Current through Register Vol. 48, No. 12, March 22, 2024
a) Projects or Transactions that Require a
Permit
A person must obtain a permit prior to establishing,
constructing or modifying a health care facility, and prior to acquiring major
medical equipment, unless an exemption from the requirement to obtain a permit
has been issued in accordance with the provisions of Subpart D and Subpart E. A
project or transaction that is not exempt is subject to review and requires a
permit if the project or transaction:
1) requires a total capital expenditure in
excess of the capital expenditure minimum. In determining the total capital
expenditure, all costs (including the fair market value of assets acquired by
lease or other means) that under generally accepted accounting principles are
not properly chargeable as expenses of operation and maintenance, must be
included even if any of such costs are not capitalized for reimbursement or
other purposes. All capital expenditure minimums shall be annually adjusted
upon the date established by the Act to reflect the increase in construction
costs due to inflation. The basis for the adjustment shall be the latest annual
inflation rate as reflected in the Means Cost Data (RSMeans Company, Inc., 700
Longwater Drive, Norwell MA 02061). The revised minimums shall be published on
HFSRB's internet site (
www.hfsrb.illinois.gov);
2) substantially changes the scope or changes
the functional operation of the facility as defined in Section
1130.140;
3) results in the establishment of a health
care facility as defined in Section 1130.140;
4) changes the bed capacity of a health care
facility as specified in the Act and Section
1130.240(f);
5) involves a change of ownership, unless an
exemption has been issued in accordance with the provisions of Subpart D and
Subpart E;
6) results in the
discontinuation of an entire health care facility or category of service (see
Section 1130.140), unless an exemption has been issued in accordance with the
provisions of Subpart D and Subpart E; or
7) involves the acquisition of major medical
equipment.
b) Components
of a Project or Transaction
In determining the elements of a transaction or a project
subject to the Act, the following factors apply:
1) Components of construction or modification
that are interdependent must be grouped together. Interdependence occurs when
components of construction or modification are architecturally and/or
programmatically interrelated to the extent that undertaking one or more of the
components compels the other components to be undertaken.
2)
Unless otherwise interdependent,
or submitted as one project by the applicant, components of construction or
modification undertaken by means of a single construction contract or financed
through the issuance of a single debt instrument shall not be grouped together
as one project. [20
ILCS 3960/3 ]
3) Projects involving acquisition of
equipment that are linked with construction for the provision of a service
cannot be segmented. A health service linkage exists when all components must
be present for a service to be operational, or when financing is obtained at
one time for a series of related components.
4) Components under an application for permit
shall be for a single health care facility unless the components are
interdependent among multiple facilities.
c) Prohibition on Splitting or Separating
Components of a Project or Transaction
1) No
health care facility or other person proposing a project or transaction that is
subject to the Act shall split what should properly be considered a single
capital expenditure into discrete components undertaken during a fiscal year to
evade the capital expenditure review threshold.
2) No health care facility or other person
proposing a project or transaction that is subject to the Act shall separate
portions of a single project into components, including, but not limited to,
site, facility, and equipment, to evade the capital expenditure review
threshold or other requirements of the Act or HFSRB rules.
d) Examples of Projects or Transactions
Subject to the Act
Examples of projects that constitute construction or
modification of a health care facility subject to the Act include:
1) Projects located within a licensed or
certified health care facility;
2)
Projects that result in a health care facility:
A) Billing for services provided by the
proposed project;
B) Capitalizing
any portion of the proposed project;
C) Receiving reimbursement for services
provided by the proposed project; or
D) Receiving recognition as the provider of
the proposed service by third party payors;
3) Projects that are staffed or operated by
the health care facility;
4)
Projects that are otherwise of, by, through or on behalf of a health care
facility;
5) Projects that provide
a category of service as defined in 77 Ill. Adm. Code 1100 that are offered or
made available on a regular basis to inpatients or outpatients of a health care
facility.