1984.
1.4. Effective Date. --
				May 5, 1984.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-08 - Legislative Rules For The Limitation On Hospital Gross Patient Revenue › Section 65-8-2 - Definitions

Current through Register Vol. XLI, No. 28, July 12, 2024
As used in the regulations, all terms have the same meaning
				  as provided in the definition section (Code section two, article twenty-nine-b,
				  chapter sixteen) of the statutes. Verbatim definitions, therefore, are not
				  repeated here. Definitions set forth below amplify and clarify the statutory
				  definitions or define terms not specifically set forth in the statute.
2.1. "Authority" means the Health Care Cost
				Review Authority established in Code section five, article twenty-nine-b,
				chapter sixteen.
2.2. "Base Period"
				means the twelve (12) months covering the period February 1, 1982 to January
				31, 1983.
2.3. "Contractual
				Allowance to Third Party Payers" means the uncollectible difference between a
				hospital's charges posted for services and the rates paid by third party payers
				in accordance with contracts between the third party payers and the
				hospital.
2.4. "Control Period for
				a Hospital" means the period from February 1, 1983 to, and including, the month
				in which the Authority establishes the hospital's initial rate schedule which
				shall not be prior to March 1984.
2.5. "Gross Patient Revenue" means the total
				amount of charges posted by a hospital for services rendered to patients in a
				given period of time (e.g., month or year).
2.6. "Gross Patient Revenue as most Recently
				Reported" means the gross patient revenue reported under Code section four,
				article five-f, chapter sixteen for the base period.
2.7. "Interested Persons" means persons on
				the Authority's general mailing list and persons who have requested to be
				notified of the review of a specific application.
2.8. "Net Patient Revenue" means the total
				amount of revenue actually received by a hospital in a given period of time
				(e.g., month or year) for services rendered to patients.
2.9. "Proportion of Medicare, Medicaid or
				Charity Care Patients" means the ratio of a hospital's uncollectible accounts,
				charity and contractual allowances to its gross patient revenue for a fiscal
				year as reported in its audited financial statement.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-08 - Legislative Rules For The Limitation On Hospital Gross Patient Revenue › Section 65-8-4 - Determination Of Certificate Of NeedRelated Adjustments To Allowed Gross Patient Revenue

Current through Register Vol. XLI, No. 28, July 12, 2024
4.1.
				Application for an adjustment.
4.1.1. Criteria
				for submission of application. -- A hospital may submit one (1) consolidated
				application to the Authority for an adjustment to the amount of gross patient
				revenue that would otherwise be allowed for the control period if:
(a) It has undertaken one or more projects
				(excluding projects solely related to nonpatient care activities, e.g., parking
				garages, physician office buildings or solely for the purpose of replacing
				obsolete equipment) in conformance with a Certificate of Need decision or
				exemption letter issued pursuant to article two-d, chapter sixteen of the Code;
				and
(b) The gross patient revenues
				reported by the hospital for the base period do not fully reflect obligations
				or volume changes directly related to projects in (a) above that were completed
				subsequent to July 1, 1980.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-08 - Legislative Rules For The Limitation On Hospital Gross Patient Revenue › Section 65-8-5 - Reporting Required

Current through Register Vol. XLI, No. 28, July 12, 2024
5.1.
				Within forty-five (45) days of the effective date of these rules, each hospital
				shall submit to the Authority a report certified by the hospital's governing
				body of its gross patient revenue for each month from June 1981 through January
				1983.
5.2. Within forty-five (45)
				days of the end of the month in which the Authority establishes a hospital's
				initial rate schedules, such hospital shall submit to the Authority a report
				certified by the hospital's governing body of its gross patient revenue for
				each month in its control period.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-08 - Legislative Rules For The Limitation On Hospital Gross Patient Revenue › Section 65-8-6 - Decisions And Records Available

Current through Register Vol. XLI, No. 28, July 12, 2024
Decisions and records of the Authority may be inspected in
				  accordance with section three, article one, chapter twenty-nine-b of the Code
				  and copied at a charge of twenty-five cents ($.25) per page.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-08 - Legislative Rules For The Limitation On Hospital Gross Patient Revenue › Section 65-8-7 - Severability

Current through Register Vol. XLI, No. 28, July 12, 2024
If any provisions of these rules or the application thereof
				  to any person or circumstance shall be held invalid, such invalidity shall not
				  affect the provisions or the application of these rules which can be given
				  effect without the invalid provisions or application, and to this end the
				  provisions of these rules are declared to be severable.
TABLE 65-8A
Where r1 = Allowed per annum rate of
				  increase in gross patient revenue for first twelve (12) months of control
				  period.
r2 = Allowed per annum rate of
				  increase in gross patient revenue for remaining months of control
				  period.
f = The mathematical formula to calculate a factor unique to
				  each hospital's circumstance that assures all hospitals and equal rate of
				  allowed increase in net patient revenue, regardless of any changes that occur
				  in the proportion of Medicare, Medicaid or charity care patients. This factor
				  eliminates any incentive for a hospital to increase its net patient revenue by
				  reducing its proportion of Medicare, Medicaid or charity care patients. It also
				  eliminates the adverse effects on net patient revenue of hospital's that
				  experience an increase in their proportion of Medicare, Medicaid or charity
				  care patients.
R = Proportion of Medicare, Medicaid or charity care
				  patients.
R1 = Proportion for fiscal year ending
				  in 1982.
R2 = Proportion for fiscal year ending
				  in 1983.
R3 = Proportion for fiscal year ending
				  in 1984.
TABLE 65-8B
GPR1 = GPRB (1
				  + r1
Where: GPR1 = Gross patient revenue
				  allowed for first twelve (12) months of control period.
GPRB = Gross patient revenue reported
				  by the hospital for the base period.
r1 = Allowed per annum rate of
				  increase for period as calculated in formula in Section 3.2 of these
				  rules.
TABLE 65-8C
Where: GPR2 = Gross patient revenue
				  allowed for the remaining portion of the control period.
r2 = Allowed per annum rate of
				  increase for period as calculated in formula in section 3.2 of this
				  regulation.
n = Number of months from February 1,1984 to, and including,
				  the month the Authority establishes the initial rate
				  schedule.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-09 - Critical Access Hospitals › Section 65-9-1 - General

Current through Register Vol. XLI, No. 28, July 12, 2024
1.1. Scope. -- This
				legislative rule establishes specific standards and procedures to provide for
				the designation of a critical access hospital as a community outpatient medical
				center pursuant to W. Va. Code §
									16-5B-14.
1.2. Authority. -- W. Va. Code §
									16-5B-14(d).
1.3. Filing Date. -- April 13,
				2020.
1.4. Effective Date. --April
				13, 2020.
1.5. Sunset Provision. --
				This rule shall terminate and have no further force or effect on April 13,
				2025.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-09 - Critical Access Hospitals › Section 65-9-2 - Definitions

Current through Register Vol. XLI, No. 28, July 12, 2024
2.1. "Critical
				Access Hospital" means a hospital that is:
2.1.1. A not-for-profit, for-profit, or
				public hospital that is located in a county in a rural area as defined in
				42 U.S.C.A. §
											1395.i.4(e);
2.1.2. Located more than a 35-mile drive from
				a hospital or another health care facility or is located more than a 15-mile
				drive from a hospital or another health care facility in the case of
				mountainous terrain or in areas where only secondary roads are
				available;
2.1.3. Designated by the
				state as being a necessary provider of health care services to residents in the
				area;
2.1.4. Makes available
				24-hour emergency care services:
Provided,
That the state will
				determine necessary criteria for ensuring access to emergency care in each area
				served by the hospital;
2.1.5.
				Provides not more than 25 beds for inpatient care for a period not to exceed 96
				hours for each hospitalization to be averaged annually, unless a longer period
				is required because transfer to a hospital is precluded because of inclement
				weather or other emergency conditions:
Provided,
That swing
				bed patients are not limited to the 96-hour requirement;
2.1.6. Has nursing services available on a
				24-hour basis;
2.1.7. Provides
				basic services as required under the Critical Access Regulations
				42 C.F.R. §
											485.635; and
2.1.8. Meets the requirements of
				42 U.S.C.A. §
											1395,
et seq.
, Emergency
				Medical Treatment and Active Labor Act (EMTALA).
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-09 - Critical Access Hospitals › Section 65-9-3 - Community Outpatient Medical Center

Current through Register Vol. XLI, No. 28, July 12, 2024
3.1. Eligibility requirements for a critical
				access hospital applying for a license designation change to a community
				outpatient medical center.
3.1.1. A critical
				access hospital may apply to be designated as a community outpatient medical
				center if:
3.1.1.a. It has been designated as
				a critical access hospital for at least one year;
3.1.1.b. It is designated as a critical
				access hospital at the time of application for a license designation change to
				a community outpatient medical center.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-09 - Critical Access Hospitals › Section 65-9-4 - Designation as a Community Outpatient Medical Center

Current through Register Vol. XLI, No. 28, July 12, 2024
4.1. A community outpatient medical center
				shall be required to comply with all relevant provisions of the Hospital
				Licensure Rule, 64 CSR 12, as applicable to the scope of services offered by
				the community outpatient medical center.
4.2. The community outpatient medical
				center's organization, scope of services to be offered, and availability of
				patient care services shall be defined and approved by the governing body of
				the critical access hospital seeking a license designation change to a
				community outpatient medical center.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-10 - Fee Schedule For Certificate Of Need Matters › Section 65-10-1 - General

Current through Register Vol. XLI, No. 28, July 12, 2024
1.1. Scope. - This
				rule establishes the schedule of fees for the filing of applications and
				exemption requests under the West Virginia Certificate of Need Program.
				Pursuant to W.Va. Code § 16-296-11, the Health Care Authority is
				authorized to administer the provisions of the Certificate of Need Program.
				W.Va. Code §§ 16-20-1 et seq.
1.2. Authority. " W.Va. Code §
									16-2D-5(f).
1.3. Filing Date. " October 8,
				2009.
1.4. Effective Date. "
				November 9, 2009.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-10 - Fee Schedule For Certificate Of Need Matters › Section 65-10-2 - Introduction

Current through Register Vol. XLI, No. 28, July 12, 2024
2.1. W.Va. Code
				§
									16-2D-5(f)
				authorizes the charging of fees "for the filing of any application, the filing
				of any notice in lieu of an application, the filing of any exemption
				determination request, or the filing of any request for a declaratory ruling."
				The statute further provides that the "fees charged may vary according to the
				type of matter involved, the type of health service or facility involved, or
				the amount of capital expenditure involved." Finally, the statute directs that
				the fees received shall be deposited into a special fund known as the
				"Certificate of Need Program Fund" and are to be expended for the purposes of
				the program.
2.2. In setting a fee
				schedule, the Health Care Authority acknowledges the Certificate of Need
				program must be economically self sustaining. Fees are the primary revenue
				source to the program. The fees must support administrative, publication,
				review and other costs related to the statutory requirements of the
				program.
2.3. The Health Care
				Authority acknowledges that the State's acute care hospitals fund the general
				operations of the agency through the assessments provided for by W.Va. Code
				§
									16-29B-8(c),
				thus supporting the legal counsel services provided for the Certificate of Need
				program. Hence, the agency is of the opinion that accommodation of that fact
				should also be made in setting a fee schedule.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-10 - Fee Schedule For Certificate Of Need Matters › Section 65-10-3 - Fee Schedule

Current through Register Vol. XLI, No. 28, July 12, 2024
3.1. The
				fee to be paid by a health care facility or other entity upon filing an
				application or a request for an exemption shall be based upon a combination of
				the type of matter and the amount of the capital expenditure proposed. In
				addition, the Health Care Authority has taken into account the amount of staff
				time and resources that can be expected to be expended during the review of the
				various types of Certificate of Need applications and requests for
				exemptions.
3.2. There shall not be
				any fee imposed for a request by any entity for a determination of whether any
				specific proposal is reviewable by the Certificate of Need program.
3.3. Fees for applications. The following
				fees shall be paid concurrently with the filing of the application.
3.3.1. A fee of $350.00 per bed for any
				application which involves the addition of beds.
3.3.2. A fee of $1,500 for an application
				with a capital expenditure less than the expenditure minimum.
3.3.3. A fee of one-tenth of one percent of
				the total capital expenditure for any application with a capital expenditure in
				excess of the expenditure minimum, with a maximum fee of $100,000.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-10 - Fee Schedule For Certificate Of Need Matters › Section 65-10-4 - Fee Schedule for Exemption Requests

Current through Register Vol. XLI, No. 28, July 12, 2024
4.1. There shall be a one thousand dollar
				($1,000.00) fee for the filing of any request for an exemption from Certificate
				of Need review.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-10 - Fee Schedule For Certificate Of Need Matters › Section 65-10-5 - Waiver of Fees

Current through Register Vol. XLI, No. 28, July 12, 2024
5.1. Any
				applicant which has had a loss (excess expenses over revenues) for its most
				recently completed fiscal year, may request a waiver of Certificate of Need
				fees.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-10 - Fee Schedule For Certificate Of Need Matters › Section 65-10-6 - Credits and Refunds of Fees

Current through Register Vol. XLI, No. 28, July 12, 2024
6.1.
				The Health Care Authority will issue a refund if the fee was erroneously
				paid.
6.2. In the event an entity
				files an exemption request which is denied, that entity will receive a credit
				applied to the application fee.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-10 - Fee Schedule For Certificate Of Need Matters › Section 65-10-7 - Adjustments to Fees Paid

Current through Register Vol. XLI, No. 28, July 12, 2024
7.1.
				Should an application be changed or should the proposed or actual capital
				expenditure of any application be increased at any point during the review of
				the application or following approval and up to the substantial compliance
				determination, then the applicant's fee will be recalculated and if an
				additional fee is determined to be required, then all review or post-review
				activities shall be placed on hold until such additional fee is paid by the
				applicant.
7.2. Should an
				application be changed or should the proposed capital expenditures be decreased
				at any point after the filing of the application, there shall not be any refund
				of the fee paid by the applicant.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-10 - Fee Schedule For Certificate Of Need Matters › Section 65-10-8 - Conflicts in the Applicable Fee

Current through Register Vol. XLI, No. 28, July 12, 2024
8.1. In the event that a proposal either fits
				into more than one category for the determination of the applicable fee or if
				more than one fee category is applicable to any given proposal, only one fee
				shall be imposed and that fee shall be the greater of the various applicable
				fees.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-10 - Fee Schedule For Certificate Of Need Matters › Section 65-10-9 - Failure to Comply with Rule

Current through Register Vol. XLI, No. 28, July 12, 2024
9.1.
				Any filing that is subject to the charging of a fee but which is not
				accompanied by the required fee shall not be processed by the agency and shall
				not be legally effective until the required fee is received.
9.2. In those instances subject to Section
				7.1 of this rule where an additional fee is required because of a change in a
				proposal or of an increase in the proposed or actual capital expenditure, the
				state agency shall discontinue review or withhold substantial compliance
				determination until the required fee is paid.
9.3. Should any entity develop a new health
				service, a new institutional health service, or any other project that requires
				the filing of a request for exemption determination or an application without
				paying the required fee, the entity is hereby placed on notice that it may be
				subject to all of the penalty provisions of the certificate of need program
				including injunctive relief and imposition of a civil penalty pursuant to W.Va.
				Code § 16-20-13 and denial or revocation of license for operating pursuant
				to W. Va. Code § 16-20-12.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-10 - Fee Schedule For Certificate Of Need Matters › Section 65-10-10 - Severability

Current through Register Vol. XLI, No. 28, July 12, 2024
If any provisions of this rule or the application thereof to
				  any entity or circumstance shall be held invalid, such invalidity shall not
				  affect the provisions or the applications of these rules which can be given
				  affect without the invalid provisions or application and to this end the
				  provisions of these rules are declared to be severable.
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West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-11 - Exemptions From Certificate Of Need Review › Section 65-11-1 - General

Current through Register Vol. XLI, No. 28, July 12, 2024
1.1. Scope - This
				legislative rule establishes the standards for the exemptions from certificate
				of need review provided for by the 1987 amendments to the Certificate of Need
				Act, West Virginia Code, § 16-2D-1
et seq
., and
				repeals subsection 4.3 of "Certificate of Need" Legislative Rule, § 65 CSR
				7 (1983). Pursuant to West Virginia Code, § 16-29B-11, the Health Care
				Cost Review Authority is designated to be the state agency charged with
				administering the certificate of need program.
1.2. Authority - West Virginia Code, §
				16-2D-8, § 16-2D-4(e) -(h), § 16-2D-6(c), and § 16-29B-11.
1.3. Filing Date -
				September_______, 1987.
1.4.
				Effective Date -_________________________.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-11 - Exemptions From Certificate Of Need Review › Section 65-11-2 - Introduction

Current through Register Vol. XLI, No. 28, July 12, 2024
This legislative rule implements certain of the provisions of
				  Enrolled Committee Substitute For House Bill 2342 which was signed by the
				  Governor. That bill amended West Virginia Code, § 16-2D-4, by adding to it
				  four (4) new subsections. Those new subsections authorize the state agency to
				  promulgate rules to exempt from certificate of need review certain activities
				  of health care facilities.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-11 - Exemptions From Certificate Of Need Review › Section 65-11-6 - New Services

Current through Register Vol. XLI, No. 28, July 12, 2024
6.1. Any
				legal entity which is otherwise subject to the certificate of need program
				which wishes to offer one or more of the health services set forth in
				subsection 6.3 and which health service was not or services were not offered on
				a regular basis by or on behalf of such legal entity within the twelve-month
				period prior to the time such service or services would now be offered shall
				follow either the procedures set forth here or those described in the
				legislative rule "Certificate of Need," § 65 CSR 7 (1983). It is expressly
				provided that subsection 4.3 of the legislative rule "Certificate of Need,"
				§ 65 CSR 7 (1983), is hereby repealed and no longer in effect from the
				date of the final promulgation of this legislative rule.
6.2. If a health service is one of the health
				services set forth in subsection 6.3, the proposed initial offering of that
				service by an established legal entity is subject to review. If the legal
				entity is established and if it proposes to add a health service not on the
				following list, then such addition is not reviewable under the Act unless It is
				associated with a capital expenditure in excess of the expenditure minimum. In
				this latter event, the proposed expenditure will be subject to review as
				provided for by the legislative rule "Certificate of Need," § 65 CSR 7
				(1933).
6.3. The list of health
				services subject to review pursuant to section 3(e) of the Act is as follows.
				This list is all inclusive and may not be added to except by formal amendment
				to this legislative rule. A health service on the list shall hereafter be
				referred to as a "listed health service."
6.3.1. Alcohol and other drug treatment and
				rehabilitation if offered in a discrete unit.
6.3.2. Ambulatory surgical facilities or
				ambulatory surgical centers.
6.3.3. Cardiac catheterization.
6.3.4. Comprehensive medical rehabilitation
				on an inpatient basis.
6.3.5.
				End-stage renal dialysis stations and home training,
6.3.6. Hyperbaric oxygen therapy.
6.3.7. Intermediate care for the mentally
				retarded.
6.3.8. Discrete units for
				intermediate or skilled nursing care.
6.3.9. Lithotripsy.
6.3.10. Magnetic resonance imaging,
6.3.11. Medical or surgical
				beds.
6.3.12. Discrete obstetrical
				units.
6.3.13. Organ transplants
				such as heart, lungs, kidney, liver, and other organs.
6.3.14. Open heart surgery.
6.3.15. Discrete pediatric units.
6.3.16. Discrete inpatient psychiatric units.
6.3.17. Special care units for
				burns, intensive care, cardiac care, neonatal intensive care, neonatal
				intermediate care, and pediatric intensive care.
6.3.18. Surgical services.
6.3.19. Radiation therapy.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-11 - Exemptions From Certificate Of Need Review › Section 65-11-7 - Requests For Hearings And Reconsideration Hearings

Current through Register Vol. XLI, No. 28, July 12, 2024
7.1. In the event that an affected person
				requests a hearing or a reconsideration hearing on any exemption provided for
				by this rule, the exemption review period shall be terminated. A hearing shall
				then be held within thirty (30) days of the request for a hearing unless the
				state agency sets a later date upon a showing of good cause therefor.
7.2. The state agency may conduct
				a prehearing conference in accordance with Rule 16 of the West Virginia Rules
				of Civil Procedure. If an order is first obtained from the state agency or a
				hearing examiner appointed by it, the parties may engage in discovery as
				provided by the West Virginia Rules of Civil Procedure; except that the scope
				of discovery shall be limited to relevant and admissible evidence.
7.3. Except as otherwise provided in this
				rule, at the conclusion of the hearing, the parties may submit proposed
				findings of fact, conclusions of law, and legal briefs. The state agency shall
				then have twenty (20) days from the receipt of those items or the closure of
				the record if those items are not tendered to make its determination in
				writing.
7.4. Except as otherwise
				provided in this rule, upon receipt of a verified claim for an exemption, the
				state agency shall cause a notice to the public to be issued of that claim. The
				notice shall identify the applicant and shall describe the proposal. The notice
				shall be published as part of the state agency's legal advertisement in the
				Saturday Charleston newspapers and shall be included in the state agency's
				weekly newsletter and in the publication in the State Register.
7.5. Notice of a section 4.1 verified claim
				shall be in such form and manner as the state agency can reasonably provide and
				may include a post-decision notice containing the information described in
				subsection 7.4 of this rule.
West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-11 - Exemptions From Certificate Of Need Review › Section 65-11-9 - Severability

Current through Register Vol. XLI, No. 28, July 12, 2024
If any provision of these rules or the application thereof to
				  any person or circumstance shall be held invalid, such invalidity shall not
				  affect the provisions or the applications of these rules which can be given
				  effect without the involved provisions or application and to this end the
				  provisions of these rules are declared to be severable.