Current through Register Vol. 47, No. 6, September 18, 2024
(1)
Purpose
and scope.
a. These standards are
measures of some of those criteria in Iowa Code section
10A.714(1)
"a" through "l." Criteria that are measured
by a standard are cited in parentheses following each standard.
b. Certificate of need applications that are
to be evaluated against these computerized tomography standards include:
(1) Proposals to commence or expand the
capacity of computerized tomography services.
(2) Any other applications that relate to
computerized tomography services.
(2)
Definitions.
a. Computerized tomographic (CT) scanner-a
diagnostic tool that rotates about and that sends X-ray beams through the body
or brain. The X-ray beams that emerge from the body or brain are absorbed by a
detector. Differences in the amount of X-rays absorbed by the detector indicate
differences in tissue density. As the scanner rotates, it takes many images of
a volume or cross-section. The images on the detector are transmitted to a
computer that displays on a monitor a reconstructed cross-sectional slice or
volume. Contrast media is often injected to alter absorption of the detector.
If the scan is repeated, it is called enhancement. Studies of the heart,
arteries and veins may be done with contrast only.
(1) Whole body scanner-one capable of imaging
the entire body.
(2) Head
scanner-one capable of imaging only the brain and structures adjacent to the
head.
b. Enhanced scan-a
scan performed on a patient who has been administered a contrast medium so that
specific organs or areas of the body will be displayed more distinctly on the
scan image.
c. Minimum
shared-market area for a scanner (hereafter referred to as "area")-the smallest
geographic area within which any scanner installation is judged to affect the
utilization rate of any other scanner is the community (as defined by the U.S.
Bureau of the Census) or a Standard Metropolitan Statistical Area (where an
area is so designated).
d.
Emergency medical service (EMS) level II trauma service-the level of various
services and staffing that qualify a facility to be designated by the emergency
medical service division of the Iowa department of health and human services,
using the facilities categorization criteria of such services that is in effect
on the date of the enactment of this standard.
e. Shared service agreements-a
multi-institutional arrangement for coordination or consolidation of services
or sharing of support services. Among the various types of arrangements are
referred services, purchased or joint contract services, multisponsored
services and regional services.
f.
CT consortia-a cooperative venture in which two or more institutions form a
separate entity that is created for the purpose of owning, leasing, planning
for, and maintaining the use of the scanner. Each facility in the consortium
maintains its autonomy for all other services.
g. Applicant-an applicant may be a facility
or a consortium of facilities within an area, or a physician or group of
physicians.
h. General imaging
procedures-a radiological diagnostic procedure performed on an X-ray machine or
similar radiological diagnostic instrument.
i. Active oncology service-full,
multidisciplinary cancer care, provided by a medical team that would include:
surgery, gynecology, medical oncology, radiation oncology, pathology,
diagnostic radiology and nuclear medicine. The surgery specialties that might
be available would include: thoracic, abdominal, genitourinary and
gynecological. The active oncology staff would include those specialists with
training in oncology, hematology, and pathology and who spend at least half of
their time at the institution.
j.
Radiotherapy service-the therapeutic application of megavoltage radiation,
using a linear accelerator or cobalt unit. The availability of such service at
a hospital would necessitate personnel trained in the therapeutic application
of radiology.
k. Chemotherapy
service-the treatment of cancer by chemical agents.
(3)
Determination of need.
a. Applicants who do not have a scanner, or
who have a scanner and seek a certificate for one or more additional scanners.
(1) Applicants in areas with no other
scanners.
1. Applicants must have performed at
least 30,000 general imaging procedures during the past calendar year or 12
months, or
2. Demonstrate that
during the past calendar year or 12 months, the applicant performed diagnostic
procedures equivalent to 1500 HECTs (head equivalent CTs), using the following:
100% of the number of patients referred to other facilities for
CT diagnosis * 1.75 (in the case of head scans) and 2.75 (in the case of body
scans)
(2)
Applicants in areas with one or more scanners.
1. An applicant must meet the requirement of
need, described in subparagraph 203.4(3)"a"(1), and
2. The average level of utilization for
scanners within the area was at least 3000 HECTs (plus or minus 10 percent) for
the past calendar year or 12 months. The average level of utilization will be
determined by adding the number of HECTs performed during the period at all
area facilities divided by the number of facilities.
3. The University of Iowa Hospitals and
Clinics is specifically exempted from consideration under numbered paragraph
203.4(3) "a"(2)"2" because it has a service area that
encompasses the entire state and adjoining states. The utilization statistics
for the University Hospital will therefore neither affect nor be affected by
Mercy Hospital, Iowa City. Additionally, the utilization statistics for
scanners at the University of Nebraska Hospitals and Clinics and St. Joseph's
Hospital (both in Omaha) will not affect the need for scanners at hospitals in
Council Bluffs.
b. Replacement scanners-applicants who
currently have a scanner.
(1) All applicants
seeking to replace a scanner with another scanner, head or body.
1. The applicant must demonstrate that the
applicant's use of the applicant's current scanner was at least at the
operating capacity level during the last calendar year or 12 months,
or
2. Below the operating capacity
level, but above 1500 CT scan level, and the applicant must demonstrate reasons
for permanently utilizing their scanner below operating capacity level and
demonstrate that discontinuation of their scanner service would impair the
applicant's ability to respond to the emergency needs of the area. Reasons for
utilizing the scanner below the capacity should include a unique patient or
procedure mix that would define the capacity level differently for this
applicant.
(2)
Reserved.
(4)
Costs and financial feasibility. (Iowa Code section
10A.714(1)
"f," "i," "p") CT scanners should be depreciated over a period
of not less than seven years. Remodeling shall be depreciated as appropriate by
generally accepted accounting principles
a.
Cost-effectiveness. Applicants should demonstrate for
themselves and the health care system that the most cost-effective method of
providing CT services has been chosen. Proposed new and replacement CT
scanner's cost per CT scan should, when compared to their peers, demonstrate
cost-effectiveness.
b.
Reserved.
(5)
Accessibility. (Iowa Code section
10A.714(1)
"c," "d")
a. All scanners
must be available to meet the needs of the communities the scanners are meant
to serve.
b. Services should be
provided to all patients regardless of the patient's ability to pay, taking
into consideration the availability of those programs available in the state
that serve the medically indigent.
c. Applicants will demonstrate a willingness
to accept referrals for CT services from all area physicians.
(6)
Quality.
(Iowa Code section 10A.714(1)
"i," "k")
a. Data on use and
costs of the CT scanners should be submitted to the Iowa department of health
and human services as a condition of approval. (Iowa Code section
10A.714(1)
"a," "h")
b. All
scanners.
(1) All applicants must demonstrate
that they have on their staff or will acquire on their staff a full-time
diagnostic radiologist, trained in the use of the CT scanner, or other
physicians with comparable training and expertise.
(2) All applicants must document that they
have on their medical staff individuals who are qualified to operate a scanner
and interpret and act upon the diagnostic results. Such documentation may
include reference to board certification, apprenticeship, academic credentials
or such other qualifications that would prompt a medical staff to accept the
responsibility for offering this new service. Applicants who intend to acquire
staff with the desired expertise should provide signed letters of intent from
the incoming medical personnel. Applicants who intend to upgrade the specialty
skills of their staff should document a plan for training their current staff
in the use of CT scanners.
(3) All
applicants should have a complement of other diagnostic modalities available.
Applicants seeking body scanners should also have available ultrasound and
conventional X-ray services.
(4)
All applicants should have the facilities for treating the conditions diagnosed
by imaging with the scanner or should demonstrate referral agreements with
treatment facilities, in the event that the scanner will be used as a screening
device.
(5)
All applicants should have on their staff or available on a consultative basis
the services of a biomedical engineer or medical physicist, with special
training in CT applications. These functions may also be provided by contract
with the scanner manufacturer.
(7)
Continuity. (Iowa Code section
10A.714(1)
"g," "h," "i," "k")
a. The
applicant should demonstrate that an attempt was made to solicit letters of
support from area hospitals and physicians to indicate a community need for the
proposed service.
b. The applicant
should provide documentation that emergency medical transport services will be
available.
c. The applicant should
demonstrate an emphasis on the availability of outpatient CT procedures and
that an appropriate percentage of all CT procedures will be done on an
outpatient basis.
(8)
Acceptability. (Iowa Code section
10A.714(1)
"k") Providers of CT services should indicate a willingness to
observe the rights of patients.