Alabama Administrative Code
Title 410 - STATE HEALTH PLANNING AND DEVELOPMENT AGENCY ALABAMA STATE HEALTH PLAN 2014-2017
Chapter 410-1-4 - SCOPE OF REVIEW
Section 410-1-4-.01 - New Institutional Health Services Subject To Review
Universal Citation: AL Admin Code R 410-1-4-.01
Current through Register Vol. 42, No. 5, February 29, 2024
(1) All new institutional health services which are subject to Section 22-21-260, et. seq.. Code of Ala. 1975, and which are proposed to be offered or developed within the state shall be subject to Certificate of Need review. New institutional health services which are subject to review shall include:
(a) the construction,
development, acquisition through lease or purchase or other establishment of a
new health care facility or health maintenance organization; or
(b) any expenditure by or on behalf of a
health care facility or health maintenance organization, which, under generally
accepted accounting principles consistently applied, is a capital expenditure
in excess of:
1. $2,000,000.00 indexed
annually for inflation for major medical equipment; or
2. resulting in excess of $800,000.00 for new
annual operating costs indexed annually for inflation; or
3. $4,000,000.00 indexed annually for
inflation for any other capital expenditure by or on behalf of a health care
facility or health maintenance organization; or
(c) any change in the existing licensed bed
capacity of a health care facility or health maintenance organization through
the:
1. addition of new beds;
2. the relocation of one or more beds from
one physical facility to another, (that is, one geographically separate
location to another); or
3.
reallocation among services of existing beds through the conversion of one or
more beds from one category to another within the following bed categories:
(i) general medical surgical
(ii) inpatient psychiatric
(iii) inpatient/residential alcohol and drug
abuse
(iv) inpatient
rehabilitation
(v) long term care
beds including skilled nursing care, intermediate care, transitional care, and
swing beds; or
(d) any health service which is proposed to
be offered in or through a health care facility or health maintenance
organization, and which was not offered on a regular basis in or through such
health care facility or health maintenance organization within the twelve-month
(12 month) period prior to the time such services would be offered, including,
without limitation, health services to be provided through equipment obtained
from vendors or lessors of equipment, provided, however, that a vendor or
lessor of equipment which does not materially engage in the provision of the
health service shall not be required to obtain a CON; or
(e) the acquisition, by any person, of major
medical equipment that will
1. be owned by or
located in a health care facility, or which will be used to provide health
services to persons admitted to a health care facility; provided, however, that
an acquisition of major medical equipment need not be reviewed if it will be
used to provide services to inpatients of a health care facility only on a
temporary basis in the case of a natural disaster, major accident, or equipment
failure; or
2. if a person acquires
major medical equipment not located in a health care facility without a
Certificate of Need and proposes at any time to use that equipment to serve
inpatients of a health care facility, then the proposed new use must be
reviewed unless the equipment will be used to provide services to inpatients of
a health care facility only on a temporary basis not to exceed six weeks in the
case of an emergency, a natural disaster, a major accident, or an equipment
failure. An extension of the six-week time period may be granted by the
Certificate of Need Review Board. For the purposes of this section, "temporary
basis" means on an occasional or irregular basis or until the applicant's
proposal for permanent acquisition or regular use by a health care facility is
reviewed under the formal review process; or
3. an acquisition made by or on behalf of a
health care facility under lease or comparable arrangement, or through
donation, which would have required a Certificate of Need if the acquisition
had been by purchase.
(f) For purposes of subsection (c)(3)(i)
above, "General Medical Surgical" shall be defined as encompassing all acute
care beds not otherwise included in subsections (c)(3)(ii)-(iv)
(g) Any other proposal which is related to
one or more of the foregoing, or any variation or combination thereof which
would be reviewable within the meaning of the statute.
(h) Notwithstanding all other provisions of
these rules to the contrary, those facilities and distinct units operated by
the Department of Mental Health and Mental Retardation and those facilities and
distinct units operating under contract or subcontract with the Department of
Mental Health and Mental Retardation where the contract constitutes the primary
source of income to the facility shall not be subject to review under this
article.
(i) Notwithstanding any
other provisions of these rules to the contrary, the definition a new
institutional health service shall not include any health services provided by
a mobile or fixed-based extra corporeal shock wave lithotripter, a mobile or
fixed-based magnetic resonance imaging scanner and/or a mobile or fixed-based
positron emission tomography scanner.
(j) Notwithstanding any other provisions of
these rules to the contrary, the modernization or construction of a
non-clinical building, parking facility or any other non-institutional health
services capital item on the existing campus of a health care facility shall be
exempt from Certificate of Need review provided the construction or
modernization does not allow the health care facility to provide any new
institutional health services subject to review and not previously provided on
a regular basis.
(k) Any reference
contained in these rules to an "index" shall be a reference to the Consumer
Price Index Market Basket Professional Medical Services Index as published by
the U. S. Department of Labor, Bureau of Labor statistics.
Author: Alva M. Lambert
Statutory Authority: Code of Ala. 1975, § 22-21-263, Act 2003-331.
Disclaimer: These regulations may not be the most recent version. Alabama may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.