| Old | New | Differences | |
|---|---|---|---|
| 1 | - | 23 LC 33 9433S | |
| 1 | + | 23 LC 33 9350 | |
| 2 | + | S. B. 162 | |
| 2 | 3 | - 1 - | |
| 3 | - | The Senate Committee on Regulated Industries and Utilities offered the following | |
| 4 | - | substitute to SB 162: | |
| 4 | + | Senate Bill 162 | |
| 5 | + | By: Senators Watson of the 1st, Dolezal of the 27th, Kirkpatrick of the 32nd, Brass of the | |
| 6 | + | 28th, Albers of the 56th and others | |
| 5 | 7 | A BILL TO BE ENTITLED | |
| 6 | 8 | AN ACT | |
| 7 | - | To amend Title 31 of the Official Code of Georgia Annotated, relating to health, so as to1 | |
| 8 | - | repeal certificate of need; to provide for a special health care services license for other health2 | |
| 9 | - | care facilities and services; to provide for definitions; to provide for requirements; to provide3 | |
| 10 | - | for exceptions; to provide for applications; to provide for notice and timely objections; to4 | |
| 11 | - | require the provision of indigent and charity care and Medicaid services; to provide for5 | |
| 12 | - | revocation; to require annual reports; to provide for rules and regulations; to provide for6 | |
| 13 | - | transition and grandfather provisions; to provide for the posting of certain documents on7 | |
| 14 | - | hospital websites; to amend Code Section 50-18-70 of the Official Code of Georgia8 | |
| 15 | - | Annotated, relating to legislative intent and definitions relative to open records laws, so as9 | |
| 16 | - | to revise definitions; to amend other provisions in various titles of the Official Code of10 | |
| 17 | - | Georgia Annotated for purposes of conformity; to provide for related matters; to provide for11 | |
| 18 | - | effective dates; to repeal conflicting laws; and for other purposes.12 | |
| 19 | - | BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:13 23 LC 33 9433S | |
| 9 | + | To amend Title 31 of the Official Code of Georgia Annotated, relating to health, so as to | |
| 10 | + | 1 | |
| 11 | + | eliminate certificate of need requirements for all health care facilities except certain2 | |
| 12 | + | long-term care facilities and services; to provide for a special health care services license for3 | |
| 13 | + | other health care facilities and services; to provide for definitions; to provide for4 | |
| 14 | + | requirements; to provide for exceptions; to provide for applications; to provide for notice and5 | |
| 15 | + | timely objections; to require the provision of indigent and charity care and Medicaid6 | |
| 16 | + | services; to provide for revocation; to require annual reports; to provide for rules and7 | |
| 17 | + | regulations; to provide for transition and grandfather provisions; to provide for the posting8 | |
| 18 | + | of certain documents on hospital websites; to amend Code Section 50-18-70 of the Official9 | |
| 19 | + | Code of Georgia Annotated, relating to legislative intent and definitions relative to open10 | |
| 20 | + | records laws, so as to revise definitions; to amend other provisions in various titles of the11 | |
| 21 | + | Official Code of Georgia Annotated for purposes of conformity; to provide for related12 | |
| 22 | + | matters; to provide for effective dates; to repeal conflicting laws; and for other purposes.13 | |
| 23 | + | BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:14 23 LC 33 9350 | |
| 24 | + | S. B. 162 | |
| 20 | 25 | - 2 - | |
| 21 | - | PART I14 | |
| 22 | - | SECTION 1-1.15 | |
| 23 | - | Title 31 of the Official Code of Georgia Annotated, relating to health, is amended by16 | |
| 24 | - | repealing Chapter 6, relating to state health planning and development, and by designating17 | |
| 25 | - | such chapter as reserved.18 | |
| 26 | - | PART II19 | |
| 27 | - | SECTION 2-1.20 | |
| 28 | - | Said title is further amended by adding a new chapter to read as follows:21 | |
| 29 | - | "CHAPTER 6A22 | |
| 30 | - | 31-6A-1.23 | |
| 31 | - | As used in this chapter, the term:24 | |
| 32 | - | (1) 'Ambulatory surgical center' means a public or private facility, not a part of a25 | |
| 33 | - | hospital, which meets the criteria contained in subparagraph (C) of paragraph (4) of Code26 | |
| 34 | - | Section 31-7-1; provided, however, that if a private facility, at least 51 percent must be27 | |
| 35 | - | owned directly or indirectly by a hospital or a physician or physicians licensed to practice28 | |
| 36 | - | in Georgia.29 | |
| 37 | - | (2) 'Bed capacity' means space used exclusively for inpatient care, including space30 | |
| 38 | - | designed or remodeled for inpatient beds even though temporarily not used for such31 | |
| 39 | - | purposes. The number of beds to be counted in any patient room shall be the maximum32 | |
| 40 | - | number for which adequate square footage is provided as established by rules of the33 | |
| 41 | - | department, except that single beds in single rooms shall be counted even if the room34 | |
| 42 | - | contains inadequate square footage.35 23 LC 33 9433S | |
| 26 | + | PART I | |
| 27 | + | 15 | |
| 28 | + | SECTION 1-1.16 | |
| 29 | + | Title 31 of the Official Code of Georgia Annotated, relating to health, is amended by revising17 | |
| 30 | + | Chapter 6, relating to state health planning and development, as follows:18 | |
| 31 | + | "CHAPTER 619 | |
| 32 | + | ARTICLE 120 | |
| 33 | + | 31-6-1.21 | |
| 34 | + | The policy of this state and the purposes of this chapter are to ensure access to quality22 | |
| 35 | + | health | |
| 36 | + | long-term care services and to ensure that long-term health care services and23 | |
| 37 | + | facilities are developed in an orderly and economical manner and are made available to all24 | |
| 38 | + | citizens and that only those long-term health care services found to be in the public interest25 | |
| 39 | + | shall be provided in this state. To achieve such public policy and purposes, it is essential26 | |
| 40 | + | that appropriate health planning activities be undertaken and implemented and that a27 | |
| 41 | + | system of mandatory review of new institutional health services be provided. Long-term28 | |
| 42 | + | health Health care services and facilities should be provided in a manner that avoids29 | |
| 43 | + | unnecessary duplication of services, that is cost effective, that provides quality health care30 | |
| 44 | + | services, and that is compatible with the long-term health care needs of the various areas31 | |
| 45 | + | and populations of the state.32 | |
| 46 | + | 31-6-2.33 | |
| 47 | + | As used in this chapter, the term:34 | |
| 48 | + | (1) 'Ambulatory surgical center or obstetrical facility' means a public or private facility,35 | |
| 49 | + | not a part of a hospital, which provides surgical or obstetrical treatment performed under36 23 LC 33 9350 | |
| 50 | + | S. B. 162 | |
| 43 | 51 | - 3 - | |
| 44 | - | (3) 'Board' means the Board of Community Health.36 | |
| 45 | - | (4) 'Clinical health services' means diagnostic, treatment, or rehabilitative services37 | |
| 46 | - | provided in a health care facility and includes, but is not limited to, the following:38 | |
| 47 | - | radiology and diagnostic imaging, such as magnetic resonance imaging and positron39 | |
| 48 | - | emission tomography (PET); radiation therapy; biliary lithotripsy; surgery; intensive care;40 | |
| 49 | - | coronary care; pediatrics; gynecology; obstetrics; general medical care; medical-surgical41 | |
| 50 | - | care; inpatient nursing care, whether intermediate, skilled, or extended care; cardiac42 | |
| 51 | - | catheterization; open heart surgery; inpatient rehabilitation; and alcohol, drug abuse, and43 | |
| 52 | - | mental health services.44 | |
| 53 | - | (5) 'Commissioner' means the commissioner of community health.45 | |
| 54 | - | (6) 'Department' means the Department of Community Health established under Chapter46 | |
| 55 | - | 2 of this title.47 | |
| 56 | - | (7) 'Develop,' with reference to a project, means constructing, remodeling, installing, or48 | |
| 57 | - | proceeding with a project, or any part of a project, or a capital expenditure project, the49 | |
| 58 | - | cost estimate for which exceeds $10 million. Notwithstanding the provisions of this50 | |
| 59 | - | paragraph, the expenditure or commitment or incurring an obligation for the expenditure51 | |
| 60 | - | of funds to develop certificate of need applications, studies, reports, schematics,52 | |
| 61 | - | preliminary plans and specifications, or working drawings or to acquire, develop, or53 | |
| 62 | - | prepare sites shall not be considered to be the developing of a project.54 | |
| 63 | - | (8) 'Diagnostic imaging' means magnetic resonance imaging, computed tomography55 | |
| 64 | - | (CT) scanning, positron emission tomography (PET), positron emission56 | |
| 65 | - | tomography/computed tomography, X-rays, fluoroscopy, or ultrasound services, and57 | |
| 66 | - | other imaging services as defined by the department by rule.58 | |
| 67 | - | (9) 'Diagnostic, treatment, or rehabilitation center' means any professional or business59 | |
| 68 | - | undertaking, whether for profit or not for profit, which offers or proposes to offer any60 | |
| 69 | - | clinical health service in a setting which is not part of a hospital; provided, however, that61 | |
| 70 | - | any such diagnostic, treatment, or rehabilitation center that offers or proposes to offer62 23 LC 33 9433S | |
| 52 | + | general or regional anesthesia in an operating room environment to patients not requiring37 | |
| 53 | + | hospitalization.38 | |
| 54 | + | (2)(1) 'Application' means a written request for a certificate of need made to the39 | |
| 55 | + | department, containing such documentation and information as the department may40 | |
| 56 | + | require.41 | |
| 57 | + | (3) 'Basic perinatal services' means providing basic inpatient care for pregnant women42 | |
| 58 | + | and newborns without complications; managing perinatal emergencies; consulting with43 | |
| 59 | + | and referring to specialty and subspecialty hospitals; identifying high-risk pregnancies;44 | |
| 60 | + | providing follow-up care for new mothers and infants; and providing public/community45 | |
| 61 | + | education on perinatal health.46 | |
| 62 | + | (4)(2) 'Bed capacity' means space used exclusively for inpatient care, including space47 | |
| 63 | + | designed or remodeled for inpatient beds even though temporarily not used for such48 | |
| 64 | + | purposes. The number of beds to be counted in any patient room shall be the maximum49 | |
| 65 | + | number for which adequate square footage is provided as established by rules of the50 | |
| 66 | + | department, except that single beds in single rooms shall be counted even if the room51 | |
| 67 | + | contains inadequate square footage.52 | |
| 68 | + | (5)(3) 'Board' means the Board of Community Health.53 | |
| 69 | + | (6)(4) 'Certificate of need' means an official finding by the department, evidenced by54 | |
| 70 | + | certification issued pursuant to an application, that the action proposed in the application55 | |
| 71 | + | satisfies and complies with the criteria contained in this chapter and rules promulgated56 | |
| 72 | + | pursuant hereto.57 | |
| 73 | + | (7)(5) 'Certificate of Need Appeal Panel' or 'appeal panel' means the panel of58 | |
| 74 | + | independent hearing officers created pursuant to Code Section 31-6-44 to conduct appeal59 | |
| 75 | + | hearings.60 | |
| 76 | + | (8)(6) 'Clinical health services' means diagnostic, treatment, or rehabilitative services61 | |
| 77 | + | provided in a health care facility and includes, but is not limited to, the following:62 | |
| 78 | + | radiology and diagnostic imaging, such as magnetic resonance imaging and positron63 23 LC 33 9350 | |
| 79 | + | S. B. 162 | |
| 71 | 80 | - 4 - | |
| 72 | - | surgery in an operating room environment and to allow patients to remain more than 2363 | |
| 73 | - | hours shall be considered a hospital for purposes of this chapter.64 | |
| 74 | - | (10) 'Exception acknowledgment' means a written notice from the department confirming65 | |
| 75 | - | that a person is exempt from the requirements of this chapter pursuant to subsection (b)66 | |
| 76 | - | of Code Section 31-6A-3 or pursuant to subsection (b) or (d) of Code Section 31-6A-10.67 | |
| 77 | - | (11) 'General cancer hospital' means an institution which was an existing and approved68 | |
| 78 | - | destination cancer hospital as of January 1, 2019; has obtained final certificate of need69 | |
| 79 | - | approval for conversion from a destination cancer hospital to a general cancer hospital70 | |
| 80 | - | in accordance with the former provisions of Code Section 31-6-40.3, as they existed on71 | |
| 81 | - | December 31, 2023; and offers inpatient and outpatient diagnostic, therapeutic, treatment,72 | |
| 82 | - | and rehabilitative cancer care services or other services to diagnose or treat co-morbid73 | |
| 83 | - | medical conditions or diseases of cancer patients so long as such services do not result74 | |
| 84 | - | in the offering of any new or expanded clinical health service that would require a75 | |
| 85 | - | certificate of need under this chapter unless a certificate of need or letter of determination76 | |
| 86 | - | has been obtained for such new or expanded services.77 | |
| 87 | - | (12) 'Health care facility' means a hospital, specialty hospital, freestanding emergency78 | |
| 88 | - | department not located on a hospital's primary campus, single specialty ambulatory79 | |
| 89 | - | surgical center, skilled nursing facility; intermediate care facility, personal care home,80 | |
| 90 | - | and home health agency.81 | |
| 91 | - | (13) 'Health maintenance organization' means a public or private organization organized82 | |
| 92 | - | under the laws of this state which:83 | |
| 93 | - | (A) Provides or otherwise makes available to enrolled participants health care services,84 | |
| 94 | - | including at least the following basic health care services: usual physicians' services,85 | |
| 95 | - | hospitalization, laboratory, X-ray, emergency and preventive services, and out-of-area86 | |
| 96 | - | coverage;87 23 LC 33 9433S | |
| 81 | + | emission tomography (PET); radiation therapy; biliary lithotripsy; surgery; intensive care;64 | |
| 82 | + | coronary care; pediatrics; gynecology; obstetrics; general medical care; medical-surgical65 | |
| 83 | + | care; inpatient nursing care, whether intermediate, skilled, or extended care; cardiac66 | |
| 84 | + | catheterization; open heart surgery; inpatient rehabilitation; and alcohol, drug abuse, and67 | |
| 85 | + | mental health services.68 | |
| 86 | + | (9)(7) 'Commissioner' means the commissioner of community health.69 | |
| 87 | + | (10) 'Consumer' means a person who is not employed by any health care facility or70 | |
| 88 | + | provider and who has no financial or fiduciary interest in any health care facility or71 | |
| 89 | + | provider.72 | |
| 90 | + | (11) Reserved.73 | |
| 91 | + | (12)(8) 'Department' means the Department of Community Health established under74 | |
| 92 | + | Chapter 2 of this title.75 | |
| 93 | + | (13) 'Destination cancer hospital' means an institution with a licensed bed capacity of 5076 | |
| 94 | + | or less which provides diagnostic, therapeutic, treatment, and rehabilitative care services77 | |
| 95 | + | to cancer inpatients and outpatients, by or under the supervision of physicians, and whose78 | |
| 96 | + | proposed annual patient base is composed of a minimum of 65 percent of patients who79 | |
| 97 | + | reside outside of the State of Georgia.80 | |
| 98 | + | (14)(9) 'Develop,' with reference to a project, means constructing, remodeling, installing,81 | |
| 99 | + | or proceeding with a project, or any part of a project, or a capital expenditure project, the82 | |
| 100 | + | cost estimate for which exceeds $10 million $3,068,601.00. Notwithstanding the83 | |
| 101 | + | provisions of this paragraph, The dollar amount specified in this paragraph shall be84 | |
| 102 | + | adjusted annually by an amount calculated by the department to reflect inflation, which85 | |
| 103 | + | may be calculated by multiplying such dollar amount, as adjusted for the preceding year,86 | |
| 104 | + | by the annual percentage of change in the composite index of construction material87 | |
| 105 | + | prices, or its successor or appropriate replacement index, if any, published by the United88 | |
| 106 | + | States Department of Commerce for the preceding calendar year, commencing on89 | |
| 107 | + | July 1, 2023, and on each anniversary thereafter of the publication of the index. The90 23 LC 33 9350 | |
| 108 | + | S. B. 162 | |
| 97 | 109 | - 5 - | |
| 98 | - | (B) Is compensated, except for copayments, for the provision of the basic health care88 | |
| 99 | - | services listed in subparagraph (A) of this paragraph to enrolled participants on a89 | |
| 100 | - | predetermined periodic rate basis; and90 | |
| 101 | - | (C) Provides physicians' services primarily:91 | |
| 102 | - | (i) Directly through physicians who are either employees or partners of such92 | |
| 103 | - | organization; or93 | |
| 104 | - | (ii) Through arrangements with individual physicians organized on a group practice94 | |
| 105 | - | or individual practice basis.95 | |
| 106 | - | (14) 'Home health agency' means a public agency or private organization, or a96 | |
| 107 | - | subdivision of such an agency or organization, which is primarily engaged in providing97 | |
| 108 | - | to individuals who are under a written plan of care of a physician, on a visiting basis in98 | |
| 109 | - | the places of residence used as such individuals' homes, part-time or intermittent nursing99 | |
| 110 | - | care provided by or under the supervision of a registered professional nurse, and one or100 | |
| 111 | - | more of the following services:101 | |
| 112 | - | (A) Physical therapy;102 | |
| 113 | - | (B) Occupational therapy;103 | |
| 114 | - | (C) Speech therapy;104 | |
| 115 | - | (D) Medical social services under the direction of a physician; or105 | |
| 116 | - | (E) Part-time or intermittent services of a home health aide.106 | |
| 117 | - | (15) 'Hospital' means an institution which is primarily engaged in providing to inpatients,107 | |
| 118 | - | by or under the supervision of physicians, diagnostic services and therapeutic services for108 | |
| 119 | - | medical diagnosis, treatment, and care of injured, disabled, or sick persons or109 | |
| 120 | - | rehabilitation services for the rehabilitation of injured, disabled, or sick persons. Such110 | |
| 121 | - | term includes public, private, psychiatric, rehabilitative, geriatric, osteopathic,111 | |
| 122 | - | micro-hospitals, general cancer hospitals, and other specialty hospitals.112 | |
| 123 | - | (16) 'Intermediate care facility' means an institution which provides, on a regular basis,113 | |
| 124 | - | health related care and services to individuals who do not require the degree of care and114 23 LC 33 9433S | |
| 110 | + | department shall immediately institute rule-making procedures to adopt such adjusted91 | |
| 111 | + | dollar amounts. In calculating the dollar amount of a proposed project for purposes of92 | |
| 112 | + | this paragraph, the costs of all items subject to review by this chapter and items not93 | |
| 113 | + | subject to review by this chapter associated with and simultaneously developed or94 | |
| 114 | + | proposed with the project shall be counted; provided, however, that the expenditure or95 | |
| 115 | + | commitment or incurring an obligation for the expenditure of funds to develop certificate96 | |
| 116 | + | of need applications, studies, reports, schematics, preliminary plans and specifications,97 | |
| 117 | + | or working drawings or to acquire, develop, or prepare sites shall not be considered to be98 | |
| 118 | + | the developing of a project.99 | |
| 119 | + | (15) 'Diagnostic imaging' means magnetic resonance imaging, computed tomography100 | |
| 120 | + | (CT) scanning, positron emission tomography (PET) scanning, positron emission101 | |
| 121 | + | tomography/computed tomography, and other advanced imaging services as defined by102 | |
| 122 | + | the department by rule, but such term shall not include X-rays, fluoroscopy, or ultrasound103 | |
| 123 | + | services.104 | |
| 124 | + | (16) 'Diagnostic, treatment, or rehabilitation center' means any professional or business105 | |
| 125 | + | undertaking, whether for profit or not for profit, which offers or proposes to offer any106 | |
| 126 | + | clinical health service in a setting which is not part of a hospital; provided, however, that107 | |
| 127 | + | any such diagnostic, treatment, or rehabilitation center that offers or proposes to offer108 | |
| 128 | + | surgery in an operating room environment and to allow patients to remain more than 23109 | |
| 129 | + | hours shall be considered a hospital for purposes of this chapter.110 | |
| 130 | + | (16.1) 'General cancer hospital' means an institution which was an existing and approved111 | |
| 131 | + | destination cancer hospital as of January 1, 2019; has obtained final certificate of need112 | |
| 132 | + | approval for conversion from a destination cancer hospital to a general cancer hospital113 | |
| 133 | + | in accordance with Code Section 31-6-40.3; and offers inpatient and outpatient114 | |
| 134 | + | diagnostic, therapeutic, treatment, and rehabilitative cancer care services or other services115 | |
| 135 | + | to diagnose or treat co-morbid medical conditions or diseases of cancer patients so long116 | |
| 136 | + | as such services do not result in the offering of any new or expanded clinical health117 23 LC 33 9350 | |
| 137 | + | S. B. 162 | |
| 125 | 138 | - 6 - | |
| 126 | - | treatment which a hospital or skilled nursing facility is designed to provide but who,115 | |
| 127 | - | because of their mental or physical condition, require health related care and services116 | |
| 128 | - | beyond the provision of room and board.117 | |
| 129 | - | (17) 'Joint venture ambulatory surgical center' means a freestanding ambulatory surgical118 | |
| 130 | - | center that is jointly owned by a hospital in the same county as the center or a hospital in119 | |
| 131 | - | a contiguous county if there is no hospital in the same county as the center and a single120 | |
| 132 | - | group of physicians practicing in the center and that provides surgery or where121 | |
| 133 | - | cardiologists perform procedures in a single specialty as defined by the department;122 | |
| 134 | - | provided, however, that general surgery, a group practice which includes one or more123 | |
| 135 | - | physiatrists who perform services that are reasonably related to the surgical procedures124 | |
| 136 | - | performed in the center, and a group practice in orthopedics which includes plastic hand125 | |
| 137 | - | surgeons with a certificate of added qualifications in Surgery of the Hand from the126 | |
| 138 | - | American Board of Plastic and Reconstructive Surgery shall be considered a single127 | |
| 139 | - | specialty. The ownership interest of the hospital shall be no less than 30 percent and the128 | |
| 140 | - | collective ownership of the physicians or group of physicians shall be no less than 30129 | |
| 141 | - | percent.130 | |
| 142 | - | (18) 'Life plan community' means an organization, whether operated for profit or not,131 | |
| 143 | - | whose owner or operator undertakes to provide shelter, food, and either nursing care or132 | |
| 144 | - | personal services, whether such nursing care or personal services are provided in the133 | |
| 145 | - | facility or in another setting, and other services, as designated by agreement, to an134 | |
| 146 | - | individual not related by consanguinity or affinity to such owner or operator providing135 | |
| 147 | - | such care pursuant to an agreement for a fixed or variable fee, or for any other136 | |
| 148 | - | remuneration of any type, whether fixed or variable, for the period of care, payable in a137 | |
| 149 | - | lump sum, lump sum and monthly maintenance charges or in installments. Agreements138 | |
| 150 | - | to provide continuing care include agreements to provide care for any duration, including139 | |
| 151 | - | agreements that are terminable by either party.140 23 LC 33 9433S | |
| 139 | + | service that would require a certificate of need under this chapter unless a certificate of118 | |
| 140 | + | need or letter of determination has been obtained for such new or expanded services.119 | |
| 141 | + | (17)(10) 'Health care facility' means hospitals; destination cancer hospitals; other special120 | |
| 142 | + | care units, including but not limited to podiatric facilities; skilled nursing facilities;121 | |
| 143 | + | intermediate care facilities; personal care homes; ambulatory surgical centers or122 | |
| 144 | + | obstetrical facilities; freestanding emergency departments or facilities not located on a123 | |
| 145 | + | hospital's primary campus; health maintenance organizations; and home health agencies;124 | |
| 146 | + | and diagnostic, treatment, or rehabilitation centers, but only to the extent paragraph (3)125 | |
| 147 | + | or (7), or both paragraphs (3) and (7), of subsection (a) of Code Section 31-6-40 are126 | |
| 148 | + | applicable thereto.127 | |
| 149 | + | (18) 'Health maintenance organization' means a public or private organization organized128 | |
| 150 | + | under the laws of this state which:129 | |
| 151 | + | (A) Provides or otherwise makes available to enrolled participants health care services,130 | |
| 152 | + | including at least the following basic health care services: usual physicians' services,131 | |
| 153 | + | hospitalization, laboratory, X-ray, emergency and preventive services, and out-of-area132 | |
| 154 | + | coverage;133 | |
| 155 | + | (B) Is compensated, except for copayments, for the provision of the basic health care134 | |
| 156 | + | services listed in subparagraph (A) of this paragraph to enrolled participants on a135 | |
| 157 | + | predetermined periodic rate basis; and136 | |
| 158 | + | (C) Provides physicians' services primarily:137 | |
| 159 | + | (i) Directly through physicians who are either employees or partners of such138 | |
| 160 | + | organization; or139 | |
| 161 | + | (ii) Through arrangements with individual physicians organized on a group practice140 | |
| 162 | + | or individual practice basis.141 | |
| 163 | + | (19) 'Health Strategies Council' or 'council' means the body created by this chapter to142 | |
| 164 | + | advise the department.143 23 LC 33 9350 | |
| 165 | + | S. B. 162 | |
| 152 | 166 | - 7 - | |
| 153 | - | (19) 'Micro-hospital' means a hospital in a rural county which has at least two and not141 | |
| 154 | - | more than seven inpatient beds and which provides emergency services seven days per142 | |
| 155 | - | week and 24 hours per day.143 | |
| 156 | - | (20) 'Multi-specialty ambulatory surgical center' means a multi-specialty physician group144 | |
| 157 | - | owning, operating, and utilizing no more than three specialty ambulatory surgical centers145 | |
| 158 | - | located in the same or different counties in which the group has provided medical146 | |
| 159 | - | services in a clinical office for at least five years and which limits each center to a single147 | |
| 160 | - | specialty which may be different single specialties; provided, however, that the specialty148 | |
| 161 | - | ambulatory surgical centers may be colocated.149 | |
| 162 | - | (21) 'Offer' means that the health care facility is open for the acceptance of patients or150 | |
| 163 | - | performance of services and has qualified personnel, equipment, and supplies necessary151 | |
| 164 | - | to provide specified clinical health services.152 | |
| 165 | - | (22) 'Operating room environment' means an environment which meets the minimum153 | |
| 166 | - | physical plant and operational standards specified in the rules of the department which154 | |
| 167 | - | shall consider and use the design and construction specifications as set forth in the155 | |
| 168 | - | Guidelines for Design and Construction of Health Care Facilities published by the156 | |
| 169 | - | American Institute of Architects.157 | |
| 170 | - | (23) 'Person' means any individual, trust or estate, partnership, limited liability company158 | |
| 171 | - | or partnership, corporation (including associations, joint-stock companies, and insurance159 | |
| 172 | - | companies), state, political subdivision, hospital authority, or instrumentality (including160 | |
| 173 | - | a municipal corporation) of a state as defined in the laws of this state. This term shall161 | |
| 174 | - | include all related parties, including individuals, business corporations, general162 | |
| 175 | - | partnerships, limited partnerships, limited liability companies, limited liability163 | |
| 176 | - | partnerships, joint ventures, nonprofit corporations, or any other for profit or not for profit164 | |
| 177 | - | entity that owns or controls, is owned or controlled by, or operates under common165 | |
| 178 | - | ownership or control with a person.166 23 LC 33 9433S | |
| 167 | + | (20)(11) 'Home health agency' means a public agency or private organization, or a144 | |
| 168 | + | subdivision of such an agency or organization, which is primarily engaged in providing145 | |
| 169 | + | to individuals who are under a written plan of care of a physician, on a visiting basis in146 | |
| 170 | + | the places of residence used as such individuals' homes, part-time or intermittent nursing147 | |
| 171 | + | care provided by or under the supervision of a registered professional nurse, and one or148 | |
| 172 | + | more of the following services:149 | |
| 173 | + | (A) Physical therapy;150 | |
| 174 | + | (B) Occupational therapy;151 | |
| 175 | + | (C) Speech therapy;152 | |
| 176 | + | (D) Medical social services under the direction of a physician; or153 | |
| 177 | + | (E) Part-time or intermittent services of a home health aide.154 | |
| 178 | + | (21) 'Hospital' means an institution which is primarily engaged in providing to inpatients,155 | |
| 179 | + | by or under the supervision of physicians, diagnostic services and therapeutic services for156 | |
| 180 | + | medical diagnosis, treatment, and care of injured, disabled, or sick persons or157 | |
| 181 | + | rehabilitation services for the rehabilitation of injured, disabled, or sick persons. Such158 | |
| 182 | + | term includes public, private, psychiatric, rehabilitative, geriatric, osteopathic,159 | |
| 183 | + | micro-hospitals, general cancer hospitals, and other specialty hospitals.160 | |
| 184 | + | (22)(12) 'Intermediate care facility' means an institution which provides, on a regular161 | |
| 185 | + | basis, health related care and services to individuals who do not require the degree of care162 | |
| 186 | + | and treatment which a hospital or skilled nursing facility is designed to provide but who,163 | |
| 187 | + | because of their mental or physical condition, require health related care and services164 | |
| 188 | + | beyond the provision of room and board.165 | |
| 189 | + | (23) 'Joint venture ambulatory surgical center' means a freestanding ambulatory surgical166 | |
| 190 | + | center that is jointly owned by a hospital in the same county as the center or a hospital in167 | |
| 191 | + | a contiguous county if there is no hospital in the same county as the center and a single168 | |
| 192 | + | group of physicians practicing in the center and that provides surgery in a single specialty169 | |
| 193 | + | as defined by the department; provided, however, that general surgery, a group practice170 23 LC 33 9350 | |
| 194 | + | S. B. 162 | |
| 179 | 195 | - 8 - | |
| 180 | - | (24) 'Personal care home' means a residential facility that is certified as a provider of167 | |
| 181 | - | medical assistance for Medicaid purposes pursuant to Article 7 of Chapter 4 of Title 49168 | |
| 182 | - | having at least 25 beds and providing, for compensation, protective care and oversight169 | |
| 183 | - | of ambulatory, nonrelated persons who need a monitored environment but who do not170 | |
| 184 | - | have injuries or disabilities which require chronic or convalescent care, including171 | |
| 185 | - | medical, nursing, or intermediate care. Personal care homes include those facilities172 | |
| 186 | - | which monitor daily residents' functioning and location, have the capability for crisis173 | |
| 187 | - | intervention, and provide supervision in areas of nutrition, medication, and provision of174 | |
| 188 | - | transient medical care. Such term does not include:175 | |
| 189 | - | (A) Old age residences which are devoted to independent living units with kitchen176 | |
| 190 | - | facilities in which residents have the option of preparing and serving some or all of their177 | |
| 191 | - | own meals; or178 | |
| 192 | - | (B) Boarding facilities which do not provide personal care.179 | |
| 193 | - | (25) 'Primary campus' means the building at which the majority of a hospital's or a180 | |
| 194 | - | remote location of a hospital's licensed and operational inpatient hospital beds are181 | |
| 195 | - | located, and includes the health care facilities of such hospital within 1,000 yards of such182 | |
| 196 | - | building. Any health care facility operated under a hospital's license prior to July 1, 2019,183 | |
| 197 | - | but not on the hospital's primary campus shall remain part of such hospital but shall not184 | |
| 198 | - | constitute such hospital's primary campus unless otherwise meeting the requirements of185 | |
| 199 | - | this paragraph.186 | |
| 200 | - | (26) 'Project' means a proposal to take an action for which a special health care services187 | |
| 201 | - | license is required under this chapter. A project or proposed project may refer to the188 | |
| 202 | - | proposal from its earliest planning stages up through the point at which the new special189 | |
| 203 | - | health care services are offered.190 | |
| 204 | - | (27) 'Remote location of a hospital' means a hospital facility or organization that is191 | |
| 205 | - | either created by, or acquired by, a hospital that is the main provider for the purpose of192 23 LC 33 9433S | |
| 196 | + | which includes one or more physiatrists who perform services that are reasonably related171 | |
| 197 | + | to the surgical procedures performed in the center, and a group practice in orthopedics172 | |
| 198 | + | which includes plastic hand surgeons with a certificate of added qualifications in Surgery173 | |
| 199 | + | of the Hand from the American Board of Plastic and Reconstructive Surgery shall be174 | |
| 200 | + | considered a single specialty. The ownership interest of the hospital shall be no less than175 | |
| 201 | + | 30 percent and the collective ownership of the physicians or group of physicians shall be176 | |
| 202 | + | no less than 30 percent.177 | |
| 203 | + | (23.1)(13) 'Life plan community' means an organization, whether operated for profit or178 | |
| 204 | + | not, whose owner or operator undertakes to provide shelter, food, and either nursing care179 | |
| 205 | + | or personal services, whether such nursing care or personal services are provided in the180 | |
| 206 | + | facility or in another setting, and other services, as designated by agreement, to an181 | |
| 207 | + | individual not related by consanguinity or affinity to such owner or operator providing182 | |
| 208 | + | such care pursuant to an agreement for a fixed or variable fee, or for any other183 | |
| 209 | + | remuneration of any type, whether fixed or variable, for the period of care, payable in a184 | |
| 210 | + | lump sum, lump sum and monthly maintenance charges or in installments. Agreements185 | |
| 211 | + | to provide continuing care include agreements to provide care for any duration, including186 | |
| 212 | + | agreements that are terminable by either party.187 | |
| 213 | + | (23.2) 'Micro-hospital' means a hospital in a rural county which has at least two and not188 | |
| 214 | + | more than seven inpatient beds and which provides emergency services seven days per189 | |
| 215 | + | week and 24 hours per day.190 | |
| 216 | + | (24) 'New and emerging health care service' means a health care service or utilization of191 | |
| 217 | + | medical equipment which has been developed and has become acceptable or available for192 | |
| 218 | + | implementation or use but which has not yet been addressed under the rules and193 | |
| 219 | + | regulations promulgated by the department pursuant to this chapter.194 | |
| 220 | + | (25) 'Nonclinical health services' means services or functions provided or performed by195 | |
| 221 | + | a health care facility, and the parts of the physical plant where they are located in a health196 23 LC 33 9350 | |
| 222 | + | S. B. 162 | |
| 206 | 223 | - 9 - | |
| 207 | - | furnishing inpatient hospital services under the name, ownership, and financial and193 | |
| 208 | - | administrative control of the main provider.194 | |
| 209 | - | (28) 'Rural county' means a county having a population of less than 50,000 according to195 | |
| 210 | - | the United States decennial census of 2020 or any future such census.196 | |
| 211 | - | (29) 'Single specialty ambulatory surgical center' means an ambulatory surgical center197 | |
| 212 | - | where surgery is performed in the offices of an individual private physician or single198 | |
| 213 | - | group practice of private physicians if such surgery is performed in a facility that is199 | |
| 214 | - | owned, operated, and utilized by such physicians who also are of a single specialty;200 | |
| 215 | - | provided, however, that general surgery, a group practice which includes one or more201 | |
| 216 | - | physiatrists who perform services that are reasonably related to the surgical procedures202 | |
| 217 | - | performed in the center, and a group practice in orthopedics which includes plastic hand203 | |
| 218 | - | surgeons with a certificate of added qualifications in Surgery of the Hand from the204 | |
| 219 | - | American Board of Plastic and Reconstructive Surgery shall be considered a single205 | |
| 220 | - | specialty.206 | |
| 221 | - | (30) 'Skilled nursing facility' means public or private institution or a distinct part of an207 | |
| 222 | - | institution which is primarily engaged in providing inpatient skilled nursing care and208 | |
| 223 | - | related services for patients who require medical or nursing care or rehabilitation services209 | |
| 224 | - | for the rehabilitation of injured, disabled, or sick persons.210 | |
| 225 | - | (31) 'Special health care services' means any facilities or services described in211 | |
| 226 | - | paragraphs (1) through (4) of subsection (a) of Code Section 31-6A-3.212 | |
| 227 | - | (32) 'Specialty hospital' means a hospital that is primarily or exclusively engaged in the213 | |
| 228 | - | care and treatment of one of the following: patients with a cardiac condition, patients with214 | |
| 229 | - | an orthopedic condition, patients receiving a surgical procedure, or patients receiving any215 | |
| 230 | - | other specialized category of services defined by the department.216 | |
| 231 | - | (33) 'Uncompensated indigent or charity care' means the dollar amount of 'net217 | |
| 232 | - | uncompensated indigent or charity care after direct and indirect (all) compensation' as218 23 LC 33 9433S | |
| 224 | + | care facility that are not diagnostic, therapeutic, or rehabilitative services to patients and197 | |
| 225 | + | are not clinical health services defined in this chapter.198 | |
| 226 | + | (26)(14) 'Offer' means that the health care facility is open for the acceptance of patients199 | |
| 227 | + | or performance of services and has qualified personnel, equipment, and supplies200 | |
| 228 | + | necessary to provide specified clinical health services.201 | |
| 229 | + | (27) 'Operating room environment' means an environment which meets the minimum202 | |
| 230 | + | physical plant and operational standards specified in the rules of the department which203 | |
| 231 | + | shall consider and use the design and construction specifications as set forth in the204 | |
| 232 | + | Guidelines for Design and Construction of Health Care Facilities published by the205 | |
| 233 | + | American Institute of Architects.206 | |
| 234 | + | (28) 'Pediatric cardiac catheterization' means the performance of angiographic,207 | |
| 235 | + | physiologic, and, as appropriate, therapeutic cardiac catheterization on children 14 years208 | |
| 236 | + | of age or younger.209 | |
| 237 | + | (29)(15) 'Person' means any individual, trust or estate, partnership, limited liability210 | |
| 238 | + | company or partnership, corporation (including associations, joint-stock companies, and211 | |
| 239 | + | insurance companies), state, political subdivision, hospital authority, or instrumentality212 | |
| 240 | + | (including a municipal corporation) of a state as defined in the laws of this state. This213 | |
| 241 | + | term shall include all related parties, including individuals, business corporations, general214 | |
| 242 | + | partnerships, limited partnerships, limited liability companies, limited liability215 | |
| 243 | + | partnerships, joint ventures, nonprofit corporations, or any other for profit or not for profit216 | |
| 244 | + | entity that owns or controls, is owned or controlled by, or operates under common217 | |
| 245 | + | ownership or control with a person.218 | |
| 246 | + | (30)(16) 'Personal care home' means a residential facility that is certified as a provider219 | |
| 247 | + | of medical assistance for Medicaid purposes pursuant to Article 7 of Chapter 4 of Title220 | |
| 248 | + | 49 having at least 25 beds and providing, for compensation, protective care and oversight221 | |
| 249 | + | of ambulatory, nonrelated persons who need a monitored environment but who do not222 | |
| 250 | + | have injuries or disabilities which require chronic or convalescent care, including223 23 LC 33 9350 | |
| 251 | + | S. B. 162 | |
| 233 | 252 | - 10 - | |
| 234 | - | defined by, and calculated in accordance with, the department's Hospital Financial Survey219 | |
| 235 | - | and related instructions.220 | |
| 236 | - | (34) 'Urban county' means a county having a population equal to or greater than 50,000221 | |
| 237 | - | according to the United States decennial census of 2020 or any future such census.222 | |
| 238 | - | 31-6A-2.223 | |
| 239 | - | (a) On and after January 1, 2024, no person shall operate or provide any new special health224 | |
| 240 | - | care services without acquiring a special health care services license under this chapter225 | |
| 241 | - | unless such person has an exception acknowledgment from the department.226 | |
| 242 | - | (b) The department shall adopt rules to specify:227 | |
| 243 | - | (1) The minimal requirements for quality and safety for patients receiving each special228 | |
| 244 | - | health care service;229 | |
| 245 | - | (2) The procedure for applying for and maintaining a special health care services license,230 | |
| 246 | - | including, but not limited to, the frequency of licensing inspections, submission of231 | |
| 247 | - | information, and data to evaluate the performance and ongoing operation of services and232 | |
| 248 | - | enforcement under this chapter;233 | |
| 249 | - | (3) The fees for applying for and maintaining a special health care services license in234 | |
| 250 | - | order to fully offset the cost to the department, including consultant fees and other related235 | |
| 251 | - | expenses necessary to process the application, and for any ongoing expenses to the236 | |
| 252 | - | department for maintaining a special health care services license; and237 | |
| 253 | - | (4) The procedure and criteria for requesting and approving an exception238 | |
| 254 | - | acknowledgment.239 | |
| 255 | - | 31-6A-3.240 | |
| 256 | - | (a) A special health care services license shall be required for:241 | |
| 257 | - | (1) The construction of a new health care facility;242 23 LC 33 9433S | |
| 253 | + | medical, nursing, or intermediate care. Personal care homes include those facilities | |
| 254 | + | 224 | |
| 255 | + | which monitor daily residents' functioning and location, have the capability for crisis225 | |
| 256 | + | intervention, and provide supervision in areas of nutrition, medication, and provision of226 | |
| 257 | + | transient medical care. Such term does not include:227 | |
| 258 | + | (A) Old age residences which are devoted to independent living units with kitchen228 | |
| 259 | + | facilities in which residents have the option of preparing and serving some or all of their229 | |
| 260 | + | own meals; or230 | |
| 261 | + | (B) Boarding facilities which do not provide personal care.231 | |
| 262 | + | (30.1) 'Primary campus' means the building at which the majority of a hospital's or a | |
| 263 | + | 232 | |
| 264 | + | remote location of a hospital's licensed and operational inpatient hospital beds are233 | |
| 265 | + | located, and includes the health care facilities of such hospital within 1,000 yards of such234 | |
| 266 | + | building. Any health care facility operated under a hospital's license prior to July 1, 2019,235 | |
| 267 | + | but not on the hospital's primary campus shall remain part of such hospital but shall not236 | |
| 268 | + | constitute such hospital's primary campus unless otherwise meeting the requirements of237 | |
| 269 | + | this paragraph.238 | |
| 270 | + | (31)(17) 'Project' means a proposal to take an action for which a certificate of need is239 | |
| 271 | + | required under this chapter. A project or proposed project may refer to the proposal from240 | |
| 272 | + | its earliest planning stages up through the point at which the new institutional health241 | |
| 273 | + | service is offered.242 | |
| 274 | + | (31.1) 'Remote location of a hospital' means a hospital facility or organization that is243 | |
| 275 | + | either created by, or acquired by, a hospital that is the main provider for the purpose of244 | |
| 276 | + | furnishing inpatient hospital services under the name, ownership, and financial and245 | |
| 277 | + | administrative control of the main provider.246 | |
| 278 | + | (32) 'Rural county' means a county having a population of less than 50,000 according to247 | |
| 279 | + | the United States decennial census of 2010 or any future such census.248 | |
| 280 | + | (33) 'Single specialty ambulatory surgical center' means an ambulatory surgical center249 | |
| 281 | + | where surgery is performed in the offices of an individual private physician or single250 23 LC 33 9350 | |
| 282 | + | S. B. 162 | |
| 258 | 283 | - 11 - | |
| 259 | - | (2) The construction of a replacement health care facility, if the bed capacity is increased243 | |
| 260 | - | by ten beds or 20 percent of bed capacity, whichever is greater; and244 | |
| 261 | - | (3) Conversion of a single specialty ambulatory surgical center to a multi-specialty245 | |
| 262 | - | venture ambulatory surgical center; provided the single specialty ambulatory surgical246 | |
| 263 | - | center demonstrates indigent and charity care services of 5 percent of revenue per year247 | |
| 264 | - | for the three years preceding the date of the application; and if the application for a248 | |
| 265 | - | conversion license is granted, the multi-specialty venture ambulatory surgical center shall249 | |
| 266 | - | provide indigent and charity care services totaling 2.5 percent of revenue per year and250 | |
| 267 | - | failure to do so shall be cause for immediate revocation of the license.251 | |
| 268 | - | (b) A special health care services license shall not be required for:252 | |
| 269 | - | (1) Adding new clinical health services;253 | |
| 270 | - | (2) A health care facility established on or after January 1, 2024, in a rural county, as254 | |
| 271 | - | defined in Code Section 31-8-9.1, that:255 | |
| 272 | - | (A) Provides inpatient hospital services;256 | |
| 273 | - | (B) Participates in both Medicaid and Medicare and accepts both Medicaid and257 | |
| 274 | - | Medicare patients;258 | |
| 275 | - | (C) Provides health care services to indigent patients;259 | |
| 276 | - | (D) Has at least 10 percent of its annual net revenue categorized as indigent care,260 | |
| 277 | - | charity care, or bad debt;261 | |
| 278 | - | (E) Annually files IRS Form 990, Return of Organization Exempt From Income Tax,262 | |
| 279 | - | with the department, or for any hospital not required to file IRS Form 990, the263 | |
| 280 | - | department will provide a form that collects the same information to be submitted to the264 | |
| 281 | - | department on an annual basis;265 | |
| 282 | - | (F) Is current with all audits and reports required by law; and266 | |
| 283 | - | (G) Has a three-year average patient margin, as a percent of expense, less than one267 | |
| 284 | - | standard deviation above the state-wide three-year average of organizations defined in268 | |
| 285 | - | subparagraphs (A) through (F) of this paragraph, as calculated by the department. For269 23 LC 33 9433S | |
| 284 | + | group practice of private physicians if such surgery is performed in a facility that is251 | |
| 285 | + | owned, operated, and utilized by such physicians who also are of a single specialty;252 | |
| 286 | + | provided, however, that general surgery, a group practice which includes one or more253 | |
| 287 | + | physiatrists who perform services that are reasonably related to the surgical procedures254 | |
| 288 | + | performed in the center, and a group practice in orthopedics which includes plastic hand255 | |
| 289 | + | surgeons with a certificate of added qualifications in Surgery of the Hand from the256 | |
| 290 | + | American Board of Plastic and Reconstructive Surgery shall be considered a single257 | |
| 291 | + | specialty.258 | |
| 292 | + | (34)(18) 'Skilled nursing facility' means a public or private institution or a distinct part259 | |
| 293 | + | of an institution which is primarily engaged in providing inpatient skilled nursing care260 | |
| 294 | + | and related services for patients who require medical or nursing care or rehabilitation261 | |
| 295 | + | services for the rehabilitation of injured, disabled, or sick persons.262 | |
| 296 | + | (35) 'Specialty hospital' means a hospital that is primarily or exclusively engaged in the263 | |
| 297 | + | care and treatment of one of the following: patients with a cardiac condition, patients with264 | |
| 298 | + | an orthopedic condition, patients receiving a surgical procedure, or patients receiving any265 | |
| 299 | + | other specialized category of services defined by the department. A 'specialty hospital'266 | |
| 300 | + | does not include a destination cancer hospital or a general cancer hospital.267 | |
| 301 | + | (36)(19) 'State health plan' means a comprehensive program based on recommendations268 | |
| 302 | + | by the Health Strategies Council and the board, approved by the Governor, and269 | |
| 303 | + | implemented by the State of Georgia for the purpose of providing adequate long-term270 | |
| 304 | + | health care services and facilities throughout the state.271 | |
| 305 | + | (37)(20) 'Uncompensated indigent or charity care' means the dollar amount of 'net272 | |
| 306 | + | uncompensated indigent or charity care after direct and indirect (all) compensation' as273 | |
| 307 | + | defined by, and calculated in accordance with, the department's Hospital Financial Survey274 | |
| 308 | + | and related instructions.275 | |
| 309 | + | (38) 'Urban county' means a county having a population equal to or greater than 50,000276 | |
| 310 | + | according to the United States decennial census of 2010 or any future such census.277 23 LC 33 9350 | |
| 311 | + | S. B. 162 | |
| 286 | 312 | - 12 - | |
| 287 | - | purposes of this subparagraph, the term 'patient margin' means gross patient revenues270 | |
| 288 | - | less contractual adjustments, bad debt, indigent and charity care, other uncompensated271 | |
| 289 | - | care, and total expenses.272 | |
| 290 | - | In the event that the county in which a health care facility established in accordance with273 | |
| 291 | - | this paragraph is located no longer meets the definition of a rural county after such health274 | |
| 292 | - | care facility has commenced operations, the health care facility shall be deemed to275 | |
| 293 | - | continue to meet the requirements of this paragraph for as long as such health care facility276 | |
| 294 | - | continues to operate.277 | |
| 295 | - | (3) Infirmaries operated by educational institutions for the sole and exclusive benefit of278 | |
| 296 | - | students, faculty members, officers, or employees thereof;279 | |
| 297 | - | (4) Infirmaries or facilities operated by businesses for the sole and exclusive benefit of280 | |
| 298 | - | officers or employees thereof, provided that such infirmaries or facilities make no281 | |
| 299 | - | provision for overnight stay by persons receiving their services;282 | |
| 300 | - | (5) Institutions operated exclusively by the federal government or by any of its agencies;283 | |
| 301 | - | (6) Offices of private physicians or dentists whether for individual or group practice;284 | |
| 302 | - | (7) Religious, nonmedical health care institutions as defined in 42 U.S.C.285 | |
| 303 | - | Section 1395x(ss)(1), listed and certified by a national accrediting organization;286 | |
| 304 | - | (8) Site acquisitions for health care facilities or preparation or development costs for287 | |
| 305 | - | such sites prior to the decision to file an application for a special health care services288 | |
| 306 | - | license;289 | |
| 307 | - | (9) Expenditures related to adequate preparation and development of an application for290 | |
| 308 | - | a special health care services license;291 | |
| 309 | - | (10) The commitment of funds conditioned upon the obtaining of a special health care292 | |
| 310 | - | services license;293 | |
| 311 | - | (11) Expenditures for the restructuring or acquisition of existing health care facilities by294 | |
| 312 | - | stock or asset purchase, merger, consolidation, or other lawful means;295 23 LC 33 9433S | |
| 313 | + | 31-6-3.278 | |
| 314 | + | (a) As used in this Code section, the term 'medical use rights' means rights or interests in279 | |
| 315 | + | real property in which the owner of the property has agreed not to sell or lease such real280 | |
| 316 | + | property for identified medical uses or purposes.281 | |
| 317 | + | (b) It shall be unlawful for any health care facility to purchase, renew, extend, lease,282 | |
| 318 | + | maintain, or hold medical use rights.283 | |
| 319 | + | (c) This Code section shall not be construed to impair any contracts in existence as of July284 | |
| 320 | + | 1, 2019.285 | |
| 321 | + | ARTICLE 2286 | |
| 322 | + | 31-6-20.287 | |
| 323 | + | Reserved.288 | |
| 324 | + | 31-6-21.289 | |
| 325 | + | (a) The Department of Community Health, established under Chapter 2 of this title, is290 | |
| 326 | + | authorized to administer the certificate of need program established under this chapter and,291 | |
| 327 | + | within the appropriations made available to the department by the General Assembly of292 | |
| 328 | + | Georgia and consistently with the laws of the State of Georgia, a state health plan adopted293 | |
| 329 | + | by the board. The department shall provide, by rule, for procedures to administer its294 | |
| 330 | + | functions until otherwise provided by the board.295 | |
| 331 | + | (b) The functions of the department shall be:296 | |
| 332 | + | (1) To conduct the health planning activities of the state and to implement those parts of297 | |
| 333 | + | the state health plan which relate to the government of the state;298 | |
| 334 | + | (2) To prepare and revise a draft state health plan with recommendations from technical299 | |
| 335 | + | advisory committees;300 23 LC 33 9350 | |
| 336 | + | S. B. 162 | |
| 313 | 337 | - 13 - | |
| 314 | - | ( | |
| 315 | - | ||
| 316 | - | ||
| 317 | - | ||
| 318 | - | ||
| 319 | - | ||
| 320 | - | ( | |
| 321 | - | ||
| 322 | - | ||
| 323 | - | ||
| 324 | - | ||
| 325 | - | ||
| 326 | - | ||
| 327 | - | ||
| 328 | - | ( | |
| 329 | - | ||
| 330 | - | ||
| 331 | - | ||
| 332 | - | ||
| 333 | - | ||
| 334 | - | ||
| 335 | - | ||
| 336 | - | ||
| 337 | - | ||
| 338 | - | ||
| 339 | - | ||
| 338 | + | (3) To seek advice, at its discretion, from technical advisory committees in the301 | |
| 339 | + | performance by the department of its functions pursuant to this chapter;302 | |
| 340 | + | (4)(3) To adopt, promulgate, and implement rules and regulations sufficient to administer303 | |
| 341 | + | the provisions of this chapter including the certificate of need program;304 | |
| 342 | + | (5)(4) To define, by rule, the form, content, schedules, and procedures for submission305 | |
| 343 | + | of applications for certificates of need, other determinations, and periodic reports;306 | |
| 344 | + | (6)(5) To establish time periods and procedures consistent with this chapter to hold307 | |
| 345 | + | hearings and to obtain the viewpoints of interested persons prior to issuance or denial of308 | |
| 346 | + | a certificate of need;309 | |
| 347 | + | (7)(6) To provide, by rule, for such fees as may be necessary to cover the costs of310 | |
| 348 | + | hearing officers, preparing the record for appeals before such hearing officers and the311 | |
| 349 | + | Certificate of Need Appeal Panel of the decisions of the department, and other related312 | |
| 350 | + | administrative costs, which costs may include reasonable sharing between the department313 | |
| 351 | + | and the parties to appeal hearings;314 | |
| 352 | + | (8)(7) To establish, by rule, need methodologies for new institutional health services and315 | |
| 353 | + | health care facilities. In developing such need methodologies, the department shall, at316 | |
| 354 | + | a minimum, consider the demographic characteristics of the population, the health status317 | |
| 355 | + | of the population, service use patterns, standards and trends, financial and geographic318 | |
| 356 | + | accessibility, and market economics. The department shall establish service-specific need319 | |
| 357 | + | methodologies and criteria for at least the following clinical health services: short stay320 | |
| 358 | + | hospital beds, adult therapeutic cardiac catheterization, adult open heart surgery, pediatric321 | |
| 359 | + | cardiac catheterization and open heart surgery, Level II and III perinatal services,322 | |
| 360 | + | freestanding birthing centers, psychiatric and substance abuse inpatient programs, skilled323 | |
| 361 | + | nursing and intermediate care facilities, home health agencies, and life plan community324 | |
| 362 | + | sheltered facilities;325 23 LC 33 9350 | |
| 363 | + | S. B. 162 | |
| 340 | 364 | - 14 - | |
| 341 | - | ||
| 342 | - | ||
| 343 | - | ||
| 344 | - | ||
| 345 | - | ||
| 346 | - | ||
| 347 | - | ||
| 348 | - | ||
| 349 | - | ||
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| 352 | - | ||
| 353 | - | ||
| 354 | - | ||
| 355 | - | ||
| 356 | - | ||
| 357 | - | ||
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| 359 | - | ||
| 360 | - | ||
| 361 | - | ||
| 362 | - | ||
| 363 | - | of the | |
| 364 | - | ||
| 365 | - | of the | |
| 366 | - | ||
| 367 | - | ||
| 365 | + | (9)(8) To provide, by rule, for a reasonable and equitable fee schedule for certificate of326 | |
| 366 | + | need applications; provided, however, that a certificate of need application filed by or on327 | |
| 367 | + | behalf of a hospital in a rural county shall be exempt from any such fee;328 | |
| 368 | + | (10)(9) To grant, deny, or revoke a certificate of need as applied for or as amended; and329 | |
| 369 | + | (11)(10) To perform powers and functions delegated by the Governor, which delegation330 | |
| 370 | + | may include the powers to carry out the duties and powers which have been delegated to331 | |
| 371 | + | the department under Section 1122 of the federal Social Security Act of 1935, as332 | |
| 372 | + | amended; and333 | |
| 373 | + | (12) Study the amount of uncompensated indigent and charity care provided by each type334 | |
| 374 | + | of health care facility, recommend requirements for the levels of uncompensated indigent335 | |
| 375 | + | and charity care required to be performed by each health care facility type and develop336 | |
| 376 | + | standardized reporting requirements for the department to accurately track the amount of337 | |
| 377 | + | uncompensated indigent and charity care provided by each health care facility.338 | |
| 378 | + | (c) The commissioner shall have the power to establish and abolish technical advisory339 | |
| 379 | + | committees as he or she deems necessary, in consultation with the board, to inform340 | |
| 380 | + | effective strategy development and execution.341 | |
| 381 | + | 31-6-21.1.342 | |
| 382 | + | (a) Rules of the department shall be adopted, promulgated, and implemented as provided343 | |
| 383 | + | in this Code section and in Chapter 13 of Title 50, the 'Georgia Administrative Procedure344 | |
| 384 | + | Act,' except that the department shall not be required to comply with subsections (c)345 | |
| 385 | + | through (g) of Code Section 50-13-4.346 | |
| 386 | + | (b) The department shall transmit three copies of the notice provided for in paragraph (1)347 | |
| 387 | + | of subsection (a) of Code Section 50-13-4 to the legislative counsel. The copies shall be348 | |
| 388 | + | transmitted at least 30 days prior to that department's intended action. Within five days349 | |
| 389 | + | after receipt of the copies, if possible, the legislative counsel shall furnish the presiding350 | |
| 390 | + | officer of each house with a copy of the notice and mail a copy of the notice to each351 23 LC 33 9350 | |
| 391 | + | S. B. 162 | |
| 368 | 392 | - 15 - | |
| 369 | - | allow not more than 10 percent of its licensed beds for new patients who are not residents349 | |
| 370 | - | of the life plan community. At no time during the first five years shall the life plan350 | |
| 371 | - | community sheltered nursing facility occupy more than 50 percent of its licensed beds351 | |
| 372 | - | with patients who are not residents under contract with the life plan community. At the352 | |
| 373 | - | end of the five-year period, the life plan community sheltered nursing facility shall be353 | |
| 374 | - | utilized exclusively by residents of the life plan community, and at no time shall a354 | |
| 375 | - | resident of a life plan community be denied access to the sheltered nursing facility. At355 | |
| 376 | - | no time shall any existing patient be forced to leave the life plan community to comply356 | |
| 377 | - | with this paragraph. The department is authorized to promulgate rules and regulations357 | |
| 378 | - | regarding the use and definition of 'sheltered nursing facility' in a manner consistent with358 | |
| 379 | - | this Code section. Agreements to provide continuing care include agreements to provide359 | |
| 380 | - | care for any duration, including agreements that are terminable by either party;360 | |
| 381 | - | (22) Any specialty ambulatory surgical center that:361 | |
| 382 | - | (A) Has a hospital affiliation agreement with a hospital within a reasonable distance362 | |
| 383 | - | from the facility or the medical staff at the center has admitting privileges or other363 | |
| 384 | - | acceptable documented arrangements with such hospital to ensure the necessary backup364 | |
| 385 | - | for the center for medical complications. The center shall have the capability to transfer365 | |
| 386 | - | a patient immediately to a hospital within a reasonable distance from the facility with366 | |
| 387 | - | adequate emergency room services. Hospitals shall not unreasonably deny a transfer367 | |
| 388 | - | agreement or affiliation agreement to the center;368 | |
| 389 | - | (B) Provides care to Medicaid beneficiaries and, if the facility provides medical care369 | |
| 390 | - | and treatment to children, to PeachCare for Kids beneficiaries and provides370 | |
| 391 | - | uncompensated indigent and charity care in accordance with Code Section 31-6A-6;371 | |
| 392 | - | provided, however, that specialty ambulatory surgical centers owned by physicians in372 | |
| 393 | - | the practice of ophthalmology shall not be required to comply with this subparagraph;373 | |
| 394 | - | and374 23 LC 33 9433S | |
| 393 | + | member of the Senate Health and Human Services Committee of the Senate and each352 | |
| 394 | + | member of the House Committee on Health and Human Services Committee of the House353 | |
| 395 | + | of Representatives. Each such rule and any part thereof shall be subject to the making of354 | |
| 396 | + | an objection by either such committee within 30 days of transmission of the rule to the355 | |
| 397 | + | members of such committee. Any rule or part thereof to which no objection is made by356 | |
| 398 | + | both such committees may become adopted by the department at the end of such 30 day357 | |
| 399 | + | period. The department may not adopt any such rule or part thereof which has been358 | |
| 400 | + | changed since having been submitted to those committees unless:359 | |
| 401 | + | (1) That change is to correct only typographical errors;360 | |
| 402 | + | (2) That change is approved in writing by both committees and that approval expressly361 | |
| 403 | + | exempts that change from being subject to the public notice and hearing requirements of362 | |
| 404 | + | subsection (a) of Code Section 50-13-4;363 | |
| 405 | + | (3) That change is approved in writing by both committees and is again subject to the364 | |
| 406 | + | public notice and hearing requirements of subsection (a) of Code Section 50-13-4; or365 | |
| 407 | + | (4) That change is again subject to the public notice and hearing requirements of366 | |
| 408 | + | subsection (a) of Code Section 50-13-4 and the change is submitted and again subject to367 | |
| 409 | + | committee objection as provided in this subsection.368 | |
| 410 | + | Nothing in this subsection shall prohibit the department from adopting any rule or part369 | |
| 411 | + | thereof without adopting all of the rules submitted to the committees if the rule or part so370 | |
| 412 | + | adopted has not been changed since having been submitted to the committees and objection371 | |
| 413 | + | thereto was not made by both committees.372 | |
| 414 | + | (c) Any rule or part thereof to which an objection is made by both committees within the373 | |
| 415 | + | 30 day objection period under subsection (b) of this Code section shall not be adopted by374 | |
| 416 | + | the department and shall be invalid if so adopted. A rule or part thereof thus prohibited375 | |
| 417 | + | from being adopted shall be deemed to have been withdrawn by the department unless the376 | |
| 418 | + | department, within the first 15 days of the next regular session of the General Assembly,377 | |
| 419 | + | transmits written notification to each member of the objecting committees that the378 23 LC 33 9350 | |
| 420 | + | S. B. 162 | |
| 395 | 421 | - 16 - | |
| 396 | - | (C) Provides annual reports in the same manner and in accordance with Code375 | |
| 397 | - | Section 31-6A-7.376 | |
| 398 | - | Noncompliance with any condition of this paragraph shall result in a monetary penalty377 | |
| 399 | - | in the amount of the difference between the services which the center is required to378 | |
| 400 | - | provide and the amount actually provided and may be subject to revocation of its379 | |
| 401 | - | exemption status by the department for repeated failure to pay any fines or moneys due380 | |
| 402 | - | to the department or for repeated failure to produce data as required by Code381 | |
| 403 | - | Section 31-6A-7 after notice to the exemption holder and a fair hearing pursuant to382 | |
| 404 | - | Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act.' Any penalty so383 | |
| 405 | - | recovered shall be dedicated and deposited by the department into the Indigent Care Trust384 | |
| 406 | - | Fund created pursuant to Code Section 31-8-152 for the purposes set out in Code385 | |
| 407 | - | Section 31-8-154, including expanding Medicaid eligibility and services; programs to386 | |
| 408 | - | support rural and other health care providers, primarily hospitals, who serve the medically387 | |
| 409 | - | indigent; and for primary health care programs for medically indigent citizens and388 | |
| 410 | - | children of this state;389 | |
| 411 | - | (23) Any joint venture ambulatory surgical center that:390 | |
| 412 | - | (A) Provides care to Medicaid beneficiaries and, if the facility provides medical care391 | |
| 413 | - | and treatment to children, to PeachCare for Kids beneficiaries and provides392 | |
| 414 | - | uncompensated indigent and charity care in accordance with Code Section 31-6A-6;393 | |
| 415 | - | and394 | |
| 416 | - | (B) Provides annual reports in the same manner and in accordance with Code395 | |
| 417 | - | Section 31-6A-7.396 | |
| 418 | - | Noncompliance with any condition of this paragraph shall result in a monetary penalty397 | |
| 419 | - | in the amount of the difference between the services which the center is required to398 | |
| 420 | - | provide and the amount actually provided and may be subject to revocation of its399 | |
| 421 | - | exemption status by the department for repeated failure to pay any fines or moneys due400 | |
| 422 | - | to the department or for repeated failure to produce data as required by Code401 23 LC 33 9433S | |
| 422 | + | department does not intend to withdraw that rule or part thereof but intends to adopt the | |
| 423 | + | 379 | |
| 424 | + | specified rule or part effective the day following adjournment sine die of that regular380 | |
| 425 | + | session. A resolution objecting to such intended adoption may be introduced in either381 | |
| 426 | + | branch of the General Assembly after the fifteenth day but before the thirtieth day of the382 | |
| 427 | + | session in which occurs the notification of intent not to withdraw a rule or part thereof. In383 | |
| 428 | + | the event the resolution is adopted by the branch of the General Assembly in which the384 | |
| 429 | + | resolution was introduced, it shall be immediately transmitted to the other branch of the385 | |
| 430 | + | General Assembly. It shall be the duty of the presiding officer of the other branch to have386 | |
| 431 | + | that branch, within five days after receipt of the resolution, consider the resolution for387 | |
| 432 | + | purposes of objecting to the intended adoption of the rule or part thereof. Upon such388 | |
| 433 | + | resolution being adopted by two-thirds of the vote of each branch of the General Assembly,389 | |
| 434 | + | the rule or part thereof objected to in that resolution shall be disapproved and not adopted390 | |
| 435 | + | by the department. If the resolution is adopted by a majority but by less than two-thirds of391 | |
| 436 | + | the vote of each such branch, the resolution shall be submitted to the Governor for his or392 | |
| 437 | + | her approval or veto. In the event of a veto, or if no resolution is introduced objecting to393 | |
| 438 | + | the rule, or if the resolution introduced is not approved by at least a majority of the vote of394 | |
| 439 | + | each such branch, the rule shall automatically become adopted the day following395 | |
| 440 | + | adjournment sine die of that regular session. In the event of the Governor's approval of the396 | |
| 441 | + | resolution, the rule shall be disapproved and not adopted by the department.397 | |
| 442 | + | (d) Any rule or part thereof which is objected to by only one committee under398 | |
| 443 | + | subsection (b) of this Code section and which is adopted by the department may be399 | |
| 444 | + | considered by the branch of the General Assembly whose committee objected to its400 | |
| 445 | + | adoption by the introduction of a resolution for the purpose of overriding the rule at any401 | |
| 446 | + | time within the first 30 days of the next regular session of the General Assembly. It shall402 | |
| 447 | + | be the duty of the department in adopting a proposed rule over such objection so to notify403 | |
| 448 | + | the chairpersons of the Senate | |
| 449 | + | Health and Human Services Committee of the Senate and404 | |
| 450 | + | the House Committee on Health and Human Services Committee of the House within ten405 23 LC 33 9350 | |
| 451 | + | S. B. 162 | |
| 423 | 452 | - 17 - | |
| 424 | - | Section 31-6A-7 after notice to the exemption holder and a fair hearing pursuant to402 | |
| 425 | - | Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act.' Any penalty so403 | |
| 426 | - | recovered shall be dedicated and deposited by the department into the Indigent Care Trust404 | |
| 427 | - | Fund created pursuant to Code Section 31-8-152 for the purposes set out in Code405 | |
| 428 | - | Section 31-8-154, including expanding Medicaid eligibility and services; programs to406 | |
| 429 | - | support rural and other health care providers, primarily hospitals, who serve the medically407 | |
| 430 | - | indigent; and for primary health care programs for medically indigent citizens and408 | |
| 431 | - | children of this state;409 | |
| 432 | - | (24) Diagnostic cardiac catheterization in a hospital setting on patients 15 years of age410 | |
| 433 | - | and older;411 | |
| 434 | - | (25) Therapeutic cardiac catheterization in hospitals selected by the department prior to412 | |
| 435 | - | July 1, 2008, to participate in the Atlantic Cardiovascular Patient Outcomes Research413 | |
| 436 | - | Team (C-PORT) Study and therapeutic cardiac catheterization in hospitals that, as414 | |
| 437 | - | determined by the department on an annual basis, meet the criteria to participate in the415 | |
| 438 | - | C-PORT Study but have not been selected for participation; provided, however, that if416 | |
| 439 | - | the criteria requires a transfer agreement to another hospital, no hospital shall417 | |
| 440 | - | unreasonably deny a transfer agreement to another hospital;418 | |
| 441 | - | (26) Infirmaries or facilities operated by, on behalf of, or under contract with the419 | |
| 442 | - | Department of Corrections or the Department of Juvenile Justice for the sole and420 | |
| 443 | - | exclusive purpose of providing health care services in a secure environment to prisoners421 | |
| 444 | - | within a penal institution, penitentiary, prison, detention center, or other secure422 | |
| 445 | - | correctional institution, including correctional institutions operated by private entities in423 | |
| 446 | - | this state which house inmates under the Department of Corrections or the Department424 | |
| 447 | - | of Juvenile Justice;425 | |
| 448 | - | (27) The relocation of any micro-hospital within the same county, any other health care426 | |
| 449 | - | facility in a rural county within the same county, and any other health care facility in an427 23 LC 33 9433S | |
| 453 | + | days after the adoption of the rule. In the event the resolution is adopted by such branch | |
| 454 | + | 406 | |
| 455 | + | of the General Assembly, it shall be immediately transmitted to the other branch of the407 | |
| 456 | + | General Assembly. It shall be the duty of the presiding officer of the other branch of the408 | |
| 457 | + | General Assembly to have such branch, within five days after the receipt of the resolution,409 | |
| 458 | + | consider the resolution for the purpose of overriding the rule. In the event the resolution410 | |
| 459 | + | is adopted by two-thirds of the votes of each branch of the General Assembly, the rule shall411 | |
| 460 | + | be void on the day after the adoption of the resolution by the second branch of the General412 | |
| 461 | + | Assembly. In the event the resolution is ratified by a majority but by less than two-thirds413 | |
| 462 | + | of the votes of either branch, the resolution shall be submitted to the Governor for his or414 | |
| 463 | + | her approval or veto. In the event of a veto, the rule shall remain in effect. In the event of415 | |
| 464 | + | the Governor's approval, the rule shall be void on the day after the date of approval.416 | |
| 465 | + | (e) Except for emergency rules, no rule or part thereof adopted by the department after417 | |
| 466 | + | April 3, 1985, shall be valid unless adopted in compliance with subsections (b), (c), and (d)418 | |
| 467 | + | of this Code section and subsection (a) of Code Section 50-13-4.419 | |
| 468 | + | (f) Emergency rules shall not be subject to the requirements of subsection (b), (c), or (d)420 | |
| 469 | + | of this Code section but shall be subject to the requirements of subsection (b) of Code421 | |
| 470 | + | Section 50-13-4. Upon the first expiration of any department emergency rules, where | |
| 471 | + | when422 | |
| 472 | + | those emergency rules are intended to cover matters which had been dealt with by the423 | |
| 473 | + | department's nonemergency rules but such nonemergency rules have been objected to by424 | |
| 474 | + | both legislative committees under this Code section, the emergency rules concerning those425 | |
| 475 | + | matters may not again be adopted except for one 120 day period. No emergency rule or426 | |
| 476 | + | part thereof which is adopted by the department shall be valid unless adopted in427 | |
| 477 | + | compliance with this subsection.428 | |
| 478 | + | (g) Any proceeding to contest any rule on the ground of noncompliance with this Code429 | |
| 479 | + | section must be commenced within two years from the effective date of the rule.430 | |
| 480 | + | (h) For purposes of this Code section, the term 'rules' shall mean rules and regulations.431 23 LC 33 9350 | |
| 481 | + | S. B. 162 | |
| 450 | 482 | - 18 - | |
| 451 | - | urban county within a three-mile radius of the existing facility so long as the facility does428 | |
| 452 | - | not propose to offer any new or expanded clinical health services at the new location;429 | |
| 453 | - | (28) Facilities which are devoted to the provision of treatment and rehabilitative care for430 | |
| 454 | - | periods continuing for 24 hours or longer for persons who have traumatic brain injury,431 | |
| 455 | - | as defined in Code Section 37-3-1;432 | |
| 456 | - | (29) Capital expenditures for a project otherwise requiring a special health care services433 | |
| 457 | - | license if those expenditures are for a project to remodel, renovate, replace, or any434 | |
| 458 | - | combination thereof, a medical-surgical hospital and:435 | |
| 459 | - | (A) That hospital:436 | |
| 460 | - | (i) Has a bed capacity of not more than 50 beds;437 | |
| 461 | - | (ii) Is located in a county in which no other medical-surgical hospital is located;438 | |
| 462 | - | (iii) Has at any time been designated as a disproportionate share hospital by the439 | |
| 463 | - | department; and440 | |
| 464 | - | (iv) Has at least 45 percent of its patient revenues derived from medicare, Medicaid,441 | |
| 465 | - | or any combination thereof, for the immediately preceding three years; and442 | |
| 466 | - | (B) That project:443 | |
| 467 | - | (i) Does not result in any of the following:444 | |
| 468 | - | (I) The offering of any new clinical health services;445 | |
| 469 | - | (II) Any increase in bed capacity;446 | |
| 470 | - | (III) Any redistribution of existing beds among existing clinical health services; or447 | |
| 471 | - | (IV) Any increase in capacity of existing clinical health services;448 | |
| 472 | - | (ii) Has at least 80 percent of its capital expenditures financed by the proceeds of a449 | |
| 473 | - | special purpose county sales and use tax imposed pursuant to Article 3 of Chapter 8450 | |
| 474 | - | of Title 48; and451 | |
| 475 | - | (iii) Is located within a three-mile radius of and within the same county as the452 | |
| 476 | - | hospital's existing facility;453 23 LC 33 9433S | |
| 483 | + | (i) The state health plan or the rules establishing considerations, standards, or similar | |
| 484 | + | 432 | |
| 485 | + | criteria for the grant or denial of a certificate of need pursuant to Code Section 31-6-42433 | |
| 486 | + | shall not apply to any application for a certificate of need as to which, prior to the effective434 | |
| 487 | + | date of such plan or rules, respectively, the evidence has been closed following a full435 | |
| 488 | + | evidentiary hearing before a hearing officer.436 | |
| 489 | + | (j) This Code section shall apply only to rules adopted pursuant to this chapter.437 | |
| 490 | + | ARTICLE 3438 | |
| 491 | + | 31-6-40.439 | |
| 492 | + | (a) On and after July 1, 2008, any new institutional health service shall be required to440 | |
| 493 | + | obtain a certificate of need pursuant to this chapter. New institutional health services441 | |
| 494 | + | include:442 | |
| 495 | + | (1) The construction, development, or other establishment of a new, expanded, or443 | |
| 496 | + | relocated health care facility, except as otherwise provided in Code Section 31-6-47;444 | |
| 497 | + | (2) Any expenditure by or on behalf of a health care facility in excess of $10 million | |
| 498 | + | 445 | |
| 499 | + | which, under generally accepted accounting principles consistently applied, is a capital446 | |
| 500 | + | expenditure, except expenditures for acquisition of an existing health care facility. The447 | |
| 501 | + | dollar amounts specified in this paragraph and in paragraph (14) of Code Section 31-6-2448 | |
| 502 | + | shall be adjusted annually by an amount calculated by multiplying such dollar amounts449 | |
| 503 | + | (as adjusted for the preceding year) by the annual percentage of change in the composite450 | |
| 504 | + | index of construction material prices, or its successor or appropriate replacement index,451 | |
| 505 | + | if any, published by the United States Department of Commerce for the preceding452 | |
| 506 | + | calendar year, commencing on July 1, 2019, and on each anniversary thereafter of453 | |
| 507 | + | publication of the index. The department shall immediately institute rule-making454 | |
| 508 | + | procedures to adopt such adjusted dollar amounts. In calculating the dollar amounts of455 | |
| 509 | + | a proposed project for purposes of this paragraph and paragraph (14) of Code Section456 23 LC 33 9350 | |
| 510 | + | S. B. 162 | |
| 477 | 511 | - 19 - | |
| 478 | - | (30) The renovation, remodeling, refurbishment, or upgrading of a health care facility,454 | |
| 479 | - | so long as the project does not result in any of the following:455 | |
| 480 | - | (A) The offering of any new or expanded clinical health services;456 | |
| 481 | - | (B) Any increase in inpatient bed capacity;457 | |
| 482 | - | (C) Any redistribution of existing beds among existing clinical health services; or458 | |
| 483 | - | (D) A capital expenditure exceeding the threshold contained in paragraph (7) of Code459 | |
| 484 | - | Section 31-6A-1;460 | |
| 485 | - | (31) Other than for equipment used to provide positron emission tomography (PET)461 | |
| 486 | - | services, the acquisition of diagnostic, therapeutic, or other imaging equipment with a462 | |
| 487 | - | value of $3 million or less, by or on behalf of:463 | |
| 488 | - | (A) A hospital; or464 | |
| 489 | - | (B) An individual private physician or single group practice of physicians exclusively465 | |
| 490 | - | for use on patients of such private physician or single group practice of physicians and466 | |
| 491 | - | such private physician or member of such single group practice of physicians is467 | |
| 492 | - | physically present at the practice location where the diagnostic or other imaging468 | |
| 493 | - | equipment is located at least 75 percent of the time that the equipment is in use.469 | |
| 494 | - | The amount specified in this paragraph shall not include build-out costs, as defined by the470 | |
| 495 | - | department, but shall include all functionally related equipment, software, and any471 | |
| 496 | - | warranty and services contract costs for the first five years. The acquisition of one or more472 | |
| 497 | - | items of functionally related diagnostic or therapeutic equipment shall be considered as one473 | |
| 498 | - | project. The dollar amount specified in this paragraph and in paragraph (10) of this474 | |
| 499 | - | subsection shall be adjusted annually by an amount calculated by multiplying such dollar475 | |
| 500 | - | amounts (as adjusted for the preceding year) by the annual percentage of change in the476 | |
| 501 | - | consumer price index, or its successor or appropriate replacement index, if any, published477 | |
| 502 | - | by the United States Department of Labor for the preceding calendar year, commencing on478 | |
| 503 | - | July 1, 2010; and479 | |
| 504 | - | (32) A capital expenditure by a hospital at such hospital's primary campus for:480 23 LC 33 9433S | |
| 512 | + | 31-6-2, the costs of all items subject to review by this chapter and items not subject to457 | |
| 513 | + | review by this chapter associated with and simultaneously developed or proposed with458 | |
| 514 | + | the project shall be counted, except for the expenditure or commitment of or incurring an459 | |
| 515 | + | obligation for the expenditure of funds to develop certificate of need applications, studies,460 | |
| 516 | + | reports, schematics, preliminary plans and specifications or working drawings, or to461 | |
| 517 | + | acquire sites;462 | |
| 518 | + | (3) The purchase or lease by or on behalf of a health care facility or a diagnostic,463 | |
| 519 | + | treatment, or rehabilitation center of diagnostic or therapeutic equipment, except as464 | |
| 520 | + | otherwise provided in Code Section 31-6-47;465 | |
| 521 | + | (4)(2) Any increase in the bed capacity of a health care facility except as provided in466 | |
| 522 | + | Code Section 31-6-47; and467 | |
| 523 | + | (5)(3) Clinical health services which are offered in or through a health care facility,468 | |
| 524 | + | which were not offered on a regular basis in or through such health care facility within469 | |
| 525 | + | the 12 month period prior to the time such services would be offered;.470 | |
| 526 | + | (6) Any conversion or upgrading of any general acute care hospital to a specialty hospital471 | |
| 527 | + | or of a facility such that it is converted from a type of facility not covered by this chapter472 | |
| 528 | + | to any of the types of health care facilities which are covered by this chapter;473 | |
| 529 | + | (7) Clinical health services which are offered in or through a diagnostic, treatment, or474 | |
| 530 | + | rehabilitation center which were not offered on a regular basis in or through that center475 | |
| 531 | + | within the 12 month period prior to the time such services would be offered, but only if476 | |
| 532 | + | the clinical health services are any of the following:477 | |
| 533 | + | (A) Radiation therapy;478 | |
| 534 | + | (B) Biliary lithotripsy;479 | |
| 535 | + | (C) Surgery in an operating room environment, including but not limited to ambulatory480 | |
| 536 | + | surgery; and481 | |
| 537 | + | (D) Cardiac catheterization; and482 | |
| 538 | + | (8) The conversion of a destination cancer hospital to a general cancer hospital.483 23 LC 33 9350 | |
| 539 | + | S. B. 162 | |
| 505 | 540 | - 20 - | |
| 506 | - | (A) The expansion or addition of the following clinical health services: operating481 | |
| 507 | - | rooms, other than dedicated outpatient operating rooms; medical-surgical services;482 | |
| 508 | - | gynecology; procedure rooms; intensive care; pharmaceutical services; pediatrics;483 | |
| 509 | - | cardiac care; or other general hospital services; provided, however, that such484 | |
| 510 | - | expenditure does not include the expansion or addition of inpatient beds or the485 | |
| 511 | - | conversion of one type of inpatient bed to another type of inpatient bed; or486 | |
| 512 | - | (B) The movement of clinical health services from one location on the hospital's487 | |
| 513 | - | primary campus to another location on such hospital's primary campus.488 | |
| 514 | - | 31-6A-4.489 | |
| 515 | - | (a) An application for a special health care services license shall include:490 | |
| 516 | - | (1) Certification that the applicant is licensed or will seek licensure under Chapter 7 of491 | |
| 517 | - | this title, if subject to the requirements of such chapter;492 | |
| 518 | - | (2) Certification that the applicant has notified the public of the intent to file the493 | |
| 519 | - | application with a description of the facility or special health care services to be licensed494 | |
| 520 | - | by publishing a notice in a newspaper of general circulation covering the area where the495 | |
| 521 | - | service is to be located in at least two separate issues of the newspaper no less than ten496 | |
| 522 | - | business days prior to the filing of the application;497 | |
| 523 | - | (3) Certification that the applicant has given written notice of the intent to file the498 | |
| 524 | - | application by registered mail no less than ten business days prior to the filing of the499 | |
| 525 | - | application to the chief executive officer of each existing facility that:500 | |
| 526 | - | (A) Is located within a ten-mile radius of the applicant's proposed new facility or501 | |
| 527 | - | services;502 | |
| 528 | - | (B) Is the same type of facility or offers the same type of services as the proposed new503 | |
| 529 | - | facility or services; and504 | |
| 530 | - | (C) Has a special health care services license issued pursuant to this chapter; and505 | |
| 531 | - | (4) Any other information deemed necessary by the department.506 23 LC 33 9433S | |
| 541 | + | (b) Any person proposing to develop or offer a new institutional health service or health | |
| 542 | + | 484 | |
| 543 | + | care facility shall, before commencing such activity, submit a letter of intent and an485 | |
| 544 | + | application to the department and obtain a certificate of need in the manner provided in this486 | |
| 545 | + | chapter unless such activity is excluded from the scope of this chapter.487 | |
| 546 | + | (c)(1) | |
| 547 | + | Any person who had a valid exemption granted or approved by the former Health488 | |
| 548 | + | Planning Agency or the department prior to July 1, 2008, shall not be required to obtain489 | |
| 549 | + | a certificate of need in order to continue to offer those previously offered services.490 | |
| 550 | + | (2) Any facility offering ambulatory surgery pursuant to the exclusion designated on491 | |
| 551 | + | June 30, 2008, as division (14)(G)(iii) of Code Section 31-6-2; any diagnostic, treatment,492 | |
| 552 | + | or rehabilitation center offering diagnostic imaging or other imaging services in operation493 | |
| 553 | + | and exempt prior to July 1, 2008; or any facility operating pursuant to a letter of494 | |
| 554 | + | nonreviewability and offering diagnostic imaging services prior to July 1, 2008, shall:495 | |
| 555 | + | (A) Provide annual reports in the same manner and in accordance with Code Section496 | |
| 556 | + | 31-6-70; and497 | |
| 557 | + | (B)(i) Provide care to Medicaid beneficiaries and, if the facility provides medical care498 | |
| 558 | + | and treatment to children, to PeachCare for Kids beneficiaries and provide499 | |
| 559 | + | uncompensated indigent and charity care in an amount equal to or greater than 2500 | |
| 560 | + | percent of its adjusted gross revenue; or501 | |
| 561 | + | (ii) If the facility is not a participant in Medicaid or the PeachCare for Kids Program,502 | |
| 562 | + | provide uncompensated care for Medicaid beneficiaries and, if the facility provides503 | |
| 563 | + | medical care and treatment to children, for PeachCare for Kids beneficiaries,504 | |
| 564 | + | uncompensated indigent and charity care, or both in an amount equal to or greater505 | |
| 565 | + | than 4 percent of its adjusted gross revenue if it:506 | |
| 566 | + | (I) Makes a capital expenditure associated with the construction, development,507 | |
| 567 | + | expansion, or other establishment of a clinical health service or the acquisition or508 | |
| 568 | + | replacement of diagnostic or therapeutic equipment with a value in excess of509 | |
| 569 | + | $800,000.00 over a two-year period;510 23 LC 33 9350 | |
| 570 | + | S. B. 162 | |
| 532 | 571 | - 21 - | |
| 533 | - | (b) In addition to publication on the department's website, any application for a special507 | |
| 534 | - | health care services license shall be available for inspection and copying by any person508 | |
| 535 | - | immediately upon it being filed.509 | |
| 536 | - | (c) Any complete application for a special health care services license shall be approved510 | |
| 537 | - | by the department within 45 days of the filing of such application unless a timely objection511 | |
| 538 | - | in writing to such application is received by the department in accordance with512 | |
| 539 | - | subsection (a) of Code Section 31-6A-5.513 | |
| 540 | - | (d) No application for a special health care services license shall be considered if the514 | |
| 541 | - | applicant or any affiliate organization of the applicant has closed a health care facility515 | |
| 542 | - | under their ownership or reduced or ceased to provide health care services by more than516 | |
| 543 | - | 25 percent at a facility under their or an affiliate organization's ownership within the517 | |
| 544 | - | previous ten years.518 | |
| 545 | - | 31-6A-5.519 | |
| 546 | - | (a) A written objection to an application for a special health care services license may be520 | |
| 547 | - | submitted within 30 days of the filing of such application with the department, on the521 | |
| 548 | - | grounds that the application is not in the public interest of the community, only by an522 | |
| 549 | - | existing facility that:523 | |
| 550 | - | (1) Is located within a 35 mile radius of the applicant's proposed new facility; and524 | |
| 551 | - | (2) Has not closed a health care facility under their or an affiliate organization's525 | |
| 552 | - | ownership or reduced or ceased to provide health care services by more than 25 percent526 | |
| 553 | - | at a facility under their or an affiliate organization's ownership within the previous ten527 | |
| 554 | - | years.528 | |
| 555 | - | (b) No later than 30 days of receipt of a timely written objection pursuant to subsection (a)529 | |
| 556 | - | of this Code section, the commissioner shall conduct a public interest review and make a530 | |
| 557 | - | written determination as to whether the application is in the public interest of the531 | |
| 558 | - | community, taking into consideration any material adverse impact on the objecting party532 23 LC 33 9433S | |
| 572 | + | (II) Builds a new operating room; or511 | |
| 573 | + | (III) Chooses to relocate in accordance with Code Section 31-6-47.512 | |
| 574 | + | Noncompliance with any condition of this paragraph shall result in a monetary penalty513 | |
| 575 | + | in the amount of the difference between the services which the center is required to514 | |
| 576 | + | provide and the amount actually provided and may be subject to revocation of its515 | |
| 577 | + | exemption status by the department for repeated failure to pay any fees or moneys due516 | |
| 578 | + | to the department or for repeated failure to produce data as required by Code Section517 | |
| 579 | + | 31-6-70 after notice to the exemption holder and a fair hearing pursuant to Chapter 13 of518 | |
| 580 | + | Title 50, the 'Georgia Administrative Procedure Act.' The dollar amount specified in this519 | |
| 581 | + | paragraph shall be adjusted annually by an amount calculated by multiplying such dollar520 | |
| 582 | + | amount (as adjusted for the preceding year) by the annual percentage of change in the521 | |
| 583 | + | consumer price index, or its successor or appropriate replacement index, if any, published522 | |
| 584 | + | by the United States Department of Labor for the preceding calendar year, commencing523 | |
| 585 | + | on July 1, 2009. In calculating the dollar amounts of a proposed project for the purposes524 | |
| 586 | + | of this paragraph, the costs of all items subject to review by this chapter and items not525 | |
| 587 | + | subject to review by this chapter associated with and simultaneously developed or526 | |
| 588 | + | proposed with the project shall be counted, except for the expenditure or commitment of527 | |
| 589 | + | or incurring an obligation for the expenditure of funds to develop certificate of need528 | |
| 590 | + | applications, studies, reports, schematics, preliminary plans and specifications or working529 | |
| 591 | + | drawings, or to acquire sites. Subparagraph (B) of this paragraph shall not apply to530 | |
| 592 | + | facilities offering ophthalmic ambulatory surgery pursuant to the exclusion designated531 | |
| 593 | + | on June 30, 2008, as division (14)(G)(iii) of Code Section 31-6-2 that are owned by532 | |
| 594 | + | physicians in the practice of ophthalmology.533 | |
| 595 | + | (d) A certificate of need issued to a destination cancer hospital shall authorize the beds and534 | |
| 596 | + | all new institutional health services of such destination cancer hospital. As used in this535 | |
| 597 | + | subsection, the term 'new institutional health service' shall have the same meaning provided536 | |
| 598 | + | for in subsection (a) of this Code section. A certificate of need shall only be issued to a537 23 LC 33 9350 | |
| 599 | + | S. B. 162 | |
| 559 | 600 | - 22 - | |
| 560 | - | or parties, unique health care needs of the community (not based on a numerical need533 | |
| 561 | - | formula), atypical barriers or factors, whether the new special health care services would534 | |
| 562 | - | foster competition or make services less costly or more accessible, and whether the535 | |
| 563 | - | applicant performs or proposes to perform activities outside of inpatient or outpatient care536 | |
| 564 | - | in the community for underserved populations. The commissioner may not deny an537 | |
| 565 | - | application based on an objection unless the objecting party shows by clear and convincing538 | |
| 566 | - | evidence that the project does not meet the criteria set forth in this subsection.539 | |
| 567 | - | (c) If the special health care services license is granted by the department over a timely540 | |
| 568 | - | objection, the person who objected shall have a right to request a fair hearing pursuant to541 | |
| 569 | - | Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act.'542 | |
| 570 | - | (d) If the special health care services license is denied by the department after a timely543 | |
| 571 | - | objection, the applicant shall have a right to request a fair hearing pursuant to Chapter 13544 | |
| 572 | - | of Title 50, the 'Georgia Administrative Procedure Act.'545 | |
| 573 | - | (e) Any party to the initial administrative appeal hearing, excluding the department, may546 | |
| 574 | - | seek judicial review of the final decision in accordance with the method set forth in547 | |
| 575 | - | Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act.'548 | |
| 576 | - | 31-6A-6.549 | |
| 577 | - | (a) As a condition for special health care services licenses issued on and after550 | |
| 578 | - | January 1, 2024, the department shall require that an applicant or licensee agrees:551 | |
| 579 | - | (1) To provide uncompensated indigent or charity care in an amount which meets or552 | |
| 580 | - | exceeds the percentage of such applicant's adjusted gross revenues equivalent to:553 | |
| 581 | - | (A) The state-wide average of net uncompensated indigent and charity care provided554 | |
| 582 | - | based on the previous two most recent years if a nonprofit entity; or555 | |
| 583 | - | (B) The state-wide average of net uncompensated indigent and charity care provided556 | |
| 584 | - | based on the previous two most recent years less 3 percent if a for profit entity; and557 23 LC 33 9433S | |
| 601 | + | destination cancer hospital that locates itself and all affiliated facilities within 25 miles of538 | |
| 602 | + | a commercial airport in this state with five or more runways. Such destination cancer539 | |
| 603 | + | hospital shall not be required to apply for or obtain additional certificates of need for new540 | |
| 604 | + | institutional health services related to the treatment of cancer patients, and such new541 | |
| 605 | + | institutional health services related to the treatment of cancer patients offered by the542 | |
| 606 | + | destination cancer hospital shall not be reviewed under any service-specific need543 | |
| 607 | + | methodology or rules except for those promulgated by the department for destination544 | |
| 608 | + | cancer hospitals. After commencing operations, in order to add an additional new545 | |
| 609 | + | institutional health service, a destination cancer hospital shall apply for and obtain an546 | |
| 610 | + | additional certificate of need under the applicable statutory provisions and any rules547 | |
| 611 | + | promulgated by the department for destination cancer hospitals, and such applications shall548 | |
| 612 | + | only be granted if the patient base of such destination cancer hospital is composed of at549 | |
| 613 | + | least 65 percent of out-of-state patients for two consecutive years. The department may550 | |
| 614 | + | apply rules for a destination cancer hospital only for those services that the department551 | |
| 615 | + | determines are to be used by the destination cancer hospital in connection with the552 | |
| 616 | + | treatment of cancer. In no case shall destination cancer hospital specific rules be used in553 | |
| 617 | + | the case of an application for open heart surgery, perinatal services, cardiac catheterization,554 | |
| 618 | + | and other services deemed by the department to be not reasonably related to the diagnosis555 | |
| 619 | + | and treatment of cancer; provided, however, that the department shall apply the destination556 | |
| 620 | + | cancer hospital specific rules if a destination cancer hospital applies for services and557 | |
| 621 | + | equipment required for it to meet federal or state laws applicable to a hospital. If such558 | |
| 622 | + | destination cancer hospital cannot show a patient base of a minimum of 65 percent from559 | |
| 623 | + | outside of this state, then its application for any new institutional health service shall be560 | |
| 624 | + | evaluated under the specific statutes and rules applicable to that particular service. If such561 | |
| 625 | + | destination cancer hospital applies for a certificate of need to add an additional new562 | |
| 626 | + | institutional health service before commencing operations or completing two consecutive563 | |
| 627 | + | years of operation, such applicant may rely on historical data from its affiliated entities, as564 23 LC 33 9350 | |
| 628 | + | S. B. 162 | |
| 585 | 629 | - 23 - | |
| 586 | - | (2) | |
| 587 | - | ||
| 588 | - | ||
| 589 | - | ||
| 590 | - | ||
| 591 | - | any | |
| 592 | - | ||
| 593 | - | ||
| 594 | - | ||
| 595 | - | ||
| 596 | - | ||
| 597 | - | ||
| 598 | - | ||
| 599 | - | health care | |
| 600 | - | ||
| 601 | - | ||
| 602 | - | ||
| 603 | - | ||
| 604 | - | by a | |
| 605 | - | ||
| 606 | - | ||
| 607 | - | ||
| 608 | - | ||
| 609 | - | ||
| 610 | - | ||
| 611 | - | ||
| 630 | + | set forth in paragraph (2) of subsection (b.1) of Code Section 31-6-42. Because destination565 | |
| 631 | + | cancer hospitals provide services primarily to out-of-state residents, the number of beds,566 | |
| 632 | + | services, and equipment destination cancer hospitals use shall not be counted as part of the567 | |
| 633 | + | department's inventory when determining the need for those items by other providers. No568 | |
| 634 | + | person shall be issued more than one certificate of need for a destination cancer hospital.569 | |
| 635 | + | Nothing in this Code section shall in any way require a destination cancer hospital to obtain570 | |
| 636 | + | a certificate of need for any purpose that is otherwise exempt from the certificate of need571 | |
| 637 | + | requirement. Beginning January 1, 2010, the department shall not accept any application572 | |
| 638 | + | for a certificate of need for a new destination cancer hospital; provided, however, all other573 | |
| 639 | + | provisions regarding the upgrading, replacing, or purchasing of diagnostic or therapeutic574 | |
| 640 | + | equipment shall be applicable to an existing destination cancer hospital.575 | |
| 641 | + | (e) The commissioner shall be authorized, with the approval of the board, to place a576 | |
| 642 | + | temporary moratorium of up to six months on the issuance of certificates of need for new577 | |
| 643 | + | and emerging health care services. Any such moratorium placed shall be for the purpose578 | |
| 644 | + | of promulgating rules and regulations regarding such new and emerging health care579 | |
| 645 | + | services. A moratorium may be extended one time for an additional three months if580 | |
| 646 | + | circumstances warrant, as approved by the board. In the event that final rules and581 | |
| 647 | + | regulations are not promulgated within the time period allowed by the moratorium, any582 | |
| 648 | + | applications received by the department for a new and emerging health care service shall583 | |
| 649 | + | be reviewed under existing general statutes and regulations relating to certificates of need.584 | |
| 650 | + | 31-6-40.1.585 | |
| 651 | + | (a) Any person who acquires a health care facility by stock or asset purchase, merger,586 | |
| 652 | + | consolidation, or other lawful means shall notify the department of such acquisition, the587 | |
| 653 | + | date thereof, and the name and address of the acquiring person. Such notification shall be588 | |
| 654 | + | made in writing to the department within 45 days following the acquisition and the589 23 LC 33 9350 | |
| 655 | + | S. B. 162 | |
| 612 | 656 | - 24 - | |
| 613 | - | (e) The department may withhold all or any portion of disproportionate share hospital584 | |
| 614 | - | funds to any hospital that is subject to the requirements contained in paragraph (1) of585 | |
| 615 | - | subsection (a) of this Code section that fails to meet the minimum indigent and charity care586 | |
| 616 | - | requirements for two consecutive years.587 | |
| 617 | - | 31-6A-7.588 | |
| 618 | - | (a) Each health care facility in this state that is required by the department to provide589 | |
| 619 | - | uncompensated indigent or charity care pursuant to Code Section 31-6A-6 shall submit an590 | |
| 620 | - | annual report of certain health care information to the department. The report shall be due591 | |
| 621 | - | on the last day of January and shall cover the 12 month period preceding each such592 | |
| 622 | - | calendar year.593 | |
| 623 | - | (b) The annual report required under subsection (a) of this Code section shall contain the594 | |
| 624 | - | following information:595 | |
| 625 | - | (1) Total gross revenues;596 | |
| 626 | - | (2) Bad debts;597 | |
| 627 | - | (3) Amounts of free care extended, excluding bad debts;598 | |
| 628 | - | (4) Contractual adjustments;599 | |
| 629 | - | (5) Amounts of care provided under a Hill-Burton commitment;600 | |
| 630 | - | (6) Amounts of charity care provided to indigent persons;601 | |
| 631 | - | (7) Amounts of outside sources of funding from governmental entities, philanthropic602 | |
| 632 | - | groups, or any other source, including the proportion of any such funding dedicated to the603 | |
| 633 | - | care of indigent persons; and604 | |
| 634 | - | (8) For cases involving indigent persons:605 | |
| 635 | - | (A) The number of persons treated;606 | |
| 636 | - | (B) The number of inpatients and outpatients;607 | |
| 637 | - | (C) Total patient days;608 | |
| 638 | - | (D) The number of patients categorized by county of residence; and609 23 LC 33 9433S | |
| 657 | + | acquiring person may be fined by the department in the amount of $500.00 for each day | |
| 658 | + | 590 | |
| 659 | + | that such notification is late. Such fine shall be paid into the state treasury.591 | |
| 660 | + | (b) The department may limit the time periods during which it will accept applications for592 | |
| 661 | + | the following health care facilities:593 | |
| 662 | + | (1) Skilled nursing facilities;594 | |
| 663 | + | (2) Intermediate care facilities; and595 | |
| 664 | + | (3) Home health agencies,596 | |
| 665 | + | to only such times after the department has determined there is an unmet need for such597 | |
| 666 | + | facilities. The department shall make a determination as to whether or not there is an598 | |
| 667 | + | unmet need for each type of facility at least every six months and shall notify those599 | |
| 668 | + | requesting such notification of that determination.600 | |
| 669 | + | (c) The department may require that any applicant for a certificate of need agree to provide601 | |
| 670 | + | a specified amount of clinical health services to indigent patients as a condition for the602 | |
| 671 | + | grant of a certificate of need; provided, however, that each facility granted a certificate of | |
| 672 | + | 603 | |
| 673 | + | need by the department as a destination cancer hospital shall be required to provide604 | |
| 674 | + | uncompensated indigent or charity care for residents of Georgia which meets or exceeds605 | |
| 675 | + | 3 percent of such destination cancer hospital's adjusted gross revenues and provide care to606 | |
| 676 | + | Medicaid beneficiaries. A grantee or successor in interest of a certificate of need or an607 | |
| 677 | + | authorization to operate under this chapter which violates such an agreement or violates608 | |
| 678 | + | any conditions imposed by the department relating to such services, whether made before609 | |
| 679 | + | or after July 1, 2008, shall be liable to the department for a monetary penalty in the amount610 | |
| 680 | + | of the difference between the amount of services so agreed to be provided and the amount611 | |
| 681 | + | actually provided and may be subject to revocation of its certificate of need, in whole or612 | |
| 682 | + | in part, by the department pursuant to Code Section 31-6-45. Any penalty so recovered613 | |
| 683 | + | shall be paid into the state treasury.614 | |
| 684 | + | (c.1)(1) A destination cancer hospital that does not meet an annual patient base615 | |
| 685 | + | composed of a minimum of 65 percent of patients who reside outside this state in a616 23 LC 33 9350 | |
| 686 | + | S. B. 162 | |
| 639 | 687 | - 25 - | |
| 640 | - | (E) The indigent care costs incurred by the health care facility by county of residence.610 | |
| 641 | - | As used in this subsection, the term 'indigent persons' means persons having as a maximum611 | |
| 642 | - | allowable income level an amount corresponding to 125 percent of the federal poverty612 | |
| 643 | - | guideline.613 | |
| 644 | - | (c) The department shall provide a form for the report required by this Code section and614 | |
| 645 | - | may provide in said form for further categorical divisions of the information listed in615 | |
| 646 | - | subsection (b) of this Code section.616 | |
| 647 | - | (d)(1) In the event the department does not receive an annual report from an institution,617 | |
| 648 | - | on or before the date such report was due or receives a timely but incomplete report, the618 | |
| 649 | - | department shall notify the institution regarding the deficiencies and shall be authorized619 | |
| 650 | - | to fine such institution an amount not to exceed $500.00 per day for every day up to 30620 | |
| 651 | - | days and $1,000.00 per day for every day over 30 days of such untimely or deficient621 | |
| 652 | - | report. Any fine so recovered shall be dedicated and deposited by the department into the622 | |
| 653 | - | Indigent Care Trust Fund created pursuant to Code Section 31-8-152 for the purposes set623 | |
| 654 | - | out in Code Section 31-8-154, including expanding Medicaid eligibility and services;624 | |
| 655 | - | programs to support rural and other health care providers, primarily hospitals, who serve625 | |
| 656 | - | the medically indigent; and for primary health care programs for medically indigent626 | |
| 657 | - | citizens and children of this state.627 | |
| 658 | - | (2) In the event the department does not receive an annual report from an institution628 | |
| 659 | - | within 180 days following the date such report was due or receives a timely but629 | |
| 660 | - | incomplete report which is not completed within such 180 days, the department shall be630 | |
| 661 | - | authorized to revoke such institution's permit in accordance with Code Section 31-7-4.631 | |
| 662 | - | 31-6A-8.632 | |
| 663 | - | (a) The department may revoke a special health care services license, in whole or in part,633 | |
| 664 | - | after notice to the holder of the special health care services license and a fair hearing634 23 LC 33 9433S | |
| 688 | + | calendar year shall be fined $2 million for the first year of noncompliance, $4 million for617 | |
| 689 | + | the second consecutive year of noncompliance, and $6 million for the third consecutive618 | |
| 690 | + | year of noncompliance. Such fine amount shall reset to $2 million after any year of619 | |
| 691 | + | compliance. In the event that a destination cancer hospital does not meet an annual620 | |
| 692 | + | patient base composed of a minimum of 65 percent of patients who reside outside this621 | |
| 693 | + | state for three calendar years in any five-year period, such hospital shall be fined an622 | |
| 694 | + | additional amount of $8 million. It is the intent of the General Assembly that all revenues623 | |
| 695 | + | collected from any such fines shall be dedicated and deposited by the department into the624 | |
| 696 | + | Indigent Care Trust Fund created pursuant to Code Section 31-8-152.625 | |
| 697 | + | (2) In the event a certificate of need for a destination cancer hospital is revoked pursuant626 | |
| 698 | + | to this subsection, such hospital shall be subject to fines pursuant to subsection (c) of627 | |
| 699 | + | Code Section 31-6-45 for operating without a certificate of need.628 | |
| 700 | + | (3) In addition to the annual report required pursuant to Code Section 31-6-70, a629 | |
| 701 | + | destination cancer hospital shall submit an annual statement, in accordance with630 | |
| 702 | + | timeframes and a format specified by the department, affirming that the hospital has met631 | |
| 703 | + | an annual patient base composed of a minimum of 65 percent of patients who reside632 | |
| 704 | + | outside this state. The chief executive officer of the destination cancer hospital shall633 | |
| 705 | + | certify under penalties of perjury that the statement as prepared accurately reflects the634 | |
| 706 | + | composition of the annual patient base. The department shall have the authority to635 | |
| 707 | + | inspect any books, records, papers, or other information pursuant to subsection (e) of636 | |
| 708 | + | Code Section 31-6-45 of the destination cancer hospital to confirm the information637 | |
| 709 | + | provided on such statement or any other information required of the destination cancer638 | |
| 710 | + | hospital. Nothing in this paragraph shall be construed to require the release of any639 | |
| 711 | + | information which would violate the Health Insurance Portability and Accountability Act640 | |
| 712 | + | of 1996, P.L. 104-191.641 | |
| 713 | + | (d) Penalties authorized under this Code section shall be subject to the same notices and642 | |
| 714 | + | hearing for the levy of fines under Code Section 31-6-45.643 23 LC 33 9350 | |
| 715 | + | S. B. 162 | |
| 665 | 716 | - 26 - | |
| 666 | - | pursuant to Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act,' for the635 | |
| 667 | - | following reasons:636 | |
| 668 | - | (1) Failure to comply with the provisions of this chapter;637 | |
| 669 | - | (2) The intentional provision of false information to the department by a licensee in that638 | |
| 670 | - | licensee's application;639 | |
| 671 | - | (3) Repeated failure to pay any fines or moneys due to the department;640 | |
| 672 | - | (4) Failure to maintain minimum quality of care standards that may be established by the641 | |
| 673 | - | department;642 | |
| 674 | - | (5) Failure to participate as a provider of medical assistance for Medicaid purposes or643 | |
| 675 | - | the PeachCare for Kids Program, if applicable; or644 | |
| 676 | - | (6) The failure to submit a timely or complete report within 180 days following the date645 | |
| 677 | - | the report is due pursuant to Code Section 31-6A-7.646 | |
| 678 | - | (b) In the event that a new special health care service is knowingly offered or developed647 | |
| 679 | - | without having obtained a special health care services license as required by this chapter,648 | |
| 680 | - | or the special health care services license for such service is revoked according to the649 | |
| 681 | - | provisions of this Code section, a facility or applicant may be fined an amount of $5,000.00650 | |
| 682 | - | per day up to 30 days, $10,000.00 per day from 31 days through 60 days, and $25,000.00651 | |
| 683 | - | per day after 60 days for each day that the violation of this chapter has existed and652 | |
| 684 | - | knowingly and willingly continues; provided, however, that the expenditure or653 | |
| 685 | - | commitment of or incurring an obligation for the expenditure of funds to take or perform654 | |
| 686 | - | actions not subject to this chapter or to acquire, develop, or prepare a health care facility655 | |
| 687 | - | site for which a special health care services license application is denied shall not be a656 | |
| 688 | - | violation of this chapter and shall not be subject to such a fine. The commissioner shall657 | |
| 689 | - | determine, after notice and a hearing, whether the fines provided in this Code section shall658 | |
| 690 | - | be levied. Any fine so recovered shall be dedicated and deposited by the department into659 | |
| 691 | - | the Indigent Care Trust Fund created pursuant to Code Section 31-8-152 for the purposes660 | |
| 692 | - | set out in Code Section 31-8-154, including expanding Medicaid eligibility and services;661 23 LC 33 9433S | |
| 717 | + | 31-6-40.2.644 | |
| 718 | + | (a) As used in this Code section only, the term:645 | |
| 719 | + | (1) 'Certificate of need application' means an application for a certificate of need filed646 | |
| 720 | + | with the department, any amendments thereto, and any other written material relating to647 | |
| 721 | + | the application and filed by the applicant with the department.648 | |
| 722 | + | (2) 'First three years of operation' means the first three consecutive 12 month periods649 | |
| 723 | + | beginning on the first day of a new perinatal service's first full calendar month of650 | |
| 724 | + | operation.651 | |
| 725 | + | (3) 'First year of operation' means the first consecutive 12 month period beginning on the652 | |
| 726 | + | first day of a new perinatal service's first full calendar month of operation.653 | |
| 727 | + | (4) 'New perinatal service' means a perinatal service whose first year of operation ends654 | |
| 728 | + | after April 6, 1992.655 | |
| 729 | + | (5) 'Perinatal service' means obstetric and neonatal services relating to managing656 | |
| 730 | + | high-risk pregnancies, care for moderately ill newborns, care for all maternal and fetal657 | |
| 731 | + | complications either on site or by referral, and operation of neonatal intensive care units658 | |
| 732 | + | equipped to treat critically ill newborns; provided however, this shall not include basic659 | |
| 733 | + | perinatal services as defined in Code Section 31-6-2.660 | |
| 734 | + | (6) 'Year' means one of the three consecutive 12 month periods in a new perinatal661 | |
| 735 | + | service's first 36 months of operation.662 | |
| 736 | + | (b)(1) A new perinatal service shall provide uncompensated indigent or charity care in663 | |
| 737 | + | an amount which meets or exceeds the department's established minimum at the time the664 | |
| 738 | + | department issued the certificate of need approval for such service for each of the665 | |
| 739 | + | service's first three years of operation; provided, however, that if the certificate of need666 | |
| 740 | + | application under which a new perinatal service was approved included a commitment667 | |
| 741 | + | that uncompensated indigent or charity care would be provided in an amount greater than668 | |
| 742 | + | the established minimum for any time period described in the certificate of need669 | |
| 743 | + | application that falls completely within such new perinatal service's first three years of670 23 LC 33 9350 | |
| 744 | + | S. B. 162 | |
| 693 | 745 | - 27 - | |
| 694 | - | programs to support rural and other health care providers, primarily hospitals, who serve662 | |
| 695 | - | the medically indigent; and for primary health care programs for medically indigent663 | |
| 696 | - | citizens and children of this state.664 | |
| 697 | - | (c) In addition, for purposes of this Code section, the State of Georgia, acting by and665 | |
| 698 | - | through the department, or any other interested person, shall have standing in any court of666 | |
| 699 | - | competent jurisdiction to maintain an action for injunctive relief to enforce the provisions667 | |
| 700 | - | of this chapter.668 | |
| 701 | - | (d) The department shall have the authority to make public or private investigations or669 | |
| 702 | - | examinations inside or outside of this state to determine whether any provisions of this670 | |
| 703 | - | chapter or any other law, rule, regulation, or formal order relating to the provision of671 | |
| 704 | - | special health care services has been violated. Such investigations may be initiated at any672 | |
| 705 | - | time in the discretion of the department and may continue during the pendency of any673 | |
| 706 | - | action initiated by the department pursuant to this Code section. For the purpose of674 | |
| 707 | - | conducting any investigation or inspection pursuant to this subsection, the department shall675 | |
| 708 | - | have the authority, upon providing reasonable notice, to require the production of any676 | |
| 709 | - | books, records, papers, or other information related to any special health care services677 | |
| 710 | - | license issue.678 | |
| 711 | - | 31-6A-9.679 | |
| 712 | - | Any person who acquires a health care facility by stock or asset purchase, merger,680 | |
| 713 | - | consolidation, or other lawful means shall notify the department of such acquisition, the681 | |
| 714 | - | date thereof, and the name and address of the acquiring person. Such notification shall be682 | |
| 715 | - | made in writing to the department within 45 days following the acquisition and the683 | |
| 716 | - | acquiring person may be fined by the department in the amount of $500.00 for each day684 | |
| 717 | - | that such notification is late. Such fine shall be paid into the state treasury. Any fine so685 | |
| 718 | - | recovered shall be dedicated and deposited by the department into the Indigent Care Trust686 | |
| 719 | - | Fund created pursuant to Code Section 31-8-152 for the purposes set out in Code687 23 LC 33 9433S | |
| 746 | + | operation, such new perinatal service shall provide indigent or charity care in an amount671 | |
| 747 | + | which meets or exceeds the amount committed in the certificate of need application for672 | |
| 748 | + | each time period described in the certificate of need application that falls completely673 | |
| 749 | + | within the service's first three years of operation.674 | |
| 750 | + | (2) The department shall revoke the certificate of need and authority to operate of a new675 | |
| 751 | + | perinatal service if after notice to the grantee of the certificate or such grantee's676 | |
| 752 | + | successors, and after opportunity for a fair hearing pursuant to Chapter 13 of Title 50, the677 | |
| 753 | + | 'Georgia Administrative Procedure Act,' the department determines that such new678 | |
| 754 | + | perinatal service has failed to provide indigent or charity care in accordance with the679 | |
| 755 | + | requirements of paragraph (1) of this subsection and such failure is determined by the680 | |
| 756 | + | department to be for reasons substantially within the perinatal service provider's control.681 | |
| 757 | + | The department shall provide the requisite notice, conduct the fair hearing, if requested,682 | |
| 758 | + | and render its determination within 90 days after the end of the first year, or, if683 | |
| 759 | + | applicable, the first time period described in paragraph (1) of this subsection during684 | |
| 760 | + | which the new perinatal service fails to provide indigent or charity care in accordance685 | |
| 761 | + | with the requirements of paragraph (1) of this subsection. Revocation shall be effective686 | |
| 762 | + | 30 days after the date of the determination by the department that the requirements of687 | |
| 763 | + | paragraph (1) of this subsection have not been met.688 | |
| 764 | + | (c)(1) A new perinatal service shall achieve the standard number of births specified in689 | |
| 765 | + | the state health plan in effect at the time of the issuance of the certificate of need approval690 | |
| 766 | + | by the department in at least one year during its first three years of operation.691 | |
| 767 | + | (2) The department shall revoke the certificate of need and authority to operate of a new692 | |
| 768 | + | perinatal service if after notice to the grantee of the certificate of need or such grantee's693 | |
| 769 | + | successors, and after opportunity for a fair hearing pursuant to Chapter 13 of Title 50, the694 | |
| 770 | + | 'Georgia Administrative Procedure Act,' the department determines that such new695 | |
| 771 | + | perinatal service has failed to comply with the applicable requirements of paragraph (1)696 | |
| 772 | + | of this subsection and such failure is determined by the department to be for reasons697 23 LC 33 9350 | |
| 773 | + | S. B. 162 | |
| 720 | 774 | - 28 - | |
| 721 | - | Section 31-8-154, including expanding Medicaid eligibility and services; programs to688 | |
| 722 | - | support rural and other health care providers, primarily hospitals, who serve the medically689 | |
| 723 | - | indigent; and for primary health care programs for medically indigent citizens and children690 | |
| 724 | - | of this state.691 | |
| 725 | - | 31-6A-10.692 | |
| 726 | - | (a) Except as provided in subsection (c) of this Code section, on and after January 1, 2024,693 | |
| 727 | - | health care facilities, as defined in Code Section 31-6A-1, shall not be subject to the former694 | |
| 728 | - | provisions of Chapter 6 of this title, as such existed on December 31, 2023, and shall not695 | |
| 729 | - | be required to obtain or retain a certificate of need in order to operate, but all such valid696 | |
| 730 | - | certificates of need in existence on December 31, 2023, shall be converted by operation of697 | |
| 731 | - | law to special health care services licenses and all such license holders shall be subject to698 | |
| 732 | - | the provisions of this chapter on and after such date; provided, however, that such health699 | |
| 733 | - | care facilities shall not be subject to the requirements of Code Section 31-6A-6 but shall700 | |
| 734 | - | instead be subject to any conditions previously imposed by the department relating to701 | |
| 735 | - | indigent or charity care and participation as a Medicaid provider that were in effect on702 | |
| 736 | - | December 31, 2023, pursuant to the former provisions of Chapter 6 of this title, as such703 | |
| 737 | - | existed on December 31, 2023. The department may withhold all or any portion of704 | |
| 738 | - | disproportionate share hospital funds to any hospital exempt pursuant to this subsection705 | |
| 739 | - | that fails to meet any conditions previously imposed by the department relating to indigent706 | |
| 740 | - | and charity care for two consecutive years. In the event a health care facility operating707 | |
| 741 | - | pursuant to this subsection receives any modification of its special health care services708 | |
| 742 | - | license, it shall immediately become subject to the requirements contained in Code Section709 | |
| 743 | - | 31-6A-6 in lieu of the conditions previously imposed by the department relating to indigent710 | |
| 744 | - | or charity care and participation as a Medicaid provider or PeachCare for Kids Program711 | |
| 745 | - | provider that were in effect on December 31, 2023.712 23 LC 33 9433S | |
| 775 | + | substantially within the perinatal service provider's control. The department shall provide698 | |
| 776 | + | the requisite notice, conduct the fair hearing, if requested, and render its determination699 | |
| 777 | + | within 90 days after the end of the new perinatal service's first three years of operation.700 | |
| 778 | + | Revocation shall be effective 30 days after the date of the determination by the701 | |
| 779 | + | department that the requirements of this paragraph or paragraph (1) of this subsection702 | |
| 780 | + | have not been met.703 | |
| 781 | + | (d) Nothing contained in this Code section shall limit the department's authority to regulate704 | |
| 782 | + | perinatal services in ways or for time periods not addressed by the provisions of this Code705 | |
| 783 | + | section.706 | |
| 784 | + | 31-6-40.3.707 | |
| 785 | + | (a) On and after July 1, 2019, a destination cancer hospital may apply for a certificate of708 | |
| 786 | + | need to convert to a general cancer hospital in accordance with this Code section. A709 | |
| 787 | + | destination cancer hospital that elects to convert to a general cancer hospital shall notify710 | |
| 788 | + | the department in a form and manner established by the department.711 | |
| 789 | + | (b) The department shall establish a form and process for a destination cancer hospital to712 | |
| 790 | + | submit a certificate of need application to convert to a general cancer hospital; provided,713 | |
| 791 | + | however, that such a conversion shall not be subject to any of the considerations in Code714 | |
| 792 | + | Section 31-6-42 or service specific rules and shall not be subject to opposition or appeal715 | |
| 793 | + | by any other health care facilities. The department shall develop such form and guidance716 | |
| 794 | + | required by this subsection within 30 days of July 1, 2019. Upon its receipt of a complete717 | |
| 795 | + | application for a destination cancer hospital to convert to a general cancer hospital, the718 | |
| 796 | + | department shall issue such certificate of need within 60 days.719 | |
| 797 | + | (c) Upon the conversion of a destination cancer hospital to a general cancer hospital:720 | |
| 798 | + | (1) The general cancer hospital may continue to provide all institutional health care721 | |
| 799 | + | services and other services it provided as of the date of such conversion, including but not722 | |
| 800 | + | limited to inpatient beds, outpatient services, surgery, radiation therapy, imaging, and723 23 LC 33 9350 | |
| 801 | + | S. B. 162 | |
| 746 | 802 | - 29 - | |
| 747 | - | (b)(1) On and after January 1, 2024, any person who had a valid exemption from713 | |
| 748 | - | certificate of need requirements under the former provisions of Chapter 6 of this title, as714 | |
| 749 | - | such existed on December 31, 2023, shall not be required to obtain or retain a special715 | |
| 750 | - | health care services license under this chapter in order to operate, but any such valid716 | |
| 751 | - | exemption in existence on December 31, 2023, shall be converted by operation of law to717 | |
| 752 | - | an exemption to special health care services license requirements under this chapter but718 | |
| 753 | - | shall be subject to any conditions previously imposed pursuant to the former provisions719 | |
| 754 | - | of Chapter 6 of this title, as such existed on December 31, 2023.720 | |
| 755 | - | (2) In the event a person that is exempt pursuant to paragraph (1) of this subsection721 | |
| 756 | - | makes any modification to the special health care services it provides, it shall722 | |
| 757 | - | immediately become subject to the requirements contained in Code Section 31-6A-6 in723 | |
| 758 | - | lieu of the conditions previously imposed by the department relating to indigent or charity724 | |
| 759 | - | care and participation as a Medicaid provider or PeachCare for Kids Program provider725 | |
| 760 | - | that were in effect on December 31, 2023.726 | |
| 761 | - | (c)(1) On and after January 1, 2024, a destination cancer hospital that was granted a727 | |
| 762 | - | certificate of need pursuant to the former provisions of Chapter 6 of this title, as such728 | |
| 763 | - | existed on December 31, 2023, may convert to a hospital by notifying the department in729 | |
| 764 | - | writing as to the date of conversion. Upon such conversion, the hospital may continue730 | |
| 765 | - | to provide all institutional health services and other services it provided as of the date of731 | |
| 766 | - | such conversion, including, but not limited to, inpatient beds, outpatient services, surgery,732 | |
| 767 | - | radiation therapy, imaging, and positron emission tomography (PET) scanning, without733 | |
| 768 | - | any further approval from the department; provided, however, that upon such conversion,734 | |
| 769 | - | such hospital shall immediately become subject to the requirements of Code735 | |
| 770 | - | Section 31-6A-6. On and after the date of conversion, the hospital shall be classified as736 | |
| 771 | - | a hospital under this chapter and shall be subject to all requirements and conditions for737 | |
| 772 | - | any new special health care services license requirements, exemptions, and for all other738 | |
| 773 | - | purposes, except as otherwise provided herein.739 23 LC 33 9433S | |
| 803 | + | positron emission tomography (PET) scanning, without any further approval from the724 | |
| 804 | + | department;725 | |
| 805 | + | (2) The destination cancer hospital shall be classified as a general cancer hospital under726 | |
| 806 | + | this chapter and shall be subject to all requirements and conditions applicable to hospitals727 | |
| 807 | + | under this article, including but not limited to, indigent and charity care and inventories728 | |
| 808 | + | and methodologies to determine need for additional providers or services; and729 | |
| 809 | + | (3) The hospital's inpatient beds, operating rooms, radiation therapy equipment, and730 | |
| 810 | + | imaging equipment existing on the date of conversion shall not be counted in the731 | |
| 811 | + | inventory by the department for purposes of determining need for additional providers732 | |
| 812 | + | or services, except that any inpatient beds, operating rooms, radiation therapy equipment,733 | |
| 813 | + | and imaging equipment added after the date of conversion shall be counted in accordance734 | |
| 814 | + | with the department's rules and regulations.735 | |
| 815 | + | (d) In the event that a destination cancer hospital does not convert to a general cancer736 | |
| 816 | + | hospital, it shall remain subject to all requirements and conditions applicable to destination737 | |
| 817 | + | cancer hospitals under this article.738 | |
| 818 | + | 31-6-41.739 | |
| 819 | + | (a) A certificate of need shall be valid only for the defined scope, location, cost, service740 | |
| 820 | + | area, and person named in an application, as it may be amended, and as such scope,741 | |
| 821 | + | location, service area, cost, and person are approved by the department, unless such742 | |
| 822 | + | certificate of need owned by an existing health care facility is transferred to a person who743 | |
| 823 | + | acquires such existing facility. In such case, the certificate of need shall be valid for the744 | |
| 824 | + | person who acquires such a facility and for the scope, location, cost, and service area745 | |
| 825 | + | approved by the department. However, in reviewing an application to relocate all or a746 | |
| 826 | + | portion of an existing skilled nursing facility, intermediate care facility, or intermingled747 | |
| 827 | + | nursing facility, the department may allow such facility to divide into two or more such748 23 LC 33 9350 | |
| 828 | + | S. B. 162 | |
| 774 | 829 | - 30 - | |
| 775 | - | (2) In the event that a destination cancer hospital does not convert to a hospital, it shall740 | |
| 776 | - | remain subject to all requirements and conditions previously in effect as of741 | |
| 777 | - | December 31, 2023, under the provisions of Chapter 6 of this title as they existed on such742 | |
| 778 | - | date.743 | |
| 779 | - | (d) Any outstanding appeals before the Certificate of Need Appeal Panel as of744 | |
| 780 | - | December 31, 2023, relating to health care facilities, as defined in Code Section 31-6A-1,745 | |
| 781 | - | shall be deemed moot and dismissed by operation of law as of January 1, 2024.746 | |
| 782 | - | 31-6A-11.747 | |
| 783 | - | The department shall be authorized to promulgate rules and regulations to implement the748 | |
| 784 | - | provisions of this chapter."749 | |
| 785 | - | PART III750 | |
| 786 | - | SECTION 3-1.751 | |
| 787 | - | Said title is further amended in Article 2 of Chapter 7, relating to the Georgia Building752 | |
| 788 | - | Authority, by redesignating Code Section 31-7-24 as Code Section 31-7-25 and by adding753 | |
| 789 | - | a new Code section to the end of Article 1, relating to regulation of hospitals and related754 | |
| 790 | - | institutions, to read as follows:755 | |
| 791 | - | "31-7-24.756 | |
| 792 | - | (a) As used in this Code section, the term:757 | |
| 793 | - | (1) 'Hospital' shall have the same meaning as in Code Section 31-7-22.758 | |
| 794 | - | (2) 'Medical use rights' means rights or interests in real property in which the owner of759 | |
| 795 | - | the property has agreed not to sell or lease such real property for identified medical uses760 | |
| 796 | - | or purposes.761 | |
| 797 | - | (b) It shall be unlawful for any hospital to purchase, renew, extend, lease, maintain, or hold762 | |
| 798 | - | medical use rights.763 23 LC 33 9433S | |
| 830 | + | facilities if the department determines that the proposed division is financially feasible and | |
| 831 | + | 749 | |
| 832 | + | would be consistent with quality patient care.750 | |
| 833 | + | (b) A certificate of need shall be valid and effective for a period of 12 months after it is751 | |
| 834 | + | issued, or such greater period of time as may be specified by the department at the time the752 | |
| 835 | + | certificate of need is issued. Within the effective period after the grant of a certificate of753 | |
| 836 | + | need, the applicant of a proposed project shall fulfill reasonable performance and754 | |
| 837 | + | scheduling requirements specified by the department, by rule, to assure reasonable progress755 | |
| 838 | + | toward timely completion of a project.756 | |
| 839 | + | (c) By rule, the department may provide for extension of the effective period of a757 | |
| 840 | + | certificate of need when an applicant, by petition, makes a good faith showing that the758 | |
| 841 | + | conditions to be specified according to subsection (b) of this Code section will be759 | |
| 842 | + | performed within the extended period and that the reasons for the extension are beyond the760 | |
| 843 | + | control of the applicant.761 | |
| 844 | + | 31-6-42.762 | |
| 845 | + | (a) The written findings of fact and decision, with respect to the department's grant or763 | |
| 846 | + | denial of a certificate of need, shall be based on the applicable considerations specified in764 | |
| 847 | + | this Code section and reasonable rules promulgated by the department interpretive thereof.765 | |
| 848 | + | The department shall issue a certificate of need to each applicant whose application is766 | |
| 849 | + | consistent with the following considerations and such rules deemed applicable to a project,767 | |
| 850 | + | except as specified in subsection (f) of Code Section 31-6-43:768 | |
| 851 | + | (1) The proposed new institutional health services are reasonably consistent with the769 | |
| 852 | + | relevant general goals and objectives of the state health plan;770 | |
| 853 | + | (2) The population residing in the area served, or to be served, by the new institutional771 | |
| 854 | + | health service has a need for such services;772 | |
| 855 | + | (3) Existing alternatives for providing services in the service area the same as the new773 | |
| 856 | + | institutional health service proposed are neither currently available, implemented,774 23 LC 33 9350 | |
| 857 | + | S. B. 162 | |
| 799 | 858 | - 31 - | |
| 800 | - | (c) This Code section shall not be construed to impair any contracts in existence as of the764 | |
| 801 | - | effective date of this Code section."765 | |
| 802 | - | SECTION 3-2.766 | |
| 803 | - | Code Section 50-18-70 of the Official Code of Georgia Annotated, relating to legislative767 | |
| 804 | - | intent and definitions relative to open records laws, is amended by revising subsection (b)768 | |
| 805 | - | as follows:769 | |
| 806 | - | "(b) As used in this article, the term:770 | |
| 807 | - | (1) 'Agency' shall have the same meaning as in Code Section 50-14-1 and shall771 | |
| 808 | - | additionally include any association, corporation, or other similar organization that has772 | |
| 809 | - | a membership or ownership body composed primarily of counties, municipal773 | |
| 810 | - | corporations, or school districts of this state, their officers, or any combination thereof774 | |
| 811 | - | and derives more than 33 1/3 percent of its general operating budget from payments from775 | |
| 812 | - | such political subdivisions. Such term shall also include any nonprofit organization to776 | |
| 813 | - | which is leased and transferred hospital assets of a hospital authority through a corporate777 | |
| 814 | - | restructuring and any subsidiaries or foundations established by such nonprofit778 | |
| 815 | - | organization in furtherance of the public mission of the hospital authority.779 | |
| 816 | - | (2) 'Public record' means all documents, papers, letters, maps, books, tapes, photographs,780 | |
| 817 | - | computer based or generated information, data, data fields, or similar material prepared781 | |
| 818 | - | and maintained or received by an agency or by a private person or entity in the782 | |
| 819 | - | performance of a service or function for or on behalf of an agency or when such783 | |
| 820 | - | documents have been transferred to a private person or entity by an agency for storage784 | |
| 821 | - | or future governmental use, including, but not limited to, any such material in the785 | |
| 822 | - | possession or control of a nonprofit organization to which is leased and transferred786 | |
| 823 | - | hospital assets of a hospital authority through a corporate restructuring which are related787 | |
| 824 | - | to the operation of the hospital and other leased facilities in the performance of services788 | |
| 825 | - | on behalf of the hospital authority."789 23 LC 33 9433S | |
| 859 | + | similarly utilized, nor capable of providing a less costly alternative, or no certificate of | |
| 860 | + | 775 | |
| 861 | + | need to provide such alternative services has been issued by the department and is776 | |
| 862 | + | currently valid;777 | |
| 863 | + | (4) The project can be adequately financed and is, in the immediate and long term,778 | |
| 864 | + | financially feasible;779 | |
| 865 | + | (5) The effects of new institutional health service on payors | |
| 866 | + | payers for health services,780 | |
| 867 | + | including governmental payors payers, are not unreasonable;781 | |
| 868 | + | (6) The costs and methods of a proposed construction project, including the costs and782 | |
| 869 | + | methods of energy provision and conservation, are reasonable and adequate for quality783 | |
| 870 | + | health care;784 | |
| 871 | + | (7) The new institutional health service proposed is reasonably financially and physically785 | |
| 872 | + | accessible to the residents of the proposed service area;786 | |
| 873 | + | (8) The proposed new institutional health service has a positive relationship to the787 | |
| 874 | + | existing health care delivery system in the service area;788 | |
| 875 | + | (9) The proposed new institutional health service encourages more efficient utilization789 | |
| 876 | + | of the health care facility proposing such service;790 | |
| 877 | + | (10) The proposed new institutional health service provides, or would provide, a791 | |
| 878 | + | substantial portion of its services to individuals not residing in its defined service area or792 | |
| 879 | + | the adjacent service area;793 | |
| 880 | + | (11) The proposed new institutional health service conducts biomedical or behavioral794 | |
| 881 | + | research projects or new service development which is designed to meet a national,795 | |
| 882 | + | regional, or state-wide need;796 | |
| 883 | + | (12) The proposed new institutional health service meets the clinical needs of health797 | |
| 884 | + | professional training programs which request assistance;798 | |
| 885 | + | (13) The proposed new institutional health service fosters improvements or innovations799 | |
| 886 | + | in the financing or delivery of health services, promotes health care quality assurance or800 23 LC 33 9350 | |
| 887 | + | S. B. 162 | |
| 826 | 888 | - 32 - | |
| 827 | - | PART IV790 | |
| 828 | - | SECTION 4-1.791 | |
| 829 | - | Code Section 16-11-62 of the Official Code of Georgia Annotated, relating to eavesdropping,792 | |
| 830 | - | surveillance, or intercepting communication which invades privacy of another, and divulging793 | |
| 831 | - | private message, is amended by revising paragraph (8) as follows:794 | |
| 832 | - | "(8) Any person to intentionally and in a clandestine manner place, or direct someone795 | |
| 833 | - | else to place, a global positioning system monitoring device, or any other electronic796 | |
| 834 | - | monitoring device, on a motor vehicle owned or leased by another person without the797 | |
| 835 | - | consent of such person when such person has a protective order pursuant to Code Section798 | |
| 836 | - | 17-17-16, 19-13-4, or 19-13A-4, or a protective order from another jurisdiction, against799 | |
| 837 | - | the person who places, or directs another to place, the global positioning system800 | |
| 838 | - | monitoring device or other electronic device. Nothing in this paragraph shall be801 | |
| 839 | - | construed to limit electronic monitoring as provided in Code Sections 31-7-12 and802 | |
| 840 | - | 31-7-12.1, and 31-6-2; or"803 | |
| 841 | - | SECTION 4-2.804 | |
| 842 | - | Title 31 of the Official Code of Georgia Annotated, relating to health, is amended in Code805 | |
| 843 | - | Section 31-2-4, relating to the powers, duties, functions, and responsibilities of the806 | |
| 844 | - | Department of Community Health, by revising paragraph (13) of subsection (d) as follows:807 | |
| 845 | - | "(13) Shall request any necessary federal approval for and facilitate the application of808 | |
| 846 | - | certificates of need for facilities capable of providing long-term care services, with809 | |
| 847 | - | Medicaid as the primary funding source, to inmates who are eligible for such services and810 | |
| 848 | - | funding upon his or her their release from a public institution, as such term is defined in811 | |
| 849 | - | Code Section 49-4-31."812 23 LC 33 9433S | |
| 889 | + | cost effectiveness, or fosters competition that is shown to result in lower patient costs | |
| 890 | + | 801 | |
| 891 | + | without a loss of the quality of care;802 | |
| 892 | + | (14) The proposed new institutional health service fosters the special needs and | |
| 893 | + | 803 | |
| 894 | + | circumstances of health maintenance organizations; Reserved;804 | |
| 895 | + | (15) The proposed new institutional health service meets the department's minimum805 | |
| 896 | + | quality standards, including, but not limited to, standards relating to accreditation,806 | |
| 897 | + | minimum volumes, quality improvements, assurance practices, and utilization review807 | |
| 898 | + | procedures;808 | |
| 899 | + | (16) The proposed new institutional health service can obtain the necessary resources,809 | |
| 900 | + | including health care personnel and management personnel; and810 | |
| 901 | + | (17) The proposed new institutional health service is an underrepresented health service,811 | |
| 902 | + | as determined annually by the department. The department shall, by rule, provide for an812 | |
| 903 | + | advantage to equally qualified applicants that agree to provide an underrepresented813 | |
| 904 | + | service in addition to the services for which the application was originally submitted.814 | |
| 905 | + | (b) In the case of applications for the development or offering of a new institutional health815 | |
| 906 | + | service or health care facility for osteopathic medicine, the need for such service or facility816 | |
| 907 | + | shall be determined on the basis of the need and availability in the community for817 | |
| 908 | + | osteopathic services and facilities in addition to the considerations in subsection (a) of this818 | |
| 909 | + | Code section. Nothing in this chapter shall, however, be construed as otherwise819 | |
| 910 | + | recognizing any distinction between allopathic and osteopathic medicine.820 | |
| 911 | + | (b.1) In the case of applications for the construction, development, or establishment of a821 | |
| 912 | + | destination cancer hospital, the applicable considerations as to the need for such service822 | |
| 913 | + | shall not include paragraphs (1), (2), (3), (7), (8), (10), (11), and (14) of subsection (a) of823 | |
| 914 | + | this Code section but shall include:824 | |
| 915 | + | (1) Paragraphs (4), (5), (6), (9), (12), (13), (15), (16), and (17) of subsection (a) of this825 | |
| 916 | + | Code section;826 23 LC 33 9350 | |
| 917 | + | S. B. 162 | |
| 850 | 918 | - 33 - | |
| 851 | - | SECTION 4-3.813 | |
| 852 | - | Said title is further amended in Code Section 31-2-5, relating to the transfer of personnel and814 | |
| 853 | - | functions to the Department of Community Health, by revising subsection (c) as follows:815 | |
| 854 | - | "(c) The department shall succeed to all rules, regulations, policies, procedures, and816 | |
| 855 | - | administrative orders of the predecessor agency or unit which were in effect on June 30,817 | |
| 856 | - | 2009, or scheduled to go into effect on or after July 1, 2009, and which relate to the818 | |
| 857 | - | functions transferred to the department by this chapter. Such rules, regulations, policies,819 | |
| 858 | - | procedures, and administrative orders shall remain in effect until amended, repealed,820 | |
| 859 | - | superseded, or nullified by proper authority or as otherwise provided by law. Rules of the821 | |
| 860 | - | department shall be adopted, promulgated, and implemented as provided in Chapter 13 of822 | |
| 861 | - | Title 50, the 'Georgia Administrative Procedure Act,.' except that only rules promulgated823 | |
| 862 | - | pursuant to Chapter 6 of this title shall be subject to the provisions of Code Section824 | |
| 863 | - | 31-6-21.1."825 | |
| 864 | - | SECTION 4-4.826 | |
| 865 | - | Said title is further amended in Code Section 31-2-7, relating to rules and regulations and827 | |
| 866 | - | variances and waivers, by revising subsection (b) as follows:828 | |
| 867 | - | "(b) The department upon application or petition may grant variances and waivers to829 | |
| 868 | - | specific rules and regulations which establish standards for facilities or entities regulated830 | |
| 869 | - | by the department as follows:831 | |
| 870 | - | (1) The department may authorize departure from the literal requirements of a rule or832 | |
| 871 | - | regulation by granting a variance upon a showing by the applicant or petitioner that the833 | |
| 872 | - | particular rule or regulation that is the subject of the variance request should not be834 | |
| 873 | - | applied as written because strict application would cause undue hardship. The applicant835 | |
| 874 | - | or petitioner additionally must show that adequate standards affording protection of836 | |
| 875 | - | health, safety, and care exist and will be met in lieu of the exact requirements of the rule837 | |
| 876 | - | or regulation in question;838 23 LC 33 9433S | |
| 919 | + | (2) That the proposed new destination cancer hospital can demonstrate, based on827 | |
| 920 | + | historical data from the applicant or its affiliated entities, that its annual patient base shall828 | |
| 921 | + | be composed of a minimum of 65 percent of patients who reside outside of the State of829 | |
| 922 | + | Georgia;830 | |
| 923 | + | (3) That the proposed new destination cancer hospital states its intent to provide831 | |
| 924 | + | uncompensated indigent or charity care which shall meet or exceed 3 percent of its832 | |
| 925 | + | adjusted gross revenues and provide care to Medicaid beneficiaries;833 | |
| 926 | + | (4) That the proposed new destination cancer hospital shall conduct biomedical or834 | |
| 927 | + | behavioral research projects or service development which is designed to meet a national835 | |
| 928 | + | or regional need;836 | |
| 929 | + | (5) That the proposed new destination cancer hospital shall be reasonably financially and837 | |
| 930 | + | physically accessible;838 | |
| 931 | + | (6) That the proposed new destination cancer hospital shall have a positive relationship839 | |
| 932 | + | to the existing health care delivery system on a regional basis;840 | |
| 933 | + | (6.1) That the proposed new destination cancer hospital shall enter into a hospital841 | |
| 934 | + | transfer agreement with one or more hospitals within a reasonable distance from the842 | |
| 935 | + | destination cancer hospital or the medical staff at the destination cancer hospital has843 | |
| 936 | + | admitting privileges or other acceptable documented arrangements with such hospital or844 | |
| 937 | + | hospitals to ensure the necessary backup for the destination cancer hospital for medical845 | |
| 938 | + | complications. The destination cancer hospital shall have the capability to transfer a846 | |
| 939 | + | patient immediately to a hospital within a reasonable distance from the destination cancer847 | |
| 940 | + | hospital with adequate emergency room services. Hospitals shall not unreasonably deny848 | |
| 941 | + | a transfer agreement with the destination cancer hospital. In the event that a destination849 | |
| 942 | + | cancer hospital and another hospital cannot agree to the terms of a transfer agreement as850 | |
| 943 | + | required by this paragraph, the department shall mediate between such parties for a period851 | |
| 944 | + | of no more than 45 days. If an agreement is still not reached within such 45 day period,852 | |
| 945 | + | the parties shall enter into binding arbitration conducted by the department;853 23 LC 33 9350 | |
| 946 | + | S. B. 162 | |
| 877 | 947 | - 34 - | |
| 878 | - | (2) The department may dispense entirely with the enforcement of a rule or regulation839 | |
| 879 | - | by granting a waiver upon a showing by the applicant or petitioner that the purpose of the840 | |
| 880 | - | rule or regulation is met through equivalent standards affording equivalent protection of841 | |
| 881 | - | health, safety, and care;842 | |
| 882 | - | (3) The department may grant waivers and variances to allow experimentation and843 | |
| 883 | - | demonstration of new and innovative approaches to delivery of services upon a showing844 | |
| 884 | - | by the applicant or petitioner that the intended protections afforded by the rule or845 | |
| 885 | - | regulation which is the subject of the request are met and that the innovative approach has846 | |
| 886 | - | the potential to improve service delivery;847 | |
| 887 | - | (4) Waivers or variances which affect an entire class of facilities may only be approved848 | |
| 888 | - | by the Board of Community Health and shall be for a time certain, as determined by the849 | |
| 889 | - | board. A notice of the proposed variance or waiver affecting an entire class of facilities850 | |
| 890 | - | shall be made in accordance with the requirements for notice of rule making in Chapter851 | |
| 891 | - | 13 of Title 50, the 'Georgia Administrative Procedure Act'; or852 | |
| 892 | - | (5) Variances or waivers which affect only one facility in a class may be approved or853 | |
| 893 | - | denied by the department and shall be for a time certain, as determined by the854 | |
| 894 | - | department. The department shall maintain a record of such action and shall make this855 | |
| 895 | - | information available to the board and all other persons who request it.856 | |
| 896 | - | This subsection shall not apply to rules adopted by the department pursuant to Code857 | |
| 897 | - | Section 31-6-21.1."858 | |
| 898 | - | SECTION 4-5.859 | |
| 899 | - | Said title is further amended in Code Section 31-7-3, relating to requirements for permits to860 | |
| 900 | - | operate institutions, by revising subsection (a) as follows:861 | |
| 901 | - | "(a) Any person or persons responsible for the operation of any institution, or who may862 | |
| 902 | - | hereafter propose to establish and operate an institution and to provide specified clinical863 | |
| 903 | - | services, shall submit an application to the department for a permit to operate the institution864 23 LC 33 9433S | |
| 948 | + | (7) That an applicant for a new destination cancer hospital shall document in its854 | |
| 949 | + | application that the new facility is not predicted to be detrimental to existing hospitals855 | |
| 950 | + | within the planning area. Such demonstration shall be made by providing an analysis in856 | |
| 951 | + | such application that compares current and projected changes in market share and payor857 | |
| 952 | + | mix for such applicant and such existing hospitals within the planning area. Impact on858 | |
| 953 | + | an existing hospital shall be determined to be adverse if, based on the utilization projected859 | |
| 954 | + | by the applicant, such existing hospital would have a total decrease of 10 percent or more860 | |
| 955 | + | in its average annual utilization, as measured by patient days for the two most recent and861 | |
| 956 | + | available preceding calendar years of data; and862 | |
| 957 | + | (8) That the destination cancer hospital shall express its intent to participate in medical863 | |
| 958 | + | staffing work force development activities.864 | |
| 959 | + | (b.2) In the case of applications for basic perinatal services in counties where:865 | |
| 960 | + | (1) Only one civilian health care facility or health system is currently providing basic866 | |
| 961 | + | perinatal services; and867 | |
| 962 | + | (2) There are not at least three different health care facilities in a contiguous county868 | |
| 963 | + | providing basic perinatal services,869 | |
| 964 | + | the department shall not apply the consideration contained in paragraph (2) of870 | |
| 965 | + | subsection (a) of this Code section.871 | |
| 966 | + | (c) If the denial of an application for a certificate of need for a new institutional health872 | |
| 967 | + | service proposed to be offered or developed by a:873 | |
| 968 | + | (1) Minority administered hospital facility serving a socially and economically874 | |
| 969 | + | disadvantaged minority population in an urban setting; or875 | |
| 970 | + | (2) Minority administered hospital facility utilized for the training of minority medical876 | |
| 971 | + | practitioners877 | |
| 972 | + | would adversely impact upon the facility and population served by said facility, the special878 | |
| 973 | + | needs of such hospital facility and the population served by said facility for the new879 | |
| 974 | + | institutional health service shall be given extraordinary consideration by the department in880 23 LC 33 9350 | |
| 975 | + | S. B. 162 | |
| 904 | 976 | - 35 - | |
| 905 | - | and provide such services, with such application to be made on forms prescribed by the865 | |
| 906 | - | department. No institution shall be operated in this state without such a permit, which shall866 | |
| 907 | - | be displayed in a conspicuous place on the premises. No clinical services shall be provided867 | |
| 908 | - | by an institution except as approved by the department in accordance with the rules and868 | |
| 909 | - | regulations established pursuant to Code Section 31-7-2.1. Failure or refusal to file an869 | |
| 910 | - | application for a permit shall constitute a violation of this chapter and shall be dealt with870 | |
| 911 | - | as provided for in Article 1 of Chapter 5 of this title. Following inspection and871 | |
| 912 | - | classification of the institution for which a permit is applied for, the department may issue872 | |
| 913 | - | or refuse to issue a permit or a provisional permit. Permits issued shall remain in force and873 | |
| 914 | - | effect until revoked or suspended; provisional permits issued shall remain in force and874 | |
| 915 | - | effect for such limited period of time as may be specified by the department. Upon875 | |
| 916 | - | conclusion of the Atlantic Cardiovascular Patient Outcomes Research Team (C-PORT)876 | |
| 917 | - | Study, the department shall consider and analyze the data and conclusions of the study and877 | |
| 918 | - | promulgate rules pursuant to Code Section 31-7-2.1 to regulate the quality of care for878 | |
| 919 | - | therapeutic cardiac catheterization. All hospitals that participated in the study and are were879 | |
| 920 | - | exempt from obtaining a certificate of need based on paragraph (22) of subsection (a) of880 | |
| 921 | - | former Code Section 31-6-47 as it existed on December 31, 2023, shall apply for a permit881 | |
| 922 | - | to continue providing therapeutic cardiac catheterization services once the department882 | |
| 923 | - | promulgates the rules required by this Code section."883 | |
| 924 | - | SECTION 4-6.884 | |
| 925 | - | Said title is further amended in Code Section 31-7-75, relating to the functions and powers885 | |
| 926 | - | of county and municipal hospital authorities, by revising paragraph (24) as follows:886 | |
| 927 | - | "(24) To provide management, consulting, and operating services including, but not887 | |
| 928 | - | limited to, administrative, operational, personnel, and maintenance services to another888 | |
| 929 | - | hospital authority, hospital, health care facility, as said term is defined in Chapter 6 of this889 | |
| 930 | - | title Code Section 31-6A-1, person, firm, corporation, or any other entity or any group890 23 LC 33 9433S | |
| 977 | + | making its determination of need as required by this Code section. The department shall881 | |
| 978 | + | have the authority to vary or modify strict adherence to the provisions of this chapter and882 | |
| 979 | + | the rules enacted pursuant hereto in considering the special needs of such facility and its883 | |
| 980 | + | population served and to avoid an adverse impact on the facility and the population served884 | |
| 981 | + | thereby. For purposes of this subsection, the term 'minority administered hospital facility'885 | |
| 982 | + | means a hospital controlled or operated by a governing body or administrative staff886 | |
| 983 | + | composed predominantly of members of a minority race.887 | |
| 984 | + | (d)(b) For the purposes of the considerations contained in this Code section and in the888 | |
| 985 | + | department's applicable rules, relevant data which were unavailable or omitted when the889 | |
| 986 | + | state health plan or rules were prepared or revised may be considered in the evaluation of890 | |
| 987 | + | a project.891 | |
| 988 | + | (e)(c) The department shall specify in its written findings of fact and decision which of the892 | |
| 989 | + | considerations contained in this Code section and the department's applicable rules are893 | |
| 990 | + | applicable to an application and its reasoning as to and evidentiary support for its894 | |
| 991 | + | evaluation of each such applicable consideration and rule.895 | |
| 992 | + | 31-6-42.1.896 | |
| 993 | + | No applicant for a new certificate of need, a modification to an existing certificate of need,897 | |
| 994 | + | or a conversion of a certificate of need that has any outstanding amounts owed to the state898 | |
| 995 | + | including fines, penalties, fees, or other payments for noncompliance with any899 | |
| 996 | + | requirements contained in Code Section 31-6-40.1, 31-6-45.2, 31-6-70, 31-7-280, or900 | |
| 997 | + | 31-8-179.2 shall be eligible to receive a new certificate of need or a modification to an901 | |
| 998 | + | existing certificate of need unless such applicant pays such outstanding amounts to the902 | |
| 999 | + | state. Any such fines, penalties, fees, or other payments for noncompliance shall be subject903 | |
| 1000 | + | to the same notices and hearing for the levy of fines under Code Section 31-6-45.904 23 LC 33 9350 | |
| 1001 | + | S. B. 162 | |
| 931 | 1002 | - 36 - | |
| 932 | - | or groups of the foregoing; to enter into contracts alone or in conjunction with others to891 | |
| 933 | - | provide such services without regard to the location of the parties to such transactions;892 | |
| 934 | - | to receive management, consulting, and operating services including, but not limited to,893 | |
| 935 | - | administrative, operational, personnel, and maintenance services from another such894 | |
| 936 | - | hospital authority, hospital, health care facility, person, firm, corporation, or any other895 | |
| 937 | - | entity or any group or groups of the foregoing; and to enter into contracts alone or in896 | |
| 938 | - | conjunction with others to receive such services without regard to the location of the897 | |
| 939 | - | parties to such transactions;"898 | |
| 940 | - | SECTION 4-7.899 | |
| 941 | - | Said title is further amended in Code Section 31-7-94.1, the "Rural Hospital Organization900 | |
| 942 | - | Assistance Act," by revising paragraph (1) of subsection (e) as follows:901 | |
| 943 | - | "(1) Infrastructure development, including, without being limited to, health information902 | |
| 944 | - | technology, facility renovation, or equipment acquisition; provided, however, that the903 | |
| 945 | - | amount granted to any qualified hospital may not exceed the expenditure thresholds that904 | |
| 946 | - | would constitute a new institutional health service requiring a certificate of need under905 | |
| 947 | - | Chapter 6 of this title and the grant award may be conditioned upon obtaining local906 | |
| 948 | - | matching funds;"907 | |
| 949 | - | SECTION 4-8.908 | |
| 950 | - | Said title is further amended in Code Section 31-7-116, relating to provisions contained in909 | |
| 951 | - | obligations and security for obligations, procedures for issuance of bonds and bond910 | |
| 952 | - | anticipation notes, interest rates, and limitations and conditions, by revising subsection (i)911 | |
| 953 | - | as follows:912 | |
| 954 | - | "(i) No bonds or bond anticipation notes except refunding bonds shall be issued by an913 | |
| 955 | - | authority under this article unless its board of directors shall adopt adopts a resolution914 | |
| 956 | - | finding that the project for which such bonds or notes are to be issued will promote the915 23 LC 33 9433S | |
| 1003 | + | 31-6-43. | |
| 1004 | + | 905 | |
| 1005 | + | (a) At least 30 days prior to submitting an application for a certificate of need for clinical906 | |
| 1006 | + | health services, a person shall submit a letter of intent to the department. The department907 | |
| 1007 | + | shall provide by rule a process for submitting letters of intent and a mechanism by which908 | |
| 1008 | + | applications may be filed to compete with and be reviewed comparatively with proposals909 | |
| 1009 | + | described in submitted letters of intent.910 | |
| 1010 | + | (b) Each application for a certificate of need shall be reviewed by the department and911 | |
| 1011 | + | within ten working days after the date of its receipt a determination shall be made as to912 | |
| 1012 | + | whether the application complies with the rules governing the preparation and submission913 | |
| 1013 | + | of applications. If the application complies with the rules governing the preparation and914 | |
| 1014 | + | submission of applications, the department shall declare the application complete for915 | |
| 1015 | + | review, shall accept and date the application, and shall notify the applicant of the timetable916 | |
| 1016 | + | for its review. The department shall also notify a newspaper of general circulation in the917 | |
| 1017 | + | county in which the project shall be developed that the application has been deemed918 | |
| 1018 | + | complete. The department shall also notify the appropriate regional commission and the919 | |
| 1019 | + | chief elected official of the county and municipal governments, if any, in whose boundaries920 | |
| 1020 | + | the proposed project will be located that the application is complete for review. If the921 | |
| 1021 | + | application does not comply with the rules governing the preparation and submission of922 | |
| 1022 | + | applications, the department shall notify the applicant in writing and provide a list of all923 | |
| 1023 | + | deficiencies. The applicant shall be afforded an opportunity to correct such deficiencies,924 | |
| 1024 | + | and upon such correction, the application shall then be declared complete for review within925 | |
| 1025 | + | ten days of the correction of such deficiencies, and notice given to a newspaper of general926 | |
| 1026 | + | circulation in the county in which the project shall be developed that the application has927 | |
| 1027 | + | been so declared. The department shall also notify the appropriate regional commission928 | |
| 1028 | + | and the chief elected official of the county and municipal governments, if any, in whose929 | |
| 1029 | + | boundaries the proposed project will be located that the application is complete for review930 | |
| 1030 | + | or when in the determination of the department a significant amendment is filed.931 23 LC 33 9350 | |
| 1031 | + | S. B. 162 | |
| 957 | 1032 | - 37 - | |
| 958 | - | objectives stated in subsection (b) of Code Section 31-7-111 and will increase or maintain916 | |
| 959 | - | employment in the territorial area of such authority. Nothing contained in this Code917 | |
| 960 | - | section shall be construed as permitting any authority created under this article or any918 | |
| 961 | - | qualified sponsor to finance, construct, or operate any project without obtaining any919 | |
| 962 | - | certificate of need or other approval, permit, or license which, under the laws of this state,920 | |
| 963 | - | is required in connection therewith."921 | |
| 964 | - | SECTION 4-9.922 | |
| 965 | - | Said title is further amended by repealing and reserving Code Section 31-7-155, relating to923 | |
| 966 | - | certificates of need for new service or extending service area and exemption from certificate.924 | |
| 967 | - | SECTION 4-10.925 | |
| 968 | - | Said title is further amended by repealing in its entirety Code Section 31-7-179, relating to926 | |
| 969 | - | certificate of need not required for hospice care.927 | |
| 970 | - | SECTION 4-11.928 | |
| 971 | - | Said title is further amended by revising Code Section 31-7-307, relating to certificate of929 | |
| 972 | - | need not required of private home care provider licensees, as follows:930 | |
| 973 | - | "31-7-307.931 | |
| 974 | - | (a) A certificate of need issued pursuant to Chapter 6 of this title is not required for any932 | |
| 975 | - | person, business entity, corporation, or association, whether operated for profit or not for933 | |
| 976 | - | profit, which is operating as a private home care provider as long as such operation does934 | |
| 977 | - | not also constitute such person, entity, or organization operating as a home health agency935 | |
| 978 | - | or personal care home under this chapter.936 | |
| 979 | - | (b) A license issued under this article shall not entitle the licensee to operate as a home937 | |
| 980 | - | health agency, as defined in Code Section 31-7-150, under medicare Medicare or Medicaid938 | |
| 981 | - | guidelines."939 23 LC 33 9433S | |
| 1033 | + | (c) The department shall specify by rule the time within which an applicant may amend | |
| 1034 | + | 932 | |
| 1035 | + | its application. The department may request an applicant to make amendments. The933 | |
| 1036 | + | department decision shall be made on an application as amended, if at all, by the applicant.934 | |
| 1037 | + | (d)(1) There shall be a time limit of 120 days for review of a project, beginning on the935 | |
| 1038 | + | day the department declares the application complete for review or in the case of936 | |
| 1039 | + | applications joined for comparative review, beginning on the day the department declares937 | |
| 1040 | + | the final application complete. The department may adopt rules for determining when938 | |
| 1041 | + | it is not practicable to complete a review in 120 days and may extend the review period939 | |
| 1042 | + | upon written notice to the applicant but only for an extended period of not longer than an940 | |
| 1043 | + | additional 30 days. The department shall adopt rules governing the submission of941 | |
| 1044 | + | additional information by the applicant and for opposing an application.942 | |
| 1045 | + | (2) No party may oppose an application for a certificate of need for a proposed project943 | |
| 1046 | + | unless:944 | |
| 1047 | + | (A) Such party offers substantially similar services as proposed within a 35 mile radius945 | |
| 1048 | + | of the proposed project or has a service area that overlaps the applicant's proposed946 | |
| 1049 | + | service area; or947 | |
| 1050 | + | (B) Such party has submitted a competing application in the same batching cycle and948 | |
| 1051 | + | is proposing to establish the same type of facility proposed or offers substantially949 | |
| 1052 | + | similar services as proposed and has a service area that overlaps the applicant's950 | |
| 1053 | + | proposed service area.951 | |
| 1054 | + | (e) To allow the opportunity for comparative review of applications, the department may952 | |
| 1055 | + | provide by rule for applications for a certificate of need to be submitted on a timetable or953 | |
| 1056 | + | batching cycle basis no less often than two times per calendar year for each clinical health954 | |
| 1057 | + | service. Applications for services, facilities, or expenditures for which there is no specified955 | |
| 1058 | + | batching cycle may be filed at any time.956 23 LC 33 9350 | |
| 1059 | + | S. B. 162 | |
| 982 | 1060 | - 38 - | |
| 983 | - | SECTION 4-12.940 | |
| 984 | - | Said title is further amended by revising Code Section 31-8-153.1, relating to irrevocable941 | |
| 985 | - | transfer of funds to trust fund and provision for indigent patients, as follows:942 | |
| 986 | - | "31-8-153.1.943 | |
| 987 | - | After June 30, 1993, any hospital authority, county, municipality, or other state or local944 | |
| 988 | - | public or governmental entity is authorized to transfer moneys to the trust fund. Transfer945 | |
| 989 | - | of funds under the control of a hospital authority, county, municipality, or other state or946 | |
| 990 | - | local public or governmental entity shall be a valid public purpose for which those funds947 | |
| 991 | - | may be expended. The department is authorized to transfer to the trust fund moneys paid948 | |
| 992 | - | to the state by a health care facility as a monetary penalty for the violation of an agreement949 | |
| 993 | - | to provide a specified amount of clinical health services to indigent patients uncompensated950 | |
| 994 | - | indigent or charity care pursuant to a certificate of need license held by such facility. Such951 | |
| 995 | - | transfers shall be irrevocable and shall be used only for the purposes contained in Code952 | |
| 996 | - | Section 31-8-154."953 | |
| 997 | - | SECTION 4-13.954 | |
| 998 | - | Said title is further amended by revising Code Section 31-8-181, relating to individuals and955 | |
| 999 | - | hospitals excluded from application of article, as follows:956 | |
| 1000 | - | "31-8-181.957 | |
| 1001 | - | This article shall not apply to the following:958 | |
| 1002 | - | (1) An individual licensed to practice medicine under the provisions of Chapter 34 of959 | |
| 1003 | - | Title 43, and persons employed by such an individual, provided that any nursing home,960 | |
| 1004 | - | personal care home as defined by Code Section 31-6-2 31-6A-1, hospice as defined by961 | |
| 1005 | - | Code Section 31-7-172, respite care service as defined by Code Section 49-6-72, adult962 | |
| 1006 | - | day program, or home health agency owned, operated, managed, or controlled by a963 | |
| 1007 | - | person licensed to practice medicine under the provisions of Chapter 34 of Title 43 shall964 | |
| 1008 | - | be subject to the provisions of this article; or965 23 LC 33 9433S | |
| 1061 | + | (f) The department may order the joinder of an application which is determined to be | |
| 1062 | + | 957 | |
| 1063 | + | complete by the department for comparative review with one or more subsequently filed958 | |
| 1064 | + | applications declared complete for review during the same batching cycle when:959 | |
| 1065 | + | (1) The first and subsequent applications involve similar clinical health service projects960 | |
| 1066 | + | in the same service area or overlapping service areas; and961 | |
| 1067 | + | (2) The subsequent applications are filed and are declared complete for review within 30962 | |
| 1068 | + | days of the date the first application was declared complete for review.963 | |
| 1069 | + | Following joinder of the first application with subsequent applications, none of the964 | |
| 1070 | + | subsequent applications so joined may be considered as a first application for the purposes965 | |
| 1071 | + | of future joinder. The department shall notify the applicant to whose application a joinder966 | |
| 1072 | + | is ordered and all other applicants previously joined to such application of the fact of each967 | |
| 1073 | + | joinder pursuant to this subsection. In the event one or more applications have been joined968 | |
| 1074 | + | pursuant to this subsection, the time limits for department action for all of the applicants969 | |
| 1075 | + | shall run from the latest date that any one of the joined applications was declared complete970 | |
| 1076 | + | for review. In the event of the consideration of one or more applications joined pursuant971 | |
| 1077 | + | to this subsection, the department may award no certificate of need or one or more972 | |
| 1078 | + | certificates of need to the application or applications | |
| 1079 | + | applicant or applicants, if any, which973 | |
| 1080 | + | are consistent with the considerations contained in Code Section 31-6-42, the department's974 | |
| 1081 | + | applicable rules, and the award of which will best satisfy the purposes of this chapter.975 | |
| 1082 | + | (g) The department shall review the application and all written information submitted by976 | |
| 1083 | + | the applicant in support of the application and all information submitted in opposition to977 | |
| 1084 | + | the application to determine the extent to which the proposed project is consistent with the978 | |
| 1085 | + | applicable considerations stated in Code Section 31-6-42 and in the department's applicable979 | |
| 1086 | + | rules. During the course of the review, the department staff may request additional980 | |
| 1087 | + | information from the applicant as deemed appropriate. Pursuant to rules adopted by the981 | |
| 1088 | + | department, a public hearing on applications covered by those regulations may be held982 | |
| 1089 | + | prior to the date of the department's decision thereon. Such rules shall provide that when983 23 LC 33 9350 | |
| 1090 | + | S. B. 162 | |
| 1009 | 1091 | - 39 - | |
| 1010 | - | (2) A hospital. However, to the extent that a hospital's nursing home, personal care966 | |
| 1011 | - | home as defined by Code Section 31-6-2 31-6A-1, hospice as defined by Code Section967 | |
| 1012 | - | 31-7-172, respite care service as defined by Code Section 49-6-72, adult day program,968 | |
| 1013 | - | or home health agency holds itself out as providing care, treatment, or therapeutic969 | |
| 1014 | - | activities for persons with Alzheimer's disease or Alzheimer's related dementia as part of970 | |
| 1015 | - | a specialty unit, such nursing home, personal care home, hospice, respite care service,971 | |
| 1016 | - | adult day program, or home health agency shall be subject to the provisions of this972 | |
| 1017 | - | article."973 | |
| 1018 | - | SECTION 4-14.974 | |
| 1019 | - | Said title is further amended in Code Section 31-11-100, relating to definitions relative to the975 | |
| 1020 | - | Georgia Trauma Care Network Commission, by revising paragraph (3) as follows:976 | |
| 1021 | - | "(3) 'Trauma center' means a facility designated by the Department of Public Health as977 | |
| 1022 | - | a Level I, II, III, or IV or burn trauma center. However, a burn trauma center shall not978 | |
| 1023 | - | be considered or treated as a trauma center for purposes of certificate of need979 | |
| 1024 | - | requirements under state law or regulations, including exceptions to need and adverse980 | |
| 1025 | - | impact standards allowed by the department for trauma centers or for purposes of981 | |
| 1026 | - | identifying safety net hospitals."982 | |
| 1027 | - | SECTION 4-15.983 | |
| 1028 | - | Code Section 33-45-1 of the Official Code of Georgia Annotated, relating to definitions984 | |
| 1029 | - | relative to continuing care providers and facilities, is amended by revising paragraphs (1),985 | |
| 1030 | - | (8), and (15) as follows:986 | |
| 1031 | - | "(1) 'Continuing care' means furnishing pursuant to a continuing care agreement:987 | |
| 1032 | - | (A) Lodging that is not:988 | |
| 1033 | - | (i) In a skilled nursing facility, as such term is defined in Code Section 31-6-2 Code989 | |
| 1034 | - | Section 31-6A-1;990 23 LC 33 9433S | |
| 1092 | + | good cause has been shown, a public hearing shall be held by the department. Any | |
| 1093 | + | 984 | |
| 1094 | + | interested person may submit information to the department concerning an application, and985 | |
| 1095 | + | an applicant shall be entitled to notice of and to respond to any such submission.986 | |
| 1096 | + | (h) The department shall provide the applicant an opportunity to meet with the department987 | |
| 1097 | + | to discuss the application and to provide an opportunity to submit additional information.988 | |
| 1098 | + | Such additional information shall be submitted within the time limits adopted by the989 | |
| 1099 | + | department. The department shall also provide an opportunity for any party that is990 | |
| 1100 | + | permitted to oppose an application pursuant to paragraph (2) of subsection (d) of this Code991 | |
| 1101 | + | section to meet with the department and to provide additional information to the992 | |
| 1102 | + | department. In order for any such opposing party to have standing to appeal an adverse993 | |
| 1103 | + | decision pursuant to Code Section 31-6-44, such party must attend and participate in an994 | |
| 1104 | + | opposition meeting.995 | |
| 1105 | + | (i) Unless extended by the department for an additional period of up to 30 days pursuant996 | |
| 1106 | + | to subsection (d) of this Code section, the department shall, no later than 120 days after an997 | |
| 1107 | + | application is determined to be complete for review, or, in the event of joined applications,998 | |
| 1108 | + | 120 days after the last application is declared complete for review, provide written999 | |
| 1109 | + | notification to an applicant of the department's decision to issue or to deny issuance of a1000 | |
| 1110 | + | certificate of need for the proposed project. Such notice shall contain the department's1001 | |
| 1111 | + | written findings of fact and decision as to each applicable consideration or rule and a1002 | |
| 1112 | + | detailed statement of the reasons and evidentiary support for issuing or denying a certificate1003 | |
| 1113 | + | of need for the action proposed by each applicant. The department shall also mail such1004 | |
| 1114 | + | notification to the appropriate regional commission and the chief elected official of the1005 | |
| 1115 | + | county and municipal governments, if any, in whose boundaries the proposed project will1006 | |
| 1116 | + | be located. In the event such decision is to issue a certificate of need, the certificate of1007 | |
| 1117 | + | need shall be effective on the day of the decision unless the decision is appealed to the1008 | |
| 1118 | + | Certificate of Need Appeal Panel in accordance with this chapter. Within seven days of1009 23 LC 33 9350 | |
| 1119 | + | S. B. 162 | |
| 1035 | 1120 | - 40 - | |
| 1036 | - | (ii) An intermediate care facility, as such term is defined in Code Section 31-6-2991 | |
| 1037 | - | Code Section 31-6A-1;992 | |
| 1038 | - | (iii) An assisted living community, as such term is defined in Code Section993 | |
| 1039 | - | 31-7-12.2; or994 | |
| 1040 | - | (iv) A personal care home, as such term is defined in Code Section 31-7-12;995 | |
| 1041 | - | (B) Food; and996 | |
| 1042 | - | (C) Nursing care provided in a facility or in another setting designated by the997 | |
| 1043 | - | agreement for continuing care to an individual not related by consanguinity or affinity998 | |
| 1044 | - | to the provider furnishing such care upon payment of an entrance fee including skilled999 | |
| 1045 | - | or intermediate nursing services and, at the discretion of the continuing care provider,1000 | |
| 1046 | - | personal care services including, without limitation, assisted living care services1001 | |
| 1047 | - | designated by the continuing care agreement, including such services being provided1002 | |
| 1048 | - | pursuant to a contract to ensure the availability of such services to an individual not1003 | |
| 1049 | - | related by consanguinity or affinity to the provider furnishing such care upon payment1004 | |
| 1050 | - | of an entrance fee.1005 | |
| 1051 | - | Such term shall not include continuing care at home."1006 | |
| 1052 | - | "(8) 'Limited continuing care' means furnishing pursuant to a continuing care agreement:1007 | |
| 1053 | - | (A) Lodging that is not:1008 | |
| 1054 | - | (i) In a skilled nursing facility, as such term is defined in Code Section 31-6-2 Code1009 | |
| 1055 | - | Section 31-6A-1;1010 | |
| 1056 | - | (ii) An intermediate care facility, as such term is defined in Code Section 31-6-21011 | |
| 1057 | - | Code Section 31-6A-1;1012 | |
| 1058 | - | (iii) An assisted living community, as such term is defined in Code Section1013 | |
| 1059 | - | 31-7-12.2; or1014 | |
| 1060 | - | (iv) A personal care home, as such term is defined in Code Section 31-7-12;1015 | |
| 1061 | - | (B) Food; and1016 23 LC 33 9433S | |
| 1121 | + | the decision, the department shall publish notice of its decision to grant or deny an | |
| 1122 | + | 1010 | |
| 1123 | + | application in the same manner as it publishes notice of the filing of an application.1011 | |
| 1124 | + | (j) Should the department fail to provide written notification of the decision within the1012 | |
| 1125 | + | time limitations set forth in this Code section, an application shall be deemed to have been1013 | |
| 1126 | + | approved as of the one hundred twenty-first day following notice from the department that1014 | |
| 1127 | + | an application, or the last of any applications joined pursuant to subsection (f) of this Code1015 | |
| 1128 | + | section, is declared 'complete for review.'1016 | |
| 1129 | + | (k) Notwithstanding other provisions of this article, when the Governor has declared a1017 | |
| 1130 | + | state of emergency in a region of the state, existing health care facilities in the affected1018 | |
| 1131 | + | region may seek emergency approval from the department to make expenditures in excess1019 | |
| 1132 | + | of the capital expenditure threshold or to offer services that may otherwise require a1020 | |
| 1133 | + | certificate of need. The department shall give special expedited consideration to such1021 | |
| 1134 | + | requests and may authorize such requests for good cause. Once the state of emergency has1022 | |
| 1135 | + | been lifted, any services offered by an affected health care facility under this subsection1023 | |
| 1136 | + | shall cease to be offered until such time as the health care facility that received the1024 | |
| 1137 | + | emergency authorization has requested and received a certificate of need. For purposes of1025 | |
| 1138 | + | this subsection, the term | |
| 1139 | + | 'good cause' means that authorization of the request shall directly1026 | |
| 1140 | + | resolve a situation posing an immediate threat to the health and safety of the public. The1027 | |
| 1141 | + | department shall establish, by rule, procedures whereby requirements for the process of1028 | |
| 1142 | + | review and issuance of a certificate of need may be modified and expedited as a result of1029 | |
| 1143 | + | emergency situations.1030 | |
| 1144 | + | 31-6-44.1031 | |
| 1145 | + | (a) Effective July 1, 2008, there is created the Certificate of Need Appeal Panel, which1032 | |
| 1146 | + | shall be an agency separate and apart from the department and shall consist of a panel of1033 | |
| 1147 | + | independent hearing officers. The purpose of the appeal panel shall be to serve as a panel1034 | |
| 1148 | + | of independent hearing officers to review the department's initial decision to grant or deny1035 23 LC 33 9350 | |
| 1149 | + | S. B. 162 | |
| 1062 | 1150 | - 41 - | |
| 1063 | - | (C) Personal services, whether such personal services are provided in a facility such1017 | |
| 1064 | - | as a personal care home or an assisted living community or in another setting1018 | |
| 1065 | - | designated by the continuing care agreement, to an individual not related by1019 | |
| 1066 | - | consanguinity or affinity to the provider furnishing such care upon payment of an1020 | |
| 1067 | - | entrance fee.1021 | |
| 1068 | - | Such term shall not include continuing care at home."1022 | |
| 1069 | - | "(15) 'Residential unit' means a residence or apartment in which a resident lives that is1023 | |
| 1070 | - | not a skilled nursing facility as defined in Code Section 31-6-2 Code Section 31-6A-1,1024 | |
| 1071 | - | an intermediate care facility as defined in Code Section 31-6-2 Code Section 31-6A-1,1025 | |
| 1072 | - | an assisted living community as defined in Code Section 31-7-12.2, or a personal care1026 | |
| 1073 | - | home as defined in Code Section 31-7-12."1027 | |
| 1074 | - | SECTION 4-16.1028 | |
| 1075 | - | Code Section 33-45-3 of the Official Code of Georgia Annotated, relating to certificate of1029 | |
| 1076 | - | authority required for operation of life plan facilities, is amended by revising subsections (b)1030 | |
| 1077 | - | and (d) as follows:1031 | |
| 1078 | - | "(b) Nothing in this chapter shall be construed so as to modify or limit in any way:1032 | |
| 1079 | - | (1) Provisions of Article 3 of Chapter 6 of Title 31 and any rules and regulations1033 | |
| 1080 | - | promulgated by the Department of Community Health pursuant to such article relating1034 | |
| 1081 | - | to certificates of need for life plan communities or home health agencies, as such terms1035 | |
| 1082 | - | are defined in Code Section 31-6-2; or1036 | |
| 1083 | - | (2) Provisions provisions of Chapter 7 of Title 31 relating to licensure or permit1037 | |
| 1084 | - | requirements and any rules and regulations promulgated by the Department of1038 | |
| 1085 | - | Community Health pursuant to such chapter, including, without limitation, licensure or1039 | |
| 1086 | - | permit requirements for nursing home care, assisted living care, personal care home1040 | |
| 1087 | - | services, home health services, and private home care services."1041 23 LC 33 9433S | |
| 1151 | + | a certificate of need application. The Health Planning Review Board which existed on | |
| 1152 | + | 1036 | |
| 1153 | + | June 30, 2008, shall cease to exist after that date and the Certificate of Need Appeal Panel1037 | |
| 1154 | + | shall be constituted effective July 1, 2008, pursuant to this Code section.1038 | |
| 1155 | + | (b) On and after July 1, 2008, the appeal panel shall be composed of five members1039 | |
| 1156 | + | appointed by the Governor for a term of up to four years each. The Governor shall appoint1040 | |
| 1157 | + | to the appeal panel attorneys who practice law in this state and who are familiar with the1041 | |
| 1158 | + | health care industry but who do not have a financial interest in or represent or have any1042 | |
| 1159 | + | compensation arrangement with any health care facility. Each member of the appeal panel1043 | |
| 1160 | + | shall be an active member of the State Bar of Georgia in good standing, and each attorney1044 | |
| 1161 | + | shall have maintained such active status for the five years immediately preceding such1045 | |
| 1162 | + | person's appointment. The Governor shall name from among such members a chairperson1046 | |
| 1163 | + | and a vice chairperson of the appeal panel. The vice chairperson shall have the same1047 | |
| 1164 | + | authority as the chairperson; provided, however, that | |
| 1165 | + | the vice chairperson shall not exercise1048 | |
| 1166 | + | such authority unless expressly delegated by the chairperson or in the event the chairperson1049 | |
| 1167 | + | becomes incapacitated, as determined by the Governor. Vacancies on the appeal panel1050 | |
| 1168 | + | caused by resignation, death, or any other cause shall be filled for the unexpired term in the1051 | |
| 1169 | + | same manner as the original appointment. No person required to register with the Secretary1052 | |
| 1170 | + | of State as a lobbyist or registered agent shall be eligible for appointment by the Governor1053 | |
| 1171 | + | to the appeal panel.1054 | |
| 1172 | + | (c) The appeal panel shall promulgate reasonable rules for its operation and rules of1055 | |
| 1173 | + | procedure for the conduct of initial administrative appeal hearings held by the appointed1056 | |
| 1174 | + | hearing officers, including an appropriate fee schedule for filing such appeals. Members1057 | |
| 1175 | + | of the appeal panel shall serve as hearing officers for appeals that are assigned to them on1058 | |
| 1176 | + | a random basis by the chairperson of the appeal panel. The members of the appeal panel1059 | |
| 1177 | + | shall receive no salary but shall be reimbursed for their expenses in attending meetings and1060 | |
| 1178 | + | for transportation costs as authorized by Code Section 45-7-21, which provides for1061 | |
| 1179 | + | compensation and allowances of certain state officials; provided, however, that the1062 23 LC 33 9350 | |
| 1180 | + | S. B. 162 | |
| 1088 | 1181 | - 42 - | |
| 1089 | - | "(d) A provider of continuing care at home may contract with a licensed home health1042 | |
| 1090 | - | agency to provide home health services to a resident. In order to provide home health1043 | |
| 1091 | - | services directly, a provider of continuing care at home shall obtain a certificate of need for1044 | |
| 1092 | - | a home health agency, as such term is defined in Code Section 31-6-2 31-6A-1, pursuant1045 | |
| 1093 | - | to the same criteria and rules as are applicable to freestanding home health agencies that1046 | |
| 1094 | - | are not components of life plan communities."1047 | |
| 1095 | - | SECTION 4-17.1048 | |
| 1096 | - | Code Section 33-45-7.1 of the Official Code of Georgia Annotated, relating to provider1049 | |
| 1097 | - | authorized to offer continuing care when resident purchases resident owned living unit, is1050 | |
| 1098 | - | amended as follows:1051 | |
| 1099 | - | "33-45-7.1.1052 | |
| 1100 | - | A provider which has obtained a certificate of authority pursuant to Code Section 33-45-51053 | |
| 1101 | - | and the written approval of the Commissioner is authorized to offer, as a part of the1054 | |
| 1102 | - | continuing care agreement, continuing care at home or continuing care in which the1055 | |
| 1103 | - | resident purchases a resident owned living unit, subject to the provisions of Chapters 6 6A1056 | |
| 1104 | - | and 7 of Title 31 and rules and regulations promulgated by the Department of Community1057 | |
| 1105 | - | Health pursuant to such chapters chapter relating to certificate of need and licensure1058 | |
| 1106 | - | requirements."1059 | |
| 1107 | - | SECTION 4-18.1060 | |
| 1108 | - | Code Section 37-1-29 of the Official Code of Georgia Annotated, relating to crisis1061 | |
| 1109 | - | stabilization units, is amended by revising subsection (j) as follows:1062 | |
| 1110 | - | "(j) Any program certified as a crisis stabilization unit pursuant to this Code section shall1063 | |
| 1111 | - | be exempt from the requirements to obtain a certificate of need pursuant to Article 3 of1064 | |
| 1112 | - | Chapter 6 of Title 31. Reserved."1065 23 LC 33 9433S | |
| 1182 | + | chairperson and vice chairperson of the appeal panel shall also be compensated for their | |
| 1183 | + | 1063 | |
| 1184 | + | services rendered to the appeal panel outside of attendance at an appeal panel meeting, such1064 | |
| 1185 | + | as for time spent assigning hearing officers, the amount of which compensation shall be1065 | |
| 1186 | + | determined according to regulations of the Department of Administrative Services. Appeal1066 | |
| 1187 | + | panel members shall receive compensation for the administration of the cases assigned to1067 | |
| 1188 | + | them, including prehearing, hearing, and posthearing work, in an amount determined to be1068 | |
| 1189 | + | appropriate and reasonable by the Department of Administrative Services. Such1069 | |
| 1190 | + | compensation to the members of the appeal panel shall be made by the Department of1070 | |
| 1191 | + | Administrative Services.1071 | |
| 1192 | + | (d) Any party that is permitted to oppose an application pursuant to paragraph (2) of1072 | |
| 1193 | + | subsection (d) of Code Section 31-6-43 that has notified the department prior to its decision1073 | |
| 1194 | + | that such party is opposed to the application before the department shall have the right to1074 | |
| 1195 | + | an initial administrative appeal hearing before an appeal panel hearing officer or to1075 | |
| 1196 | + | intervene in such hearing. Such request for hearing or intervention shall be filed with the1076 | |
| 1197 | + | chairperson of the appeal panel within 30 days of the date of the decision made pursuant1077 | |
| 1198 | + | to Code Section 31-6-43. In the event an appeal is filed by a party that is permitted to1078 | |
| 1199 | + | oppose an application pursuant to paragraph (2) of subsection (d) of Code Section 31-6-43,1079 | |
| 1200 | + | the appeal shall be accompanied by payment of such fee as is established by the appeal1080 | |
| 1201 | + | panel. In the event an appeal is requested, the chairperson of the appeal panel shall appoint1081 | |
| 1202 | + | a hearing officer for each such hearing within 30 days after the date the appeal is received.1082 | |
| 1203 | + | Within 14 days after the appointment of the hearing officer, such hearing officer shall1083 | |
| 1204 | + | confer with the parties and set the date or dates for the hearing, provided that no hearing1084 | |
| 1205 | + | shall be scheduled less than 60 days nor more than 120 days after the filing of the request1085 | |
| 1206 | + | for a hearing, unless the applicant consents or, in the case of competing applicants, all1086 | |
| 1207 | + | applicants consent to an extension of this time period to a specified date. Unless the1087 | |
| 1208 | + | applicant consents or, in the case of competing applicants, all applicants consent to an1088 | |
| 1209 | + | extension of said 120 day period, any hearing officer who regularly fails to commence a1089 23 LC 33 9350 | |
| 1210 | + | S. B. 162 | |
| 1113 | 1211 | - 43 - | |
| 1114 | - | ||
| 1115 | - | ||
| 1116 | - | for | |
| 1117 | - | ||
| 1118 | - | ||
| 1119 | - | ||
| 1120 | - | ||
| 1121 | - | ||
| 1122 | - | ||
| 1123 | - | ||
| 1124 | - | ||
| 1125 | - | ||
| 1126 | - | ||
| 1127 | - | ||
| 1128 | - | ||
| 1129 | - | ||
| 1130 | - | ||
| 1131 | - | the | |
| 1132 | - | ||
| 1133 | - | ||
| 1134 | - | ||
| 1135 | - | ||
| 1136 | - | ||
| 1137 | - | ||
| 1138 | - | ||
| 1139 | - | ||
| 1140 | - | ||
| 1141 | - | ||
| 1212 | + | hearing within the required time period shall not be eligible for continued service as a | |
| 1213 | + | 1090 | |
| 1214 | + | hearing officer for the purposes of this Code section. The hearing officer shall have the1091 | |
| 1215 | + | authority to dispose of all motions made by any party before the issuance of the hearing1092 | |
| 1216 | + | officer's decision and shall make such rulings as may be required for the conduct of the1093 | |
| 1217 | + | hearing.1094 | |
| 1218 | + | (e) In fulfilling the functions and duties of this chapter, the hearing officer shall act, and1095 | |
| 1219 | + | the hearing shall be conducted as a full evidentiary hearing, in accordance with Chapter 131096 | |
| 1220 | + | of Title 50, the 'Georgia Administrative Procedure Act,' relating to contested cases, except1097 | |
| 1221 | + | as otherwise specified in this Code section. Subject to the provisions of Article 4 of1098 | |
| 1222 | + | Chapter 18 of Title 50, all files, working papers, studies, notes, and other writings or1099 | |
| 1223 | + | information used by the department in making its decision shall be public records and1100 | |
| 1224 | + | available to the parties, and the hearing officer may permit each party to exercise such1101 | |
| 1225 | + | reasonable rights of prehearing discovery of such information used by the parties as will1102 | |
| 1226 | + | expedite the hearing.1103 | |
| 1227 | + | (f) In addition to evidence submitted to the department, a party may present any additional1104 | |
| 1228 | + | relevant evidence to the appeal panel hearing officer reviewing the decision of the1105 | |
| 1229 | + | department if the evidence was not reasonably available to the party presenting the1106 | |
| 1230 | + | evidence at the time of the department's review. The burden of proof as to whether the1107 | |
| 1231 | + | evidence was reasonably available shall be on the party attempting to introduce the new1108 | |
| 1232 | + | evidence. The issue for the decision by the hearing officer shall be whether, and the1109 | |
| 1233 | + | hearing officer shall order the issuance of a certificate of need if, in the hearing officer's1110 | |
| 1234 | + | judgment, the application is consistent with the considerations as set forth in Code Section1111 | |
| 1235 | + | 31-6-42 and the department's rules, as the hearing officer deems such considerations and1112 | |
| 1236 | + | rules applicable to the review of the project. The appeal hearing conducted by the appeal1113 | |
| 1237 | + | panel hearing officer shall be a de novo review of the decision of the department. The1114 | |
| 1238 | + | hearing officer shall also consider:1115 23 LC 33 9350 | |
| 1239 | + | S. B. 162 | |
| 1142 | 1240 | - 44 - | |
| 1143 | - | board, arranged by the applicant under the oversight of a registered professional nurse1094 | |
| 1144 | - | where such applicant is transitioned into the role of a registered professional nurse.1095 | |
| 1145 | - | The preceptorship shall have prior approval of the board, and successful completion1096 | |
| 1146 | - | of the preceptorship shall be verified in writing by the preceptor.1097 | |
| 1147 | - | (B) For purposes of this paragraph, the term 'health care facility' means an acute care1098 | |
| 1148 | - | inpatient facility, a long-term acute care facility, an ambulatory surgical center or1099 | |
| 1149 | - | obstetrical facility as defined in Code Section 31-6-2 31-6A-1, and a skilled nursing1100 | |
| 1150 | - | facility, so long as such skilled nursing facility has 100 beds or more and provides1101 | |
| 1151 | - | health care to patients with similar health care needs as those patients in a long-term1102 | |
| 1152 | - | acute care facility;"1103 | |
| 1153 | - | SECTION 4-20.1104 | |
| 1154 | - | Code Section 50-13-42 of the Official Code of Georgia Annotated, relating to the1105 | |
| 1155 | - | applicability of the Administrative Procedure Act, is amended by revising subsection (a) as1106 | |
| 1156 | - | follows:1107 | |
| 1157 | - | "(a) In addition to those agencies expressly exempted from the operation of this chapter1108 | |
| 1158 | - | under paragraph (1) of Code Section 50-13-2, this article shall not apply to the1109 | |
| 1159 | - | Commissioner of Agriculture, the Public Service Commission, the Certificate of Need1110 | |
| 1160 | - | Appeal Panel, or the Department of Community Health, unless specifically provided1111 | |
| 1161 | - | otherwise for certain programs or in relation to specific laws, or to the Department of Labor1112 | |
| 1162 | - | with respect to unemployment insurance benefit hearings conducted under the authority of1113 | |
| 1163 | - | Chapter 8 of Title 34. Such exclusion does not prohibit such office or agencies from1114 | |
| 1164 | - | contracting with the Office of State Administrative Hearings on a case-by-case basis."1115 | |
| 1165 | - | SECTION 4-21.1116 | |
| 1166 | - | Code Section 50-26-19 of the Official Code of Georgia Annotated, relating to financing1117 | |
| 1167 | - | acquisition, construction, and equipping of health care facilities, is amended by repealing1118 | |
| 1168 | - | subsection (c).1119 23 LC 33 9433S | |
| 1241 | + | (1) Whether the department committed prejudicial procedural error in its consideration | |
| 1242 | + | 1116 | |
| 1243 | + | of the application;1117 | |
| 1244 | + | (2) Whether the appeal lacks substantial justification; and1118 | |
| 1245 | + | (3) Whether such appeal was undertaken primarily for the purpose of delay or1119 | |
| 1246 | + | harassment.1120 | |
| 1247 | + | The burden of proof shall be on the appellant. Appellants or applicants shall proceed first1121 | |
| 1248 | + | with their cases before the hearing officer in the order determined by the hearing officer,1122 | |
| 1249 | + | and the department, if a party, shall proceed last. In the event of a consolidated hearing on1123 | |
| 1250 | + | applications which were joined for comparative review pursuant to subsection (f) of Code1124 | |
| 1251 | + | Section 31-6-43, the hearing officer shall have the same powers specified for the1125 | |
| 1252 | + | department in subsection (f) of Code Section 31-6-43 to order the issuance of no certificate1126 | |
| 1253 | + | of need or one or more certificates of need.1127 | |
| 1254 | + | (g) All evidence shall be presented at the initial administrative appeal hearing conducted1128 | |
| 1255 | + | by the appointed hearing officer. A party or intervenor may present any relevant evidence1129 | |
| 1256 | + | on all issues raised by the hearing officer or any party to the hearing or revealed during1130 | |
| 1257 | + | discovery and shall not be limited to evidence or information presented to the department1131 | |
| 1258 | + | prior to its decision, except that an applicant may not present a new need study or analysis1132 | |
| 1259 | + | responsive to the general need consideration or service-specific need formula as provided1133 | |
| 1260 | + | in the applicable rules that is substantially different from any such study or analysis1134 | |
| 1261 | + | submitted to the department prior to its decision and that could have reasonably been1135 | |
| 1262 | + | available for submission. The hearing officer may consider the latest data available,1136 | |
| 1263 | + | including updates of studies previously submitted, in deciding whether an application is1137 | |
| 1264 | + | consistent with the applicable considerations or rules. The hearing officer shall consider1138 | |
| 1265 | + | the applicable considerations and rules in effect on the date the appeal is filed, even if the1139 | |
| 1266 | + | provisions of those considerations or rules were changed after the department's decision.1140 | |
| 1267 | + | The hearing officer may remand a matter to the department if the hearing officer1141 | |
| 1268 | + | determines that it would be beneficial for the department to consider new data, studies, or1142 23 LC 33 9350 | |
| 1269 | + | S. B. 162 | |
| 1169 | 1270 | - 45 - | |
| 1170 | - | SECTION 4-22.1120 | |
| 1171 | - | Code Section 51-16-1 of the Official Code of Georgia Annotated, relating to definitions1121 | |
| 1172 | - | relative to the COVID-19 Pandemic Business Safety Act, is amended by revising paragraph1122 | |
| 1173 | - | (5) as follows:1123 | |
| 1174 | - | "(5) 'Healthcare facility' shall have the same meaning as 'healthcare facility' as provided1124 | |
| 1175 | - | for in paragraph (17) of Code Section 31-6-2, as it existed on December 30, 2023, and1125 | |
| 1176 | - | all related parties; as 'institution' as provided for in subparagraphs (A) and (C) through1126 | |
| 1177 | - | (G) of paragraph (4) and paragraph (5) of Code Section 31-7-1 and all related parties; as1127 | |
| 1178 | - | 'end stage renal disease' as provided for in paragraph (6) of Code Section 31-44-1 and all1128 | |
| 1179 | - | related parties; and shall mean the recipient of a contract as authorized in paragraph (5)1129 | |
| 1180 | - | of Code Section 37-1-20 and any clinical laboratory certified under the Clinical1130 | |
| 1181 | - | Laboratory Improvement Amendments in Section 353 of the Public Health Service Act,1131 | |
| 1182 | - | 42 U.S.C. Section 263a. Such term shall not be construed to include premises."1132 | |
| 1183 | - | PART V1133 | |
| 1184 | - | SECTION 5-1.1134 | |
| 1185 | - | For purposes of rule-making, this Act shall become effective upon its approval by the1135 | |
| 1186 | - | Governor or upon its becoming law without such approval. For all other purposes, this Act1136 | |
| 1187 | - | shall become effective on January 1, 2024.1137 | |
| 1188 | - | SECTION 5-2.1138 | |
| 1189 | - | All laws and parts of laws in conflict with this Act are repealed.1139 | |
| 1271 | + | analyses that were not available before the decision or changes to the provisions of the | |
| 1272 | + | 1143 | |
| 1273 | + | applicable considerations or rules made after the department's decision. The hearing officer1144 | |
| 1274 | + | shall establish the time deadlines for completion of the remand and shall retain jurisdiction1145 | |
| 1275 | + | of the matter throughout the completion of the remand.1146 | |
| 1276 | + | (h) After the issuance of a decision by the department pursuant to Code Section 31-6-43,1147 | |
| 1277 | + | no party to an appeal hearing, nor any person on behalf of such party, including the1148 | |
| 1278 | + | department, shall make any ex parte contact with the appeal panel hearing officer appointed1149 | |
| 1279 | + | to conduct the appeal hearing, any other member of the appeal panel, or the commissioner1150 | |
| 1280 | + | in regard to a decision under appeal.1151 | |
| 1281 | + | (i) Within 30 days after the conclusion of the hearing, the hearing officer shall make1152 | |
| 1282 | + | written findings of fact and conclusions of law as to each consideration as set forth in Code1153 | |
| 1283 | + | Section 31-6-42 and the department's rules, including a detailed statement of the reasons1154 | |
| 1284 | + | for the decision of the hearing officer. If any party has alleged that an appeal lacks1155 | |
| 1285 | + | substantial justification or was undertaken primarily for the purpose of delay or harassment,1156 | |
| 1286 | + | the decision of the hearing officer shall make findings of fact addressing the merits of the1157 | |
| 1287 | + | allegation. The hearing officer shall file such decision with the chairperson of the appeal1158 | |
| 1288 | + | panel who shall serve such decision upon all parties, and shall transmit the administrative1159 | |
| 1289 | + | record to the commissioner. Any party, including the department, which disputes any1160 | |
| 1290 | + | finding of fact or conclusion of law rendered by the hearing officer in such hearing officer's1161 | |
| 1291 | + | decision and which wishes to appeal that decision may appeal to the commissioner and1162 | |
| 1292 | + | shall file its specific objections with the commissioner or his or her designee within 30 days1163 | |
| 1293 | + | of the date of the hearing officer's decision pursuant to rules adopted by the department.1164 | |
| 1294 | + | (j) The decision of the appeal panel hearing officer will become the final decision of the1165 | |
| 1295 | + | department upon the sixty-first day following the date of the decision unless an objection1166 | |
| 1296 | + | thereto is filed with the commissioner within the time limit established in subsection (i) of1167 | |
| 1297 | + | this Code section.1168 23 LC 33 9350 | |
| 1298 | + | S. B. 162 | |
| 1299 | + | - 46 - | |
| 1300 | + | (k)(1) In the event an appeal of the hearing officer's decision is filed, the commissioner | |
| 1301 | + | 1169 | |
| 1302 | + | may adopt the hearing officer's order as the final order of the department or the1170 | |
| 1303 | + | commissioner may reject or modify the conclusions of law over which the department has1171 | |
| 1304 | + | substantive jurisdiction and the interpretation of administrative rules over which it has1172 | |
| 1305 | + | substantive jurisdiction. By rejecting or modifying such conclusion of law or1173 | |
| 1306 | + | interpretation of administrative rule, the department must state with particularity its1174 | |
| 1307 | + | reasons for rejecting or modifying such conclusion of law or interpretation of1175 | |
| 1308 | + | administrative rule and must make a finding that its substituted conclusion of law or1176 | |
| 1309 | + | interpretation of administrative rule is as or more reasonable than that which was rejected1177 | |
| 1310 | + | or modified. Rejection or modification of conclusions of law may not form the basis for1178 | |
| 1311 | + | rejection or modification of findings of fact. The commissioner may not reject or modify1179 | |
| 1312 | + | the findings of fact unless the commissioner first determines from a review of the entire1180 | |
| 1313 | + | record, and states with particularity in the order, that the findings of fact were not based1181 | |
| 1314 | + | upon any competent substantial evidence or that the proceedings on which the findings1182 | |
| 1315 | + | were based did not comply with the essential requirements of law.1183 | |
| 1316 | + | (2) If, before the date set for the commissioner's decision, application is made to the1184 | |
| 1317 | + | commissioner for leave to present additional evidence and it is shown to the satisfaction1185 | |
| 1318 | + | of the commissioner that the additional evidence is material and there were good reasons1186 | |
| 1319 | + | for failure to present it in the proceedings before the hearing officer, the commissioner1187 | |
| 1320 | + | may order that the additional evidence be taken before the same hearing officer who1188 | |
| 1321 | + | rendered the initial decision upon conditions determined by the commissioner. The1189 | |
| 1322 | + | hearing officer may modify the initial decision by reason of the additional evidence and1190 | |
| 1323 | + | shall file that evidence and any modifications, new findings, or decision with the1191 | |
| 1324 | + | commissioner. Unless leave is given by the commissioner in accordance with the1192 | |
| 1325 | + | provisions of this subsection, the appeal panel may not consider new evidence under any1193 | |
| 1326 | + | circumstances. In all circumstances, the commissioner's decision shall be based upon1194 | |
| 1327 | + | considerations as set forth in Code Section 31-6-42 and the department's rules.1195 23 LC 33 9350 | |
| 1328 | + | S. B. 162 | |
| 1329 | + | - 47 - | |
| 1330 | + | (l) If, based upon the findings of fact by the hearing officer, the commissioner determines | |
| 1331 | + | 1196 | |
| 1332 | + | that the appeal filed by any party of a decision of the department lacks substantial1197 | |
| 1333 | + | justification and was undertaken primarily for the purpose of delay or harassment, the1198 | |
| 1334 | + | commissioner may enter an award in his or her written order against such party and in1199 | |
| 1335 | + | favor of the successful party or parties, including the department, of all or any part of their1200 | |
| 1336 | + | respective reasonable and necessary attorney's fees and expenses of litigation, as the1201 | |
| 1337 | + | commissioner deems just. Such award may be enforced by any court undertaking judicial1202 | |
| 1338 | + | review of the final decision. In the absence of any petition for judicial review, then such1203 | |
| 1339 | + | award shall be enforced, upon due application, by any court having personal jurisdiction1204 | |
| 1340 | + | over the party against whom such an award is made.1205 | |
| 1341 | + | (m) Unless the hearing officer's decision becomes the department's final decision by1206 | |
| 1342 | + | operation of law as provided in subsection (j) of this Code section, the decision of the1207 | |
| 1343 | + | commissioner shall become the department's final decision by operation of law. Such final1208 | |
| 1344 | + | decision shall be the final department decision for purposes of Chapter 13 of Title 50, the1209 | |
| 1345 | + | 'Georgia Administrative Procedure Act.' The appeals process provided by this Code1210 | |
| 1346 | + | section shall be the administrative remedy only for decisions made by the department1211 | |
| 1347 | + | pursuant to Code Section 31-6-43 which involve the approval or denial of applications for1212 | |
| 1348 | + | certificates of need.1213 | |
| 1349 | + | (n) A party responding to an appeal to the commissioner may be entitled to reasonable1214 | |
| 1350 | + | attorney's fees and costs of such appeal if it is determined that the appeal lacked substantial1215 | |
| 1351 | + | justification and was undertaken primarily for the purpose of delay or harassment;1216 | |
| 1352 | + | provided, however, that the department shall not be required to pay attorney's fees or costs.1217 | |
| 1353 | + | This subsection shall not apply to the portion of attorney's fees accrued on behalf of a party1218 | |
| 1354 | + | responding to or bringing a challenge to the department's authority to enact a rule or1219 | |
| 1355 | + | regulation or the department's jurisdiction or another challenge that could not have been1220 | |
| 1356 | + | decided in the administrative proceeding, nor shall it apply to costs accrued when the only1221 | |
| 1357 | + | argument raised by the appealing party is one described in this subsection.1222 23 LC 33 9350 | |
| 1358 | + | S. B. 162 | |
| 1359 | + | - 48 - | |
| 1360 | + | 31-6-44.1. | |
| 1361 | + | 1223 | |
| 1362 | + | (a) Any party to the initial administrative appeal hearing conducted by the appointed1224 | |
| 1363 | + | appeal panel hearing officer, excluding the department, may seek judicial review of the1225 | |
| 1364 | + | final decision in accordance with the method set forth in Chapter 13 of Title 50, the1226 | |
| 1365 | + | 'Georgia Administrative Procedure Act,' except as otherwise modified by this Code section;1227 | |
| 1366 | + | provided, however, that in conducting such review, the court may reverse or modify the1228 | |
| 1367 | + | final decision only if substantial rights of the appellant have been prejudiced because the1229 | |
| 1368 | + | procedures followed by the department, the hearing officer, or the commissioner or the1230 | |
| 1369 | + | administrative findings, inferences, and conclusions contained in the final decision are:1231 | |
| 1370 | + | (1) In violation of constitutional or statutory provisions;1232 | |
| 1371 | + | (2) In excess of the statutory authority of the department;1233 | |
| 1372 | + | (3) Made upon unlawful procedures;1234 | |
| 1373 | + | (4) Affected by other error of law;1235 | |
| 1374 | + | (5) Not supported by substantial evidence, which shall mean that the record does not1236 | |
| 1375 | + | contain such relevant evidence as a reasonable mind might accept as adequate to support1237 | |
| 1376 | + | such findings, inferences, conclusions, or decisions, which such evidentiary standard shall1238 | |
| 1377 | + | be in excess of the 'any evidence' standard contained in other statutory provisions; or1239 | |
| 1378 | + | (6) Arbitrary or capricious or characterized by abuse of discretion or clearly unwarranted1240 | |
| 1379 | + | exercise of discretion.1241 | |
| 1380 | + | (b) In the event a party seeks judicial review, the proceedings for such review shall be1242 | |
| 1381 | + | governed by Chapter 3 of Title 5 except as provided otherwise in this Code section. If a1243 | |
| 1382 | + | party seeks judicial review, the department shall, within 30 days after being served with a1244 | |
| 1383 | + | copy of the petition for review filed in the superior court, transmit certified copies of all1245 | |
| 1384 | + | documents and papers in its file together with a transcript of the testimony taken and its1246 | |
| 1385 | + | findings of fact and decision to the clerk of the superior court to which the case has been1247 | |
| 1386 | + | appealed. The case so appealed may then be brought by either party upon ten days' written1248 | |
| 1387 | + | notice to the other before the superior court for a hearing upon such record, subject to an1249 23 LC 33 9350 | |
| 1388 | + | S. B. 162 | |
| 1389 | + | - 49 - | |
| 1390 | + | assignment of the case for hearing by the court; provided, however, that, if the court does | |
| 1391 | + | 1250 | |
| 1392 | + | not hear the case within 120 days of the date of docketing in the superior court, the decision1251 | |
| 1393 | + | of the department shall be considered affirmed by operation of law unless a hearing1252 | |
| 1394 | + | originally scheduled to be heard within the 120 days has been continued to a date certain1253 | |
| 1395 | + | by order of the court. In the event a hearing is held later than 90 days after the date of1254 | |
| 1396 | + | docketing in the superior court because same has been continued to a date certain by order1255 | |
| 1397 | + | of the court, the decision of the department shall be considered affirmed by operation of1256 | |
| 1398 | + | law if no order of the court disposing of the issues on appeal has been entered within 301257 | |
| 1399 | + | days after the date of the continued hearing. If a case is heard within 120 days from the1258 | |
| 1400 | + | date of docketing in the superior court, the decision of the department shall be considered1259 | |
| 1401 | + | affirmed by operation of law if no order of the court disposing of the issues on appeal has1260 | |
| 1402 | + | been entered within 30 days of the date of the hearing.1261 | |
| 1403 | + | (c) A party responding to an appeal to the superior court shall be entitled to reasonable1262 | |
| 1404 | + | attorney's fees and costs if such party is the prevailing party of such appeal as decided by1263 | |
| 1405 | + | final order; provided, however, that | |
| 1406 | + | the department shall not be required to pay attorney's1264 | |
| 1407 | + | fees or costs. This subsection shall not apply to the portion of attorney's fees accrued on1265 | |
| 1408 | + | behalf of a party responding to or bringing a challenge to the department's authority to1266 | |
| 1409 | + | enact a rule or regulation or the department's jurisdiction or another challenge that could1267 | |
| 1410 | + | not have been raised in the administrative proceeding.1268 | |
| 1411 | + | 31-6-45.1269 | |
| 1412 | + | (a) The department may revoke a certificate of need, in whole or in part, after notice to the1270 | |
| 1413 | + | holder of the certificate and a fair hearing pursuant to Chapter 13 of Title 50, the 'Georgia1271 | |
| 1414 | + | Administrative Procedure Act,' for the following reasons:1272 | |
| 1415 | + | (1) Failure to comply with the provisions of Code Section 31-6-41;1273 | |
| 1416 | + | (2) The intentional provision of false information to the department by an applicant in1274 | |
| 1417 | + | that applicant's application;1275 23 LC 33 9350 | |
| 1418 | + | S. B. 162 | |
| 1419 | + | - 50 - | |
| 1420 | + | (3) Repeated failure to pay any fines or moneys due to the department; | |
| 1421 | + | 1276 | |
| 1422 | + | (4) Failure to maintain minimum quality of care standards that may be established by the1277 | |
| 1423 | + | department;1278 | |
| 1424 | + | (5) Failure to participate as a provider of medical assistance for Medicaid purposes1279 | |
| 1425 | + | pursuant to Code Section 31-6-45.2 or any other applicable Code section; or | |
| 1426 | + | 1280 | |
| 1427 | + | (6) The failure to submit a timely or complete report within 180 days following the date1281 | |
| 1428 | + | the report is due pursuant to Code Section 31-6-70; or1282 | |
| 1429 | + | (7) Failure of a destination cancer hospital to meet an annual patient base composed of1283 | |
| 1430 | + | a minimum of 65 percent of patients who reside outside this state for three calendar years1284 | |
| 1431 | + | in any five-year period.1285 | |
| 1432 | + | The department may not, however, revoke a certificate of need if the applicant changes the1286 | |
| 1433 | + | defined location of the project within the same county less than three miles from the1287 | |
| 1434 | + | location specified in the certificate of need for financial reasons or other reasons beyond1288 | |
| 1435 | + | its control, including, but not limited to, failure to obtain any required approval from1289 | |
| 1436 | + | zoning or other governmental agencies or entities, provided that such change in location1290 | |
| 1437 | + | is otherwise consistent with the considerations and rules applied in the evaluation of the1291 | |
| 1438 | + | project.1292 | |
| 1439 | + | (a.1) The department may revoke a certificate of need, in whole or in part, after notice to1293 | |
| 1440 | + | the holder of the certificate and a fair hearing pursuant to Chapter 13 of Title 50, the1294 | |
| 1441 | + | 'Georgia Administrative Procedure Act,' if the services or units of services for which the1295 | |
| 1442 | + | certificate of need was issued are not implemented in a timely manner, as established by1296 | |
| 1443 | + | the department in its rules. This subsection shall apply only to certificates of need issued1297 | |
| 1444 | + | on or after July 1, 2008.1298 | |
| 1445 | + | (b) Any health care facility offering a new institutional health service without having1299 | |
| 1446 | + | obtained a certificate of need and which has not been previously licensed as a health care1300 | |
| 1447 | + | facility shall be denied a license to operate.1301 23 LC 33 9350 | |
| 1448 | + | S. B. 162 | |
| 1449 | + | - 51 - | |
| 1450 | + | (c) In the event that a new institutional health service is knowingly offered or developed | |
| 1451 | + | 1302 | |
| 1452 | + | without having obtained a certificate of need as required by this chapter, or the certificate1303 | |
| 1453 | + | of need for such service is revoked according to the provisions of this Code section, a1304 | |
| 1454 | + | facility or applicant may be fined an amount of $5,000.00 per day up to 30 days,1305 | |
| 1455 | + | $10,000.00 per day from 31 days through 60 days, and $25,000.00 per day after 60 days1306 | |
| 1456 | + | for each day that the violation of this chapter has existed and knowingly and willingly1307 | |
| 1457 | + | continues; provided, however, that the expenditure or commitment of or incurring an1308 | |
| 1458 | + | obligation for the expenditure of funds to take or perform actions not subject to this chapter1309 | |
| 1459 | + | or to acquire, develop, or prepare a health care facility site for which a certificate of need1310 | |
| 1460 | + | application is denied shall not be a violation of this chapter and shall not be subject to such1311 | |
| 1461 | + | a fine. The commissioner shall determine, after notice and a hearing, whether the fines1312 | |
| 1462 | + | provided in this Code section shall be levied.1313 | |
| 1463 | + | (d) In addition, for purposes of this Code section, the State of Georgia, acting by and1314 | |
| 1464 | + | through the department, or any other interested person, shall have standing in any court of1315 | |
| 1465 | + | competent jurisdiction to maintain an action for injunctive relief to enforce the provisions1316 | |
| 1466 | + | of this chapter.1317 | |
| 1467 | + | (e) The department shall have the authority to make public or private investigations or1318 | |
| 1468 | + | examinations inside or outside of this state to determine whether all provisions of this Code1319 | |
| 1469 | + | section or any other law, rule, regulation, or formal order relating to the provisions of Code1320 | |
| 1470 | + | Section 31-6-40 has been violated. Such investigations may be initiated at any time in the1321 | |
| 1471 | + | discretion of the department and may continue during the pendency of any action initiated1322 | |
| 1472 | + | by the department pursuant to subsection (a) of this Code section. For the purpose of1323 | |
| 1473 | + | conducting any investigation or inspection pursuant to this subsection, the department shall1324 | |
| 1474 | + | have the authority, upon providing reasonable notice, to require the production of any1325 | |
| 1475 | + | books, records, papers, or other information related to any certificate of need issue.1326 23 LC 33 9350 | |
| 1476 | + | S. B. 162 | |
| 1477 | + | - 52 - | |
| 1478 | + | 31-6-45.1. | |
| 1479 | + | 1327 | |
| 1480 | + | (a) A health care facility which has a certificate of need or is otherwise authorized to1328 | |
| 1481 | + | operate pursuant to this chapter shall have such certificate of need or authority to operate1329 | |
| 1482 | + | automatically revoked by operation of law without any action by the department when that1330 | |
| 1483 | + | facility's permit to operate pursuant to Code Section 31-7-4 is finally revoked by order of1331 | |
| 1484 | + | the department. For purposes of this subsection, the date of such final revocation shall be1332 | |
| 1485 | + | as follows:1333 | |
| 1486 | + | (1) When there is no appeal of the order pursuant to Chapter 5 of this title, the one1334 | |
| 1487 | + | hundred and eightieth day after the date upon which expires the time for appealing the1335 | |
| 1488 | + | revocation order without such an appeal being filed; or1336 | |
| 1489 | + | (2) When there is an appeal of the order pursuant to Chapter 5 of this title, the date upon1337 | |
| 1490 | + | which expires the time to appeal the last administrative or judicial order affirming or1338 | |
| 1491 | + | approving the revocation or revocation order without such appeal being filed.1339 | |
| 1492 | + | (b) The services which had been authorized to be offered by a health care facility for1340 | |
| 1493 | + | which a certificate of need has been revoked pursuant to subsection (a) of this Code section1341 | |
| 1494 | + | may continue to be offered in the service area in which that facility was located under such1342 | |
| 1495 | + | conditions as specified by the department notwithstanding that some or all of such services1343 | |
| 1496 | + | could not otherwise be offered as new institutional health services.1344 | |
| 1497 | + | 31-6-45.2.1345 | |
| 1498 | + | (a) The department may require that any applicant for a certificate of need agree to1346 | |
| 1499 | + | participate as a provider of medical assistance for Medicaid purposes pursuant to Article 71347 | |
| 1500 | + | of Chapter 4 of Title 49.1348 | |
| 1501 | + | (b) Any proposed or existing health care facility which obtains a certificate of need on or1349 | |
| 1502 | + | after April 6, 1992, based in part upon assurances that it will participate as a provider of1350 | |
| 1503 | + | medical assistance, as defined in paragraph (6) of Code Section 49-4-141, and which1351 | |
| 1504 | + | terminates its participation as a provider of medical assistance or violates any conditions1352 23 LC 33 9350 | |
| 1505 | + | S. B. 162 | |
| 1506 | + | - 53 - | |
| 1507 | + | imposed by the department relating to such participation, shall be subject to a monetary | |
| 1508 | + | 1353 | |
| 1509 | + | penalty in the amount of the difference between the Medicaid covered services which the1354 | |
| 1510 | + | facility agreed to provide in its certificate of need application and the amount actually1355 | |
| 1511 | + | provided and may be subject to revocation of its certificate of need by the department1356 | |
| 1512 | + | pursuant to Code Section 31-6-45; provided, however, that this Code section shall not1357 | |
| 1513 | + | apply if:1358 | |
| 1514 | + | (1) The proposed or existing health care facility's certificate of need application was1359 | |
| 1515 | + | approved by the Health Planning Agency prior to April 6, 1992, and the Health Planning1360 | |
| 1516 | + | Agency's approval of such application was under appeal on or after April 6, 1992, and the1361 | |
| 1517 | + | Health Planning Agency's approval of such application is ultimately affirmed;1362 | |
| 1518 | + | (2) Such facility's participation as a provider of medical assistance is terminated by the1363 | |
| 1519 | + | state or federal government; or1364 | |
| 1520 | + | (3) Such facility establishes good cause for terminating its participation as a provider of1365 | |
| 1521 | + | medical assistance. For purposes of this Code section, the term | |
| 1522 | + | 'good cause' shall mean:1366 | |
| 1523 | + | (A) Changes in the adequacy of medical assistance payments, as 'medical assistance'1367 | |
| 1524 | + | is defined in paragraph (5) of Code Section 49-4-141, provided that at least 10 percent1368 | |
| 1525 | + | of the facility's utilization during the preceding 12 month period was attributable to1369 | |
| 1526 | + | services to recipients of medical assistance, as defined in paragraph (7) of Code1370 | |
| 1527 | + | Section 49-4-141. Medical assistance payments to a facility shall be presumed1371 | |
| 1528 | + | adequate unless the revenues received by the facility from all sources are less than the1372 | |
| 1529 | + | total costs set forth in the cost report for the preceding full 12 month period filed by1373 | |
| 1530 | + | such facility pursuant to the state plan as defined in paragraph (8) of Code1374 | |
| 1531 | + | Section 49-4-141 which are allowed under the state plan for purposes of determining1375 | |
| 1532 | + | such facility's reimbursement rate for medical assistance and the aggregate amount of1376 | |
| 1533 | + | such facility's medical assistance payments (including any amounts received by the1377 | |
| 1534 | + | facility from recipients of medical assistance) during the preceding full 12 month cost1378 | |
| 1535 | + | reporting period is less than 85 percent of such facility's Medicaid costs for such period.1379 23 LC 33 9350 | |
| 1536 | + | S. B. 162 | |
| 1537 | + | - 54 - | |
| 1538 | + | Medicaid costs shall be determined by multiplying the allowable costs set forth in the | |
| 1539 | + | 1380 | |
| 1540 | + | cost report, less any audit adjustments, by the percentage of the facility's utilization1381 | |
| 1541 | + | during the cost reporting period which was attributable to recipients of medical1382 | |
| 1542 | + | assistance;1383 | |
| 1543 | + | (B) Changes in the overall ability of the facility to cover its costs if such changes are1384 | |
| 1544 | + | of such a degree as to seriously threaten the continued viability of the facility; or1385 | |
| 1545 | + | (C) Changes in the state plan, statutes, or rules and regulations governing providers of1386 | |
| 1546 | + | medical assistance which impose substantial new obligations upon the facility which1387 | |
| 1547 | + | are not reimbursed by Medicaid and which adversely affect the financial viability of the1388 | |
| 1548 | + | facility in a substantial manner.1389 | |
| 1549 | + | (c) A facility seeking to terminate its enrollment as a provider of medical assistance shall1390 | |
| 1550 | + | submit a written request to the department documenting good cause for termination. The1391 | |
| 1551 | + | department shall grant or deny the facility's request within 30 days. If the department1392 | |
| 1552 | + | denies the facility's request, the facility shall be entitled to a hearing conducted in the same1393 | |
| 1553 | + | manner as an evidentiary hearing conducted by the department pursuant to the provisions1394 | |
| 1554 | + | of Code Section 49-4-153 within 30 days of the department's decision.1395 | |
| 1555 | + | (d) The imposition of the monetary penalty provided in this Code section shall commence1396 | |
| 1556 | + | upon the date that said facility has terminated its participation as a provider of medical1397 | |
| 1557 | + | assistance, as determined by the commissioner. The monetary penalty shall be levied and1398 | |
| 1558 | + | collected by the department on an annual basis for every year in which the facility fails to1399 | |
| 1559 | + | participate as a provider of medical assistance. Penalties authorized under this Code1400 | |
| 1560 | + | section shall be subject to the same notices and hearings as provided for levy of fines under1401 | |
| 1561 | + | Code Section 31-6-45.1402 | |
| 1562 | + | 31-6-46.1403 | |
| 1563 | + | The department shall prepare and submit an annual report to the board and to the Senate | |
| 1564 | + | 1404 | |
| 1565 | + | Health and Human Services Committee of the Senate and the House Committee on Health1405 23 LC 33 9350 | |
| 1566 | + | S. B. 162 | |
| 1567 | + | - 55 - | |
| 1568 | + | and Human Services Committee of the House of Representatives about its operations and1406 | |
| 1569 | + | decisions for the preceding 12 month period, not later than 30 days prior to each convening1407 | |
| 1570 | + | of the General Assembly in regular session. Either committee may request any additional1408 | |
| 1571 | + | reports or information, including decisions, from the department at any time, including a1409 | |
| 1572 | + | period in which the General Assembly is not in regular session. The annual report shall1410 | |
| 1573 | + | include information and updates relating to the state health plan and the certificate of need1411 | |
| 1574 | + | program and an annual analysis of proactive and prospective approaches to need1412 | |
| 1575 | + | methodologies and access to health care services. The annual report shall include1413 | |
| 1576 | + | information for Georgia's congressional delegation which highlights issues regarding1414 | |
| 1577 | + | federal laws and regulations influencing Medicaid and medicare, insurance and related tax1415 | |
| 1578 | + | laws, and long-term health care.1416 | |
| 1579 | + | 31-6-47.1417 | |
| 1580 | + | (a) Notwithstanding the other provisions of this chapter, this chapter shall not apply to:1418 | |
| 1581 | + | (1) Infirmaries operated by educational institutions for the sole and exclusive benefit of1419 | |
| 1582 | + | students, faculty members, officers, or employees thereof;1420 | |
| 1583 | + | (2) Infirmaries or facilities operated by businesses for the sole and exclusive benefit of1421 | |
| 1584 | + | officers or employees thereof, provided that such infirmaries or facilities make no1422 | |
| 1585 | + | provision for overnight stay by persons receiving their services;1423 | |
| 1586 | + | (3)(1) Institutions operated exclusively by the federal government or by any of its1424 | |
| 1587 | + | agencies;1425 | |
| 1588 | + | (4) Offices of private physicians or dentists whether for individual or group practice,1426 | |
| 1589 | + | except as otherwise provided in paragraph (3) or (7) of subsection (a) of Code Section1427 | |
| 1590 | + | 31-6-40;1428 | |
| 1591 | + | (5)(2) Religious, nonmedical health care institutions as defined in 42 U.S.C. Section1429 | |
| 1592 | + | 1395x(ss)(1), listed and certified by a national accrediting organization;1430 23 LC 33 9350 | |
| 1593 | + | S. B. 162 | |
| 1594 | + | - 56 - | |
| 1595 | + | (6)(3) Site acquisitions for health care facilities or preparation or development costs for1431 | |
| 1596 | + | such sites prior to the decision to file a certificate of need application;1432 | |
| 1597 | + | (7)(4) Expenditures related to adequate preparation and development of an application1433 | |
| 1598 | + | for a certificate of need;1434 | |
| 1599 | + | (8)(5) The commitment of funds conditioned upon the obtaining of a certificate of need;1435 | |
| 1600 | + | (9)(6) Expenditures for the restructuring or acquisition of existing health care facilities1436 | |
| 1601 | + | by stock or asset purchase, merger, consolidation, or other lawful means;1437 | |
| 1602 | + | (9.1) The purchase of a closing hospital or of a hospital that has been closed for no more1438 | |
| 1603 | + | than 12 months by a hospital in a contiguous county to repurpose the facility as a1439 | |
| 1604 | + | micro-hospital;1440 | |
| 1605 | + | (10) Expenditures of less than $870,000.00 for any minor or major repair or replacement1441 | |
| 1606 | + | of equipment by a health care facility that is not owned by a group practice of physicians1442 | |
| 1607 | + | or a hospital and that provides diagnostic imaging services if such facility received a1443 | |
| 1608 | + | letter of nonreviewability from the department prior to July 1, 2008. This paragraph shall1444 | |
| 1609 | + | not apply to such facilities in rural counties;1445 | |
| 1610 | + | (10.1)(7) Expenditures Except as provided in paragraph (10) of this subsection,1446 | |
| 1611 | + | expenditures for the minor or major repair of a health care facility or a facility that is1447 | |
| 1612 | + | exempt from the requirements of this chapter, parts thereof or services provided or1448 | |
| 1613 | + | equipment used therein; or the replacement of equipment, including but not limited to CT1449 | |
| 1614 | + | scanners, magnetic resonance imaging, positron emission tomography (PET), and1450 | |
| 1615 | + | positron emission tomography/computed tomography previously approved for a1451 | |
| 1616 | + | certificate of need;1452 | |
| 1617 | + | (11)(8) Capital expenditures otherwise covered by this chapter required solely to1453 | |
| 1618 | + | eliminate or prevent safety hazards as defined by federal, state, or local fire, building,1454 | |
| 1619 | + | environmental, occupational health, or life safety codes or regulations, to comply with1455 | |
| 1620 | + | licensing requirements of the department, or to comply with accreditation standards of1456 | |
| 1621 | + | a nationally recognized health care accreditation body;1457 23 LC 33 9350 | |
| 1622 | + | S. B. 162 | |
| 1623 | + | - 57 - | |
| 1624 | + | (12)(9) Cost overruns whose percentage of the cost of a project is equal to or less than1458 | |
| 1625 | + | the cumulative annual rate of increase in the composite construction index, published by1459 | |
| 1626 | + | the United States Bureau of the Census of the Department of Commerce, calculated from1460 | |
| 1627 | + | the date of approval of the project;1461 | |
| 1628 | + | (13)(10) Transfers from one health care facility to another such facility of major medical1462 | |
| 1629 | + | equipment previously approved under or exempted from certificate of need review,1463 | |
| 1630 | + | except where such transfer results in the institution of a new clinical health service for1464 | |
| 1631 | + | which a certificate of need is required in the facility acquiring such equipment, provided1465 | |
| 1632 | + | that such transfers are recorded at net book value of the medical equipment as recorded1466 | |
| 1633 | + | on the books of the transferring facility;1467 | |
| 1634 | + | (14)(11) New institutional health services provided by or on behalf of health1468 | |
| 1635 | + | maintenance organizations or related health care facilities in circumstances defined by1469 | |
| 1636 | + | the department pursuant to federal law;1470 | |
| 1637 | + | (15) Increases in the bed capacity of a hospital up to ten beds or 10 percent of capacity,1471 | |
| 1638 | + | whichever is greater, in any consecutive two-year period, in a hospital that has1472 | |
| 1639 | + | maintained an overall occupancy rate greater than 75 percent for the previous 12 month1473 | |
| 1640 | + | period;1474 | |
| 1641 | + | (16)(12) Expenditures for nonclinical projects, including parking lots, parking decks, and1475 | |
| 1642 | + | other parking facilities; computer systems, software, and other information technology;1476 | |
| 1643 | + | medical office buildings; administrative office space; conference rooms; education1477 | |
| 1644 | + | facilities; lobbies; common spaces; clinical staff lounges and sleep areas; waiting rooms;1478 | |
| 1645 | + | bathrooms; cafeterias; hallways; engineering facilities; mechanical systems; roofs;1479 | |
| 1646 | + | grounds; signage; family meeting or lounge areas; and other nonclinical physical plant1480 | |
| 1647 | + | renovations or upgrades that do not result in new or expanded clinical health services, and1481 | |
| 1648 | + | state mental health facilities;1482 | |
| 1649 | + | (17)(13) Life plan communities, provided that the skilled nursing component of the1483 | |
| 1650 | + | facility is for the exclusive use of residents of the life plan community and that a written1484 23 LC 33 9350 | |
| 1651 | + | S. B. 162 | |
| 1652 | + | - 58 - | |
| 1653 | + | exemption is obtained from the department; provided, however, that new sheltered | |
| 1654 | + | 1485 | |
| 1655 | + | nursing home beds may be used on a limited basis by persons who are not residents of1486 | |
| 1656 | + | the life plan community for a period up to five years after the date of issuance of the1487 | |
| 1657 | + | initial nursing home license, but such beds shall not be eligible for Medicaid1488 | |
| 1658 | + | reimbursement. For the first year, the life plan community sheltered nursing facility may1489 | |
| 1659 | + | utilize not more than 50 percent of its licensed beds for patients who are not residents of1490 | |
| 1660 | + | the life plan community. In the second year of operation, the life plan community shall1491 | |
| 1661 | + | allow not more than 40 percent of its licensed beds for new patients who are not residents1492 | |
| 1662 | + | of the life plan community. In the third year of operation, the life plan community shall1493 | |
| 1663 | + | allow not more than 30 percent of its licensed beds for new patients who are not residents1494 | |
| 1664 | + | of the life plan community. In the fourth year of operation, the life plan community shall1495 | |
| 1665 | + | allow not more than 20 percent of its licensed beds for new patients who are not residents1496 | |
| 1666 | + | of the life plan community. In the fifth year of operation, the life plan community shall1497 | |
| 1667 | + | allow not more than 10 percent of its licensed beds for new patients who are not residents1498 | |
| 1668 | + | of the life plan community. At no time during the first five years shall the life plan1499 | |
| 1669 | + | community sheltered nursing facility occupy more than 50 percent of its licensed beds1500 | |
| 1670 | + | with patients who are not residents under contract with the life plan community. At the1501 | |
| 1671 | + | end of the five-year period, the life plan community sheltered nursing facility shall be1502 | |
| 1672 | + | utilized exclusively by residents of the life plan community, and at no time shall a1503 | |
| 1673 | + | resident of a life plan community be denied access to the sheltered nursing facility. At1504 | |
| 1674 | + | no time shall any existing patient be forced to leave the life plan community to comply1505 | |
| 1675 | + | with this paragraph. The department is authorized to promulgate rules and regulations1506 | |
| 1676 | + | regarding the use and definition of 'sheltered nursing facility' in a manner consistent with1507 | |
| 1677 | + | this Code section. Agreements to provide continuing care include agreements to provide1508 | |
| 1678 | + | care for any duration, including agreements that are terminable by either party;1509 | |
| 1679 | + | (18) Any single specialty ambulatory surgical center that: | |
| 1680 | + | 1510 23 LC 33 9350 | |
| 1681 | + | S. B. 162 | |
| 1682 | + | - 59 - | |
| 1683 | + | (A)(i) Has capital expenditures associated with the construction, development, or1511 | |
| 1684 | + | other establishment of the clinical health service which do not exceed $2.5 million;1512 | |
| 1685 | + | or1513 | |
| 1686 | + | (ii) Is the only single specialty ambulatory surgical center in the county owned by the1514 | |
| 1687 | + | group practice and has two or fewer operating rooms; provided, however, that a center1515 | |
| 1688 | + | exempt pursuant to this division shall be required to obtain a certificate of need in1516 | |
| 1689 | + | order to add any additional operating rooms;1517 | |
| 1690 | + | (B) Has a hospital affiliation agreement with a hospital within a reasonable distance1518 | |
| 1691 | + | from the facility or the medical staff at the center has admitting privileges or other1519 | |
| 1692 | + | acceptable documented arrangements with such hospital to ensure the necessary backup1520 | |
| 1693 | + | for the center for medical complications. The center shall have the capability to transfer1521 | |
| 1694 | + | a patient immediately to a hospital within a reasonable distance from the facility with1522 | |
| 1695 | + | adequate emergency room services. Hospitals shall not unreasonably deny a transfer1523 | |
| 1696 | + | agreement or affiliation agreement to the center;1524 | |
| 1697 | + | (C)(i) Provides care to Medicaid beneficiaries and, if the facility provides medical1525 | |
| 1698 | + | care and treatment to children, to PeachCare for Kids beneficiaries and provides1526 | |
| 1699 | + | uncompensated indigent and charity care in an amount equal to or greater than1527 | |
| 1700 | + | 2 percent of its adjusted gross revenue; or1528 | |
| 1701 | + | (ii) If the center is not a participant in Medicaid or the PeachCare for Kids Program,1529 | |
| 1702 | + | provides uncompensated care to Medicaid beneficiaries and, if the facility provides1530 | |
| 1703 | + | medical care and treatment to children, to PeachCare for Kids beneficiaries,1531 | |
| 1704 | + | uncompensated indigent and charity care, or both in an amount equal to or greater1532 | |
| 1705 | + | than 4 percent of its adjusted gross revenue;1533 | |
| 1706 | + | provided, however, that single specialty ambulatory surgical centers owned by1534 | |
| 1707 | + | physicians in the practice of ophthalmology shall not be required to comply with this1535 | |
| 1708 | + | subparagraph; and1536 23 LC 33 9350 | |
| 1709 | + | S. B. 162 | |
| 1710 | + | - 60 - | |
| 1711 | + | (D) Provides annual reports in the same manner and in accordance with Code1537 | |
| 1712 | + | Section 31-6-70.1538 | |
| 1713 | + | Noncompliance with any condition of this paragraph shall result in a monetary penalty1539 | |
| 1714 | + | in the amount of the difference between the services which the center is required to1540 | |
| 1715 | + | provide and the amount actually provided and may be subject to revocation of its1541 | |
| 1716 | + | exemption status by the department for repeated failure to pay any fines or moneys due1542 | |
| 1717 | + | to the department or for repeated failure to produce data as required by Code1543 | |
| 1718 | + | Section 31-6-70 after notice to the exemption holder and a fair hearing pursuant to1544 | |
| 1719 | + | Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act.' The dollar amount1545 | |
| 1720 | + | specified in this paragraph shall be adjusted annually by an amount calculated by1546 | |
| 1721 | + | multiplying such dollar amount (as adjusted for the preceding year) by the annual1547 | |
| 1722 | + | percentage of change in the composite index of construction material prices, or its1548 | |
| 1723 | + | successor or appropriate replacement index, if any, published by the United States1549 | |
| 1724 | + | Department of Commerce for the preceding calendar year, commencing on July 1, 2009,1550 | |
| 1725 | + | and on each anniversary thereafter of publication of the index. The department shall1551 | |
| 1726 | + | immediately institute rule-making procedures to adopt such adjusted dollar amounts. In1552 | |
| 1727 | + | calculating the dollar amounts of a proposed project for purposes of this paragraph, the1553 | |
| 1728 | + | costs of all items subject to review by this chapter and items not subject to review by this1554 | |
| 1729 | + | chapter associated with and simultaneously developed or proposed with the project shall1555 | |
| 1730 | + | be counted, except for the expenditure or commitment of or incurring an obligation for1556 | |
| 1731 | + | the expenditure of funds to develop certificate of need applications, studies, reports,1557 | |
| 1732 | + | schematics, preliminary plans and specifications or working drawings, or to acquire sites;1558 | |
| 1733 | + | (19) Any joint venture ambulatory surgical center that:1559 | |
| 1734 | + | (A) Has capital expenditures associated with the construction, development, or other1560 | |
| 1735 | + | establishment of the clinical health service which do not exceed $5 million;1561 | |
| 1736 | + | (B)(i) Provides care to Medicaid beneficiaries and, if the facility provides medical1562 | |
| 1737 | + | care and treatment to children, to PeachCare for Kids beneficiaries and provides1563 23 LC 33 9350 | |
| 1738 | + | S. B. 162 | |
| 1739 | + | - 61 - | |
| 1740 | + | uncompensated indigent and charity care in an amount equal to or greater than 21564 | |
| 1741 | + | percent of its adjusted gross revenue; or1565 | |
| 1742 | + | (ii) If the center is not a participant in Medicaid or the PeachCare for Kids Program,1566 | |
| 1743 | + | provides uncompensated care to Medicaid beneficiaries and, if the facility provides1567 | |
| 1744 | + | medical care and treatment to children, to PeachCare for Kids beneficiaries,1568 | |
| 1745 | + | uncompensated indigent and charity care, or both in an amount equal to or greater1569 | |
| 1746 | + | than 4 percent of its adjusted gross revenue; and1570 | |
| 1747 | + | (C) Provides annual reports in the same manner and in accordance with Code Section1571 | |
| 1748 | + | 31-6-70.1572 | |
| 1749 | + | Noncompliance with any condition of this paragraph shall result in a monetary penalty1573 | |
| 1750 | + | in the amount of the difference between the services which the center is required to1574 | |
| 1751 | + | provide and the amount actually provided and may be subject to revocation of its1575 | |
| 1752 | + | exemption status by the department for repeated failure to pay any fines or moneys due1576 | |
| 1753 | + | to the department or for repeated failure to produce data as required by Code1577 | |
| 1754 | + | Section 31-6-70 after notice to the exemption holder and a fair hearing pursuant to1578 | |
| 1755 | + | Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act.' The dollar amount1579 | |
| 1756 | + | specified in this paragraph shall be adjusted annually by an amount calculated by1580 | |
| 1757 | + | multiplying such dollar amount (as adjusted for the preceding year) by the annual1581 | |
| 1758 | + | percentage of change in the composite index of construction material prices, or its1582 | |
| 1759 | + | successor or appropriate replacement index, if any, published by the United States1583 | |
| 1760 | + | Department of Commerce for the preceding calendar year, commencing on July 1, 2009,1584 | |
| 1761 | + | and on each anniversary thereafter of publication of the index. The department shall1585 | |
| 1762 | + | immediately institute rule-making procedures to adopt such adjusted dollar amounts. In1586 | |
| 1763 | + | calculating the dollar amounts of a proposed project for purposes of this paragraph, the1587 | |
| 1764 | + | costs of all items subject to review by this chapter and items not subject to review by this1588 | |
| 1765 | + | chapter associated with and simultaneously developed or proposed with the project shall1589 | |
| 1766 | + | be counted, except for the expenditure or commitment of or incurring an obligation for1590 23 LC 33 9350 | |
| 1767 | + | S. B. 162 | |
| 1768 | + | - 62 - | |
| 1769 | + | the expenditure of funds to develop certificate of need applications, studies, reports,1591 | |
| 1770 | + | schematics, preliminary plans and specifications or working drawings, or to acquire sites;1592 | |
| 1771 | + | (20) Expansion of services by an imaging center based on a population needs1593 | |
| 1772 | + | methodology taking into consideration whether the population residing in the area served1594 | |
| 1773 | + | by the imaging center has a need for expanded services, as determined by the department1595 | |
| 1774 | + | in accordance with its rules and regulations, if such imaging center:1596 | |
| 1775 | + | (A) Was in existence and operational in this state on January 1, 2008;1597 | |
| 1776 | + | (B) Is owned by a hospital or by a physician or a group of physicians comprising at1598 | |
| 1777 | + | least 80 percent ownership who are currently board certified in radiology;1599 | |
| 1778 | + | (C) Provides three or more diagnostic and other imaging services;1600 | |
| 1779 | + | (D) Accepts all patients regardless of ability to pay; and1601 | |
| 1780 | + | (E) Provides uncompensated indigent and charity care in an amount equal to or greater1602 | |
| 1781 | + | than the amount of such care provided by the geographically closest general acute care1603 | |
| 1782 | + | hospital; provided, however, that this paragraph shall not apply to an imaging center in1604 | |
| 1783 | + | a rural county;1605 | |
| 1784 | + | (21) Diagnostic cardiac catheterization in a hospital setting on patients 15 years of age1606 | |
| 1785 | + | and older;1607 | |
| 1786 | + | (22) Therapeutic cardiac catheterization in hospitals selected by the department prior to1608 | |
| 1787 | + | July 1, 2008, to participate in the Atlantic Cardiovascular Patient Outcomes Research1609 | |
| 1788 | + | Team (C-PORT) Study and therapeutic cardiac catheterization in hospitals that, as1610 | |
| 1789 | + | determined by the department on an annual basis, meet the criteria to participate in the1611 | |
| 1790 | + | C-PORT Study but have not been selected for participation; provided, however, that if1612 | |
| 1791 | + | the criteria requires a transfer agreement to another hospital, no hospital shall1613 | |
| 1792 | + | unreasonably deny a transfer agreement to another hospital;1614 | |
| 1793 | + | (23)(14) Facilities Infirmaries or facilities operated by, on behalf of, or under contract1615 | |
| 1794 | + | with the Department of Corrections or the Department of Juvenile Justice for the sole and1616 | |
| 1795 | + | exclusive purpose of providing health care services in a secure environment to prisoners1617 23 LC 33 9350 | |
| 1796 | + | S. B. 162 | |
| 1797 | + | - 63 - | |
| 1798 | + | within a penal institution, penitentiary, prison, detention center, or other secure | |
| 1799 | + | 1618 | |
| 1800 | + | correctional institution, including correctional institutions operated by private entities in1619 | |
| 1801 | + | this state which house inmates under the Department of Corrections or the Department1620 | |
| 1802 | + | of Juvenile Justice;1621 | |
| 1803 | + | (24) | |
| 1804 | + | (15) The relocation of any skilled nursing facility, or intermediate care facility, or1622 | |
| 1805 | + | micro-hospital within the same county, any other health care facility in a rural county1623 | |
| 1806 | + | within the same county, and any other health care facility in an urban county within a1624 | |
| 1807 | + | three-mile radius of the existing facility so long as the facility does not propose to offer1625 | |
| 1808 | + | any new or expanded clinical health services at the new location; or1626 | |
| 1809 | + | (25) Facilities which are devoted to the provision of treatment and rehabilitative care for1627 | |
| 1810 | + | periods continuing for 24 hours or longer for persons who have traumatic brain injury,1628 | |
| 1811 | + | as defined in Code Section 37-3-1;1629 | |
| 1812 | + | (26) Capital expenditures for a project otherwise requiring a certificate of need if those1630 | |
| 1813 | + | expenditures are for a project to remodel, renovate, replace, or any combination thereof,1631 | |
| 1814 | + | a medical-surgical hospital and:1632 | |
| 1815 | + | (A) That hospital:1633 | |
| 1816 | + | (i) Has a bed capacity of not more than 50 beds;1634 | |
| 1817 | + | (ii) Is located in a county in which no other medical-surgical hospital is located;1635 | |
| 1818 | + | (iii) Has at any time been designated as a disproportionate share hospital by the1636 | |
| 1819 | + | department; and1637 | |
| 1820 | + | (iv) Has at least 45 percent of its patient revenues derived from medicare, Medicaid,1638 | |
| 1821 | + | or any combination thereof, for the immediately preceding three years; and1639 | |
| 1822 | + | (B) That project:1640 | |
| 1823 | + | (i) Does not result in any of the following:1641 | |
| 1824 | + | (I) The offering of any new clinical health services;1642 | |
| 1825 | + | (II) Any increase in bed capacity;1643 | |
| 1826 | + | (III) Any redistribution of existing beds among existing clinical health services; or1644 23 LC 33 9350 | |
| 1827 | + | S. B. 162 | |
| 1828 | + | - 64 - | |
| 1829 | + | (IV) Any increase in capacity of existing clinical health services;1645 | |
| 1830 | + | (ii) Has at least 80 percent of its capital expenditures financed by the proceeds of a1646 | |
| 1831 | + | special purpose county sales and use tax imposed pursuant to Article 3 of Chapter 81647 | |
| 1832 | + | of Title 48; and1648 | |
| 1833 | + | (iii) Is located within a three-mile radius of and within the same county as the1649 | |
| 1834 | + | hospital's existing facility;1650 | |
| 1835 | + | (27)(16) The renovation, remodeling, refurbishment, or upgrading of a health care1651 | |
| 1836 | + | facility, so long as the project does not result in any of the following:1652 | |
| 1837 | + | (A) The offering of any new or expanded clinical health services; or1653 | |
| 1838 | + | (B) Any increase in inpatient bed capacity;1654 | |
| 1839 | + | (C) Any redistribution of existing beds among existing clinical health services; or1655 | |
| 1840 | + | (D)(B) A capital expenditure exceeding the threshold contained in paragraph (2) of1656 | |
| 1841 | + | subsection (a) of Code Section 31-6-40;.1657 | |
| 1842 | + | (28) Other than for equipment used to provide positron emission tomography (PET)1658 | |
| 1843 | + | services, the acquisition of diagnostic, therapeutic, or other imaging equipment with a1659 | |
| 1844 | + | value of $3 million or less, by or on behalf of:1660 | |
| 1845 | + | (A) A hospital; or1661 | |
| 1846 | + | (B) An individual private physician or single group practice of physicians exclusively1662 | |
| 1847 | + | for use on patients of such private physician or single group practice of physicians and1663 | |
| 1848 | + | such private physician or member of such single group practice of physicians is1664 | |
| 1849 | + | physically present at the practice location where the diagnostic or other imaging1665 | |
| 1850 | + | equipment is located at least 75 percent of the time that the equipment is in use.1666 | |
| 1851 | + | The amount specified in this paragraph shall not include build-out costs, as defined by1667 | |
| 1852 | + | the department, but shall include all functionally related equipment, software, and any1668 | |
| 1853 | + | warranty and services contract costs for the first five years. The acquisition of one or1669 | |
| 1854 | + | more items of functionally related diagnostic or therapeutic equipment shall be1670 | |
| 1855 | + | considered as one project. The dollar amount specified in this paragraph and in1671 23 LC 33 9350 | |
| 1856 | + | S. B. 162 | |
| 1857 | + | - 65 - | |
| 1858 | + | paragraph (10) of this subsection shall be adjusted annually by an amount calculated by1672 | |
| 1859 | + | multiplying such dollar amounts (as adjusted for the preceding year) by the annual1673 | |
| 1860 | + | percentage of change in the consumer price index, or its successor or appropriate1674 | |
| 1861 | + | replacement index, if any, published by the United States Department of Labor for the1675 | |
| 1862 | + | preceding calendar year, commencing on July 1, 2010; and1676 | |
| 1863 | + | (29) A capital expenditure of $10 million or less by a hospital at such hospital's primary1677 | |
| 1864 | + | campus for:1678 | |
| 1865 | + | (A) The expansion or addition of the following clinical health services: operating1679 | |
| 1866 | + | rooms, other than dedicated outpatient operating rooms; medical-surgical services;1680 | |
| 1867 | + | gynecology; procedure rooms; intensive care; pharmaceutical services; pediatrics;1681 | |
| 1868 | + | cardiac care or other general hospital services; provided, however, that such1682 | |
| 1869 | + | expenditure does not include the expansion or addition of inpatient beds or the1683 | |
| 1870 | + | conversion of one type of inpatient bed to another type of inpatient bed; or1684 | |
| 1871 | + | (B) The movement of clinical health services from one location on the hospital's1685 | |
| 1872 | + | primary campus to another location on such hospital's primary campus.1686 | |
| 1873 | + | (b) By rule, the department shall establish a procedure for expediting or waiving reviews1687 | |
| 1874 | + | of certain projects the nonreview of which it deems compatible with the purposes of this1688 | |
| 1875 | + | chapter, in addition to expenditures exempted from review by this Code section.1689 | |
| 1876 | + | 31-6-47.1.1690 | |
| 1877 | + | The department shall require prior notice from a new health care facility for approval of1691 | |
| 1878 | + | any activity which is believed to be exempt pursuant to Code Section 31-6-47 or excluded1692 | |
| 1879 | + | from the requirements of this chapter under other provisions of this chapter. The1693 | |
| 1880 | + | department may require prior notice and approval of any activity which is believed to be1694 | |
| 1881 | + | exempt pursuant to paragraphs (10), (15), (16), (17), (20), (21), (23), (25), (26), (27), (28),1695 | |
| 1882 | + | and (29) (12), (13), and (14) of subsection (a) of Code Section 31-6-47. The department1696 | |
| 1883 | + | shall establish timeframes, forms, and criteria to request a letter of determination that an1697 23 LC 33 9350 | |
| 1884 | + | S. B. 162 | |
| 1885 | + | - 66 - | |
| 1886 | + | activity is properly exempt or excluded under this chapter prior to its implementation. The | |
| 1887 | + | 1698 | |
| 1888 | + | department shall publish notice of all requests for letters of determination regarding exempt1699 | |
| 1889 | + | activity and opposition to such request. Persons opposing a request for approval of an1700 | |
| 1890 | + | exempt activity shall be entitled to file an objection with the department and the department1701 | |
| 1891 | + | shall consider any filed objection when determining whether an activity is exempt. After1702 | |
| 1892 | + | the department's decision, an opposing party shall have the right to a fair hearing pursuant1703 | |
| 1893 | + | to Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act,' on an adverse1704 | |
| 1894 | + | decision of the department and judicial review of a final decision in the same manner and1705 | |
| 1895 | + | under the same provisions as in Code Section 31-6-44.1. If no objection to a request for1706 | |
| 1896 | + | determination is filed within 30 days of the department's receipt of such request for1707 | |
| 1897 | + | determination, the department shall have 60 days from the date of the department's receipt1708 | |
| 1898 | + | of such request to review the request and issue a letter of determination. The department1709 | |
| 1899 | + | may adopt rules for deciding when it is not practicable to provide a determination in 601710 | |
| 1900 | + | days and may extend the review period upon written notice to the requestor but only for an1711 | |
| 1901 | + | extended period of no longer than an additional 30 days.1712 | |
| 1902 | + | 31-6-48.1713 | |
| 1903 | + | The State Health Planning and Development Agency, the State-wide Health Coordinating1714 | |
| 1904 | + | Council, and the State Health Planning Review Board existing immediately prior to1715 | |
| 1905 | + | July 1, 1983, are abolished, and their respective successors on and after July 1, 1983, shall1716 | |
| 1906 | + | be the Health Planning Agency, the Health Policy Council, and the Health Planning1717 | |
| 1907 | + | Review Board, as established in this chapter, except that on and after July 1, 1991, the1718 | |
| 1908 | + | Health Strategies Council shall be the successor to the Health Policy Council, and except1719 | |
| 1909 | + | that on and after July 1, 1999, the Department of Community Health shall be the successor1720 | |
| 1910 | + | to the Health Planning Agency, and except that on and after July 1, 2008, the Board of1721 | |
| 1911 | + | Community Health shall be the successor to the duties of the Health Strategies Council1722 | |
| 1912 | + | with respect to adoption of the state health plan, and except that on June 30, 2008, the1723 23 LC 33 9350 | |
| 1913 | + | S. B. 162 | |
| 1914 | + | - 67 - | |
| 1915 | + | Health Planning Review Board is abolished and the terms of all members on such board | |
| 1916 | + | 1724 | |
| 1917 | + | on such date shall automatically terminate and the Certificate of Need Appeal Panel shall1725 | |
| 1918 | + | be the successor to the duties of the Health Planning Review Board on such date. For1726 | |
| 1919 | + | purposes of any existing contract with the federal government, or federal law referring to1727 | |
| 1920 | + | such abolished agency, council, or board, the successor department, council, or board1728 | |
| 1921 | + | established in this chapter or in Chapter 2 of this title shall be deemed to be the abolished1729 | |
| 1922 | + | agency, council, or board and shall succeed to the abolished agency's, council's, or board's1730 | |
| 1923 | + | functions. The State Health Planning and Development Commission is abolished.1731 | |
| 1924 | + | 31-6-49.1732 | |
| 1925 | + | All matters transferred to the Health Planning Agency by the previously existing provisions1733 | |
| 1926 | + | of this Code section and that are in effect on June 30, 1999, shall automatically be1734 | |
| 1927 | + | transferred to the Department of Community Health on July 1, 1999. All matters of the1735 | |
| 1928 | + | Health Planning Review Board that are pending on June 30, 2008, shall automatically be1736 | |
| 1929 | + | transferred to the Certificate of Need Appeal Panel established pursuant to Code1737 | |
| 1930 | + | Section 31-6-44.1738 | |
| 1931 | + | 31-6-50.1739 | |
| 1932 | + | The review and appeal considerations and procedures set forth in Code Sections 31-6-421740 | |
| 1933 | + | through 31-6-44, respectively, shall apply to and govern the review of capital expenditures1741 | |
| 1934 | + | under the Section 1122 program of the federal Social Security Act of 1935, as amended,1742 | |
| 1935 | + | including, but not limited to, any application for approval under Section 1122 which is1743 | |
| 1936 | + | under consideration by the Health Planning Agency or on appeal before the Certificate of1744 | |
| 1937 | + | Need Appeal Panel, successor to the former Health Planning Review Board as of June 30,1745 | |
| 1938 | + | 2008.1746 23 LC 33 9350 | |
| 1939 | + | S. B. 162 | |
| 1940 | + | - 68 - | |
| 1941 | + | ARTICLE 4 | |
| 1942 | + | 1747 | |
| 1943 | + | 31-6-70.1748 | |
| 1944 | + | (a) There shall be required from each health care facility in this state requiring a certificate1749 | |
| 1945 | + | of need and all ambulatory surgical centers and imaging centers, whether or not exempt | |
| 1946 | + | 1750 | |
| 1947 | + | from obtaining a certificate of need under this chapter, an annual report of such health care1751 | |
| 1948 | + | information as determined by the department. The report shall be due on the date1752 | |
| 1949 | + | determined by the department and shall cover the 12 month period preceding each such1753 | |
| 1950 | + | calendar year.1754 | |
| 1951 | + | (b) The report required under subsection (a) of this Code section shall contain the1755 | |
| 1952 | + | following information:1756 | |
| 1953 | + | (1) Total gross revenues;1757 | |
| 1954 | + | (2) Bad debts;1758 | |
| 1955 | + | (3) Amounts of free care extended, excluding bad debts;1759 | |
| 1956 | + | (4) Contractual adjustments;1760 | |
| 1957 | + | (5) Amounts of care provided under a Hill-Burton commitment;1761 | |
| 1958 | + | (6) Amounts of charity care provided to indigent and nonindigent persons;1762 | |
| 1959 | + | (7) Amounts of outside sources of funding from governmental entities, philanthropic1763 | |
| 1960 | + | groups, or any other source, including the proportion of any such funding dedicated to the1764 | |
| 1961 | + | care of indigent persons; and1765 | |
| 1962 | + | (8) For cases involving indigent persons and nonindigent person persons receiving1766 | |
| 1963 | + | charity care:1767 | |
| 1964 | + | (A) The number of persons treated;1768 | |
| 1965 | + | (B) The number of inpatients and outpatients;1769 | |
| 1966 | + | (C) Total patient days;1770 | |
| 1967 | + | (D) The number of patients categorized by county of residence; and1771 23 LC 33 9350 | |
| 1968 | + | S. B. 162 | |
| 1969 | + | - 69 - | |
| 1970 | + | (E) The indigent and nonindigent care costs incurred by the health care facility by | |
| 1971 | + | 1772 | |
| 1972 | + | county of residence; | |
| 1973 | + | 1773 | |
| 1974 | + | (9) Transfers to a hospital or hospital emergency department, including both direct1774 | |
| 1975 | + | transfers and transfers by emergency medical services;1775 | |
| 1976 | + | (10) Number of rooms, beds, procedures, and patients, including, without limitation,1776 | |
| 1977 | + | demographic information and payer source;1777 | |
| 1978 | + | (11) Patient origin by county; and1778 | |
| 1979 | + | (12) Operational information such as procedure types, volumes, and charges.1779 | |
| 1980 | + | (c) As used in subsection (b) of this Code section, the term 'indigent persons' means1780 | |
| 1981 | + | persons having as a maximum allowable income level an amount corresponding to 1251781 | |
| 1982 | + | percent of the federal poverty guideline.1782 | |
| 1983 | + | (d) The department shall provide a form for the reports required by this Code section and1783 | |
| 1984 | + | may provide in said form for further categorical divisions of the information listed in1784 | |
| 1985 | + | subsection (b) or (c.1) of this Code section.1785 | |
| 1986 | + | (e)(1) In the event the department does not receive an annual report from a health care1786 | |
| 1987 | + | facility requiring a certificate of need or an ambulatory surgical center or imaging center,1787 | |
| 1988 | + | whether or not exempt from obtaining a certificate of need under this chapter, on or1788 | |
| 1989 | + | before the date such report was due or receives a timely but incomplete report, the1789 | |
| 1990 | + | department shall notify the health care facility or center regarding the deficiencies and1790 | |
| 1991 | + | shall be authorized to fine such health care facility or center an amount not to exceed1791 | |
| 1992 | + | $500.00 per day for every day up to 30 days and $1,000.00 per day for every day over 301792 | |
| 1993 | + | days for every day of such untimely or deficient report.1793 | |
| 1994 | + | (2) In the event the department does not receive an annual report from a health care1794 | |
| 1995 | + | facility within 180 days following the date such report was due or receives a timely but1795 | |
| 1996 | + | incomplete report which is not completed within such 180 days, the department shall be1796 | |
| 1997 | + | authorized to revoke such health care facility's certificate of need in accordance with1797 | |
| 1998 | + | Code Section 31-6-45.1798 23 LC 33 9350 | |
| 1999 | + | S. B. 162 | |
| 2000 | + | - 70 - | |
| 2001 | + | (f) No application for a certificate of need under Article 3 of this chapter shall be | |
| 2002 | + | 1799 | |
| 2003 | + | considered as complete if the applicant has not submitted the annual report required by1800 | |
| 2004 | + | subsection (a) of this Code section.1801 | |
| 2005 | + | (g) The department shall make publicly available all annual reports submitted pursuant to1802 | |
| 2006 | + | this Code section on the department website. The department shall also provide a copy of1803 | |
| 2007 | + | such annual reports to the Governor, the President of the Senate, the Speaker of the House1804 | |
| 2008 | + | of Representatives, and the chairpersons of the House Committee on Health and Human | |
| 2009 | + | 1805 | |
| 2010 | + | Services and the Senate Health and Human Services Committee.1806 | |
| 2011 | + | (h) All health care facilities, ambulatory surgical centers, and imaging centers required to1807 | |
| 2012 | + | submit an annual report pursuant to subsection (a) of this Code section shall make such1808 | |
| 2013 | + | annual reports publicly available on their websites."1809 | |
| 2014 | + | PART II1810 | |
| 2015 | + | SECTION 2-1.1811 | |
| 2016 | + | Said title is further amended by adding a new chapter to read as follows:1812 | |
| 2017 | + | "CHAPTER 6A1813 | |
| 2018 | + | 31-6A-1.1814 | |
| 2019 | + | As used in this chapter, the term:1815 | |
| 2020 | + | (1) 'Ambulatory surgical center' means a public or private facility, not a part of a1816 | |
| 2021 | + | hospital, which meets the criteria contained in subparagraph (C) of paragraph (4) of Code1817 | |
| 2022 | + | Section 31-7-1; provided, however, that if a private facility, at least 51 percent must be1818 | |
| 2023 | + | owned directly or indirectly by a hospital or a physician or physicians licensed to practice1819 | |
| 2024 | + | in Georgia.1820 23 LC 33 9350 | |
| 2025 | + | S. B. 162 | |
| 2026 | + | - 71 - | |
| 2027 | + | (2) 'Bed capacity' means space used exclusively for inpatient care, including space1821 | |
| 2028 | + | designed or remodeled for inpatient beds even though temporarily not used for such1822 | |
| 2029 | + | purposes. The number of beds to be counted in any patient room shall be the maximum1823 | |
| 2030 | + | number for which adequate square footage is provided as established by rules of the1824 | |
| 2031 | + | department, except that single beds in single rooms shall be counted even if the room1825 | |
| 2032 | + | contains inadequate square footage.1826 | |
| 2033 | + | (3) 'Board' means the Board of Community Health.1827 | |
| 2034 | + | (4) 'Clinical health services' means diagnostic, treatment, or rehabilitative services1828 | |
| 2035 | + | provided in a health care facility, or parts of the physical plant where such services are1829 | |
| 2036 | + | located in a health care facility, and includes, but is not limited to, the following:1830 | |
| 2037 | + | radiation therapy; biliary lithotripsy; surgery; intensive care; coronary care; pediatrics;1831 | |
| 2038 | + | gynecology; obstetrics; general medical care; medical/surgical care; inpatient nursing1832 | |
| 2039 | + | care, whether intermediate, skilled, or extended care; cardiac catheterization; open-heart1833 | |
| 2040 | + | surgery; and inpatient rehabilitation.1834 | |
| 2041 | + | (5) 'Commissioner' means the commissioner of community health.1835 | |
| 2042 | + | (6) 'Department' means the Department of Community Health established under Chapter1836 | |
| 2043 | + | 2 of this title.1837 | |
| 2044 | + | (7) 'Destination cancer hospital' means an institution with a licensed bed capacity of 501838 | |
| 2045 | + | or fewer which provides diagnostic, therapeutic, treatment, and rehabilitative care1839 | |
| 2046 | + | services to cancer inpatients and outpatients, by or under the supervision of physicians,1840 | |
| 2047 | + | and whose proposed annual patient base is composed of a minimum of 65 percent of1841 | |
| 2048 | + | patients who reside outside of this state.1842 | |
| 2049 | + | (8) 'Develop,' with reference to a project, means constructing, remodeling, installing, or1843 | |
| 2050 | + | proceeding with a project, or any part of a project, or a capital expenditure project, the1844 | |
| 2051 | + | cost estimate for which exceeds $3,068,601.00. The dollar amount specified in this1845 | |
| 2052 | + | paragraph shall be adjusted annually by an amount calculated by the department to reflect1846 | |
| 2053 | + | inflation, which may be calculated by multiplying such dollar amount, as adjusted for the1847 23 LC 33 9350 | |
| 2054 | + | S. B. 162 | |
| 2055 | + | - 72 - | |
| 2056 | + | preceding year, by the annual percentage of change in the composite index of1848 | |
| 2057 | + | construction material prices, or its successor or appropriate replacement index, if any,1849 | |
| 2058 | + | published by the United States Department of Commerce for the preceding calendar year,1850 | |
| 2059 | + | commencing on July 1, 2023, and on each anniversary thereafter of the publication of the1851 | |
| 2060 | + | index. The department shall immediately institute rule-making procedures to adopt such1852 | |
| 2061 | + | adjusted dollar amounts. In calculating the dollar amount of a proposed project for1853 | |
| 2062 | + | purposes of this paragraph, the costs of all items subject to review by this chapter and1854 | |
| 2063 | + | items not subject to review by this chapter associated with and simultaneously developed1855 | |
| 2064 | + | or proposed with the project shall be counted; provided, however, that the expenditure1856 | |
| 2065 | + | or commitment or incurring an obligation for the expenditure of funds to develop special1857 | |
| 2066 | + | health care services license applications, studies, reports, schematics, preliminary plans1858 | |
| 2067 | + | and specifications, or working drawings or to acquire, develop, or prepare sites shall not1859 | |
| 2068 | + | be considered to be the developing of a project.1860 | |
| 2069 | + | (9) 'Diagnostic imaging' means magnetic resonance imaging, computed tomography1861 | |
| 2070 | + | (CT) scanning, positron emission tomography (PET), positron emission1862 | |
| 2071 | + | tomography/computed tomography, X-rays, fluoroscopy, or ultrasound services, and1863 | |
| 2072 | + | other imaging services as defined by the department by rule.1864 | |
| 2073 | + | (10) 'Diagnostic, treatment, or rehabilitation center' means any professional or business1865 | |
| 2074 | + | undertaking, whether for profit or not for profit, which offers or proposes to offer any1866 | |
| 2075 | + | clinical health service in a setting which is not part of a hospital; provided, however, that1867 | |
| 2076 | + | any such diagnostic, treatment, or rehabilitation center that offers or proposes to offer1868 | |
| 2077 | + | surgery in an operating room environment and to allow patients to remain more than 231869 | |
| 2078 | + | hours shall be considered a hospital for purposes of this chapter.1870 | |
| 2079 | + | (11) 'Exception acknowledgment' means a written notice from the department confirming1871 | |
| 2080 | + | that a person is exempt from the requirements of this chapter pursuant to subsection (b)1872 | |
| 2081 | + | of Code Section 31-6A-3 or pursuant to subsection (b) or (d) of Code Section 31-6A-10.1873 23 LC 33 9350 | |
| 2082 | + | S. B. 162 | |
| 2083 | + | - 73 - | |
| 2084 | + | (12) 'Health care facility' means hospitals; other special care units, including, but not1874 | |
| 2085 | + | limited to, podiatric facilities; ambulatory surgical centers; health maintenance1875 | |
| 2086 | + | organizations; and diagnostic, treatment, or rehabilitation centers, but only to the extent1876 | |
| 2087 | + | subparagraph (a)(3)(B) of Code Section 31-6A-3 is applicable thereto.1877 | |
| 2088 | + | (13) 'Health maintenance organization' means a public or private organization organized1878 | |
| 2089 | + | under the laws of this state which:1879 | |
| 2090 | + | (A) Provides or otherwise makes available to enrolled participants health care services,1880 | |
| 2091 | + | including at least the following basic health care services: usual physicians' services,1881 | |
| 2092 | + | hospitalization, laboratory, X-ray, emergency and preventive services, and out-of-area1882 | |
| 2093 | + | coverage;1883 | |
| 2094 | + | (B) Is compensated, except for copayments, for the provision of the basic health care1884 | |
| 2095 | + | services listed in subparagraph (A) of this paragraph to enrolled participants on a1885 | |
| 2096 | + | predetermined periodic rate basis; and1886 | |
| 2097 | + | (C) Provides physicians' services primarily:1887 | |
| 2098 | + | (i) Directly through physicians who are either employees or partners of such1888 | |
| 2099 | + | organization; or1889 | |
| 2100 | + | (ii) Through arrangements with individual physicians organized on a group practice1890 | |
| 2101 | + | or individual practice basis.1891 | |
| 2102 | + | (14) 'Hospital' means an institution which is primarily engaged in providing to inpatients,1892 | |
| 2103 | + | by or under the supervision of physicians, diagnostic services and therapeutic services for1893 | |
| 2104 | + | medical diagnosis, treatment, and care of injured, disabled, or sick persons or1894 | |
| 2105 | + | rehabilitation services for the rehabilitation of injured, disabled, or sick persons. Such1895 | |
| 2106 | + | term includes micro-hospitals and public, private, psychiatric, rehabilitative, geriatric,1896 | |
| 2107 | + | osteopathic, and other specialty hospitals.1897 | |
| 2108 | + | (15) 'Joint venture ambulatory surgical center' means a freestanding ambulatory surgical1898 | |
| 2109 | + | center that is jointly owned by a hospital in the same county as the center or a hospital in1899 | |
| 2110 | + | a contiguous county if there is no hospital in the same county as the center and a single1900 23 LC 33 9350 | |
| 2111 | + | S. B. 162 | |
| 2112 | + | - 74 - | |
| 2113 | + | group of physicians practicing in the center and that provides surgery or where1901 | |
| 2114 | + | cardiologists perform procedures in a single specialty as defined by the department;1902 | |
| 2115 | + | provided, however, that general surgery, a group practice which includes one or more1903 | |
| 2116 | + | physiatrists who perform services that are reasonably related to the surgical procedures1904 | |
| 2117 | + | performed in the center, and a group practice in orthopedics which includes plastic hand1905 | |
| 2118 | + | surgeons with a certificate of added qualifications in Surgery of the Hand from the1906 | |
| 2119 | + | American Board of Plastic and Reconstructive Surgery shall be considered a single1907 | |
| 2120 | + | specialty. The ownership interest of the hospital shall be no less than 30 percent and the1908 | |
| 2121 | + | collective ownership of the physicians or group of physicians shall be no less than 301909 | |
| 2122 | + | percent.1910 | |
| 2123 | + | (16) 'Micro-hospital' means a hospital in a rural county which has at least two and not1911 | |
| 2124 | + | more than seven inpatient beds and which provides emergency services seven days per1912 | |
| 2125 | + | week and 24 hours per day.1913 | |
| 2126 | + | (17) 'Offer' means that the health care facility is open for the acceptance of patients or1914 | |
| 2127 | + | performance of services and has qualified personnel, equipment, and supplies necessary1915 | |
| 2128 | + | to provide specified clinical health services.1916 | |
| 2129 | + | (18) 'Operating room environment' means an environment which meets the minimum1917 | |
| 2130 | + | physical plant and operational standards specified in the rules of the department which1918 | |
| 2131 | + | shall consider and use the design and construction specifications as set forth in the1919 | |
| 2132 | + | Guidelines for Design and Construction of Health Care Facilities published by the1920 | |
| 2133 | + | American Institute of Architects.1921 | |
| 2134 | + | (19) 'Person' means any individual, trust or estate, partnership, limited liability company1922 | |
| 2135 | + | or partnership, corporation (including associations, joint-stock companies, and insurance1923 | |
| 2136 | + | companies), state, political subdivision, hospital authority, or instrumentality (including1924 | |
| 2137 | + | a municipal corporation) of a state as defined in the laws of this state. This term shall1925 | |
| 2138 | + | include all related parties, including individuals, business corporations, general1926 | |
| 2139 | + | partnerships, limited partnerships, limited liability companies, limited liability1927 23 LC 33 9350 | |
| 2140 | + | S. B. 162 | |
| 2141 | + | - 75 - | |
| 2142 | + | partnerships, joint ventures, nonprofit corporations, or any other for profit or not for profit1928 | |
| 2143 | + | entity that owns or controls, is owned or controlled by, or operates under common1929 | |
| 2144 | + | ownership or control with a person.1930 | |
| 2145 | + | (20) 'Project' means a proposal to take an action for which a special health care services1931 | |
| 2146 | + | license is required under this chapter. A project or proposed project may refer to the1932 | |
| 2147 | + | proposal from its earliest planning stages up through the point at which the new special1933 | |
| 2148 | + | health care services are offered.1934 | |
| 2149 | + | (21) 'Rural county' means a county having a population of less than 50,000 according to1935 | |
| 2150 | + | the United States decennial census of 2010 or any future such census.1936 | |
| 2151 | + | (22) 'Special health care services' means any facilities or services described in1937 | |
| 2152 | + | paragraphs (1) through (4) of subsection (a) of Code Section 31-6A-3.1938 | |
| 2153 | + | (23) 'Specialty ambulatory surgical center' means:1939 | |
| 2154 | + | (A) An ambulatory surgical center where surgery is performed or where cardiologists1940 | |
| 2155 | + | perform procedures in the offices of an individual private physician or single group1941 | |
| 2156 | + | practice of private physicians if such surgery or cardiology procedures are performed1942 | |
| 2157 | + | in a facility that is owned, operated, and utilized by such physicians who also are of a1943 | |
| 2158 | + | single specialty; provided, however, that general surgery, a group practice which1944 | |
| 2159 | + | includes one or more physiatrists who perform services that are reasonably related to1945 | |
| 2160 | + | the surgical procedures performed in the center, and a group practice in orthopedics1946 | |
| 2161 | + | which includes plastic hand surgeons with a certificate of added qualifications in1947 | |
| 2162 | + | Surgery of the Hand from the American Board of Plastic and Reconstructive Surgery1948 | |
| 2163 | + | shall be considered a single specialty; or1949 | |
| 2164 | + | (B) A multispecialty physician group owning, operating, and utilizing no more than1950 | |
| 2165 | + | three specialty ambulatory surgical centers located in the same or different counties in1951 | |
| 2166 | + | which the group has provided medical services in a clinical office for at least five years1952 | |
| 2167 | + | and which limits each center to a single specialty which may be different single1953 23 LC 33 9350 | |
| 2168 | + | S. B. 162 | |
| 2169 | + | - 76 - | |
| 2170 | + | specialties; provided, however, that the specialty ambulatory surgical centers may be1954 | |
| 2171 | + | colocated.1955 | |
| 2172 | + | (24) 'Specialty hospital' means a hospital that is primarily or exclusively engaged in the1956 | |
| 2173 | + | care and treatment of one of the following: patients with a cardiac condition, patients with1957 | |
| 2174 | + | an orthopedic condition, patients receiving a surgical procedure, or patients receiving any1958 | |
| 2175 | + | other specialized category of services defined by the department.1959 | |
| 2176 | + | (25) 'Uncompensated indigent or charity care' means the dollar amount of 'net1960 | |
| 2177 | + | uncompensated indigent or charity care after direct and indirect (all) compensation' as1961 | |
| 2178 | + | defined by, and calculated in accordance with, the department's Hospital Financial Survey1962 | |
| 2179 | + | and related instructions.1963 | |
| 2180 | + | (26) 'Urban county' means a county having a population equal to or greater than 50,0001964 | |
| 2181 | + | according to the United States decennial census of 2010 or any future such census.1965 | |
| 2182 | + | 31-6A-2.1966 | |
| 2183 | + | (a) On and after January 1, 2024, no person shall operate or provide any new special health1967 | |
| 2184 | + | care services without acquiring a special health care services license under this chapter1968 | |
| 2185 | + | unless such person has an exception acknowledgment from the department.1969 | |
| 2186 | + | (b) The department shall adopt rules to specify:1970 | |
| 2187 | + | (1) The minimal requirements for quality and safety for patients receiving each special1971 | |
| 2188 | + | health care service;1972 | |
| 2189 | + | (2) The procedure for applying for and maintaining a special health care services license,1973 | |
| 2190 | + | including, but not limited to, the frequency of licensing inspections, submission of1974 | |
| 2191 | + | information, and data to evaluate the performance and ongoing operation of services and1975 | |
| 2192 | + | enforcement under this chapter;1976 | |
| 2193 | + | (3) The fees for applying for and maintaining a special health care services license in1977 | |
| 2194 | + | order to fully offset the cost to the department, including consultant fees and other related1978 23 LC 33 9350 | |
| 2195 | + | S. B. 162 | |
| 2196 | + | - 77 - | |
| 2197 | + | expenses necessary to process the application, and for any ongoing expenses to the1979 | |
| 2198 | + | department for maintaining a special health care services license; and1980 | |
| 2199 | + | (4) The procedure and criteria for requesting and approving an exception1981 | |
| 2200 | + | acknowledgment.1982 | |
| 2201 | + | 31-6A-3.1983 | |
| 2202 | + | (a) A special health care services license shall be required for:1984 | |
| 2203 | + | (1) The construction, development, or other establishment of a new health care facility;1985 | |
| 2204 | + | (2) Any increase in the bed capacity of a health care facility except as provided in1986 | |
| 2205 | + | subsection (b) of this Code section;1987 | |
| 2206 | + | (3) Clinical health services which are offered in or through:1988 | |
| 2207 | + | (A) A health care facility, which were not offered on a regular basis in or through such1989 | |
| 2208 | + | health care facility within the 12 month period prior to the time such services would be1990 | |
| 2209 | + | offered; and1991 | |
| 2210 | + | (B) A diagnostic, treatment, or rehabilitation center, which were not offered on a1992 | |
| 2211 | + | regular basis in or through such center within the 12 month period prior to the time such1993 | |
| 2212 | + | services would be offered, but only if the clinical health services are any of the1994 | |
| 2213 | + | following:1995 | |
| 2214 | + | (i) Radiation therapy;1996 | |
| 2215 | + | (ii) Biliary lithotripsy;1997 | |
| 2216 | + | (iii) Surgery in an operating room environment, including, but not limited to,1998 | |
| 2217 | + | ambulatory surgery; and1999 | |
| 2218 | + | (iv) Cardiac catheterization; and2000 | |
| 2219 | + | (4) Any conversion or upgrading of any general acute care hospital to a specialty hospital2001 | |
| 2220 | + | or of a facility such that it is converted from a type of facility not covered by this chapter2002 | |
| 2221 | + | to any of the types of health care facilities which are covered by this chapter.2003 | |
| 2222 | + | (b) A special health care services license shall not be required for:2004 23 LC 33 9350 | |
| 2223 | + | S. B. 162 | |
| 2224 | + | - 78 - | |
| 2225 | + | (1) Infirmaries operated by educational institutions for the sole and exclusive benefit of2005 | |
| 2226 | + | students, faculty members, officers, or employees thereof;2006 | |
| 2227 | + | (2) Infirmaries or facilities operated by businesses for the sole and exclusive benefit of2007 | |
| 2228 | + | officers or employees thereof, provided that such infirmaries or facilities make no2008 | |
| 2229 | + | provision for overnight stay by persons receiving their services;2009 | |
| 2230 | + | (3) Institutions operated exclusively by the federal government or by any of its agencies;2010 | |
| 2231 | + | (4) Offices of private physicians or dentists whether for individual or group practice;2011 | |
| 2232 | + | (5) Religious, nonmedical health care institutions as defined in 42 U.S.C.2012 | |
| 2233 | + | Section 1395x(ss)(1), listed and certified by a national accrediting organization;2013 | |
| 2234 | + | (6) Site acquisitions for health care facilities or preparation or development costs for2014 | |
| 2235 | + | such sites prior to the decision to file an application for a special health care services2015 | |
| 2236 | + | license;2016 | |
| 2237 | + | (7) Expenditures related to adequate preparation and development of an application for2017 | |
| 2238 | + | a special health care services license;2018 | |
| 2239 | + | (8) The commitment of funds conditioned upon the obtaining of a special health care2019 | |
| 2240 | + | services license;2020 | |
| 2241 | + | (9) Expenditures for the acquisition of existing health care facilities by stock or asset2021 | |
| 2242 | + | purchase, merger, consolidation, or other lawful means unless the facilities are owned or2022 | |
| 2243 | + | operated by or on behalf of a:2023 | |
| 2244 | + | (A) Political subdivision of this state;2024 | |
| 2245 | + | (B) Combination of such political subdivisions; or2025 | |
| 2246 | + | (C) Hospital authority, as defined in Article 4 of Chapter 7 of this title;2026 | |
| 2247 | + | (10) Expenditures for the restructuring of or for the acquisition by stock or asset2027 | |
| 2248 | + | purchase, merger, consolidation, or other lawful means of an existing health care facility2028 | |
| 2249 | + | which is owned or operated by or on behalf of any entity described in2029 | |
| 2250 | + | subparagraph (A), (B), or (C) of paragraph (9) of this subsection only if such2030 23 LC 33 9350 | |
| 2251 | + | S. B. 162 | |
| 2252 | + | - 79 - | |
| 2253 | + | restructuring or acquisition is made by any entity described in subparagraph (A), (B),2031 | |
| 2254 | + | or (C) of paragraph (9) of this subsection;2032 | |
| 2255 | + | (11) The purchase of a closing hospital or of a hospital that has been closed for no more2033 | |
| 2256 | + | than 12 months by a hospital in a contiguous county to repurpose the facility as a2034 | |
| 2257 | + | micro-hospital;2035 | |
| 2258 | + | (12) Expenditures for the purchase, lease, replacement, upgrade, or repair of diagnostic2036 | |
| 2259 | + | imaging equipment, diagnostic or therapeutic equipment, or medical equipment or the2037 | |
| 2260 | + | provision of diagnostic imaging services;2038 | |
| 2261 | + | (13) Expenditures for the minor or major repair of a health care facility or a facility that2039 | |
| 2262 | + | is exempt from the requirements of this chapter or parts thereof or services provided2040 | |
| 2263 | + | therein;2041 | |
| 2264 | + | (14) Capital expenditures otherwise covered by this chapter required solely to eliminate2042 | |
| 2265 | + | or prevent safety hazards as defined by federal, state, or local fire, building,2043 | |
| 2266 | + | environmental, occupational health, or life safety codes or regulations, to comply with2044 | |
| 2267 | + | licensing requirements of the department, or to comply with accreditation standards of2045 | |
| 2268 | + | a nationally recognized health care accreditation body;2046 | |
| 2269 | + | (15) Cost overruns whose percentage of the cost of a project is equal to or less than the2047 | |
| 2270 | + | cumulative annual rate of increase in the composite construction index, published by the2048 | |
| 2271 | + | federal Bureau of the Census of the Department of Commerce, calculated from the date2049 | |
| 2272 | + | of approval of the project;2050 | |
| 2273 | + | (16) Transfers from one health care facility to another such facility of major medical2051 | |
| 2274 | + | equipment previously approved under or exempted from special health care services2052 | |
| 2275 | + | license review, except where such transfer results in the institution of a new clinical2053 | |
| 2276 | + | health service for which a special health care services license is required in the facility2054 | |
| 2277 | + | acquiring said equipment;2055 23 LC 33 9350 | |
| 2278 | + | S. B. 162 | |
| 2279 | + | - 80 - | |
| 2280 | + | (17) New special health care services provided by or on behalf of health maintenance2056 | |
| 2281 | + | organizations or related health care facilities in circumstances defined by the department2057 | |
| 2282 | + | pursuant to federal law;2058 | |
| 2283 | + | (18) Increases in the bed capacity of a hospital up to ten beds or 20 percent of capacity,2059 | |
| 2284 | + | whichever is greater, in any consecutive two-year period, in a hospital that has2060 | |
| 2285 | + | maintained an overall occupancy rate greater than 60 percent for the previous 12 month2061 | |
| 2286 | + | period;2062 | |
| 2287 | + | (19) Expenditures for nonclinical projects, including parking lots, parking decks, and2063 | |
| 2288 | + | other parking facilities; computer systems, software, and other information technology;2064 | |
| 2289 | + | and medical office buildings;2065 | |
| 2290 | + | (20) Continuing care retirement communities, home health agencies, intermediate care2066 | |
| 2291 | + | facilities, personal care homes, and skilled nursing facilities, as all such terms are defined2067 | |
| 2292 | + | in Code Section 31-6-2;2068 | |
| 2293 | + | (21) Any specialty ambulatory surgical center that:2069 | |
| 2294 | + | (A) Has a hospital affiliation agreement with a hospital within a reasonable distance2070 | |
| 2295 | + | from the facility or the medical staff at the center has admitting privileges or other2071 | |
| 2296 | + | acceptable documented arrangements with such hospital to ensure the necessary backup2072 | |
| 2297 | + | for the center for medical complications. The center shall have the capability to transfer2073 | |
| 2298 | + | a patient immediately to a hospital within a reasonable distance from the facility with2074 | |
| 2299 | + | adequate emergency room services. Hospitals shall not unreasonably deny a transfer2075 | |
| 2300 | + | agreement or affiliation agreement to the center;2076 | |
| 2301 | + | (B) Provides care to Medicaid beneficiaries and, if the facility provides medical care2077 | |
| 2302 | + | and treatment to children, to PeachCare for Kids beneficiaries and provides2078 | |
| 2303 | + | uncompensated indigent and charity care in accordance with Code Section 31-6A-6;2079 | |
| 2304 | + | provided, however, that specialty ambulatory surgical centers owned by physicians in2080 | |
| 2305 | + | the practice of ophthalmology shall not be required to comply with this subparagraph;2081 | |
| 2306 | + | and2082 23 LC 33 9350 | |
| 2307 | + | S. B. 162 | |
| 2308 | + | - 81 - | |
| 2309 | + | (C) Provides annual reports in the same manner and in accordance with Code2083 | |
| 2310 | + | Section 31-6A-7.2084 | |
| 2311 | + | Noncompliance with any condition of this paragraph shall result in a monetary penalty2085 | |
| 2312 | + | in the amount of the difference between the services which the center is required to2086 | |
| 2313 | + | provide and the amount actually provided and may be subject to revocation of its2087 | |
| 2314 | + | exemption status by the department for repeated failure to pay any fines or moneys due2088 | |
| 2315 | + | to the department or for repeated failure to produce data as required by Code2089 | |
| 2316 | + | Section 31-6A-7 after notice to the exemption holder and a fair hearing pursuant to2090 | |
| 2317 | + | Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act.' Any penalty so2091 | |
| 2318 | + | recovered shall be dedicated and deposited by the department into the Indigent Care Trust2092 | |
| 2319 | + | Fund created pursuant to Code Section 31-8-152 for the purposes set out in Code2093 | |
| 2320 | + | Section 31-8-154, including expanding Medicaid eligibility and services; programs to2094 | |
| 2321 | + | support rural and other health care providers, primarily hospitals, who serve the medically2095 | |
| 2322 | + | indigent; and for primary health care programs for medically indigent citizens and2096 | |
| 2323 | + | children of this state;2097 | |
| 2324 | + | (22) Any joint venture ambulatory surgical center that:2098 | |
| 2325 | + | (A) Provides care to Medicaid beneficiaries and, if the facility provides medical care2099 | |
| 2326 | + | and treatment to children, to PeachCare for Kids beneficiaries and provides2100 | |
| 2327 | + | uncompensated indigent and charity care in accordance with Code Section 31-6A-6;2101 | |
| 2328 | + | and2102 | |
| 2329 | + | (B) Provides annual reports in the same manner and in accordance with Code2103 | |
| 2330 | + | Section 31-6A-7.2104 | |
| 2331 | + | Noncompliance with any condition of this paragraph shall result in a monetary penalty2105 | |
| 2332 | + | in the amount of the difference between the services which the center is required to2106 | |
| 2333 | + | provide and the amount actually provided and may be subject to revocation of its2107 | |
| 2334 | + | exemption status by the department for repeated failure to pay any fines or moneys due2108 | |
| 2335 | + | to the department or for repeated failure to produce data as required by Code2109 23 LC 33 9350 | |
| 2336 | + | S. B. 162 | |
| 2337 | + | - 82 - | |
| 2338 | + | Section 31-6A-7 after notice to the exemption holder and a fair hearing pursuant to2110 | |
| 2339 | + | Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act.' Any penalty so2111 | |
| 2340 | + | recovered shall be dedicated and deposited by the department into the Indigent Care Trust2112 | |
| 2341 | + | Fund created pursuant to Code Section 31-8-152 for the purposes set out in Code2113 | |
| 2342 | + | Section 31-8-154, including expanding Medicaid eligibility and services; programs to2114 | |
| 2343 | + | support rural and other health care providers, primarily hospitals, who serve the medically2115 | |
| 2344 | + | indigent; and for primary health care programs for medically indigent citizens and2116 | |
| 2345 | + | children of this state;2117 | |
| 2346 | + | (23) Diagnostic cardiac catheterization in a hospital setting on patients 15 years of age2118 | |
| 2347 | + | and older;2119 | |
| 2348 | + | (24) Therapeutic cardiac catheterization in hospitals selected by the department prior to2120 | |
| 2349 | + | July 1, 2008, to participate in the Atlantic Cardiovascular Patient Outcomes Research2121 | |
| 2350 | + | Team (C-PORT) Study and therapeutic cardiac catheterization in hospitals that, as2122 | |
| 2351 | + | determined by the department on an annual basis, meet the criteria to participate in the2123 | |
| 2352 | + | C-PORT Study but have not been selected for participation; provided, however, that if2124 | |
| 2353 | + | the criteria requires a transfer agreement to another hospital, no hospital shall2125 | |
| 2354 | + | unreasonably deny a transfer agreement to another hospital;2126 | |
| 2355 | + | (25) Infirmaries or facilities operated by, on behalf of, or under contract with the2127 | |
| 2356 | + | Department of Corrections or the Department of Juvenile Justice for the sole and2128 | |
| 2357 | + | exclusive purpose of providing health care services in a secure environment to prisoners2129 | |
| 2358 | + | within a penal institution, penitentiary, prison, detention center, or other secure2130 | |
| 2359 | + | correctional institution, including correctional institutions operated by private entities in2131 | |
| 2360 | + | this state which house inmates under the Department of Corrections or the Department2132 | |
| 2361 | + | of Juvenile Justice;2133 | |
| 2362 | + | (26) The relocation of any micro-hospital within the same county, any other health care2134 | |
| 2363 | + | facility in a rural county within the same county, and any other health care facility in an2135 23 LC 33 9350 | |
| 2364 | + | S. B. 162 | |
| 2365 | + | - 83 - | |
| 2366 | + | urban county within a three-mile radius of the existing facility so long as the facility does2136 | |
| 2367 | + | not propose to offer any new or expanded clinical health services at the new location;2137 | |
| 2368 | + | (27) Facilities which are devoted to the provision of treatment and rehabilitative care for2138 | |
| 2369 | + | periods continuing for 24 hours or longer for persons who have traumatic brain injury,2139 | |
| 2370 | + | as defined in Code Section 37-3-1;2140 | |
| 2371 | + | (28) Capital expenditures for a project otherwise requiring a special health care services2141 | |
| 2372 | + | license if those expenditures are for a project to remodel, renovate, replace, or any2142 | |
| 2373 | + | combination thereof, a medical-surgical hospital and:2143 | |
| 2374 | + | (A) That hospital:2144 | |
| 2375 | + | (i) Has a bed capacity of not more than 50 beds;2145 | |
| 2376 | + | (ii) Is located in a county in which no other medical-surgical hospital is located;2146 | |
| 2377 | + | (iii) Has at any time been designated as a disproportionate share hospital by the2147 | |
| 2378 | + | department; and2148 | |
| 2379 | + | (iv) Has at least 45 percent of its patient revenues derived from medicare, Medicaid,2149 | |
| 2380 | + | or any combination thereof, for the immediately preceding three years; and2150 | |
| 2381 | + | (B) That project:2151 | |
| 2382 | + | (i) Does not result in any of the following:2152 | |
| 2383 | + | (I) The offering of any new clinical health services;2153 | |
| 2384 | + | (II) Any increase in bed capacity;2154 | |
| 2385 | + | (III) Any redistribution of existing beds among existing clinical health services; or2155 | |
| 2386 | + | (IV) Any increase in capacity of existing clinical health services;2156 | |
| 2387 | + | (ii) Has at least 80 percent of its capital expenditures financed by the proceeds of a2157 | |
| 2388 | + | special purpose county sales and use tax imposed pursuant to Article 3 of Chapter 82158 | |
| 2389 | + | of Title 48; and2159 | |
| 2390 | + | (iii) Is located within a three-mile radius of and within the same county as the2160 | |
| 2391 | + | hospital's existing facility;2161 23 LC 33 9350 | |
| 2392 | + | S. B. 162 | |
| 2393 | + | - 84 - | |
| 2394 | + | (29) Public or private psychiatric hospitals; mental health or substance abuse facilities2162 | |
| 2395 | + | or programs; or mental health or substance abuse services; and2163 | |
| 2396 | + | (30) A freestanding ambulatory surgical center with no more than six operating rooms2164 | |
| 2397 | + | developed on the same site as a sports training and educational facility that includes2165 | |
| 2398 | + | sports training facilities and fields; a medical education facility and program for2166 | |
| 2399 | + | physicians and other health care professionals training in sports medicine; a medical2167 | |
| 2400 | + | research program; ancillary services, including physical therapy and diagnostic imaging;2168 | |
| 2401 | + | a community education program for student athletic programs on injury prevention and2169 | |
| 2402 | + | treatment and related topics, and that provides uncompensated indigent or charity care2170 | |
| 2403 | + | in accordance with Code Section 31-6A-6, provides care to Medicaid patients, and, if the2171 | |
| 2404 | + | facility provides medical care and treatment to children, participates as a provider for2172 | |
| 2405 | + | PeachCare for Kids beneficiaries; and demonstrates a positive economic impact of no less2173 | |
| 2406 | + | than $25 million, taking into consideration the full-time and part-time jobs generated by2174 | |
| 2407 | + | the initial construction and ongoing operation of the center, new state and local tax2175 | |
| 2408 | + | revenue generated by the initial construction and ongoing operation of the center, and2176 | |
| 2409 | + | other factors deemed relevant as determined by the department based on a report prepared2177 | |
| 2410 | + | by an independent consultant or expert retained by the center.2178 | |
| 2411 | + | 31-6A-4.2179 | |
| 2412 | + | (a) An application for a special health care services license shall include:2180 | |
| 2413 | + | (1) Certification that the applicant is licensed or will seek licensure under Chapter 7 of2181 | |
| 2414 | + | this title, if subject to the requirements of such chapter;2182 | |
| 2415 | + | (2) Certification that the applicant has notified the public of the intent to file the2183 | |
| 2416 | + | application with a description of the facility or special health care services to be licensed2184 | |
| 2417 | + | by publishing a notice in a newspaper of general circulation covering the area where the2185 | |
| 2418 | + | service is to be located in at least two separate issues of the newspaper no less than ten2186 | |
| 2419 | + | business days prior to the filing of the application;2187 23 LC 33 9350 | |
| 2420 | + | S. B. 162 | |
| 2421 | + | - 85 - | |
| 2422 | + | (3) Certification that the applicant has given written notice of the intent to file the2188 | |
| 2423 | + | application by registered mail no less than ten business days prior to the filing of the2189 | |
| 2424 | + | application to the chief executive officer of each existing facility that:2190 | |
| 2425 | + | (A) Is located within a ten-mile radius of the applicant's proposed new facility or2191 | |
| 2426 | + | services;2192 | |
| 2427 | + | (B) Is the same type of facility or offers the same type of services as the proposed new2193 | |
| 2428 | + | facility or services; and2194 | |
| 2429 | + | (C) Has a special health care services license issued pursuant to this chapter; and2195 | |
| 2430 | + | (4) Any other information deemed necessary by the department.2196 | |
| 2431 | + | (b) In addition to publication on the department's website, any application for a special2197 | |
| 2432 | + | health care services license shall be available for inspection and copying by any person2198 | |
| 2433 | + | immediately upon it being filed.2199 | |
| 2434 | + | (c) Any complete application for a special health care services license shall be approved2200 | |
| 2435 | + | by the department within 45 days of the filing of such application unless a timely objection2201 | |
| 2436 | + | in writing to such application is received by the department in accordance with2202 | |
| 2437 | + | subsection (a) of Code Section 31-6A-5.2203 | |
| 2438 | + | 31-6A-5.2204 | |
| 2439 | + | (a)(1) No written objection may be made to an application for a special health care2205 | |
| 2440 | + | services license for a new special health care service located in a county within health2206 | |
| 2441 | + | planning area three of the department's established health planning areas, as such exists2207 | |
| 2442 | + | on June 30, 2023, unless an existing facility is located outside of health planning area2208 | |
| 2443 | + | three but is within a ten-mile radius of the proposed new facility or services.2209 | |
| 2444 | + | (2) Except as provided in paragraph (1) of this subsection, a written objection to an2210 | |
| 2445 | + | application for a special health care services license may be submitted by an existing2211 | |
| 2446 | + | facility within 30 days of the filing of such application with the department, on the2212 23 LC 33 9350 | |
| 2447 | + | S. B. 162 | |
| 2448 | + | - 86 - | |
| 2449 | + | grounds that the application is not in the public interest of the community, if such existing2213 | |
| 2450 | + | facility:2214 | |
| 2451 | + | (A) Is located within a ten-mile radius of the applicant's proposed new facility or2215 | |
| 2452 | + | services;2216 | |
| 2453 | + | (B) Is the same type of facility or offers the same type of services as the proposed new2217 | |
| 2454 | + | facility or services; and2218 | |
| 2455 | + | (C) Has a special health care services license issued pursuant to this chapter.2219 | |
| 2456 | + | (b) No later than 30 days of receipt of a timely written objection pursuant to paragraph (2)2220 | |
| 2457 | + | of subsection (a) of this Code section, the commissioner shall conduct a public interest2221 | |
| 2458 | + | review and make a written determination as to whether the application is in the public2222 | |
| 2459 | + | interest of the community, taking into consideration any material adverse impact on the2223 | |
| 2460 | + | objecting party or parties, unique health care needs of the community (not based on a2224 | |
| 2461 | + | numerical need formula), atypical barriers or factors, whether the new special health care2225 | |
| 2462 | + | services would foster competition or make services less costly or more accessible, and2226 | |
| 2463 | + | whether the applicant performs or proposes to perform activities outside of inpatient or2227 | |
| 2464 | + | outpatient care in the community for underserved populations. The commissioner may not2228 | |
| 2465 | + | deny an application based on an objection unless the objecting party shows by clear and2229 | |
| 2466 | + | convincing evidence that the project does not meet the criteria set forth in this subsection.2230 | |
| 2467 | + | (c) If the special health care services license is granted by the department over a timely2231 | |
| 2468 | + | objection, the person who objected shall have a right to request a fair hearing pursuant to2232 | |
| 2469 | + | Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act.'2233 | |
| 2470 | + | (d) If the special health care services license is denied by the department after a timely2234 | |
| 2471 | + | objection, the applicant shall have a right to request a fair hearing pursuant to Chapter 132235 | |
| 2472 | + | of Title 50, the 'Georgia Administrative Procedure Act.'2236 | |
| 2473 | + | (e) Any party to the initial administrative appeal hearing, excluding the department, may2237 | |
| 2474 | + | seek judicial review of the final decision in accordance with the method set forth in2238 | |
| 2475 | + | Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act.'2239 23 LC 33 9350 | |
| 2476 | + | S. B. 162 | |
| 2477 | + | - 87 - | |
| 2478 | + | 31-6A-6.2240 | |
| 2479 | + | (a) As a condition for special health care services licenses issued on and after2241 | |
| 2480 | + | January 1, 2024, the department shall require that an applicant or licensee agrees:2242 | |
| 2481 | + | (1) To provide uncompensated indigent or charity care in an amount which meets or2243 | |
| 2482 | + | exceeds the percentage of such applicant's adjusted gross revenues equivalent to:2244 | |
| 2483 | + | (A) The state-wide average of net uncompensated indigent and charity care provided2245 | |
| 2484 | + | based on the previous two most recent years if a nonprofit entity; or2246 | |
| 2485 | + | (B) The state-wide average of net uncompensated indigent and charity care provided2247 | |
| 2486 | + | based on the previous two most recent years less 3 percent if a for profit entity; and2248 | |
| 2487 | + | (2) To participate as a provider of medical assistance for Medicaid purposes, and, if the2249 | |
| 2488 | + | facility provides medical care and treatment to children, to participate as a provider for2250 | |
| 2489 | + | PeachCare for Kids beneficiaries.2251 | |
| 2490 | + | (b) A grantee or successor in interest for a special health care services license or an2252 | |
| 2491 | + | authorization to operate under this chapter which violates such an agreement or violates2253 | |
| 2492 | + | any conditions imposed by the department relating to such services shall be liable to the2254 | |
| 2493 | + | department for a monetary penalty in the amount of 1 percent of its net revenue for every2255 | |
| 2494 | + | 0.5 percent of uncompensated indigent and charity care not provided and may be subject2256 | |
| 2495 | + | to revocation of its special health care services license, in whole or in part, by the2257 | |
| 2496 | + | department pursuant to Code Section 31-6A-8. Any penalty so recovered shall be2258 | |
| 2497 | + | dedicated and deposited by the department into the Indigent Care Trust Fund created2259 | |
| 2498 | + | pursuant to Code Section 31-8-152 for the purposes set out in Code Section 31-8-154,2260 | |
| 2499 | + | including expanding Medicaid eligibility and services; programs to support rural and other2261 | |
| 2500 | + | health care providers, primarily hospitals, who serve the medically indigent; and for2262 | |
| 2501 | + | primary health care programs for medically indigent citizens and children of this state.2263 | |
| 2502 | + | (c) Penalties authorized under this Code section shall be subject to the same notices and2264 | |
| 2503 | + | hearing for the levy of fines under Code Section 31-6A-8.2265 23 LC 33 9350 | |
| 2504 | + | S. B. 162 | |
| 2505 | + | - 88 - | |
| 2506 | + | (d)(1) This Code section shall not apply to a hospital or any health care facilities owned2266 | |
| 2507 | + | by a hospital or health care system that has a payer mix of greater than 40 percent2267 | |
| 2508 | + | Medicaid recipients and uncompensated indigent and charity care of at least 2 percent;2268 | |
| 2509 | + | provided, however, that a hospital's cost gap between its Medicaid reimbursement rate2269 | |
| 2510 | + | and the Medicare reimbursement shall count toward such uncompensated indigent and2270 | |
| 2511 | + | charity care amount.2271 | |
| 2512 | + | (2) As used in this subsection, the term 'payer mix' means the proportionate share of2272 | |
| 2513 | + | itemized charges attributable to patients assignable to a specific payer classification to2273 | |
| 2514 | + | total itemized charges for all patients.2274 | |
| 2515 | + | (e) The department may withhold all or any portion of disproportionate share hospital2275 | |
| 2516 | + | funds to any hospital that is subject to the requirements contained in paragraph (1) of2276 | |
| 2517 | + | subsection (a) of this Code section that fails to meet the minimum indigent and charity care2277 | |
| 2518 | + | requirements for two consecutive years.2278 | |
| 2519 | + | 31-6A-7.2279 | |
| 2520 | + | (a) Each health care facility in this state that is required by the department to provide2280 | |
| 2521 | + | uncompensated indigent or charity care pursuant to Code Section 31-6A-6 shall submit an2281 | |
| 2522 | + | annual report of certain health care information to the department. The report shall be due2282 | |
| 2523 | + | on the last day of January and shall cover the 12 month period preceding each such2283 | |
| 2524 | + | calendar year.2284 | |
| 2525 | + | (b) The annual report required under subsection (a) of this Code section shall contain the2285 | |
| 2526 | + | following information:2286 | |
| 2527 | + | (1) Total gross revenues;2287 | |
| 2528 | + | (2) Bad debts;2288 | |
| 2529 | + | (3) Amounts of free care extended, excluding bad debts;2289 | |
| 2530 | + | (4) Contractual adjustments;2290 | |
| 2531 | + | (5) Amounts of care provided under a Hill-Burton commitment;2291 23 LC 33 9350 | |
| 2532 | + | S. B. 162 | |
| 2533 | + | - 89 - | |
| 2534 | + | (6) Amounts of charity care provided to indigent persons;2292 | |
| 2535 | + | (7) Amounts of outside sources of funding from governmental entities, philanthropic2293 | |
| 2536 | + | groups, or any other source, including the proportion of any such funding dedicated to the2294 | |
| 2537 | + | care of indigent persons; and2295 | |
| 2538 | + | (8) For cases involving indigent persons:2296 | |
| 2539 | + | (A) The number of persons treated;2297 | |
| 2540 | + | (B) The number of inpatients and outpatients;2298 | |
| 2541 | + | (C) Total patient days;2299 | |
| 2542 | + | (D) The number of patients categorized by county of residence; and2300 | |
| 2543 | + | (E) The indigent care costs incurred by the health care facility by county of residence.2301 | |
| 2544 | + | As used in this subsection, the term 'indigent persons' means persons having as a maximum2302 | |
| 2545 | + | allowable income level an amount corresponding to 125 percent of the federal poverty2303 | |
| 2546 | + | guideline.2304 | |
| 2547 | + | (c) The department shall provide a form for the report required by this Code section and2305 | |
| 2548 | + | may provide in said form for further categorical divisions of the information listed in2306 | |
| 2549 | + | subsection (b) of this Code section.2307 | |
| 2550 | + | (d)(1) In the event the department does not receive an annual report from an institution,2308 | |
| 2551 | + | on or before the date such report was due or receives a timely but incomplete report, the2309 | |
| 2552 | + | department shall notify the institution regarding the deficiencies and shall be authorized2310 | |
| 2553 | + | to fine such institution an amount not to exceed $500.00 per day for every day up to 302311 | |
| 2554 | + | days and $1,000.00 per day for every day over 30 days of such untimely or deficient2312 | |
| 2555 | + | report. Any fine so recovered shall be dedicated and deposited by the department into the2313 | |
| 2556 | + | Indigent Care Trust Fund created pursuant to Code Section 31-8-152 for the purposes set2314 | |
| 2557 | + | out in Code Section 31-8-154, including expanding Medicaid eligibility and services;2315 | |
| 2558 | + | programs to support rural and other health care providers, primarily hospitals, who serve2316 | |
| 2559 | + | the medically indigent; and for primary health care programs for medically indigent2317 | |
| 2560 | + | citizens and children of this state.2318 23 LC 33 9350 | |
| 2561 | + | S. B. 162 | |
| 2562 | + | - 90 - | |
| 2563 | + | (2) In the event the department does not receive an annual report from an institution2319 | |
| 2564 | + | within 180 days following the date such report was due or receives a timely but2320 | |
| 2565 | + | incomplete report which is not completed within such 180 days, the department shall be2321 | |
| 2566 | + | authorized to revoke such institution's permit in accordance with Code Section 31-7-4.2322 | |
| 2567 | + | 31-6A-8.2323 | |
| 2568 | + | (a) The department may revoke a special health care services license, in whole or in part,2324 | |
| 2569 | + | after notice to the holder of the special health care services license and a fair hearing2325 | |
| 2570 | + | pursuant to Chapter 13 of Title 50, the 'Georgia Administrative Procedure Act,' for the2326 | |
| 2571 | + | following reasons:2327 | |
| 2572 | + | (1) Failure to comply with the provisions of this chapter;2328 | |
| 2573 | + | (2) The intentional provision of false information to the department by a licensee in that2329 | |
| 2574 | + | licensee's application;2330 | |
| 2575 | + | (3) Repeated failure to pay any fines or moneys due to the department;2331 | |
| 2576 | + | (4) Failure to maintain minimum quality of care standards that may be established by the2332 | |
| 2577 | + | department;2333 | |
| 2578 | + | (5) Failure to participate as a provider of medical assistance for Medicaid purposes or2334 | |
| 2579 | + | the PeachCare for Kids Program, if applicable; or2335 | |
| 2580 | + | (6) The failure to submit a timely or complete report within 180 days following the date2336 | |
| 2581 | + | the report is due pursuant to Code Section 31-6A-7.2337 | |
| 2582 | + | (b) In the event that a new special health care service is knowingly offered or developed2338 | |
| 2583 | + | without having obtained a special health care services license as required by this chapter,2339 | |
| 2584 | + | or the special health care services license for such service is revoked according to the2340 | |
| 2585 | + | provisions of this Code section, a facility or applicant may be fined an amount of $5,000.002341 | |
| 2586 | + | per day up to 30 days, $10,000.00 per day from 31 days through 60 days, and $25,000.002342 | |
| 2587 | + | per day after 60 days for each day that the violation of this chapter has existed and2343 | |
| 2588 | + | knowingly and willingly continues; provided, however, that the expenditure or2344 23 LC 33 9350 | |
| 2589 | + | S. B. 162 | |
| 2590 | + | - 91 - | |
| 2591 | + | commitment of or incurring an obligation for the expenditure of funds to take or perform2345 | |
| 2592 | + | actions not subject to this chapter or to acquire, develop, or prepare a health care facility2346 | |
| 2593 | + | site for which a special health care services license application is denied shall not be a2347 | |
| 2594 | + | violation of this chapter and shall not be subject to such a fine. The commissioner shall2348 | |
| 2595 | + | determine, after notice and a hearing, whether the fines provided in this Code section shall2349 | |
| 2596 | + | be levied. Any fine so recovered shall be dedicated and deposited by the department into2350 | |
| 2597 | + | the Indigent Care Trust Fund created pursuant to Code Section 31-8-152 for the purposes2351 | |
| 2598 | + | set out in Code Section 31-8-154, including expanding Medicaid eligibility and services;2352 | |
| 2599 | + | programs to support rural and other health care providers, primarily hospitals, who serve2353 | |
| 2600 | + | the medically indigent; and for primary health care programs for medically indigent2354 | |
| 2601 | + | citizens and children of this state.2355 | |
| 2602 | + | (c) In addition, for purposes of this Code section, the State of Georgia, acting by and2356 | |
| 2603 | + | through the department, or any other interested person, shall have standing in any court of2357 | |
| 2604 | + | competent jurisdiction to maintain an action for injunctive relief to enforce the provisions2358 | |
| 2605 | + | of this chapter.2359 | |
| 2606 | + | (d) The department shall have the authority to make public or private investigations or2360 | |
| 2607 | + | examinations inside or outside of this state to determine whether any provisions of this2361 | |
| 2608 | + | chapter or any other law, rule, regulation, or formal order relating to the provision of2362 | |
| 2609 | + | special health care services has been violated. Such investigations may be initiated at any2363 | |
| 2610 | + | time in the discretion of the department and may continue during the pendency of any2364 | |
| 2611 | + | action initiated by the department pursuant to this Code section. For the purpose of2365 | |
| 2612 | + | conducting any investigation or inspection pursuant to this subsection, the department shall2366 | |
| 2613 | + | have the authority, upon providing reasonable notice, to require the production of any2367 | |
| 2614 | + | books, records, papers, or other information related to any special health care services2368 | |
| 2615 | + | license issue.2369 23 LC 33 9350 | |
| 2616 | + | S. B. 162 | |
| 2617 | + | - 92 - | |
| 2618 | + | 31-6A-9.2370 | |
| 2619 | + | Any person who acquires a health care facility by stock or asset purchase, merger,2371 | |
| 2620 | + | consolidation, or other lawful means shall notify the department of such acquisition, the2372 | |
| 2621 | + | date thereof, and the name and address of the acquiring person. Such notification shall be2373 | |
| 2622 | + | made in writing to the department within 45 days following the acquisition and the2374 | |
| 2623 | + | acquiring person may be fined by the department in the amount of $500.00 for each day2375 | |
| 2624 | + | that such notification is late. Such fine shall be paid into the state treasury. Any fine so2376 | |
| 2625 | + | recovered shall be dedicated and deposited by the department into the Indigent Care Trust2377 | |
| 2626 | + | Fund created pursuant to Code Section 31-8-152 for the purposes set out in Code2378 | |
| 2627 | + | Section 31-8-154, including expanding Medicaid eligibility and services; programs to2379 | |
| 2628 | + | support rural and other health care providers, primarily hospitals, who serve the medically2380 | |
| 2629 | + | indigent; and for primary health care programs for medically indigent citizens and children2381 | |
| 2630 | + | of this state.2382 | |
| 2631 | + | 31-6A-10.2383 | |
| 2632 | + | (a) Except as provided in subsection (c) of this Code section, on and after January 1, 2024,2384 | |
| 2633 | + | health care facilities, as defined in Code Section 31-6A-1, shall not be subject to the former2385 | |
| 2634 | + | provisions of Chapter 6 of this title, as such existed on December 31, 2023, and shall not2386 | |
| 2635 | + | be required to obtain or retain a certificate of need in order to operate, but all such valid2387 | |
| 2636 | + | certificates of need in existence on December 31, 2023, shall be converted by operation of2388 | |
| 2637 | + | law to special health care services licenses and all such license holders shall be subject to2389 | |
| 2638 | + | the provisions of this chapter on and after such date; provided, however, that such health2390 | |
| 2639 | + | care facilities shall not be subject to the requirements of Code Section 31-6A-6 but shall2391 | |
| 2640 | + | instead be subject to any conditions previously imposed by the department relating to2392 | |
| 2641 | + | indigent or charity care and participation as a Medicaid provider that were in effect on2393 | |
| 2642 | + | December 31, 2023, pursuant to the former provisions of Chapter 6 of this title, as such2394 | |
| 2643 | + | existed on December 31, 2023. The department may withhold all or any portion of2395 23 LC 33 9350 | |
| 2644 | + | S. B. 162 | |
| 2645 | + | - 93 - | |
| 2646 | + | disproportionate share hospital funds to any hospital exempt pursuant to this subsection2396 | |
| 2647 | + | that fails to meet any conditions previously imposed by the department relating to indigent2397 | |
| 2648 | + | and charity care for two consecutive years. In the event a health care facility operating2398 | |
| 2649 | + | pursuant to this subsection receives any modification of its special health care services2399 | |
| 2650 | + | license, it shall immediately become subject to the requirements contained in Code Section2400 | |
| 2651 | + | 31-6A-6 in lieu of the conditions previously imposed by the department relating to indigent2401 | |
| 2652 | + | or charity care and participation as a Medicaid provider or PeachCare for Kids Program2402 | |
| 2653 | + | provider that were in effect on December 31, 2023.2403 | |
| 2654 | + | (b)(1) On and after January 1, 2024, any person who had a valid exemption from2404 | |
| 2655 | + | certificate of need requirements under the former provisions of Chapter 6 of this title, as2405 | |
| 2656 | + | such existed on December 31, 2023, shall not be required to obtain or retain a special2406 | |
| 2657 | + | health care services license under this chapter in order to operate, but any such valid2407 | |
| 2658 | + | exemption in existence on December 31, 2023, shall be converted by operation of law to2408 | |
| 2659 | + | an exemption to special health care services license requirements under this chapter but2409 | |
| 2660 | + | shall be subject to any conditions previously imposed pursuant to the former provisions2410 | |
| 2661 | + | of Chapter 6 of this title, as such existed on December 31, 2023.2411 | |
| 2662 | + | (2) In the event a person that is exempt pursuant to paragraph (1) of this subsection2412 | |
| 2663 | + | makes any modification to the special health care services it provides, it shall2413 | |
| 2664 | + | immediately become subject to the requirements contained in Code Section 31-6A-6 in2414 | |
| 2665 | + | lieu of the conditions previously imposed by the department relating to indigent or charity2415 | |
| 2666 | + | care and participation as a Medicaid provider or PeachCare for Kids Program provider2416 | |
| 2667 | + | that were in effect on December 31, 2023.2417 | |
| 2668 | + | (c)(1) On and after January 1, 2024, a destination cancer hospital that was granted a2418 | |
| 2669 | + | certificate of need pursuant to the former provisions of Chapter 6 of this title, as such2419 | |
| 2670 | + | existed on December 31, 2023, may convert to a hospital by notifying the department in2420 | |
| 2671 | + | writing as to the date of conversion. Upon such conversion, the hospital may continue2421 | |
| 2672 | + | to provide all institutional health services and other services it provided as of the date of2422 23 LC 33 9350 | |
| 2673 | + | S. B. 162 | |
| 2674 | + | - 94 - | |
| 2675 | + | such conversion, including, but not limited to, inpatient beds, outpatient services, surgery,2423 | |
| 2676 | + | radiation therapy, imaging, and positron emission tomography (PET) scanning, without2424 | |
| 2677 | + | any further approval from the department; provided, however, that upon such conversion,2425 | |
| 2678 | + | such hospital shall immediately become subject to the requirements of Code2426 | |
| 2679 | + | Section 31-6A-6. On and after the date of conversion, the hospital shall be classified as2427 | |
| 2680 | + | a hospital under this chapter and shall be subject to all requirements and conditions for2428 | |
| 2681 | + | any new special health care services license requirements, exemptions, and for all other2429 | |
| 2682 | + | purposes, except as otherwise provided herein.2430 | |
| 2683 | + | (2) In the event that a destination cancer hospital does not convert to a hospital, it shall2431 | |
| 2684 | + | remain subject to all requirements and conditions previously in effect as of2432 | |
| 2685 | + | December 31, 2023, under the provisions of Chapter 6 of this title as they existed on such2433 | |
| 2686 | + | date.2434 | |
| 2687 | + | (d) Any outstanding appeals before the Certificate of Need Appeal Panel as of2435 | |
| 2688 | + | December 31, 2023, relating to health care facilities, as defined in Code Section 31-6A-1,2436 | |
| 2689 | + | shall be deemed moot and dismissed by operation of law as of January 1, 2024.2437 | |
| 2690 | + | 31-6A-11.2438 | |
| 2691 | + | The department shall be authorized to promulgate rules and regulations to implement the2439 | |
| 2692 | + | provisions of this chapter."2440 | |
| 2693 | + | PART III2441 | |
| 2694 | + | SECTION 3-1.2442 | |
| 2695 | + | Said title is further amended in Article 2 of Chapter 7, relating to the Georgia Building2443 | |
| 2696 | + | Authority, by redesignating Code Section 31-7-24 as Code Section 31-7-25 and by adding2444 | |
| 2697 | + | a new Code section to the end of Article 1, relating to regulation of hospitals and related2445 | |
| 2698 | + | institutions, to read as follows:2446 23 LC 33 9350 | |
| 2699 | + | S. B. 162 | |
| 2700 | + | - 95 - | |
| 2701 | + | "31-7-24.2447 | |
| 2702 | + | (a) As used in this Code section, the term:2448 | |
| 2703 | + | (1) 'Hospital' shall have the same meaning as in Code Section 31-7-22.2449 | |
| 2704 | + | (2) 'Medical use rights' means rights or interests in real property in which the owner of2450 | |
| 2705 | + | the property has agreed not to sell or lease such real property for identified medical uses2451 | |
| 2706 | + | or purposes.2452 | |
| 2707 | + | (b) It shall be unlawful for any hospital to purchase, renew, extend, lease, maintain, or hold2453 | |
| 2708 | + | medical use rights.2454 | |
| 2709 | + | (c) This Code section shall not be construed to impair any contracts in existence as of the2455 | |
| 2710 | + | effective date of this Code section."2456 | |
| 2711 | + | SECTION 3-2.2457 | |
| 2712 | + | Code Section 50-18-70 of the Official Code of Georgia Annotated, relating to legislative2458 | |
| 2713 | + | intent and definitions relative to open records laws, is amended by revising subsection (b)2459 | |
| 2714 | + | as follows:2460 | |
| 2715 | + | "(b) As used in this article, the term:2461 | |
| 2716 | + | (1) 'Agency' shall have the same meaning as in Code Section 50-14-1 and shall2462 | |
| 2717 | + | additionally include any association, corporation, or other similar organization that has2463 | |
| 2718 | + | a membership or ownership body composed primarily of counties, municipal2464 | |
| 2719 | + | corporations, or school districts of this state, their officers, or any combination thereof2465 | |
| 2720 | + | and derives more than 33 1/3 percent of its general operating budget from payments from2466 | |
| 2721 | + | such political subdivisions. Such term shall also include any nonprofit organization to2467 | |
| 2722 | + | which is leased and transferred hospital assets of a hospital authority through a corporate2468 | |
| 2723 | + | restructuring and any subsidiaries or foundations established by such nonprofit2469 | |
| 2724 | + | organization in furtherance of the public mission of the hospital authority.2470 | |
| 2725 | + | (2) 'Public record' means all documents, papers, letters, maps, books, tapes, photographs,2471 | |
| 2726 | + | computer based or generated information, data, data fields, or similar material prepared2472 23 LC 33 9350 | |
| 2727 | + | S. B. 162 | |
| 2728 | + | - 96 - | |
| 2729 | + | and maintained or received by an agency or by a private person or entity in the | |
| 2730 | + | 2473 | |
| 2731 | + | performance of a service or function for or on behalf of an agency or when such2474 | |
| 2732 | + | documents have been transferred to a private person or entity by an agency for storage2475 | |
| 2733 | + | or future governmental use, including, but not limited to, any such material in the | |
| 2734 | + | 2476 | |
| 2735 | + | possession or control of a nonprofit organization to which is leased and transferred2477 | |
| 2736 | + | hospital assets of a hospital authority through a corporate restructuring which are related2478 | |
| 2737 | + | to the operation of the hospital and other leased facilities in the performance of services2479 | |
| 2738 | + | on behalf of the hospital authority."2480 | |
| 2739 | + | PART IV2481 | |
| 2740 | + | SECTION 4-1.2482 | |
| 2741 | + | Title 31 of the Official Code of Georgia Annotated, relating to health, is amended in Code2483 | |
| 2742 | + | Section 31-7-3, relating to requirements for permits to operate institutions, by revising2484 | |
| 2743 | + | subsection (a) as follows:2485 | |
| 2744 | + | "(a) Any person or persons responsible for the operation of any institution, or who may2486 | |
| 2745 | + | hereafter propose to establish and operate an institution and to provide specified clinical2487 | |
| 2746 | + | services, shall submit an application to the department for a permit to operate the institution2488 | |
| 2747 | + | and provide such services, with such application to be made on forms prescribed by the2489 | |
| 2748 | + | department. No institution shall be operated in this state without such a permit, which shall2490 | |
| 2749 | + | be displayed in a conspicuous place on the premises. No clinical services shall be provided2491 | |
| 2750 | + | by an institution except as approved by the department in accordance with the rules and2492 | |
| 2751 | + | regulations established pursuant to Code Section 31-7-2.1. Failure or refusal to file an2493 | |
| 2752 | + | application for a permit shall constitute a violation of this chapter and shall be dealt with2494 | |
| 2753 | + | as provided for in Article 1 of Chapter 5 of this title. Following inspection and2495 | |
| 2754 | + | classification of the institution for which a permit is applied for, the department may issue2496 | |
| 2755 | + | or refuse to issue a permit or a provisional permit. Permits issued shall remain in force and2497 23 LC 33 9350 | |
| 2756 | + | S. B. 162 | |
| 2757 | + | - 97 - | |
| 2758 | + | effect until revoked or suspended; provisional permits issued shall remain in force and | |
| 2759 | + | 2498 | |
| 2760 | + | effect for such limited period of time as may be specified by the department. Upon2499 | |
| 2761 | + | conclusion of the Atlantic Cardiovascular Patient Outcomes Research Team (C-PORT)2500 | |
| 2762 | + | Study, the department shall consider and analyze the data and conclusions of the study and2501 | |
| 2763 | + | promulgate rules pursuant to Code Section 31-7-2.1 to regulate the quality of care for2502 | |
| 2764 | + | therapeutic cardiac catheterization. All hospitals that participated in the study and are | |
| 2765 | + | were2503 | |
| 2766 | + | exempt from obtaining a certificate of need based on paragraph (22) of subsection (a) of2504 | |
| 2767 | + | former Code Section 31-6-47 as it existed on December 31, 2023, shall apply for a permit2505 | |
| 2768 | + | to continue providing therapeutic cardiac catheterization services once the department2506 | |
| 2769 | + | promulgates the rules required by this Code section."2507 | |
| 2770 | + | SECTION 4-2.2508 | |
| 2771 | + | Said title is further amended in Code Section 31-7-75, relating to the functions and powers2509 | |
| 2772 | + | of county and municipal hospital authorities, by revising paragraph (24) as follows:2510 | |
| 2773 | + | "(24) To provide management, consulting, and operating services including, but not2511 | |
| 2774 | + | limited to, administrative, operational, personnel, and maintenance services to another2512 | |
| 2775 | + | hospital authority, hospital, health care facility, as said term is defined in Chapter 6 of this2513 | |
| 2776 | + | title Code Section 31-6A-1, person, firm, corporation, or any other entity or any group2514 | |
| 2777 | + | or groups of the foregoing; to enter into contracts alone or in conjunction with others to2515 | |
| 2778 | + | provide such services without regard to the location of the parties to such transactions;2516 | |
| 2779 | + | to receive management, consulting, and operating services, including, but not limited to,2517 | |
| 2780 | + | administrative, operational, personnel, and maintenance services from another such2518 | |
| 2781 | + | hospital authority, hospital, health care facility, person, firm, corporation, or any other2519 | |
| 2782 | + | entity or any group or groups of the foregoing; and to enter into contracts alone or in2520 | |
| 2783 | + | conjunction with others to receive such services without regard to the location of the2521 | |
| 2784 | + | parties to such transactions;"2522 23 LC 33 9350 | |
| 2785 | + | S. B. 162 | |
| 2786 | + | - 98 - | |
| 2787 | + | SECTION 4-3. | |
| 2788 | + | 2523 | |
| 2789 | + | Said title is further amended in Code Section 31-7-94.1, the "Rural Hospital Organization2524 | |
| 2790 | + | Assistance Act of 2017," by revising paragraph (1) of subsection (e) as follows:2525 | |
| 2791 | + | "(1) Infrastructure development, including, without being limited to, health information2526 | |
| 2792 | + | technology, facility renovation, or equipment acquisition; provided, however, that the | |
| 2793 | + | 2527 | |
| 2794 | + | amount granted to any qualified hospital may not exceed the expenditure thresholds that2528 | |
| 2795 | + | would constitute a new institutional health service requiring a certificate of need under2529 | |
| 2796 | + | Chapter 6 of this title and the grant award may be conditioned upon obtaining local2530 | |
| 2797 | + | matching funds;"2531 | |
| 2798 | + | SECTION 4-4.2532 | |
| 2799 | + | Said title is further amended in Code Section 31-7-116, relating to provisions contained in2533 | |
| 2800 | + | obligations and security for obligations, procedures for issuance of bonds and bond2534 | |
| 2801 | + | anticipation notes, interest rates, and limitations and conditions, by revising subsection (i)2535 | |
| 2802 | + | as follows:2536 | |
| 2803 | + | "(i) No bonds or bond anticipation notes except refunding bonds shall be issued by an2537 | |
| 2804 | + | authority under this article unless its board of directors shall adopt adopts a resolution2538 | |
| 2805 | + | finding that the project for which such bonds or notes are to be issued will promote the2539 | |
| 2806 | + | objectives stated in subsection (b) of Code Section 31-7-111 and will increase or maintain2540 | |
| 2807 | + | employment in the territorial area of such authority. Nothing contained in this Code2541 | |
| 2808 | + | section shall be construed as permitting any authority created under this article or any2542 | |
| 2809 | + | qualified sponsor to finance, construct, or operate any project without obtaining any2543 | |
| 2810 | + | certificate of need or other approval, permit, or license which, under the laws of this state,2544 | |
| 2811 | + | is required in connection therewith."2545 23 LC 33 9350 | |
| 2812 | + | S. B. 162 | |
| 2813 | + | - 99 - | |
| 2814 | + | SECTION 4-5. | |
| 2815 | + | 2546 | |
| 2816 | + | Said title is further amended by revising Code Section 31-8-153.1, relating to irrevocable2547 | |
| 2817 | + | transfer of funds to trust fund and provision for indigent patients, as follows:2548 | |
| 2818 | + | "31-8-153.1.2549 | |
| 2819 | + | After June 30, 1993, any hospital authority, county, municipality, or other state or local2550 | |
| 2820 | + | public or governmental entity is authorized to transfer moneys to the trust fund. Transfer2551 | |
| 2821 | + | of funds under the control of a hospital authority, county, municipality, or other state or2552 | |
| 2822 | + | local public or governmental entity shall be a valid public purpose for which those funds2553 | |
| 2823 | + | may be expended. The department is authorized to transfer to the trust fund moneys paid2554 | |
| 2824 | + | to the state by a health care facility as a monetary penalty for the violation of an agreement2555 | |
| 2825 | + | to provide a specified amount of clinical health services to indigent patients | |
| 2826 | + | uncompensated2556 | |
| 2827 | + | indigent or charity care pursuant to a certificate of need license held by such facility. Such2557 | |
| 2828 | + | transfers shall be irrevocable and shall be used only for the purposes contained in Code2558 | |
| 2829 | + | Section 31-8-154."2559 | |
| 2830 | + | SECTION 4-6.2560 | |
| 2831 | + | Said title is further amended in Code Section 31-11-100, relating to definitions relative to the2561 | |
| 2832 | + | Georgia Trauma Care Network Commission, by revising paragraph (3) as follows:2562 | |
| 2833 | + | "(3) 'Trauma center' means a facility designated by the Department of Public Health as2563 | |
| 2834 | + | a Level I, II, III, or IV or burn trauma center. However, a burn trauma center shall not2564 | |
| 2835 | + | be considered or treated as a trauma center for purposes of certificate of need2565 | |
| 2836 | + | requirements under state law or regulations, including exceptions to need and adverse2566 | |
| 2837 | + | impact standards allowed by the department for trauma centers or for purposes of2567 | |
| 2838 | + | identifying safety net hospitals."2568 23 LC 33 9350 | |
| 2839 | + | S. B. 162 | |
| 2840 | + | - 100 - | |
| 2841 | + | SECTION 4-7. | |
| 2842 | + | 2569 | |
| 2843 | + | Code Section 37-1-29 of the Official Code of Georgia Annotated, relating to crisis2570 | |
| 2844 | + | stabilization units, is amended by revising subsection (j) as follows:2571 | |
| 2845 | + | "(j) Any program certified as a crisis stabilization unit pursuant to this Code section shall | |
| 2846 | + | 2572 | |
| 2847 | + | be exempt from the requirements to obtain a certificate of need pursuant to Article 3 of2573 | |
| 2848 | + | Chapter 6 of Title 31. Reserved."2574 | |
| 2849 | + | SECTION 4-8.2575 | |
| 2850 | + | Code Section 43-26-7 of the Official Code of Georgia Annotated, relating to requirements2576 | |
| 2851 | + | for licensure as a registered professional nurse, is amended by revising paragraph (4) of2577 | |
| 2852 | + | subsection (c) as follows:2578 | |
| 2853 | + | "(4)(A)(i) Meet continuing competency requirements as established by the board;2579 | |
| 2854 | + | (B)(ii) If the applicant entered a nontraditional nursing education program as a2580 | |
| 2855 | + | licensed practical nurse whose academic education as a licensed practical nurse2581 | |
| 2856 | + | included clinical training in pediatrics, obstetrics and gynecology, medical-surgical,2582 | |
| 2857 | + | and mental illness, have practiced nursing as a registered professional nurse in a2583 | |
| 2858 | + | health care facility for at least one year in the three years preceding the date of the2584 | |
| 2859 | + | application, and such practice is documented by the applicant and approved by the2585 | |
| 2860 | + | board; provided, however, that for an applicant who does not meet the experience2586 | |
| 2861 | + | requirement of this subparagraph, the board shall require the applicant to complete a2587 | |
| 2862 | + | 320 hour postgraduate preceptorship arranged by the applicant under the oversight of2588 | |
| 2863 | + | a registered nurse where such applicant is transitioned into the role of a registered2589 | |
| 2864 | + | professional nurse. The preceptorship shall have prior approval of the board, and2590 | |
| 2865 | + | successful completion of the preceptorship shall be verified in writing by the2591 | |
| 2866 | + | preceptor; or2592 | |
| 2867 | + | (C)(iii) If the applicant entered a nontraditional nursing education program as2593 | |
| 2868 | + | anything other than a licensed practical nurse whose academic education as a licensed2594 23 LC 33 9350 | |
| 2869 | + | S. B. 162 | |
| 2870 | + | - 101 - | |
| 2871 | + | practical nurse included clinical training in pediatrics, obstetrics and gynecology, | |
| 2872 | + | 2595 | |
| 2873 | + | medical-surgical, and mental illness, have graduated from such program and practiced2596 | |
| 2874 | + | nursing as a registered professional nurse in a health care facility for at least two years2597 | |
| 2875 | + | in the five years preceding the date of the application, and such practice is2598 | |
| 2876 | + | documented by the applicant and approved by the board; provided, however, that for2599 | |
| 2877 | + | an applicant who does not meet the experience requirement of this subparagraph | |
| 2878 | + | 2600 | |
| 2879 | + | subdivision, the board shall require the applicant to complete a postgraduate2601 | |
| 2880 | + | preceptorship of at least 480 hours but not more than 640 hours, as determined by the2602 | |
| 2881 | + | board, arranged by the applicant under the oversight of a registered professional nurse2603 | |
| 2882 | + | where such applicant is transitioned into the role of a registered professional nurse.2604 | |
| 2883 | + | The preceptorship shall have prior approval of the board, and successful completion2605 | |
| 2884 | + | of the preceptorship shall be verified in writing by the preceptor.2606 | |
| 2885 | + | (B) For purposes of this paragraph, the term 'health care facility' means an acute care2607 | |
| 2886 | + | inpatient facility, a long-term acute care facility, an ambulatory surgical center or2608 | |
| 2887 | + | obstetrical facility as defined in Code Section 31-6-2 31-6A-1, and a skilled nursing2609 | |
| 2888 | + | facility, so long as such skilled nursing facility has 100 beds or more and provides2610 | |
| 2889 | + | health care to patients with similar health care needs as those patients in a long-term2611 | |
| 2890 | + | acute care facility;"2612 | |
| 2891 | + | PART V2613 | |
| 2892 | + | SECTION 5-1.2614 | |
| 2893 | + | For purposes of rule-making, this Act shall become effective upon its approval by the2615 | |
| 2894 | + | Governor or upon its becoming law without such approval. For all other purposes, this Act2616 | |
| 2895 | + | shall become effective on January 1, 2024.2617 23 LC 33 9350 | |
| 2896 | + | S. B. 162 | |
| 2897 | + | - 102 - | |
| 2898 | + | SECTION 5-2. | |
| 2899 | + | 2618 | |
| 2900 | + | All laws and parts of laws in conflict with this Act are repealed.2619 |