Current through Register Vol. 54, No. 12, March 23, 2024
(a)
Letter
of intent.
(1) As early as possible,
any person desiring to obtain a certificate of need shall submit a letter of
intent to the Division of Need Review of the Department and to the Health
Systems Agency (HSA) responsible for reviewing applications in the health
service area where the proposed project will be located. A letter of intent
shall contain at least the following information:
(i) The name and address of the
applicant.
(ii) The name and
location of the project.
(iii) The
reason the project is needed.
(iv)
The type of capital expenditure, acquisition, health service, or change in bed
capacity involved in the project.
(v) The expected date of project commencement
and completion.
(vi) The estimated
cost and anticipated source of project financing.
(2) The Department, after consultation with
the HSA, will determine whether the project is subject to review and notify the
applicant within 30 days of receipt of the letter of intent. Only projects for
which letters of nonreviewability are issued will be considered not subject to
review. A determination by the Department that a project is subject to review
may be appealed to the Hearing Board, under 37 Pa. Code Chapter 197 (relating
to practice and procedure). An application may be submitted and reviewed during
an appeal to the Hearing Board.
(3)
If the project has been inactive for more than 1 year the project proposed by
the applicant shall be considered withdrawn.
(b)
Application.
(1) An applicant for a certificate of need
may obtain the necessary application forms from the local HSA. Applications to
obtain or amend a certificate of need shall be submitted simultaneously to the
Department and the HSA responsible for reviewing applications in the health
service area where the proposed project will be located. The HSA shall advise
the applicant as to the number of copies of the application the agency will
require to conduct a review.
(2)
Applications for a certificate of need shall contain all data and information
required by the Department and the HSA. The following information shall be
submitted in a format published by the Department:
(i) General.
(A) Identifying information.
(B) Type of ownership.
(C) Type of applicant.
(D) Type of application.
(E) Anticipated proposal schedule.
(ii) Synopsis of
proposal.
(iii) Proposal planning
process.
(A) Description of annual
institutional planning process.
(B)
Results of planning with other organizations.
(C) Description of institutional long range
plan.
(iv) Specific
description of proposal.
(A) Service,
building, equipment and bed changes.
(B) Personnel requirements.
(C) Projected utilization by
service.
(D) Projected
costs.
(E) Anticipated
financing.
(v) Need for
proposal.
(A) Compatibility with institutional
long range plan.
(B) Consistency of
proposal objectives with the following:
(I)
Goals, objectives and recommended actions in the health systems plan and annual
implementation plan.
(II) Goals,
objectives, and recommended actions in the State health plan.
(C) Consistency of specific
criteria used to calculate need with the following:
(I) Criteria in the health systems
plan.
(II) Criteria in the State
health plan.
(III) Other relevant
criteria developed by professional organizations, if available.
(D) Documentation of alternatives
studied and found not practicable.
(I) More
efficient use of existing services or facilities, or both.
(II) Implementation of modernization or
sharing arrangements to the maximum extent feasible.
(vi) Economic feasibility of
proposal.
(A) Documentation of financial
feasibility.
(I) Past historical financial
data.
(II) Pro Forma statements:
status quo; proposal; alternatives.
(III) Financing arrangements and
assumptions.
(B)
Evaluation of economic feasibility.
(I)
Adequate volume of care projected.
(II) Availability of financing.
(III) No inappropriate adverse impact on
overall areawide cost of providing services.
(IV) No appropriate, less costly or more
effective alternative methods of providing the services available.
(vii) When the HSA, with
concurrence of the Department, has adopted additional information requirements,
the information requirements shall be published by the HSA in a format approved
by the Department, and incorporated into the application. The applicant shall
submit this information within the format published by the
HSA.
(3) The application
for a certificate of need shall specify the time the applicant will need to
make the service or equipment available or to complete the project, and a
timetable to substantially implement the approved project. The timetable to
substantially implement the project must conform with the timetable established
at subsection (m).
(4) The
appropriate HSA and the Department will review each certificate of need
application for completeness. If it is determined that the application is
incomplete, the reviewing agency shall send notice to the applicant within 20
business days of the receipt of the application and shall advise such persons
in writing of the additional information required to complete the application.
Upon receipt of the additional information, the reviewing agency shall
determine if the application is complete and send notice within 15 business
days of the receipt of same. The application and additional information must be
sent to both the Department and the HSA. The time frames for review of the
application or additional information will not begin until both the Department
and HSA have received the information. If the Department and HSA receive
information on different dates, the time frame begins on the later of the two
dates. An applicant shall only be required to provide information under
paragraph (2).
(5) Any conflicts
regarding the completeness of an application will be resolved by the
Department. An applicant may notify the Department at any time while an
application is under consideration for completeness by an HSA, and request in
writing a determination by the Department as to whether the application is
complete. The request must indicate the reasons why the HSA determined the
application incomplete, and the reasons why the applicant believes the
information is contained in the application or in the additional information
provided. The Department will notify the applicant of its determination within
14 business days. If the Department determines the application is complete, the
HSA shall review the application.
(6) An applicant may, 60 days or more after
filing an application, request in writing that the review begin. Requests shall
be mailed to the HSA and the Department by certified mail, return receipt
requested. Upon receipt of such a request the HSA shall notify the applicant
and the Department in writing that the review process will begin on the date of
notification in accordance with subsection (d)(1) and shall include at least
the same information as required in subsection (c)(3). All subsequent
requirements pertinent to a complete application shall apply.
(c)
HSA notification of
review.
(1) After the HSA determines
that an application is complete in accordance with subsection (b)(3) or upon
expiration of the time to determine that an application is complete, whichever
comes first, the HSA shall send a written notice to the applicant stating that
the application is deemed complete and that the review process will begin on
the date of notification in accordance with subsection (d)(1).
(2) [Reserved].
(3) The HSA shall notify all affected persons
of a complete certificate of need application by publishing a notice in at
least one newspaper of general circulation serving the locality in which the
proposed service or facility will be developed. The notice shall contain the
name and address of the applicant, a brief description and an estimate of the
cost of the project, the schedule for review by the agency, the date by which a
public hearing must be requested, and the manner in which notice will be given
if a public hearing is to be held. If this notice states the date and location
of the public hearing, it shall satisfy the requirement for public notice of
the HSAs. The Department will publish a similar notice in the
Pennsylvania Bulletin.
(4) The HSA shall also provide written notice
of a completed certificate of need application to HSAs serving contiguous
health service areas, any health care facilities and health maintenance
organizations located in the health service area which provide institutional
health services, appropriate third party payors, and public agencies. The
written notice shall contain the same information as required in paragraph (3)
and may be satisfied if published as part of a newsletter.
(d)
HSA period for review.
(1) The date of notification begins the time
period in which the HSA must complete the review of an application for a
certificate of need. The date of notification is the date the HSA publishes a
notice in accordance with subsection (c)(3). The HSA shall send the applicant
the required notice that the review process will begin and publish such notice
within 30 days after either the application is deemed complete in accordance
with subsection (b)(4) or after receipt of the applicant's request that review
begin in accordance with subsection (b)(6), whichever date first
occurs.
(2) The HSA shall have 60
days from the date of notification to complete its review of the
application.
(3) The HSA with
concurrence of the Department may extend the time for review beyond 60 days
from the date of notification only if the applicant agrees in writing to a
specific extension of time for the review by the HSA. Any agreed extension of
time must indicate the date upon which the running of the 60 day period stops
and begins, and the date upon which the 60 day period expires. Copies of agreed
extensions must be submitted to the Department. If there are not agreed
extensions in writing, the 60 day period shall not be considered extended, and
will expire on the 60th day from the date of notification.
(4) [Reserved].
(5) The HSA, with concurrence from the
Department, may establish review cycles for the review of applications. There
shall be at least six review cycles per year-one every other month. During a
review cycle, all completed applications pertaining to similar types of
services, facilities or equipment shall be considered in relation to each
other.
(e)
Public
hearing and objection procedures.
(1) A public hearing shall be conducted by
the appropriate HSA if any affected person or any appropriate third-party payor
submits a written request for a hearing to the HSA within 15 days from the
notice published under subsection (c)(3). Timely notification within the 15 day
period shall be determined by the postmark. The HSA may require a public
hearing during the course of its review of any application for a certificate of
need.
(2) Any person directly
affected may file an objection to an application within 15 days from the
publication of notice in accordance with subsection (c)(3). The date of filing
will be determined by the postmark. Such an objection must be filed with the
appropriate HSA and set forth specifically the reasons such objection is filed.
Persons filing objections shall be parties to the proceeding unless and until
such objections are withdrawn. Any person, other than the applicant, or the
HSA, who appeals the decision of the Department subsection (j)(1) must have
become a party to the proceedings by having filed an objection with the
appropriate HSA.
(3) Notice of a
public hearing on a certificate of need application shall be published by the
HSA in a newspaper of general circulation serving the locality in which the
proposed service or facility would be developed. The HSA shall notify affected
persons of the hearing at least 14 days prior to the hearing. This requirement
may be satisfied as part of subsection (c)(3).
(4) [Reserved].
(5) Each HSA shall adopt and publish specific
procedures for conducting public hearings on certificate of need applications.
The procedures must be approved by the Department and shall conform to the
following:
(i) The applicant and any person
shall be afforded the opportunity to submit testimony, oral or written
arguments, and relevant evidence at the hearing. Such persons should request
the opportunity to testify by notifying the HSA prior to the hearing date or
may register to testify at the hearing. Any person shall have the right to be
represented by counsel. Any person directly affected may conduct reasonable
questioning of persons who make relevant factual allegations. A record of the
hearing shall be maintained. A transcript of this record shall be made upon
request of a party to the proceedings and at the expense of the requesting
party.
(ii) The time allocated to
persons wishing to present testimony may be limited under the hearing
procedures adopted and published by the HSA governing body.
(iii) The public shall be notified as soon as
possible regarding any changes in the scheduled date of a public hearing or any
changes in the applications to be heard therein.
(f)
HSA review and
recommendations.
(1) A HSA may, with
the approval of the Department, give a nonsubstantive review to a proposed new
institutional health service. See §
401.2 (relating to definitions)
for definitions of nonsubstantive reviews.
(2) HSAs, in formulating recommendations to
the Department on a certificate of need application, shall make their findings
regarding the criteria set forth in §
401.4 (relating to criteria for
Certificate of Need review) under procedures established by the
Department.
(3) The HSA shall
concurrently send the applicant notification of the findings and
recommendations it submits to the Department. The findings shall be submitted
to the Department in such form as the Department requires.
(4) The HSA shall submit its findings and
recommendations to the Department within the time period allotted in subsection
(d)(2) and (3).
(g)
Department review and findings.
(1) The Department will consider the timely
filed findings and recommendations of the HSA, any information accompanying the
application or presented on behalf of the application, any duly promulgated
criteria and standards adopted by the Department, and the criteria listed in
§ 401.4.
(2) If there has been
no provision for a public hearing before the HSA, the Department will comply
with the requirements of subsection (e).
(3) The Department will approve or disapprove
the application within 30 days from the date that the HSA's recommendation is
received.
(4) If the Department
determines that an application cannot be adequately reviewed within the time
periods stated in paragraph (3), it will notify the applicant indicating the
reasons why, and request the applicant to agree to an extension of the review
period.
(5) If a decision is not
made within the required time period, the applicant may bring an action in the
Commonwealth Court to require the Department to approve or disapprove the
application. If an order is issued by the Court, the Department will promptly,
and in accordance with the order, issue its decision. If the decision is
adverse to the applicant, the applicant may appeal to the Hearing
Board.
(6) Decisions of the
Department will be based solely on the record. There shall be no ex parte
contacts.
(i) For purposes of this section, an
ex parte contact is a contact between an applicant for a certificate of need,
any person acting on behalf of the applicant, or any person opposed to the
issuance of a certificate, and any person in the Department who exercises any
responsibility respecting the application after the commencement of the public
hearing on the applicant's application and before a decision is made with
respect to it. A status report shall not be considered an ex parte contact. A
contact which is recorded as part of the official application file in
accordance with paragraphs (ii) and (iv) shall not be considered an ex parte
contact.
(A) For the purpose of this
subsection, a person acting on behalf of the applicant for, or holder of, a
certificate of need is any person, including an HSA, who favors the issuance of
a certificate of need.
(B) For the
purpose of this subsection, a person in the Department who exercises any
responsibility respecting the application includes any Departmental employe
involved in a given review, from the initial reviewer up to and including the
Secretary.
(C) For the purpose of
this section, status reports are any communications which do not go to the
substance of a certificate of need review. They are routine statements of the
progress of the review of an application for a certificate of need.
(ii) When the Department receives
a written communication from a person who supports or opposes the granting of a
certificate of need, the communication shall be made a part of the official
project file regarding the issuance of the certificate of need. Any person may
review the official project file during the normal business hours of the
Department. Any affected person may receive a copy of written communications
which have been made part of the official project file by contacting the
Division of Need Review. Requests will be considered to be requests for status
reports as defined in clause (C).
(iii) When the Department receives a
communication either in person or by telephone from a person who supports or
opposes the granting of a certificate of need, a summary of the communication
will be made part of the file.
(iv)
When the Department holds a meeting with an applicant or a person opposing or
supporting the issuance of a certificate of need, parties to the proceeding
will be notified, in advance of the time and place of the meeting. A summary of
the meeting will be made part of the project file.
(7) When the Department approves an
application, the certificate of need shall specify the maximum amount of
capital expenditures which may be obligated under the certificate.
(8) Certificates of need shall be granted or
refused. They shall not be conditioned upon the applicant changing other
aspects of its facilities or services or requiring the applicant to meet other
specified requirements and no such obligation shall be imposed in granting or
refusing approval.
(9) The
Department may grant a certificate of need which permits expenditures only for
predevelopment of the new institutional health service with respect to which
such predevelopment costs are incurred.
(10) When the Department makes a decision
regarding the proposed new institutional health service which is inconsistent
with the recommendation made with respect thereto by a HSA, or with the
applicable health systems plan, or annual implementation plan, the Department
will submit to the HSA and all parties to the proceeding a written detailed
statement which describes why it has made findings that are inconsistent with
the findings of the HSA, the health systems plan or the annual implementation
plan.
(11) The Department will make
written findings which state the basis for any final decision made by the
Department. The findings shall be sent to the applicant, the HSA, and all
parties to the proceedings as soon as reasonably possible following its
decision, but no later than 10 business days after its decision, and it shall
be made available to others upon request.
(12) A person proposing a new institutional
health service may withdraw a previously filed application without prejudice by
filing written notice of the withdrawal with both the HSA and the Department at
any time prior to final approval or disapproval of the required certificate of
need.
(13) An applicant may modify
a proposal at any time during the review period. When an applicant desires to
modify a proposal, the applicant shall submit in writing a detailed statement
of the desired changes and an explanation to justify each change to the HSA and
the Department. The HSA shall review the proposed changes to determine if a
substantial modification to the original application would occur. If it is
determined that a substantial modification would occur, the proposed change
will be submitted to the HSA for review and a recommendation on the proposed
change returned to the Department within 60 days. The Department will approve
or disapprove the application within 30 days from the date the HSA
recommendation is received. For the purposes of this paragraph, a substantial
modification occurs when one of the following occurs:
(i) The proposed bed complement is
increased.
(ii) The total costs are
increased by more than 20% or $2 million, whichever is less.
(iii) A proposed service is added or
deleted.
(iv) The Department and
HSA determine there is a significant change in site.
(h)
Emergency
certificates.
(1) The application and
review process may be suspended, with the concurrence of the HSA and the
Department, for a project limited to a replacement of plant and equipment as a
result of natural disaster, fire, unforeseen equipment failure or similar
occurrence, which endangers the health and safety of patients. Within 5 days of
the occurrence, written notification shall be given to the Department and the
local HSA.
(2) If the Department
suspends the review process, an emergency certificate of need shall be issued
subject to any restrictions imposed by the Department. Within 30 days of the
issuance of the emergency certificate, the health care provider shall file an
application for review of the plant and equipment replaced as a result of the
emergency. This application shall be reviewed under the HSA's nonsubstantive
review procedures.
(i)
Reconsideration of Department decision.
(1) Any person may, for good cause shown,
request, in writing, a public hearing for the purpose of reconsideration of a
decision of the Department within 10 days of the decision of the Department. If
such hearing is granted, the Department will set forth the cause for the
hearing and the issues to be considered at such hearing. The hearing shall be
held no sooner than 6 days and no later than 14 days after a request is made,
and may be limited to the issues submitted for reconsideration. Notification of
such a public hearing shall be sent at least 5 days prior to the date of the
hearing, to the person requesting the hearing, the person proposing the new
institutional health service, the HSA for the health service area in which the
new institutional health service is proposed to be offered or developed, and
shall be sent to others upon request. Within 14 days of the conclusion of the
hearing, a summary of the oral testimony shall be made of the hearing, and
copies thereof supplied at cost to the person proposing the new institutional
health service, the appropriate HSA and any parties to the proceeding, and
shall be made available by the Department to others upon request. The
Department will affirm or reverse its decision and submit the same to the
parties, the person requesting the hearing, and the HSA within 14 days of the
conclusion of such hearing. Any change in the decision shall be supported by
the reasons therefore.
(2) Where
reconsideration hearings are held on more than 2 days, consecutive days of
hearings and intervening weekends and holidays shall be excluded in calculating
the time permitted for the Department to conduct its review and if briefs are
to be filed, 10 days subsequent to the adjournment of the hearing shall also be
excluded.
(3) Good cause shall be
deemed to have been shown if one of the following occurs:
(i) There is significant, relevant
information not previously considered.
(ii) There is significant change in factors
or circumstances relied on in making the decision.
(iii) There has been material failure to
comply with the procedural requirements of this chapter.
(iv) The Department determines that there is
good cause shown for some other reason.
(4) If good cause under paragraph (3)(i) and
(ii) is found by the Department, a reconsideration hearing will be conducted
under section 704(b) and (c) of the act (35 P. S. §
448.704(b) and
(c)).
(j)
Appeals.
(1) Decisions of the Department on an
application for a certificate of need or amendment thereto may be appealed
within 30 days by any party or HSA who is involved in the proceeding. The
appeal to the Hearing Board shall be commenced within 30 days of receipt of the
appeal request and shall be limited to issues raised by the appellant in the
specification of objections to the decisions of the Department. Those issues
shall be restricted to whether the findings and recommendations of the
Department are supported by substantial evidence, and must have been raised or
brought to the attention of the HSA or the Department during the course of the
review.
(2) The Board shall
entertain no evidence that the Hearing Board is satisfied the appellant was
able, by the exercise of reasonable diligence, to have submitted before the HSA
and the Department.
(k)
Cost increases to certificates.
(1) A certificate of need shall state the
maximum amount of expenditures which may be obligated under it. Applicants
proceeding with an approved project may not exceed this level of expenditures
except under the following procedures:
(i)
When the applicant proposes an expenditure greater than that stated on the
certificate, the applicant shall notify the Division of Need Review in writing.
The applicant may not proceed with the proposed changes until the appropriate
Departmental approvals have been granted. The written notice shall include at
least all of the following:
(A) The name and
address of the applicant.
(B) The
name and location of the project.
(C) The amount of the cost
increase.
(D) The primary reasons
for the cost increase.
(E) The
anticipated source of financing for the cost increase.
(ii) Within 20 days of receipt of the
information set forth in subparagraph (i), the Department, after consultation
with the HSA, will notify the applicant of the type of review which will be
conducted.
(A) A cost increase which exceeds
20% of the originally approved amount shall receive a full review as specified
in subparagraph (iii).
(B) A cost
increase which is less than or equal to 20% of the originally approved amount
may receive a nonsubstantive review.
(iii) For purposes of this subsection, a full
review shall be limited to the criteria specified in section 707(a)(4)-(6), and
(8), (b)(1) and (2) and (c)(1) and (5) of the act (35 P. S. §
448.707(a)(4)-(6), and (8),
(b)(1) and (2) and (c)(1) and (5)).
(iv) Due to the relatively insignificant
consequences of some of the changes that would require a nonsubstantive review,
an administrative review can be substituted if the HSA and the Department agree
that only an administrative review is necessary. The Department will render its
decision on the project within 30 business days of receipt of the required
information.
(v) The procedures set
forth in this section shall also apply to approvals under
42 U.S.C.A. §
1320a-1 and projects covered under section
901 of the act (35 P. S. §
448.901).
(l)
Changes to certificate of
need.
(1) When an applicant proposes
a change to an approved certificate of need, the applicant shall notify the
Division of Need Review in writing. The applicant may not proceed with the
proposed changes until the appropriate Departmental approvals have been
granted. The written notice shall include at least the following:
(i) Name and address of the
applicant.
(ii) Name and location
of the project.
(iii) The change
and reason for the change.
(2) Within 20 days of receipt of the
information in paragraph (1)(i), the Department, after consultation with the
HSA, will notify the applicant of the type of certificate of need review which
will be conducted.
(3) Substantial
changes which require a full review include, but are not limited to, the
following:
(i) A significant change in site as
determined by the Department and the HSA.
(ii) The addition or deletion of a health
service.
(iii) A change in an
application line item by 20%. Line item is defined as single cost categories as
listed in the financial section of the certificate of need application. If the
overall cost increase does not meet the full review criteria under paragraph
(1)(ii)(A) the Department after consultation with the HSA may elect to do a
nonsubstantive review.
(iv) A
change of greater than 10 beds or 10%, whichever is less, of affected beds in
the application.
(v) A 20% change
in renovation or construction square footage. Square footage is defined as
allocations as listed in the space exhibit of the certificate of need
application.
(4) Changes
which do not meet the thresholds set forth in this subsection may receive a
nonsubstantive review. A change of less than 10 beds or 10%, whichever is less,
is not reviewable if the project has been substantially implemented.
(5) Due to the relatively insignificant
consequences of some of the changes that would require a nonsubstantive review,
an administrative review can be substituted if the HSA and the Department agree
that only an administrative review is necessary. The Department will render its
decision on the project within 30 business days of receipt of the required
information.
(6) This subsection
shall also apply to approvals under
42 U.S.C.A. §
1320a-1 and projects covered under section
901 of the act (35 P. S. §
448.901).
(m)
Withdrawal of
certificates.
(1) A certificate of
need shall remain in effect, providing the facilities and services authorized
are in use. In the absence of substantial implementation of an approved project
for which a certificate of need was issued, the certificate shall be withdrawn
1 year after issuance, unless the Department extends the time for a definite
period, not to exceed 6 months. Notification of a request for an extension
shall be made in writing to the Department and appropriate HSA and should be
made at least 60 days prior to the expiration of the certificate. Only one such
extension may be granted for a project. For projects which are approved to be
carried out in phases estimated to require no more than 3 years, the
certificate of need shall remain in effect after the first phase is implemented
but no longer than 3 years unless the project is substantially implemented. All
phased construction must commence within 5 years of approval. All phased
construction time frames must be approved as part of the review
process.
(2) When it comes to the
attention of the Department that the time period in which to substantially
implement the project has passed without the project being substantially
implemented, the Department will send a notice to the holder of the certificate
advising that the certificate shall be withdrawn for failure to implement the
project in a timely manner.
(i) A notice of
the withdrawal shall be sent to all affected persons, published in a newspaper
of general circulation in the area to be served by the project, and published
in the Pennsylvania Bulletin. The notice shall state the
reasons for the withdrawal, and the date by which any affected person may
request a hearing on the withdrawal. Objections or comments on the withdrawal
may be filed by any persons directly affected.
(ii) If a hearing is requested, the
Department will forward the request to the appropriate HSA to hold a hearing in
accordance with the procedures established by the HSA for public hearings.
Notice of the hearing shall be given in writing to all affected persons, and
through a newspaper of general circulation for all others.
(iii) A record of the hearing shall be
maintained and forwarded to the Department along with a recommendation by the
HSA as to whether the certificate should be withdrawn.
(iv) The Department will consider the
recommendation of the HSA, the record of the hearing, and any other pertinent
information and render a final decision on the withdrawal within 30 days of
receipt of the HSA recommendation.
(3) Substantial implementation of a project
occurs when the following requirements are completed relative to, but not
limited to, the following types of projects. All of the requirements listed in
this paragraph must be completed within 1 year after issuance of the
certificate or within 18 months after issuance of the certificate if an
extension has been granted.
(i) New
construction or renovation projects shall include the following:
(A) The title or long-term lease to the
appropriate site has been acquired.
(B) The appropriate State agency has approved
the complete set of schematic drawings for the project.
(C) A financial commitment has been obtained,
for at least 60% of the total approved capital expenditure. The commitment may
be any combination of funds such as the applicant's own funds, grants, gifts,
or an enforceable offer and acceptance from a financial institution to provide
adequate capital financing for the project.
(D) An enforceable construction contract has
been entered into causing the commencement of construction no later than 24
months after issuance of a certificate. Failure to commence construction within
this time period shall be considered an abandonment of the project and the
certificate issued shall be withdrawn. Erection of the foundation shall
constitute commencement of construction.
(ii) Acquisition of equipment. The equipment
must either be purchased; the lease agreement must be entered into by the
proponent; or if acquired by a comparable arrangement the health care facility
or health maintenance organization must have possession of the
equipment.
(iii) Addition of new
service. A written statement must be submitted to the Department verifying that
the service is in operation.
(iv)
Donated property. In the case of donated property, the date on which title to
the donated property is transferred in accordance with applicable State
statutes.
(n)
Reporting requirements.
(1)
During the course of review, the HSA and the Department will, upon request of
any person, set forth the status and any findings then made or any other
appropriate information regarding an application before them. Other appropriate
information includes information regarding the conducting of public hearings,
the review cycle, or other information to which the public has access under
this chapter.
(2) Each HSA shall
prepare and publish, at least annually, reports of certificate of need reviews,
including a statement of findings and decisions made in the course of each
review since the last report.
(3)
The Department will prepare and publish, at least annually, reports of the
reviews being conducted, including a statement concerning the status of each
review, and of the reviews completed by the agency since the publication of the
last report and a general statement of the findings and decisions made in the
course of review.
(4) Persons
subject to review under this chapter shall submit periodic progress reports to
the HSA and the Department pertaining to the development of projects which have
received certificate of need approval. The reports must detail the progress
toward the substantial implementation of projects as defined in subsection (m).
The time period for submission of the progress reports is the end of the 10th
month following certificate of need approval, although in the case of an
extension, an additional report is required by the end of the 18th month
following project approval.
(5) For
information purposes only, at least 30 days prior to termination or substantial
reduction of a service or a permanent decrease in the bed complement, a health
care provider shall notify in writing the HSA and the Department of its
intended action. However, if any such change should involve a capital
expenditure in excess of the minimum threshold for review of capital
expenditures, as established by Federal law or regulation, the health care
provider shall be required to obtain a certificate of need in accordance with
this section.
(o)
Penalties. Penalties shall be imposed in accordance with the
act.
The provisions of this §
401.5 issued under section 2102
(a) and (g) of The Administrative Code of 1929 (71 P. S. §
532(a) and (g)); and section
201(14) of the Health Care Facilities Act (35 P. S. §
448.201(14)).
This section cited in 28 Pa. Code §
401.7 (relating to simultaneous
and comparative review); 55 Pa. Code §
1163.453 (relating to allowable
and nonallowable costs); 55 Pa. Code §
1181.65 (relating to
cost-finding); 55 Pa. Code §
1181.259 (relating to depreciation
allowance); and 55 Pa. Code §
1181.260 (relating to interest
allowance).