Code of Massachusetts Regulations
105 CMR - DEPARTMENT OF PUBLIC HEALTH
Title 105 CMR 100.000 - Determination of Need
Section 100.210 - Determination of Need Factors

(a) The Applicant has demonstrated sufficient need for the Proposed Project by the Applicant's Patient Panel;

(b) The Applicant has demonstrated that the Proposed Project will add measurable public health value in terms of improved health outcomes and quality of life of the Applicant's Patient Panel, while providing reasonable assurances of health equity;

(c) The Department has determined that the Applicant has provided sufficient evidence that the Proposed Project will operate efficiently and effectively by furthering and improving continuity and coordination of care for the Applicant's Patient Panel, including, sufficient evidence that the Proposed Project will create or ensure appropriate linkages to patients' primary care services;

(d) The Applicant has provided evidence of consultation, both prior to and after the Filing Date, with all Government Agencies with relevant licensure, certification, or other regulatory oversight of the Applicant or the Proposed Project;

(e) The Applicant has provided evidence of sound community engagement and consultation throughout the development of the Proposed Project, including documentation of the Applicant's efforts to ensure engagement of community coalitions statistically representative of the Applicant's Patient Panel. Representation should consider age, gender and sexual identity, race, ethnicity, disability status, as well as socioeconomic and health status; and

(f) The Applicant has demonstrated that the Proposed Project will compete on the basis of price, total medical expenses, provider costs, and other recognized measures of health care spending.

(a) The Applicant has sufficiently demonstrated that the Proposed Project will meaningfully contribute to the Commonwealth's goals for cost containment, improved public health outcomes, and delivery system transformation; and

(b) The Department has determined, either:

(a) The Department, in consultation with CHIA, has determined that the Applicant has provided sufficient documentation of the availability of sufficient funds for capital and ongoing operating costs necessary to support the Proposed Project without negative impacts or consequences to the Applicant's Patient Panel. Said documentation shall include an analysis by an independent certified public accountant (CPA). Said independent CPA's analysis shall include, but not be limited to: a review of the Applicant's and where appropriate, as a matter of standard accounting practices, its Affiliates, past and present operating and capital budgets; balance sheets; projected cash flow statements; proposed levels of financing for the Proposed Project, including a compilation of prospective financial information, such as a forecast or a projection, for the subsequent five-year period prepared in accordance with the attestation standards established by the American Institute of Certified Public Accountants, and any other relevant information required for the independent CPA to provide reasonable assurances to the Department that the Proposed Project is financially feasible and within the financial capability of the Applicant, and where appropriate, as a matter of standard accounting practice, its Affiliates; and

(b) If the Commissioner has determined that an independent cost-analysis is required pursuant to M.G.L. c. Ill, § 25C(h), the analysis has demonstrated that the Proposed Project is consistent with the Commonwealth's efforts to meet the health care cost-containment goals.

(a) For a Proposed Project on behalf of a Long-term Care Facility, which is not deemed a Conservation Project by the Department, funding shall be 3% of the total Capital Expenditure of the Proposed Project.

(b) For a Proposed Project on behalf of a Health Care Facility, other than a Long-term Care Facility deemed a Conservation Project by the Department, funding shall be 2.5% of the total Capital Expenditure of the proposed Conservation Project.

(c) For a Proposed Project on behalf of a Long-term Care Facility, which is deemed a Conservation Project by the Department, funding shall be 1% of the total Capital Expenditure of the proposed Conservation Project.