Certificate of Need




    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. 58, March 25, 2019 issue of the Florida Administrative Register.

    Pursuant to comments from the Joint Administrative Procedures Committee the definition of an exemption will be removed as it is duplicative of statute.  Additional deletions occurred 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 following sections of the proposed rule will be changed to read:


    59C-1.002 Definitions.

    (1) “Acute care bed” means a patient accommodation or space licensed by the Agency pursuant to Chapter 395, Part I, F.S. Acute care beds exclude neonatal intensive care beds, comprehensive medical rehabilitation beds, hospital inpatient psychiatric beds, hospital inpatient substance abuse beds, beds in distinct part skilled nursing units, and beds in long term care hospitals licensed pursuant to Chapter 395, Part I, F.S.

    (2) through (10) renumbered (1) through (9) no change.

    (10)(11) “Comparative review” means the process by which Certificate of Need applications, submitted in the same batching cycle for beds or, services or programs for the same planning area, as defined by applicable rules, are competitively evaluated by the Agency through final Agency action for purposes of awarding a Certificate of Need.

    (12) renumbered to (11) no change.

    (12)(13) “Conversion from one type of health care facility to another” means the reclassification of one licensed facility type to another licensed facility type, including reclassification from a general acute care hospital to a long term care hospital or specialty hospital, or from a long term care hospital or specialty hospital to a general acute care hospital.

    (14) through (15) renumbered (13) through (14) no change.

    (16) “Established program” means a program for the provision of a Certificate of Need regulated institutional health service which has a valid Certificate of Need for the program or existed prior to the requirement for a Certificate of Need and has been continuously in operation, and has performed at least one institutional health service.

    (17) “Exemption” means the process by which a proposal that would otherwise require a Certificate of Need may proceed without a Certificate of Need.

    (18) through (27) renumbered (15) through (24) no change.

    (25)(28) “Nongovernmental health care consumer” means an individual who is not a health care provider or a health care purchaser as defined in subsections (17) (20) and (18) (21) of this section. Nongovernmental health care consumers include but are not limited to elected government officials, members of the general public and representatives of consumer organizations.

    (29) through (34) renumbered (26) through (31) no change.

    (32)(35) “Subdistricts” mean a subdivision of a district designated by the local health council as established under Rules 59C-2.100 and 59C-2.200, F.A.C.

    (36) “Substantial change in health services” means:

    (a) The offering by a health care facility, through conversion of beds or other means, of a new institutional health service or a health service which has not been offered on a continuing basis by or on behalf of the health care facility within the 12-month period prior to the time such service would be offered, excluding obstetrical services.; or

    (b) The designation of acute care beds in a health care facility as beds regulated under Rule 59C-1.036, F.A.C., or the redesignation of such beds retuning to acute care beds; or

    (c) The conversion of a general acute care or specialty hospital licensed under Chapter 395, Part I, F.S., to a long term care hospital.

    (37) renumbered to (33) no change.

    (38) “Tertiary health service” means a health service which, due to its high level of intensity, complexity, specialized or limited applicability, and cost, should be limited to, and concentrated in, a limited number of hospitals to ensure the quality, availability, and cost effectiveness of such service. Examples of such service include, but are not limited to, organ transplantation, neonatal intensive care units, comprehensive rehabilitation, and medical or surgical services which are experimental or developmental in nature to the extent that the provision of such services is not yet contemplated within the commonly accepted course of diagnosis or treatment for the condition addressed by a given service. The types of tertiary services to be regulated under the Certificate of Need Program in addition to those listed in Florida Statutes include:

    (a) Heart transplantation;

    (b) Kidney transplantation;

    (c) Liver transplantation;

    (d) Bone marrow transplantation;

    (e) Lung transplantation;

    (f) Pancreas and islet cells transplantation;

    (g) Heart/lung transplantation;

    (h) Neonatal and pediatric cardiac and vascular surgery; and,

    (i) Pediatric oncology and hematology.

    In order to determine whether services should be added or deleted, the listing of tertiary services shall be reviewed annually by the Agency.

    (39) through (40) renumbered (34) through (35) no change.

    Rulemaking Authority 408.034(8), 408.15(8) FS. Law Implemented 408.033(1)(a), 408.036(1), (2), 408.037(1), 408.039(1), (2). History–New 1-1-77, Joint Administrative Procedures Committee Objection Filed–See F.A.R. Volume 3, No. 10, March 11, 1977, Amended 11-1-77, 9-1-78, 6-5-79, 4-25-80, 2-1-81, 3-31-82, 7-29-82, 12-23-82, Formerly 10-5.02, Amended 11-24-86, 11-17-87, 12-5-90, 1-31-91, 1-1-92, Formerly 10-5.002, Amended 12-14-92, 2-27-94, 6-23-94, 10-18-95, 10-8-97, 12-12-00,__________ , Amendment resolved Joint Administrative Procedures Committee objection, 10-27-77, Florida Administrative Register Vol. 35, No. 27, July 10, 2009.

Document Information

Related Rules: (1)
59C-1.002. Definitions