Mississippi Administrative Code
Title 15 - Mississippi Department of Health
Part 8 - Office of Health Policy and Planning
Subpart 90 - Planning and Resource Development
Chapter 05 - Acute Care Facilities and Services Overview
Section 15-8-90-05-515 - Certificate of Need Criteria and Standards for Cardiac Catheterization Services and Open-Heart Surgery Services
Section 15-8-90-05-515.02 - Policy Statement Regarding Certificate of Need Applications for the Acquisition or Otherwise Control of Cardiac Catheterization Equipment and/or the Offering of Cardiac Catheterization Services
Current through September 24, 2024
1. Cardiac Catheterization Services: For purposes of the following CON criteria and standards the term "cardiac catheterization services" or "catheterization services" shall include three levels of cardiac catheterization services an applicant may provide: diagnostic cardiac catheterization services, percutaneous coronary intervention (PCI) in a hospital without on-site cardiac surgery, or therapeutic cardiac catheterization services.
2. Open-Heart Surgery Capability: MSDH shall not approve CON applications for the establishment of therapeutic cardiac catheterization services at any facility that does not have open-heart surgery capability; i.e., new therapeutic cardiac catheterization services may not be established and existing therapeutic cardiac catheterization services may not be extended without approved and operational open-heart surgery services in place. This policy does not preclude approval of a Certificate of Need application proposing the concurrent establishment of both therapeutic cardiac catheterization and open-heart surgery services. This policy also does not preclude approval of a Certificate of Need application to perform percutaneous coronary intervention (PCI) services in a hospital without on-site cardiac surgery or in a Cardiac Ambulatory Surgical Facility as defined in 515.06.
3. Service Areas: The State has nine designated Cardiac Catheterization/Open-Heart Surgery Planning Areas (CC/OHSPAs) presented in the Open Heart Surgery section of this chapter of the Plan. Map 5-2 shows the CC/OHSPAs.
4. Pediatric Cardiac Catheterization: Because the number of pediatric patients requiring study is relatively small, the provision of cardiac catheterization for neonates, infants, and young children shall be restricted to those facilities currently providing the service. National standards indicate that a minimum of 150 cardiac catheterization cases should be done per year and that catheterization of infants should not be performed in facilities which do not have active pediatric cardiac-surgical programs.
5. Present Utilization of Cardiac Catheterization Equipment/Services: MSDH shall consider utilization of existing equipment/services and the presence of valid CONs for equipment/services within a given CC/OHSPA when reviewing CON applications. MSDH shall not consider utilization of equipment/services at any hospital owned and/or operated by the state or its agencies when reviewing CON applications. MSDH may collect and consider any additional information it deems essential, including information regarding access to care, to render a decision regarding any application.
6. Minimum Caseload: Applicants for a diagnostic cardiac catheterization Certificate of Need must be able to project a caseload of at least 300 diagnostic catheterizations per year per year by the end of the third year of operation. Applicants for a therapeutic cardiac catheterization Certificate of Need must be able to project a caseload of at least 450 catheterizations, diagnostic and therapeutic, per year by the end of the third year of operation. Applicant for a Certificate of Need to provide PCI services in a hospital without on-site cardiac surgery must be able to project a caseload of at least 300 catheterizations, diagnostic and PCI, with at least 100 being PCIs, per year by the end of the third year of operation.
7. Residence of Medical Staff: Cardiac catheterizations must be under the control of and performed by personnel living and working within the specific hospital area. No site shall be approved for the provision of services by traveling teams.
8. Hospital-Based: All cardiac catheterizations and open-heart surgery services shall be located in acute care hospitals or in a Cardiac Ambulatory Surgical Facility, subject to the policy statements and need criteria and standards set forth in Sections 515.06 and 515.07 of this State Health Plan.
9. Conversion of Existing Therapeutic Cardiac Catheterization Services to PCI Services in a Hospital without On-Site Cardiac Surgery Capabilities: A hospital currently providing therapeutic cardiac catheterization services may convert their cardiac catheterization program to provide PCI services in the hospital without on-site cardiac surgery capability without certificate of need review; provided, however, that the facility shall submit an application for determination of non-reviewability prior to eliminating on-site cardiac surgery. The hospital must attest in the application for determination of non-reviewability that it will meet the CON criteria and standards as set out in Rule 515.04 of this Plan. If, at any time, the hospital goes twelve (12) consecutive months of providing PCI services without on-site cardiac surgery, the hospital wants to convert back to a therapeutic cardiac catheterization program, the hospital must submit a certificate of need application for review.
