West Virginia Code of State Rules › Agency 65 - Health Care Authority › Title 65 - LEGISLATIVE RULE HEALTH CARE AUTHORITY › Series 65-32 - Certificate of Need › Section 65-32-4 - Certificate of Need Application

Current through Register Vol. XLI, No. 28, July 12, 2024
4.1.
				An application for a certificate of need shall be on forms approved by the
				Authority. The forms may be located on the Authority's website,
www.hca.wv.gov
. The applicant shall submit
				the original and one paper copy to the Authority. The applicant may also submit
				the application electronically. The application shall have a verification
				signed by the chief executive officer and the person or persons who prepared
				the application. Any application received after 4:30 p.m., Eastern Standard
				Time, on a business day or on a weekend or holiday shall be deemed received on
				the next business day.
4.2. The
				application shall, at a minimum, include the following:
4.2.a. The identification of the
				applicant;
4.2.b. A copy of the
				governing body's approval of the proposal and also a written authorization
				empowering specified individuals to sign the application and to act on its
				behalf. One authorization is sufficient for multiple applications provided the
				individual empowered to sign the application and to act on the applicant's
				behalf has not changed. This must be clearly stated in the written
				authorization and a copy provided in each application;
4.2.c. A description of the
				project;
4.2.d. A timetable for
				implementation of the project, including the projected date for incurring the
				obligation for any capital expenditure;
4.2.e. A documented analysis of the need of
				the population to be served by the project, including the medically
				underserved, and the extent to which the proposed service will be accessible to
				the population;
4.2.f. Policies for
				patient admission and provision of fully or partially uncompensated
				care;
4.2.g. A documented analysis
				of alternatives considered by the applicant;
4.2.h. A documented analysis of the
				proposal's relationship to the existing health care system, including providers
				of direct, ancillary, and support services and health professional training
				programs in the area in which services are to be provided, and, when
				applicable, the extent to which the proposal will meet the needs of those
				training programs;
4.2.i. A
				documented analysis of the proposal's relationship to the state health
				plan;
4.2.j. An analysis of the
				relationship of the proposal to the most recent statements of deficiencies and
				plans of corrections from surveys conducted by accreditation organizations and
				other federal, state and local inspection agencies, as well as copies of those
				survey reports or portions of the reports as may be required by the
				Authority;
4.2.k. Documentation of
				the availability of resources, including health care providers, management
				personnel and funds for capital and operating needs;
4.2.l. A preliminary financial feasibility
				study which includes an analysis of historical and projected utilization,
				charges, sources of revenue, statements of revenues and expenses, a statement
				of changes in fund balance, a statement of cash flows, balance sheets, and a
				statement of the specific assumptions upon which the feasibility study was
				based; and.
4.2.m. If applicable, a
				documented analysis of the needs and circumstances of research
				projects.