Certificate of Need Application Procedures

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Certificate of Need

RULE NO.:RULE TITLE:

59C-1.008Certificate of Need Application Procedures

NOTICE OF CHANGE

Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 45 No. 82, April 26, 2019 issue of the Florida Administrative Register.

Additional deletions are required pursuant to the signing of HB 21 from the 2019 Legislative session which was effective July 1, 2019 and eliminated certain hospital projects from the purview of Certificate of Need review.  The batching cycles are being adjusted to balance workloads for the industry as well as the unit.

 

The following sections of the proposed rule will be changed to read:

 

59C-1.008 Certificate of Need Application Procedures.

(1) Letters of Intent and applications subject to comparative review shall be accepted in two batching cycles annually each for hospital beds and facilities and hospice and for nursing homes and intermediate care facilities for the developmentally disabled (ICF/DD) other beds and programs, as specified in paragraph (g) of this subsection. The category “hospital beds and facilities and hospice” includes proposals for new Class II, III or IV hospital facilities pursuant to 59A-3.252 (1), replacement Class II, III or IV hospital facilities if being replaced more than a mile away, hospice programs and hospice inpatient facilities. the establishment of new neonatal level II and level III programs unless otherwise exempt pursuant to Section 408.036(3)(l), F.S., and comprehensive medical rehabilitation beds unless otherwise exempt pursuant to Section 408.036(3)(j), F.S., and except as provided in Section 408.037(2), F.S., for a general hospital. Unless otherwise directed by Section 408.037(2), F.S., general hospital applications shall conform to the schedules in this rule and will use all the applications and schedules described in paragraph (1)(f). The category “nursing homes and intermediate care facilities for the developmentally disabled other beds and programs” includes proposals for pediatric open heart surgery, pediatric cardiac catheterization, organ transplantation, community nursing home projects unless the project meets criteria in Section 408.036(2) or Section 408.036(3), F.S., hospice programs, hospice inpatient facilities, and intermediate care facilities for the developmentally disabled.

(a) through (b)  No Change

(c) As to content, the letter of intent shall describe the proposal with specificity by indicating clearly and unequivocally the following information:

1. Identification of the applicant means the legal name, mailing address, and telephone number of the applicant.

a. If an existing health care facility or Hospice seeks to undertake a project subject to a comparative review, then the legal name of the license holder must be stated and the license holder must be the applicant except when the applicant has a pending application to become the new licensee of the existing health care facility or Hospice filed with the applicable licensure unit within the Agency’s Bureau of Health Facility Regulation. In addition, the license number and date of expiration must be stated. It is the responsibility of the person issued a license to keep licensure information current. If Agency records indicate information different from that presented in the letter of intent with respect to the identification of the holder of the license and the licensure status, then the Agency records create a rebuttable presumption as to the correctness of those records and therefore the letter of intent is not valid.

b. If the proposal is for a project which will result in licensure of a new health care facility or Hospice, the applicant seeking the Certificate of Need must be in existence at the time the letter of intent is submitted. If the applicant is a corporation, Limited Partnership, or otherwise organized, it must have filed an application with the Florida Department of State authorizing the applicant to conduct business in Florida.

2. through 5. No Change

(d) Letter of Intent Deadline Extension. In order to provide for a mechanism by which applications may be filed to compete with the proposals described in filed letters of intent the following provisions apply:

1. No Change

2. The grace period provides an opportunity for applicants applying for beds, or services, or programs having the same Certificate of Need need methodology or health service licensing category proposed in the initially accepted letter of intent in the same applicable subdistrict or, district or region to file a proposed competing letter of intent. Under this grace period, a competing letter of intent must be filed not later than 16 days after the letter of intent deadline promulgated under paragraph 59C-1.008(1)(g), F.A.C.

3. through 5. No Change

(e) No Change

(f) Certificate of Need Application Submission.

An application for a Certificate of Need shall be submitted on AHCA Forms 3150-0001, March 2009 Application For A Certificate of Need, which includes a Cover Page, Schedules A, B, C, D, D-1, 1, 2, 3, 4, 5, 6, 6A, 7, 7A, 7B, 8, 8A, 9, 10 and 11, which are incorporated by reference herein. An application for a transfer of a Certificate of Need shall be submitted on AHCA Form 3150-0003, March 2009 Transfer Of A Certificate of Need which includes Schedules 1(TRN), 10(TRN), 12(TRN), B(TRN), D-1, in addition to a Cover (TRN) Page, which are incorporated by reference herein. An application for a general hospital shall be submitted on AHCA Form 3150-0002, March 2009 Application for a General Hospital Certificate of Need which includes Schedules 11, A(H), B(H), C, D(H) in addition to a Cover (H) Page, which are incorporated by reference herein. Paper copies or copies on electronic media of AHCA Form 3150-0001, March 2009 Application For A Certificate of Need, AHCA Form 3150-0002, March 2009 Application For A General Hospital Certificate of Need or AHCA Form 3150-0003, March 2009 Transfer of A Certificate of Need, and the Schedules may be obtained from:

Agency for Health Care Administration

Certificate of Need

2727 Mahan Drive, Mail Stop #28

Tallahassee, FL 32308

Electronic versions of AHCA Forms 3150-0001, 3150-0002 and 3150-0003 and the Schedules are also available at http://ahca.myflorida.com/MCHQ/CON_FA/Application/index.shtml.

1. through 3. No Change

(g) Applications Subject to Comparative Review – Batching Cycles. In order that applications pertaining to similar types of services or facilities affecting the same service district or subdistrict may be considered in relation to each other for purposes of comparative review, letters of intent and applications shall be received by the agency no later than dates prescribed in the following schedule, unless the date is a designated state holiday then it shall be received by the agency the next business day:

 

Hospital Beds and Facilities and Hospice 1st Batching Cycle
Summary Need Projections Published in the F.A.R.	Third Friday in January
Letter of Intent Deadline	First Monday in February
Application Deadline	First Wednesday in March
Completeness Review Deadline	Second Wednesday in March
Application Omissions Deadline	Second Wednesday in April
Agency Initial Decision Deadline	First Friday in June

 

Hospital Beds and Facilities and Hospice 2nd Batching Cycle
Summary Need Projections Published in the F.A.R.		Third Friday in July
Letter of Intent Deadline	First Monday in August
Application Deadline	First Wednesday in September
Completeness Review Deadline	Second Wednesday in September
Application Omissions Deadline	Second Wednesday in October
Agency Initial Decision Deadline	First Friday in December

 

Nursing Homes and ICF/DDs Other Beds and Programs 1st Batching Cycle
Summary Need Projections Published in the F.A.R.	First Friday in April
Letter of Intent Deadline	Third Monday in April
Application Deadline	Third Wednesday in May
Completeness Review Deadline	Fourth Wednesday in May
Application Omissions Deadline	Fourth Wednesday in June
Agency Initial Decision Deadline	Third Friday in August

 

Nursing Homes and ICF/DDs Other Beds and Programs 2nd Batching Cycle
Summary Need Projections Published in the F.A.R.	First Friday in October
Letter of Intent Deadline	Third Monday in October
Application Deadline	Third Wednesday in November
Completeness Review Deadline	Fourth Wednesday in November
Application Omissions Deadline	Fourth Wednesday in December
Agency Initial Decision Deadline	Third Friday in February

 

1. through 3. No Change

4. For CY 2020 only, hospice facilities will not be included in the first batching cycle so that need for hospice services will not be published while the 2019 2nd batch decisions are still pending.

(h) An applicant for a project subject to Certificate of Need review which affects an existing licensed health care facility, an existing licensed Hospice, or an existing licensed intermediate care facility for the developmentally disabled must be the license holder. The legal name of the license holder must be stated. In addition, the license number and date of expiration must be stated. It is the responsibility of the person issued a license to keep licensure information current. If Agency records indicate information different from that presented in the letter of intent with respect to the identification of the holder of the license and the licensure status, then the Agency records create a rebuttable presumption as to the correctness of those records and therefore the application will be rejected.

(i) No Change

(2) Fixed Need Pools.

(a) Publication of Fixed Need Pools.

1. The Agency shall publish in the Florida Administrative Register at least 15 days prior to the letter of intent deadline for a particular batching cycle the Fixed Need Pools for the applicable planning horizon specified for each service in applicable Agency rules contained in Rules 59C-1.0341-.0414, F.A.C. In cases of conflict with 59C-1.008(1)(g), F.A.C., 59C-1.008(2)(a)1., F.A.C., prevails, and the summary need projections published in the F.A.R. shall be published one week earlier with all other dates in the batching cycle remaining as noticed in 59C-1.008(1)(g), F.A.C.

2. through 3. No Change

(b) through (d) No Change

(e) Comparative Review. Applications submitted to the Agency in the same batching cycle for the same service or beds having the same Certificate of Need methodology in the same district or subdistrict, as defined in applicable rules, shall be comparatively reviewed through final Agency action against the same Fixed Need Pools in existence at the initial review. The Fixed Need Pools and other relevant planning information shall be used by the Agency to review the application against all applicable statutory review criteria contained in Section 408.035, F.S., and applicable rules, and policies. If an Agency need methodology does not exist for the proposed project:

1. through 2. No Change

3. Regardless of need methodology, the existence of unmet need will not be based solely on the absence of a health service, health care facility, or beds in the district or, subdistrict, region or proposed service area.

(3) Filing Fees. Certificate of Need applications shall not be accepted by the Agency at the time of filing unless accompanied by the minimum base Certificate of Need application filing fee in accordance with Section 408.038, F.S. The minimum base fee shall be $10,000. In addition to the base fee of $10,000, the fee shall be 0.015 of each dollar of the proposed expenditure, except that no fee shall exceed $50,000.

(a) through (b) No Change

(c) Checks that are returned by the bank for insufficient funds will be received by the Agency staff.

1. No Change

2. For a batched review application, the Agency or designee will send the applicant a letter returning the check along with the application, and advising the applicant that the application is incomplete and is deemed withdrawn from review.

(4) Certificate of Need Application Contents. An application for a Certificate of Need shall contain the following items:

(a) All requirements set forth in Sections 408.037(1), and (2) and (3), F.S.

(b) No Change

(c) The following provision does not apply to general hospital applications pursuant to section 408.037(1), F.S. An audited financial statement of the applicant or the applicant’s parent corporation if the applicant’s audited financial statements do not exist. The following provisions apply to audited financial statements:

1. through 3. No Change

(d) To comply with Section 408.037(1)(b)1., F.S., which requires a listing of all capital projects, an applicant, for any applications other than general hospital applications, shall provide the total approximate amount of anticipated expenditures for capital projects which meet the definition in subsection 59C-1.002(6)(7), F.A.C., at the time of initial application submission, or state that there are none. An itemized list or grouping of capital projects is not required, although an applicant may choose to itemize or group its capital projects. The applicant shall also indicate the actual or proposed financial commitment to those projects, and include an assessment of the impact of those projects on the applicant’s ability to provide the proposed project; and,

(e) No Change

(5) No Change

Rulemaking Authority 408.034(3), (8), 408.15(8) FS. Law Implemented 408.033, 408.034, 408.036, 408.037, 408.038, 408.039, 408.042 FS. History–New 1-1-77, Amended 11-1-77, 9-1-78, 6-5-79, 2-1-81, 4-1-82, 7-29-82, 9-6-84, Formerly 10-5.08, Amended 11-24-86, 3-2-87, 6-11-87, 11-17-87, 3-23-88, 5-30-90, 12-20-90, 1-31-91, 9-9-91, 5-12-92, 7-1-92, 8-9-92, Formerly 10-5.008, Amended 4-19-93, 6-23-94, 10-12-94, 10-18-95, 2-12-96, 7-18-96, 9-16-96, 11-4-97, 7-21-98, 12-12-00, 4-2-01, 1-10-02, 6-26-03, 12-13-04, 9-28-05, 10-9-07, 4-21-10, 2-13-12, 8-15-13, 10-29-15, _______.