reglab/statecodes huggingface dataset:
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-490 - Written findings and actions on certificate of need applications

Current through Register Vol. 24-14, July 15, 2024
(1) Written
				findings.
(a) The findings of the
				department's review of a certificate of need application shall be stated in
				writing and include the basis for the decision of the secretary's designee as
				to whether a certificate of need is to be issued or denied for the proposed
				project.
(b) In making its findings
				and taking action on a certificate of need application, the department shall
				use all criteria contained in chapter 246-310 WAC applicable to the proposed
				project.
(i) The written findings shall
				identify any criterion the department has decided is not applicable to the
				particular project and give the reason for such decision.
(ii) The secretary's designee may deny a
				certificate of need if the applicant has not provided the information which is
				necessary to a determination that the project meets all applicable criteria and
				which the department has prescribed and published as necessary to a certificate
				of need review of the type proposed: Provided however, That the department has
				requested such information in a screening letter sent in accordance with WAC
				246-310-090(1)(c).
(c) The department shall make
				written findings on the extent to which the project meets the criteria set
				forth in WAC
				246-310-210(1) and
				(2) when the secretary's designee issues a
				certificate of need directly related to the provision of health services, or
				beds: Provided however, That no such written finding shall be necessary for
				projects for the correction of deficiencies of the types described in WAC
				246-310-480 and for projects
				proposed by or on behalf of a health maintenance organization or a health care
				facility controlled, directly or indirectly, by a health maintenance
				organization.
(d) When, as a part
				of concurrent review proceedings, the secretary's designee makes a decision to
				approve an application or applications and to disapprove other competing
				applications, he or she shall provide a specific written statement of reasons
				for determining the approved application or applications to be
				superior.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-500 - Issuance, suspension, denial, revocation, and transfer of a certificate of need

Current through Register Vol. 24-14, July 15, 2024
(1) The secretary's
				designee shall issue a certificate of need to the applicant.
(a) The secretary's designee shall issue a
				certificate of need for:
(i) The proposed
				project, or
(ii) A separable
				portion of the proposed project.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-560 - Provision for reconsideration decision

Current through Register Vol. 24-14, July 15, 2024
(1) Any interested or affected person may,
				for good cause shown, request a public hearing for the purpose of
				reconsideration of the decision of the secretary's designee on a certificate of
				need application or withdrawal of a certificate of
				need.1
(2) The department shall conduct a
				reconsideration hearing if it finds the request is in accord with the following
				requirements:
(a) The request for a
				reconsideration hearing shall be written, be received by the department within
				twenty-eight days of the department's decision on the certificate of need
				application or withdrawal of the certificate of need, state in detail the
				grounds which the person requesting the hearing believes to show good cause,
				and be signed by the person making the request.
(b) Grounds which the department may deem to
				show good cause for a reconsideration hearing shall include but not be limited
				to the following:
(i) Significant relevant
				information not previously considered by the department which, with reasonable
				diligence, could not have been presented before the department made its
				decision;
(ii) Information on
				significant changes in factors or circumstances relied upon by the department
				in making its findings and decision; or
(iii) Evidence the department materially
				failed to follow adopted procedures in reaching a decision.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-570 - Circumstances for which an amended certificate of need is required

Current through Register Vol. 24-14, July 15, 2024
(1) An amended
				certificate of need shall be required for any of the following modifications of
				a project for which a certificate of need was issued and has been submitted in
				accordance with subsection (2) of this section:
(a) An addition of a new service;
(b) An expansion of a service beyond that
				which was included in the certificate of need application on which the issuance
				of the certificate of need was based;
(c) An increase in the inpatient bed
				capacity;
(d) The modification or
				release of a condition placed on a certificate of need;
(e) A significant reduction in the scope of a
				project for which a certificate of need has been issued without a commensurate
				reduction in the cost of the project, or the project cost increases (as
				represented in bids on a construction project or final cost estimate or
				estimates acceptable to the person to whom the certificate of need was issued)
				when the total of such increases exceeds twelve percent or fifty thousand
				dollars, whichever is greater, over the maximum capital expenditure specified
				by the secretary's designee in issuing the certificate of need: Provided
				however, That the review of such reductions or cost increases shall be
				restricted to the continued conformance of the project with the criteria
				contained in WAC
				246-310-220 and
				246-310-240; or
(f) A change in the approved site.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-580 - Validity and extensions

Current through Register Vol. 24-14, July 15, 2024
(1) A
				certificate of need shall be valid for two years: Provided, That one six-month
				extension may be made if the certificate holder can demonstrate that
				substantial and continuing progress toward commencement of the project has been
				made.
(2) In the case of a project
				involving construction, substantial and continuing progress shall include one
				of the following:
(a) When review and
				approval by the department of the final plans for construction is required, the
				submission of working drawings;
(b)
				When plan approval is not required by the department, receipt of copies of the
				working drawings for construction; or
(c) In the event working drawings have not
				been submitted, the applicant must demonstrate that he or she has made
				continuous progress toward commencement of the project.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-590 - Monitoring of approved projects

Current through Register Vol. 24-14, July 15, 2024
(1)
				The department shall monitor the costs and components of approved projects to
				assure conformance with certificates of need that have been issued.
(2) The department shall require periodic
				progress reports from those applicants to whom certificates of need have been
				issued.
(a) Progress reports shall be
				required quarterly.
(b) Progress
				reports shall be submitted in the form and manner prescribed and published by
				the department.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-600 - Withdrawal of a certificate of need

Current through Register Vol. 24-14, July 15, 2024
(1)
				The secretary's designee may withdraw a certificate of need if the department
				determines that the holder of a certificate is not meeting the timetable
				specified in the certificate of need application for completing the project and
				is not making a good-faith effort to meet such timetable.
(2) In reviewing a proposed withdrawal of a
				certificate of need, the department shall adhere to the provisions of WAC
				246-310-170,
				246-310-180,
				246-310-190, and
				246-310-560.
(3) The review period for a proposed
				withdrawal of a certificate of need shall not exceed ninety days unless
				extended by the department to allow sufficient time for the conduct of a public
				hearing pursuant to the provisions of WAC
				246-310-180. Such extension shall
				not exceed thirty days.
(4) The
				findings of the department's review of a proposed withdrawal of a certificate
				of need shall be stated in writing and include the basis for the decision of
				the secretary's designee as to whether the certificate of need is to be
				withdrawn for a proposed project. A copy of the department's written findings
				and statement of the decision of the secretary's designee on the proposed
				withdrawal of a certificate of need shall be sent to:
(a) The holder of the certificate of
				need;
(b) In the case of a project
				proposed by a health maintenance organization, the appropriate regional office
				of the United States Department of Health and Human Services.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-610 - Adjudicative proceeding

Current through Register Vol. 24-14, July 15, 2024
(1) An
				applicant denied a certificate of need or a certificate holder whose
				certificate was suspended or revoked has the right to an adjudicative
				proceeding.
(2) A certificate
				applicant or holder contesting a department certificate decision shall within
				twenty-eight days of receipt of the department's decision or reconsidered
				decision:
(a) File a written application for
				an adjudicative proceeding by a method showing proof of receipt with the
				Adjudicative Clerk Office, Department of Health, 2413 Pacific Avenue, P.O. Box
				47879, Olympia, WA 98504-7879; and
(b) Include in or with the application:
(i) A specific statement of the issue or
				issues and law involved;
(ii) The
				grounds for contesting the department decision; and
(iii) A copy of the contested department
				decision.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-700 - Adult elective percutaneous coronary interventions (PCI) without on-site cardiac surgery

Current through Register Vol. 24-14, July 15, 2024
Purpose and applicability of chapter.
Adult
				  elective percutaneous coronary interventions are tertiary services as listed in
				  WAC 246-310-020. To be granted a
				  certificate of need, an adult elective PCI program must meet the standards in
				  this section and WAC
				  246-310-715,
				  246-310-720,
				  246-310-725,
				  246-310-730,
				  246-310-735,
				  246-310-740, and
				  246-310-745 in addition to
				  applicable review criteria in WAC
				  246-310-210,
				  246-310-220,
				  246-310-230, and
				  246-310-240. This chapter is
				  adopted by the Washington state department of health to implement chapter 70.38
				  RCW and establish minimum requirements for obtaining a certificate of need and
				  operating an elective PCI program.
Statutory Authority: RCW 70.38.128. 09-01-113, §
					 246-310-700, filed 12/19/08, effective
					 12/19/08.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-705 - PCI definitions

Current through Register Vol. 24-14, July 15, 2024
For the purposes of this chapter and chapter 70.38 RCW, the
				  words and phrases below will have the following meanings unless the context
				  clearly indicates otherwise:
(1)
				"Concurrent review" means the process by which applications competing to
				provide services in the same planning area are reviewed simultaneously by the
				department. The department compares the applications to one another and these
				rules.
(2) "Elective" means a PCI
				performed on a patient with cardiac function that has been stable in the days
				or weeks prior to the operation. Elective cases are usually scheduled at least
				one day prior to the surgical procedure.
(3) "Emergent" means a patient needs
				immediate PCI because, in the treating physician's best clinical judgment,
				delay would result in undue harm or risk to the patient.
(4) "Percutaneous coronary interventions
				(PCI)" means invasive but nonsurgical mechanical procedures and devices that
				are used by cardiologists for the revascularization of obstructed coronary
				arteries. These interventions include, but are not limited to:
(a) Bare and drug-eluting stent
				implantation;
(b) Percutaneous
				transluminal coronary angioplasty (PTCA);
(c) Cutting balloon atherectomy;
(d) Rotational atherectomy;
(e) Directional atherectomy;
(f) Excimer laser angioplasty;
(g) Extractional thrombectomy.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-710 - Concurrent review

Current through Register Vol. 24-14, July 15, 2024
The department shall review new adult elective percutaneous
				  coronary intervention (PCI) services using the concurrent review cycle
				  according to the following table:
Concurrent Review Cycle:
Application Submission Period
Letters of Intent Due
First working day through last working day of
								January of each year.
Receipt of Initial Application
First working day through last working day of
								February of each year.
End of Screening Period
Last working day of March of each year.
Applicant Response
Last working day of April of each year.
Department Action
Beginning of Review Preparation
May 1 through May 15
Application Review Period
Public Comment Period (includes public hearing if
								requested)
60-Day Public Comment Period
Begins May 16 of each year or the first working day
								after May 16.
Rebuttal Period
30-Day Rebuttal period
Applicant and affected party response to public
								comment.
Ex parte Period
45-Day Ex parte period
Department evaluation and decision.
(1) If the
				department is unable to meet the deadline for making a decision on the
				application, it will notify applicants fifteen days prior to the scheduled
				decision date. In that event, the department will establish a new decision
				date.
(2) The department may not
				accept new applications for a planning area if there are any pending
				applications in that planning area filed under a previous concurrent review
				cycle, or applications submitted prior to the effective date of these rules
				that affect any of the new planning areas, unless the department has not made a
				decision on the pending applications within the review timelines of nine months
				for a concurrent review and six months for a regular review.
(3) If the department determines that an
				application does not compete with another application, it may convert the
				review of an application that was initially submitted under a concurrent review
				cycle to a regular review process.
Statutory Authority: RCW 70.38.128. 09-01-113, §
					 246-310-710, filed 12/19/08, effective
					 12/19/08.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-715 - General requirements

Current through Register Vol. 24-14, July 15, 2024
The applicant hospital must:
(1) Submit a detailed analysis of the impact
				that their new adult elective PCI services will have on the Cardiovascular
				Disease and Interventional Cardiology Fellowship Training programs at the
				University of Washington, and allow the university an opportunity to respond.
				New programs may not reduce current volumes at the University of Washington
				fellowship training program.
(2)
				Submit a detailed analysis of the projected volume of adult elective PCIs that
				it anticipates it will perform in years one, two and three after it begins
				operations. All new elective PCI programs must comply with the state of
				Washington annual PCI volume standards of two hundred) by the end of year
				three. The projected volumes must be sufficient to assure that all physicians
				working only at the applicant hospital will be able to meet volume standards of
				fifty PCIs per year. If an applicant hospital fails to meet annual volume
				standards, the department may conduct a review of certificate of need approval
				for the program under WAC
				246-310-755.
(3) Submit a plan detailing how they will
				effectively recruit and staff the new program with qualified nurses,
				catheterization laboratory technicians, and interventional cardiologists
				without negatively affecting existing staffing at PCI programs in the same
				planning area.
(4) Maintain one
				catheterization lab used primarily for cardiology. The lab must be a fully
				equipped cardiac catheterization laboratory with all appropriate devices,
				optimal digital imaging systems, life sustaining apparati, intra-aortic balloon
				pump assist device (IABP). The lab must be staffed by qualified, experienced
				nursing and technical staff with documented competencies in the treatment of
				acutely ill patients.
(5) Be
				prepared and staffed to perform emergent PCIs twenty-four hours per day, seven
				days per week in addition to the scheduled PCIs.
(6)If an existing CON approved heart surgery
				program relinquishes the CON for heart surgery, the facility must apply for an
				amended CON to continue elective PCI services. The applicant must demonstrate
				ability to meet the elective PCI standards in this chapter.
Statutory Authority:
					 RCW
					 70.38.128. 09-01-113, § 246-310-715,
					 filed 12/19/08, effective 12/19/08.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-720 - Hospital volume standards

Current through Register Vol. 24-14, July 15, 2024
(1)
				Hospitals with an elective PCI program must perform a minimum of two hundred
				adult PCIs per year by the end of the third year of operation and each year
				thereafter.
(2) The department
				shall only grant a certificate of need to new programs within the identified
				planning area if:
(a) The state need
				forecasting methodology projects unmet volumes sufficient to establish one or
				more programs within a planning area; and
(b) All existing PCI programs in that
				planning area are meeting or exceeding the minimum volume standard.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-725 - Physician volume standards

Current through Register Vol. 24-14, July 15, 2024
Physicians performing adult elective PCI procedures at the
				  applying hospital must perform a minimum of fifty PCIs per year. Applicant
				  hospitals must provide documentation that physicians performed fifty PCI
				  procedures per year for the previous three years prior to the applicant's CON
				  request.
Statutory Authority:
					 RCW
					 70.38.128. 09-01-113, § 246-310-725,
					 filed 12/19/08, effective 12/19/08.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-730 - Staffing requirements

Current through Register Vol. 24-14, July 15, 2024
The applicant hospital must:
(1) Employ a sufficient number of properly
				credentialed physicians so that both emergent and elective PCIs can be
				performed.
(2) Staff its
				catheterization laboratory with a qualified, trained team of technicians
				experienced in interventional lab procedures.
(a) Nursing staff should have coronary care
				unit experience and have demonstrated competency in operating PCI related
				technologies.
(b) Staff should be
				capable of endotracheal intubation and ventilator management both on-site and
				during transfer if necessary.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-740 - Quality assurance

Current through Register Vol. 24-14, July 15, 2024
The applicant hospital must submit a written quality
				  assurance/quality improvement plan specific to the elective PCI program as part
				  of its application. At minimum, the plan must include:
(1) A process for ongoing review of the
				outcomes of adult elective PCIs. Outcomes must be benchmarked against state or
				national quality of care indicators for elective PCIs.
(2) A system for patient selection that
				results in outcomes that are equal to or better than the benchmark standards in
				the applicant's plan.
(3) A process
				for formalized case reviews with partnering surgical backup hospital(s) of
				preoperative and post-operative elective PCI cases, including all transferred
				cases.
(4) A description of the
				hospital's cardiac catheterization laboratory and elective PCI quality
				assurance reporting processes for information requested by the department or
				the department's designee. The department of health does not intend to require
				duplicative reporting of information.
Statutory Authority: RCW 70.38.128. 09-01-113, §
					 246-310-740, filed 12/19/08, effective
					 12/19/08.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-745 - Need forecasting methodology

Current through Register Vol. 24-14, July 15, 2024
For the purposes of the need forecasting method in this
				  section, the following terms have the following specific meanings:
(1) "Base year" means the most recent
				calendar year for which December 31 data is available as of the first day of
				the application submission period from the department's CHARS reports or
				successor reports.
(2) "Current
				capacity" means the sum of all PCIs performed on people (aged fifteen years of
				age and older) by all certificate of need approved adult elective PCI programs,
				or department grandfathered programs within the planning area. To determine the
				current capacity for those planning areas where a new program has operated less
				than three years, the department will measure the volume of that hospital as
				the greater of:
(a) The actual volume;
				or
(b) The minimum volume standard
				for an elective PCI program established in WAC
				246-310-720.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-750 - Tiebreaker

Current through Register Vol. 24-14, July 15, 2024
If two or more applicant hospitals are competing to meet the
				  same forecasted net need, the department shall consider which facility's
				  location provides the most improvement in geographic access. Geographic access
				  means the facility that is located the farthest in statue miles from an
				  existing facility authorized to provide PCI procedures.
Statutory Authority: RCW 70.38.128. 09-01-113, §
					 246-310-750, filed 12/19/08, effective
					 12/19/08.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-755 - Ongoing compliance with standards

Current through Register Vol. 24-14, July 15, 2024
If the department issues a certificate of need (CON), it will
				  be conditioned to require ongoing compliance with the CON standards. Failure to
				  meet the standards may be grounds for revocation or suspension of a hospital's
				  CON, or other appropriate licensing or certification actions.
(1) Hospitals granted a certificate of need
				must meet:
(a) The program procedure volume
				standards within three years from the date of initiating the program;
				and
(b) QA standards in WAC
				246-310-740.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-800 - Kidney disease treatment centers-Definitions

Current through Register Vol. 24-14, July 15, 2024
The definitions in this section apply to WAC 246-310-800
				  through 246-310-833, unless the context
				  clearly indicates otherwise:
(1)
				"Affiliate" or "affiliated" means:
(a) Having
				at least a ten percent but less than one hundred percent ownership in a kidney
				dialysis facility;
(b) Having at
				least a ten percent but less than one hundred percent financial interest in a
				kidney dialysis facility; or
(c)
				Three years or more operational management responsibilities for a kidney
				dialysis facility.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-803 - Kidney disease treatment facilitiesData reporting requirements

Current through Register Vol. 24-14, July 15, 2024
(1) By February
				15th or the first working day thereafter of each year, each provider will
				electronically submit the following data elements for each of its kidney
				dialysis facilities in the state of Washington and each out-of-state kidney
				dialysis facility that might be used in an application review during the next
				year (an out-of-state kidney dialysis facility may be used as one of the three
				closest facilities for a future project during the next year pursuant to WAC
				246-310-827):
(a) Cost report data for the most recent
				calendar or fiscal year reporting period for which data is available reported
				to the Centers for Medicare and Medicaid Services (CMS) that is used to
				calculate net revenue per treatment; and
(b) Data reported to providers by CMS for the
				most recent calendar or fiscal year reporting period for which data is
				available to identify the percentage of nursing home patients and the average
				number of comorbid conditions.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-809 - One-time exempt isolation station reconciliation

Current through Register Vol. 24-14, July 15, 2024
(1) The department will identify each
				certificate of need approved kidney dialysis facility and the total number of
				certificate of need approved stations as of the effective date of these
				rules.
(2) The department will make
				a one-time administrative station adjustment to each kidney dialysis facility
				to add one station as an approved exempt isolation station for those facilities
				that were approved prior to the effective date of these rules.
(3) The department will notify each kidney
				dialysis facility of its adjusted certificate of need approved station
				count.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-812 - Kidney disease treatment facilities-Methodology

Current through Register Vol. 24-14, July 15, 2024
A kidney dialysis facility that provides hemodialysis or
				  peritoneal dialysis, training, or backup must meet the following standards in
				  addition to applicable review criteria in WAC
				  246-310-210,
				  246-310-220,
				  246-310-230, and
				  246-310-240.
(1) Applications for new stations may only
				address projected station need in the planning area in which the facility is to
				be located.
(a) If there is no existing
				facility in an adjacent planning area, the application may also address the
				projected station need in that planning area.
(b) Station need projections must be
				calculated separately for each planning area within the application.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-815 - Kidney disease treatment facilities-Financial feasibility

Current through Register Vol. 24-14, July 15, 2024
(1) The kidney
				dialysis facility must demonstrate positive net income by the third full year
				of operation.
(a) The calculation of net
				income is subtraction of all operating and nonoperating expenses, including
				appropriate allocated and overhead expenses, amortization and depreciation of
				capital expenditures from total revenue generated by the kidney dialysis
				facility.
(b) Existing facilities.
				Revenue and expense projections for existing facilities must be based on that
				facility's current payor mix and current expenses.
(c) New facilities.
(i) Revenue projections must be based on the
				net revenue per treatment of the applicant's three closest dialysis
				facilities.
(ii) Known expenses
				must be used in the pro forma income statement. Known expenses may include, but
				are not limited to, rent, medical director agreement, and other types of
				contracted services.
(iii) All
				other expenses not known must be based on the applicant's three closest
				dialysis facilities.
(iv) If an
				applicant has no experience operating kidney dialysis facilities, the
				department will use its experience in determining the reasonableness of the pro
				forma financial statements provided in the application.
(v) If an applicant has one or two kidney
				dialysis facilities, revenue projections and unknown expenses must be based on
				the applicant's operational facilities.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-818 - Special circumstances one- or two-station expansion-Eligibility criteria and application process

Current through Register Vol. 24-14, July 15, 2024
(1)
				The department will approve one or two additional special circumstance stations
				for an existing kidney dialysis facility (facility) if it meets the following
				criteria, regardless of whether the need methodology in WAC 246-310-812
				projects a need for additional stations in the planning area:
(a) For 4.8 planning areas, the facility has
				operated at or above an average of 5.0 patients per station for the most recent
				six consecutive month period preceding the letter of intent submission date for
				which data is available. Data used to determine patients per station must be
				obtained from the Northwest Renal Network; or
(b) For 3.2 planning areas, the facility has
				operated at or above an average of 3.5 patients per station for the most recent
				six consecutive month period preceding the letter of intent submission date for
				which data is available. Data used to determine patients per station must be
				obtained from the Northwest Renal Network; and
(c) The facility can accommodate one or two
				additional stations within its existing building, which may include shelled
				space. If renovation is needed to accommodate the additional station(s),
				renovation must be within the existing building.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-821 - Kidney disease treatment facilities-Standards for planning areas without an existing facility

Current through Register Vol. 24-14, July 15, 2024
(1) Columbia,
				Ferry, Garfield, Klickitat, Lincoln, Pend Oreille, San Juan, Skamania, Stevens,
				Wahkiakum, and Whitman counties do not have an existing kidney dialysis
				facility as of the effective date of these rules. The department will award the
				first project proposing to establish a facility in each of these planning areas
				as follows:
(a) A minimum of four stations,
				provided the project meets applicable review criteria and standards;
				and
(b) The facility must be
				projected to operate at 3.2 in-center patients per station by the third full
				year of operation. For purposes of this subsection, the applicant may
				supplement data obtained from the Northwest Renal Network with other documented
				demographic and utilization data to demonstrate station need.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-824 - Kidney disease treatment centers-Exceptions

Current through Register Vol. 24-14, July 15, 2024
The department will not approve new stations in a planning
				  area if the projections in WAC
				  246-310-812(4)
				  show no net need, and will not approve more than the number of stations
				  projected as needed unless:
(1) The
				proposed project qualifies under WAC
				246-310-818 for special
				circumstances one- or two-station expansions; or
(2) All other applicable review criteria and
				standards have been met; and
(3)
				One or more of the following have been met:
(a) The department finds the additional
				stations are needed to be located reasonably close to the people they serve;
				or
(b) Existing dialysis stations
				in the kidney dialysis facility requesting the exception are operating at 5.5
				patients for a 4.8 planning area or, 3.7 patients per station for the 3.2
				planning areas. Data used to make this calculation must be from the most recent
				quarterly modality report from the Northwest Renal Network as of the letter of
				intent submission date; or
(c) The
				applicant documents a significant change in ESRD treatment practice has
				occurred, affecting dialysis station use in the planning area; and
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-830 - Kidney disease treatment facilities-Relocation of facilities

Current through Register Vol. 24-14, July 15, 2024
(1) When an
				existing facility proposes to relocate any of its stations to another planning
				area, a new health care facility is considered to be established under WAC
				246-310-020(1)(a).
(2) When an existing kidney dialysis facility
				proposes to relocate a portion but not all of its stations within the same
				planning area, a new health care facility is considered to be established under
				WAC 246-310-020(1)(a).
(3) When an existing kidney dialysis facility
				proposes to relocate a portion but not all of its stations to an existing
				facility, it will be considered a station addition under WAC
				246-310-020(1)(e).
(4) When an entire existing kidney dialysis
				facility proposes to relocate all of its stations within the same planning
				area, a new health care facility is not considered to be established under WAC
				246-310-020(1)(a)
				 if:
(a)
				The existing kidney dialysis facility ceases operation after the
				relocation;
(b) No new stations are
				added to the replacement kidney dialysis facility. The maximum treatment floor
				area square footage as defined in WAC
				246-310-800(11)(a)
				is limited to the number of certificate of need stations that were approved at
				the existing facility;
(c) There is
				no break in service between the closure of the existing kidney dialysis
				facility and the operation of the replacement facility;
(d) The existing facility has been in
				operation for at least five years at its present location; and
(e) The existing kidney dialysis facility has
				not been purchased, sold, or leased within the past five years.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-833 - One-time state border kidney dialysis facility station relocation

Current through Register Vol. 24-14, July 15, 2024
(1) When an
				existing owner-operator of a Washington state kidney dialysis facility is also
				the owner-operator of a kidney dialysis facility in a contiguous Idaho or
				Oregon county, the department will not consider a facility that combines the
				Washington facility and the out-of-state facility to be a new health care
				facility under WAC
				246-310-020(1) 
				provided all of the following criteria are satisfied:
(a) The Washington state kidney dialysis
				facility is located in Asotin, Benton, Clark, Columbia, Cowlitz, Gar-field,
				Klickitat, Pend Oreille, Skamania, Wahkiakum, Walla Walla, or Whitman
				counties;
(b) The kidney dialysis
				facility is the sole provider of dialysis services in the Washington state
				county;
(c) The kidney dialysis
				facility is the sole provider of dialysis services in the contiguous Idaho or
				Oregon county;
(d) The replacement
				kidney dialysis facility will be located in the same county or planning area as
				the current Washington state facility;
(e) Both existing kidney dialysis facilities
				cease operation;
(f) There is no
				break in service between the closure of the existing kidney dialysis facilities
				and the operation of the replacement facility;
(g) There has been no change in ownership of
				either the Washington kidney dialysis facility or out-of-state kidney dialysis
				facility for at least five years prior to applying for the exemption under this
				section;
(h) Each existing kidney
				dialysis facility has been operated by the current provider for a minimum of
				five years prior to applying for the exemption under this section;
(i) Each existing kidney dialysis facility
				has been operating at its current location for a minimum of five years prior to
				applying for the exemption under this section;
(j) The department has not granted a previous
				exemption under the provisions of this section; and
(k) The number of stations at the replacement
				kidney dialysis facility does not exceed the total of:
(i) All stations from the Washington state
				kidney dialysis facility; and
(ii)
				Using the 4.8 patients per station standard, the stations necessary for the
				number of patients receiving dialysis at the out-of-state kidney dialysis
				facility as reported on the most recent Northwest Renal Network quarterly
				modality report.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-900 - Capital expenditure minimum adjustment procedures

Current through Register Vol. 24-14, July 15, 2024
These rules and regulations are adopted pursuant to
				  RCW
				  70.38.025(6) and (12) for
				  the purpose of establishing the index to be used and procedures for making
				  adjustments to the "expenditure minimum" for capital expenditures which are
				  subject to the requirements of the certificate of need program established
				  under the provisions of chapter 70.38 RCW.
(1) Index to be used. For the purposes of the
				certificate of need program, the United States Department of Commerce Composite
				Construction Cost Index shall be used in the annual adjustments of the
				following:
The "expenditure minimum" as this term is defined in
				  RCW
				  70.38.025 and WAC
				  246-310-010.
(2) Procedure for adjustment.
(a) On or before the first day of each
				January, the department shall adjust and publish the adjusted expenditure
				minimum for capital expenditures. Such adjusted minimums shall be in effect
				during the entire calendar year for which they are established.
(b) The adjustments in the minimums shall be
				based on the changes which occurred in the Department of Commerce Composite
				Construction Cost Index during the twelve month period ending the preceding
				October.
(c) The adjusted minimums
				shall be published by the department by public notice in one or more newspapers
				of general circulation within the state and through a written notice sent to
				each health care facility subject to the requirements of the certificate of
				need program, and each statewide organization of such health care
				facilities.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-310 - Certificate of need › Section 246-310-990 - Certificate of need review fees

Current through Register Vol. 24-14, July 15, 2024
(1)
				An application for a certificate of need under chapter 246-310 WAC must include
				payment of a fee consisting of the following:
(a) A review fee based on the
				facility/project type;
(b) If more
				than one facility/project type applies to an application, the review fee for
				each type of facility/project must be included.
Facility/Project Type
Review Fee
Ambulatory Surgical Centers/Facilities
$20,427.00
Amendments to Issued Certificates of Need
$12,874.00
Emergency Review
$8,286.00
Exemption Requests
Continuing Care Retirement Communities
								(CCRCs)/Health Maintenance Organization (HMOs)
$8,286.00
Bed Banking/Conversions
$1,347.00
Determinations of Nonreviewability
$1,925.00
Hospice Care Center
$1,733.00
Nursing Home Replacement/Renovation
								Authorizations
$1,733.00
Nursing Home Capital Threshold under
								RCW
								70.38.105(4)(e) (Excluding
								Replacement/Renovation Authorizations)
$1,733.00
Rural Hospital/Rural Health Care Facility
$1,733.00
Extensions
Bed Banking
$770.00
Certificate of Need/Replacement Renovation
								Authorization Validity Period
$770.00
Home Health Agency
$24,666.00
Hospice Agency
$21,968.00
Hospice Care Centers
$12,874.00
Hospital (Excluding Transitional Care Units-TCUs,
								Ambulatory Surgical Center/Facilities, Home Health, Hospice, and Kidney Disease
								Treatment Centers)
$40,470.00
Kidney Disease Treatment Centers
$25,054.00
Nursing Homes (Including CCRCs and TCUs)
$46,253.00
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-312 - Acquisition of nonprofit hospitals › Part I - GENERAL PROVISIONS › Section 246-312-010 - Purpose

Current through Register Vol. 24-14, July 15, 2024
The purpose of this chapter is to implement chapter 332,
					 Laws of 1997, the nonprofit hospital sales review program. The legislature has
					 determined that the state has an interest to assure the continued existence of
					 accessible, affordable health care facilities. To achieve this goal the
					 department of health is responsible for reviewing and approving the acquisition
					 of nonprofit hospitals by for-profit entities. The department may approve an
					 acquisition of a nonprofit hospital only if it determines that the nonprofit
					 hospital has taken appropriate steps to safeguard charitable assets and any
					 proceeds of the acquisition are used for appropriate charitable health and
					 health care purposes.
Statutory Authority: 1997 c 332 § 14. 97-21-052,
						§ 246-312-010, filed 10/13/97, effective
						11/13/97.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-312 - Acquisition of nonprofit hospitals › Part II - APPLICATION REQUIREMENTS › Section 246-312-030 - Application information

Current through Register Vol. 24-14, July 15, 2024
(1) Acquiring
				  persons may obtain an application from the department.
(2) An application is determined to be
				  complete when the acquiring person submits a completed application, the
				  documents required in WAC
				  246-312-040 and required
				  fee(s).
(3) The department may
				  subpoena additional information or witnesses, require and administer oaths,
				  require sworn statements, take depositions, and use related discovery
				  procedures at any time prior to making a decision on the application.
(4) The application and supporting documents
				  are subject to the Public Disclosure Act and any exemptions (chapter 42.17
				  RCW).
Statutory Authority: Chapter 70.45 RCW and RCW 70.44.007.
						98-14-056, § 246-312-030, filed 6/26/98, effective
						7/27/98.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-312 - Acquisition of nonprofit hospitals › Part II - APPLICATION REQUIREMENTS › Section 246-312-035 - Amendments to the application

Current through Register Vol. 24-14, July 15, 2024
The applicant may submit amendments to its application at
					 any time. Timelines will begin again from the application stage of the review
					 process. A processing and review fee is required for each
					 amendment.
Statutory Authority: Chapter 70.45 RCW and RCW 70.44.007.
						98-14-056, § 246-312-035, filed 6/26/98, effective
						7/27/98.
Washington Administrative Code › Title 246 - Health, Department of › FACILITY STANDARDS AND LICENSING › Chapter 246-312 - Acquisition of nonprofit hospitals › Part III - REVIEW PROCESS › Section 246-312-050 - Criteria the department will use for review

Current through Register Vol. 24-14, July 15, 2024
(1)Chapter 70.45 RCW states that the
				  department may not approve an application unless, at a minimum, it determines
				  that:
(a) The acquisition is permitted under
				  chapter 24.03 RCW, the Washington Nonprofit Corporation Act, and other laws
				  governing nonprofit entities, trusts, or charities;
(b) The nonprofit corporation that owns the
				  hospital being acquired has exercised due diligence in authorizing the
				  acquisition, selecting the acquiring person, and negotiating the terms and
				  conditions of the acquisition;
(c)
				  The procedures used by the nonprofit corporation's board of trustees and
				  officers in making its decision fulfilled their fiduciary duties, that the
				  board and officers were sufficiently informed about the proposed acquisition
				  and possible alternatives, and that they used appropriate expert
				  assistance;
(d) There is no
				  conflict of interest related to the acquisition, including, but not limited to,
				  board members and executives of, and experts retained by, the nonprofit
				  corporation, acquiring person, or other parties to the acquisition;
(e) The nonprofit corporation will receive
				  fair market value for its assets. The attorney general or the department may
				  employ reasonably necessary expert assistance in making this determination. The
				  acquiring person is responsible for any cost of this expert assistance, in
				  addition to the fees charged under WAC
				  246-312-990;
(f) If the acquisition is financed in part by
				  the nonprofit corporation, that charitable funds will not be placed at
				  unreasonable risk;
(g) Any
				  management contract under the acquisition is for fair market value;
(h) The proceeds from the acquisition will be
				  controlled as charitable funds independently of the acquiring person or parties
				  to the acquisition, and will be used for charitable health purposes consistent
				  with the nonprofit corporation's original purpose. Charitable health purposes
				  include providing health care to the disadvantaged, the uninsured, and the
				  underinsured, and providing benefits to promote improved health in the affected
				  community;
(i) The charitable
				  entity established to hold the proceeds of the acquisition will be broadly
				  based in, and representative of, the community where the hospital to be
				  acquired is located, taking into consideration the structure and governance of
				  such entity; and
(j) If the
				  hospital is subsequently sold to, acquired by, or merged with another entity
				  that a right of first refusal to repurchase the assets by a successor nonprofit
				  corporation or foundation has been retained.