| 1 | 1 | | FIRSTREGULARSESSION |
|---|
| 2 | 2 | | HOUSEBILLNO.1240 |
|---|
| 3 | 3 | | 103RDGENERALASSEMBLY |
|---|
| 4 | 4 | | INTRODUCEDBYREPRESENTATIVEOVERCAST. |
|---|
| 5 | 5 | | 2787H.01I JOSEPHENGLER,ChiefClerk |
|---|
| 6 | 6 | | ANACT |
|---|
| 7 | 7 | | Torepealsections197.300,197.305,197.310,197.311,197.312,197.315,197.316,197.318, |
|---|
| 8 | 8 | | 197.320,197.325,197.326,197.327,197.330,197.335,197.340,197.345,197.355, |
|---|
| 9 | 9 | | 197.357,197.366,197.367,197.705,198.530,208.169,and208.225,RSMo,andto |
|---|
| 10 | 10 | | enactinlieuthereoffournewsectionsrelatingtocertificatesofneed. |
|---|
| 11 | 11 | | BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows: |
|---|
| 12 | 12 | | SectionA.Sections197.300,197.305,197.310,197.311,197.312,197.315,197.316, |
|---|
| 13 | 13 | | 2197.318,197.320,197.325,197.326,197.327,197.330,197.335,197.340,197.345,197.355, |
|---|
| 14 | 14 | | 3197.357,197.366,197.367,197.705,198.530,208.169,and208.225,RSMo,arerepealedand |
|---|
| 15 | 15 | | 4fournewsectionsenactedinlieuthereof,tobeknownassections197.705,198.530,208.169, |
|---|
| 16 | 16 | | 5and208.225,toreadasfollows: |
|---|
| 17 | 17 | | 197.705.1.Forpurposesofthissection,theterm"healthcarefacilities"means: |
|---|
| 18 | 18 | | 2 (1)Facilitieslicensedunderchapter198; |
|---|
| 19 | 19 | | 3 (2)Long-termcarebedsinahospitalasdescribedinsubdivision(3)of |
|---|
| 20 | 20 | | 4subsection1ofsection198.012;and |
|---|
| 21 | 21 | | 5 (3)Long-termcarehospitalsorbedsinalong-termcarehospitalmeetingthe |
|---|
| 22 | 22 | | 6requirementsdescribedin42CFR412.23(e). |
|---|
| 23 | 23 | | 7 2.Allhospitals, asdefinedinsection197.020,andhealthcarefacilities[, definedin |
|---|
| 24 | 24 | | 8sections197.020and197.305,] shallrequireallpersonnelprovidingservicesinsuchfacilities |
|---|
| 25 | 25 | | 9towearidentificationbadgeswhileactingwithinthescopeoftheiremployment.The |
|---|
| 26 | 26 | | 10identificationbadgesofallpersonnelshallprominentlydisplaythelicensurestatusofsuch |
|---|
| 27 | 27 | | 11personnel. |
|---|
| 28 | 28 | | EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis |
|---|
| 29 | 29 | | intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 198.530.1.Forpurposesofthissection,theterm"continuingcareretirement |
|---|
| 30 | 30 | | 2community"meansacommunitythatprovidesatthesamesiteorlocationindependent |
|---|
| 31 | 31 | | 3housing,long-termhealthcare,andotherservicestoolderpersonsnotrelatedbyblood |
|---|
| 32 | 32 | | 4ormarriagetotheowneroroperatorofthecommunityunderanagreementeffective |
|---|
| 33 | 33 | | 5forthelifeofthepersonoraspecifiedperiodoftimeinexcessofoneyearthat |
|---|
| 34 | 34 | | 6guaranteesorprovidespriorityaccesstoon-sitehealth-relatedlong-termcareservices |
|---|
| 35 | 35 | | 7whenneeded. |
|---|
| 36 | 36 | | 8 2.Ifanenrolleeinamanagedcareorganizationisalsoaresidentinalong-termcare |
|---|
| 37 | 37 | | 9facilitylicensedpursuanttochapter198,oracontinuingcareretirementcommunity[, as |
|---|
| 38 | 38 | | 10definedinsection197.305], suchenrollee'smanagedcareorganizationshallprovidethe |
|---|
| 39 | 39 | | 11enrolleewiththeoptionofreceivingthecoveredserviceinthelong-termcarefacilitywhich |
|---|
| 40 | 40 | | 12servesastheenrollee'sprimaryresidence.Forpurposesofthissection,"managedcare |
|---|
| 41 | 41 | | 13organization"meansanyorganizationthatoffersanyhealthplancertifiedbythedepartment |
|---|
| 42 | 42 | | 14ofhealthandseniorservicesdesignedtoprovideincentivestomedicalcareprovidersto |
|---|
| 43 | 43 | | 15managethecostanduseofcareassociatedwithclaims,including,butnotlimitedto,ahealth |
|---|
| 44 | 44 | | 16maintenanceorganizationandpreferredproviderorganization.Theresidentenrollee's |
|---|
| 45 | 45 | | 17managedcareorganizationshallreimbursetheresidentfacilityforthoseserviceswhich |
|---|
| 46 | 46 | | 18wouldotherwisebecoveredbythemanagedcareorganizationifthefollowingconditions |
|---|
| 47 | 47 | | 19apply: |
|---|
| 48 | 48 | | 20 (1)Thefacilityiswillingandabletoprovidetheservicestotheresident;and |
|---|
| 49 | 49 | | 21 (2)Thefacilityandthosehealthcareprofessionalsdeliveringservicestoresidents |
|---|
| 50 | 50 | | 22pursuanttothissectionmeetthelicensingandtrainingstandardsasprescribedbylaw;and |
|---|
| 51 | 51 | | 23 (3)ThefacilityiscertifiedthroughMedicare;and |
|---|
| 52 | 52 | | 24 (4)Thefacilityandthosehealthcareprofessionalsdeliveringservicestoresidents |
|---|
| 53 | 53 | | 25pursuanttothissectionagreetoabidebythetermsandconditionsofthehealthcarrier's |
|---|
| 54 | 54 | | 26contractswithsimilarproviders,abidebypatientprotectionstandardsandrequirements |
|---|
| 55 | 55 | | 27imposedbystateorfederallawforplanenrolleesandmeetthequalitystandardsestablished |
|---|
| 56 | 56 | | 28bythehealthcarrierforsimilarproviders. |
|---|
| 57 | 57 | | 29 [2.]3.Themanagedcareorganizationshallreimbursetheresidentfacilityatarateof |
|---|
| 58 | 58 | | 30reimbursementnotlessthantheMedicareallowableratepursuanttoMedicarerulesand |
|---|
| 59 | 59 | | 31regulations. |
|---|
| 60 | 60 | | 32 [3.]4.Theservicesinsubsection[1]2ofthissectionshallinclude,butarenotlimited |
|---|
| 61 | 61 | | 33to,skillednursingcare,rehabilitativeandothertherapyservices,andpostacutecare,as |
|---|
| 62 | 62 | | 34needed.Nothinginthissectionshalllimitthemanagedcareorganizationfromutilizing |
|---|
| 63 | 63 | | 35contractedproviderstodelivertheservicesintheenrollee'sresidentfacility. |
|---|
| 64 | 64 | | 36 [4.]5.Aresidentfacilityshallnotprohibitahealthcarrier'sparticipatingproviders |
|---|
| 65 | 65 | | 37fromprovidingcoveredbenefitstoanenrolleeintheresidentfacility.Aresidentfacilityor |
|---|
| 66 | 66 | | HB1240 2 38healthcareprofessionalshallnotimposeanychargesonanenrolleeforanyservicethatis |
|---|
| 67 | 67 | | 39ancillaryto,acomponentof,orinsupportoftheservicesprovidedunderthissectionwhen |
|---|
| 68 | 68 | | 40theservicesareprovidedbyahealthcarrier'sparticipatingprovider,orotherwisecreatea |
|---|
| 69 | 69 | | 41disincentivefortheuseofthehealthcarrier'sparticipatingproviders.Anyviolationofthe |
|---|
| 70 | 70 | | 42requirementsofthissubsectionbytheresidentfacilityshallbeconsideredabuseorneglectof |
|---|
| 71 | 71 | | 43theresidentenrollee. |
|---|
| 72 | 72 | | 208.169.[1.]Notwithstandingotherprovisionsofthischapter,includingbutnot |
|---|
| 73 | 73 | | 2limitedtosections208.152,208.153,208.159and208.162[: |
|---|
| 74 | 74 | | 3 (1)Thereshallbenorevisionstoafacility'sreimbursementrateforprovidingnursing |
|---|
| 75 | 75 | | 4careservicesunderthischapteruponachangeinownership,managementcontrol,operation, |
|---|
| 76 | 76 | | 5stock,leaseholdinterestsbywhateverformforanyfacilitypreviouslylicensedorcertifiedfor |
|---|
| 77 | 77 | | 6participationintheMedicaidprogram.Increasedcostsforthesuccessorowner,management |
|---|
| 78 | 78 | | 7orleaseholderthatresultfromsuchachangeshallnotberecognizedforpurposesof |
|---|
| 79 | 79 | | 8reimbursement; |
|---|
| 80 | 80 | | 9 (2)Inthecaseofanewlybuiltfacilityorpartthereofwhichislessthantwoyearsof |
|---|
| 81 | 81 | | 10ageandenterstheTitleXIXprogramunderthischapterafterJuly1,1983,areimbursement |
|---|
| 82 | 82 | | 11rateshallbeassignedbasedonthelesserofprojectedestimatedoperatingcostsorone |
|---|
| 83 | 83 | | 12hundredtenpercentofthemedianrateforthefacility'sclasstoincludeurbanandrural |
|---|
| 84 | 84 | | 13categoriesforeachlevelofcareincludingICFonlyandSNF/ICF.Theratessetunderthis |
|---|
| 85 | 85 | | 14provisionshallbeeffectiveforaperiodoftwelvemonthsfromtheeffectivedateofthe |
|---|
| 86 | 86 | | 15provideragreementatwhichtimetherateforthefutureyearshallbesetinaccordancewith |
|---|
| 87 | 87 | | 16reportedcostsofthefacilityrecognizedunderthereimbursementplanandasprovidedin |
|---|
| 88 | 88 | | 17subdivisions(3)and(4)ofthissubsection.Ratessetunderthissectionmayinnocaseexceed |
|---|
| 89 | 89 | | 18themaximumceilingamountsineffectunderthereimbursementregulation; |
|---|
| 90 | 90 | | 19 (3)Reimbursementforcapitalrelatedexpensesfornewlybuiltfacilitiesenteringthe |
|---|
| 91 | 91 | | 20TitleXIXprogramafterMarch18,1983,shallbecalculatedasthebuildingandbuilding |
|---|
| 92 | 92 | | 21equipmentrate,movableequipmentrate,landrate,andworkingcapitalrate. |
|---|
| 93 | 93 | | 22 (a)Thebuildingandbuildingequipmentratewillbethelowerof: |
|---|
| 94 | 94 | | 23 a.Actualacquisitioncosts,whichistheoriginalcosttoconstructoracquirethe |
|---|
| 95 | 95 | | 24building,nottoexceedthecostsasdeterminedinsection197.357;or |
|---|
| 96 | 96 | | 25 b.Reasonableconstructionoracquisitioncostcomputedbyapplyingtheregional |
|---|
| 97 | 97 | | 26DodgeConstructionIndexfor1981withatrendfactor,ifnecessary,oranothercurrent |
|---|
| 98 | 98 | | 27constructioncostmeasuremultipliedbyonehundredeightpercentasanallowanceforfees |
|---|
| 99 | 99 | | 28authorizedasarchitecturalorlegalnotincludedintheDodgeIndexValue,multipliedbythe |
|---|
| 100 | 100 | | 29squarefootageofthefacilitynottoexceedthreehundredtwenty-fivesquarefeetperbed, |
|---|
| 101 | 101 | | 30multipliedbytheratiooffortyminustheactualyearsoftheageofthefacilitydividedby |
|---|
| 102 | 102 | | HB1240 3 31forty;andmultipliedbyareturnrateoftwelvepercent;anddividedbyninety-threepercentof |
|---|
| 103 | 103 | | 32thefacility'stotalavailablebedstimesthreehundredsixty-fivedays. |
|---|
| 104 | 104 | | 33 (b)Themaximummovableequipmentratewillbefifty-threecentsperbedday. |
|---|
| 105 | 105 | | 34 (c)Themaximumallowablelandareaisdefinedasfiveacresforafacilitywithone |
|---|
| 106 | 106 | | 35hundredorlessbedsandoneadditionalacreforeachadditionalonehundredbedsorfraction |
|---|
| 107 | 107 | | 36thereofforafacilitywithonehundredoneormorebeds. |
|---|
| 108 | 108 | | 37 (d)Thelandratewillbecalculatedas: |
|---|
| 109 | 109 | | 38 a.Forfacilitieswithlandareasatorbelowthemaximumallowablelandarea, |
|---|
| 110 | 110 | | 39multiplytheacquisitioncostofthelandbythereturnrateoftwelvepercent,dividebyninety- |
|---|
| 111 | 111 | | 40threepercentofthefacility'stotalavailablebedstimesthreehundredsixty-fivedays. |
|---|
| 112 | 112 | | 41 b.Forfacilitieswithlandareasgreaterthanthemaximumallowablelandarea,divide |
|---|
| 113 | 113 | | 42theacquisitioncostofthelandbythetotalacres,multiplybythemaximumallowableland |
|---|
| 114 | 114 | | 43area,multiplybythereturnrateoftwelvepercent,dividebyninety-threepercentofthe |
|---|
| 115 | 115 | | 44facility'stotalavailablebedstimesthreehundredsixty-fivedays. |
|---|
| 116 | 116 | | 45 (e)Themaximumworkingcapitalratewillbetwentycentsperday; |
|---|
| 117 | 117 | | 46 (4)Ifaproviderdoesnotprovidetheactualacquisitioncosttodeterminea |
|---|
| 118 | 118 | | 47reimbursementrateundersubparagrapha.ofparagraph(a)ofsubdivision(3)ofsubsection1 |
|---|
| 119 | 119 | | 48ofthissection,thesumofthebuildingandbuildingequipmentrate,movableequipmentrate, |
|---|
| 120 | 120 | | 49landrate,andworkingcapitalrateshallbesetatareimbursementrateofsixdollars; |
|---|
| 121 | 121 | | 50 (5)],foreachstatefiscalyearanegotiatedtrendfactorshallbeappliedtoeach |
|---|
| 122 | 122 | | 51facility'sTitleXIXperdiemreimbursementrate.Thetrendfactorshallbedetermined |
|---|
| 123 | 123 | | 52throughnegotiationsbetweenthedepartmentandtheaffectedprovidersandisintendedto |
|---|
| 124 | 124 | | 53holdtheprovidersharmlessagainstincreaseincost.Innocircumstancesshallthenegotiated |
|---|
| 125 | 125 | | 54trendfactortobeappliedtostatefundsexceedthehealthcarefinanceadministrationmarket |
|---|
| 126 | 126 | | 55basketpriceindexforthatyear.Theprovisionsofthissubdivisionshallapplytofiscalyear |
|---|
| 127 | 127 | | 561996andthereafter. |
|---|
| 128 | 128 | | 57 [2.Theprovisionsofsubdivisions(1),(2),(3),and(4)ofsubsection1ofthissection |
|---|
| 129 | 129 | | 58shallremainineffectuntilJuly1,1989,unlessotherwiseprovidedbylaw.] |
|---|
| 130 | 130 | | 208.225.1.Toimplementfullytheprovisionsofsection208.152,theMOHealthNet |
|---|
| 131 | 131 | | 2divisionshallcalculatetheMedicaidperdiemreimbursementratesofeachnursinghome |
|---|
| 132 | 132 | | 3participatingintheMedicaidprogramasaproviderofnursinghomeservicesbasedonits |
|---|
| 133 | 133 | | 4costsreportedintheTitleXIXcostreportfiledwiththeMOHealthNetdivisionforitsfiscal |
|---|
| 134 | 134 | | 5yearasprovidedinsubsection2ofthissection. |
|---|
| 135 | 135 | | 6 2.TherecalculationofMedicaidratestoallMissourifacilitieswillbeperformedas |
|---|
| 136 | 136 | | 7follows:effectiveJuly1,2004,thedepartmentofsocialservicesshallusetheMedicaidcost |
|---|
| 137 | 137 | | 8reportcontainingadjustedcostsforthefacilityfiscalyearendingin2001andredeterminethe |
|---|
| 138 | 138 | | 9allowableper-patientdaycostsforeachfacility.Thedepartmentshallrecalculatetheclass |
|---|
| 139 | 139 | | HB1240 4 10ceilingsinthepatientcare,onehundredtwentypercentofthemedian;ancillary,onehundred |
|---|
| 140 | 140 | | 11twentypercentofthemedian;andadministration,onehundredtenpercentofthemediancost |
|---|
| 141 | 141 | | 12centers.Eachfacilityshallreceiveasarateincreaseone-thirdoftheamountthatisunpaid |
|---|
| 142 | 142 | | 13basedontherecalculatedcostdetermination. |
|---|
| 143 | 143 | | 14 3.(1)Forpurposesofthissubsection,theterm"capitalexpenditures"means |
|---|
| 144 | 144 | | 15expendituresbyoronbehalfofafacilitythat,undergenerallyacceptedaccounting |
|---|
| 145 | 145 | | 16principles,arenotproperlychargeableasanexpenseofoperationandmaintenance. |
|---|
| 146 | 146 | | 17 (2)Anyintermediatecarefacilityorskillednursingfacility,assuchtermsaredefined |
|---|
| 147 | 147 | | 18insection198.006,participatinginMOHealthNetthatincurstotalcapitalexpenditures[, as |
|---|
| 148 | 148 | | 19suchtermisdefinedinsection197.305,] inexcessoftwothousanddollarsperbedshallbe |
|---|
| 149 | 149 | | 20entitledtoobtainfromtheMOHealthNetdivisionarecalculationofitsMedicaidperdiem |
|---|
| 150 | 150 | | 21reimbursementratebasedonitsadditionalcapitalcostsorallcostsincurredduringthefacility |
|---|
| 151 | 151 | | 22fiscalyearduringwhichsuchcapitalexpendituresweremade.Suchrecalculated |
|---|
| 152 | 152 | | 23reimbursementrateshallbecomeeffectiveandpayablewhengrantedbytheMO |
|---|
| 153 | 153 | | 24HealthNetdivisionasofthedateofapplicationforarateadjustment. |
|---|
| 154 | 154 | | [197.300.Sections197.300to197.366shallbeknownasthe |
|---|
| 155 | 155 | | 2 "MissouriCertificateofNeedLaw".] |
|---|
| 156 | 156 | | [197.305.Asusedinsections197.300to197.366,thefollowingterms |
|---|
| 157 | 157 | | 2 mean: |
|---|
| 158 | 158 | | 3 (1)"Affectedpersons",thepersonproposingthedevelopmentofa |
|---|
| 159 | 159 | | 4 newinstitutionalhealthservice,thepublictobeserved,andhealthcare |
|---|
| 160 | 160 | | 5 facilitieswithintheserviceareainwhichtheproposednewhealthcareservice |
|---|
| 161 | 161 | | 6 istobedeveloped; |
|---|
| 162 | 162 | | 7 (2)"Agency",thecertificateofneedprogramoftheMissouri |
|---|
| 163 | 163 | | 8 departmentofhealthandseniorservices; |
|---|
| 164 | 164 | | 9 (3)"Capitalexpenditure",anexpenditurebyoronbehalfofahealth |
|---|
| 165 | 165 | | 10 carefacilitywhich,undergenerallyacceptedaccountingprinciples,isnot |
|---|
| 166 | 166 | | 11 properlychargeableasanexpenseofoperationandmaintenance; |
|---|
| 167 | 167 | | 12 (4)"Certificateofneed",awrittencertificateissuedbythecommittee |
|---|
| 168 | 168 | | 13 settingforththecommittee'saffirmativefindingthataproposedproject |
|---|
| 169 | 169 | | 14 sufficientlysatisfiesthecriteriaprescribedforsuchprojectsbysections |
|---|
| 170 | 170 | | 15 197.300to197.366; |
|---|
| 171 | 171 | | 16 (5)"Develop",toundertakethoseactivitieswhichontheircompletion |
|---|
| 172 | 172 | | 17 willresultintheofferingofanewinstitutionalhealthserviceortheincurring |
|---|
| 173 | 173 | | 18 ofafinancialobligationinrelationtotheofferingofsuchaservice; |
|---|
| 174 | 174 | | 19 (6)"Expenditureminimum"shallmean: |
|---|
| 175 | 175 | | 20 (a)Forbedsinexistingorproposedhealthcarefacilitieslicensed |
|---|
| 176 | 176 | | 21 pursuanttochapter198andlong-termcarebedsinahospitalasdescribedin |
|---|
| 177 | 177 | | 22 subdivision(3)ofsubsection1ofsection198.012,sixhundredthousand |
|---|
| 178 | 178 | | 23 dollarsinthecaseofcapitalexpenditures,orfourhundredthousanddollarsin |
|---|
| 179 | 179 | | 24 thecaseofmajormedicalequipment,provided,however,thatpriortoJanuary |
|---|
| 180 | 180 | | 25 1,2003,theexpenditureminimumforbedsinsuchafacilityandlong-term |
|---|
| 181 | 181 | | HB1240 5 26 carebedsinahospitaldescribedinsection198.012shallbezero,subjecttothe |
|---|
| 182 | 182 | | 27 provisionsofsubsection7ofsection197.318; |
|---|
| 183 | 183 | | 28 (b)Forbedsorequipmentinalong-termcarehospitalmeetingthe |
|---|
| 184 | 184 | | 29 requirementsdescribedin42CFR,Section412.23(e),theexpenditure |
|---|
| 185 | 185 | | 30 minimumshallbezero;and |
|---|
| 186 | 186 | | 31 (c)Forhealthcarefacilities,newinstitutionalhealthservicesorbeds |
|---|
| 187 | 187 | | 32 notdescribedinparagraph(a)or(b)ofthissubdivisiononemilliondollarsin |
|---|
| 188 | 188 | | 33 thecaseofcapitalexpenditures,excludingmajormedicalequipment,andone |
|---|
| 189 | 189 | | 34 milliondollarsinthecaseofmedicalequipment; |
|---|
| 190 | 190 | | 35 (7)"Healthservicearea",ageographicregionappropriateforthe |
|---|
| 191 | 191 | | 36 effectiveplanninganddevelopmentofhealthservices,determinedonthebasis |
|---|
| 192 | 192 | | 37 offactorsincludingpopulationandtheavailabilityofresources,consistingof |
|---|
| 193 | 193 | | 38 apopulationofnotlessthanfivehundredthousandormorethanthreemillion; |
|---|
| 194 | 194 | | 39 (8)"Majormedicalequipment",medicalequipmentusedforthe |
|---|
| 195 | 195 | | 40 provisionofmedicalandotherhealthservices; |
|---|
| 196 | 196 | | 41 (9)"Newinstitutionalhealthservice": |
|---|
| 197 | 197 | | 42 (a)Thedevelopmentofanewhealthcarefacilitycostinginexcessof |
|---|
| 198 | 198 | | 43 theapplicableexpenditureminimum; |
|---|
| 199 | 199 | | 44 (b)Theacquisition,includingacquisitionbylease,ofanyhealthcare |
|---|
| 200 | 200 | | 45 facility,ormajormedicalequipmentcostinginexcessoftheexpenditure |
|---|
| 201 | 201 | | 46 minimum; |
|---|
| 202 | 202 | | 47 (c)Anycapitalexpenditurebyoronbehalfofahealthcarefacilityin |
|---|
| 203 | 203 | | 48 excessoftheexpenditureminimum; |
|---|
| 204 | 204 | | 49 (d)Predevelopmentactivitiesasdefinedinsubdivision(12)hereof |
|---|
| 205 | 205 | | 50 costinginexcessofonehundredfiftythousanddollars; |
|---|
| 206 | 206 | | 51 (e)Anychangeinlicensedbedcapacityofahealthcarefacility |
|---|
| 207 | 207 | | 52 licensedunderchapter198whichincreasesthetotalnumberofbedsbymore |
|---|
| 208 | 208 | | 53 thantenormorethantenpercentoftotalbedcapacity,whicheverisless,over |
|---|
| 209 | 209 | | 54 atwo-yearperiod,providedthatanysuchhealthcarefacilityseekinga |
|---|
| 210 | 210 | | 55 nonapplicabilityreviewforanincreaseintotalbedsortotalbedcapacityinan |
|---|
| 211 | 211 | | 56 amountlessthandescribedinthisparagraphshallbeeligibleforsuchreview |
|---|
| 212 | 212 | | 57 onlyifthefacilityhashadnopatientcareclassIdeficiencieswithinthelast |
|---|
| 213 | 213 | | 58 eighteenmonthsandhasmaintainedatleastaneighty-fivepercentaverage |
|---|
| 214 | 214 | | 59 occupancyratefortheprevioussixquarters; |
|---|
| 215 | 215 | | 60 (f)Healthservices,excludinghomehealthservices,whichareoffered |
|---|
| 216 | 216 | | 61 inahealthcarefacilityandwhichwerenotofferedonaregularbasisinsuch |
|---|
| 217 | 217 | | 62 healthcarefacilitywithinthetwelve-monthperiodpriortothetimesuch |
|---|
| 218 | 218 | | 63 serviceswouldbeoffered; |
|---|
| 219 | 219 | | 64 (g)Areallocationbyanexistinghealthcarefacilityoflicensedbeds |
|---|
| 220 | 220 | | 65 amongmajortypesofserviceorreallocationoflicensedbedsfromone |
|---|
| 221 | 221 | | 66 physicalfacilityorsitetoanotherbymorethantenbedsormorethanten |
|---|
| 222 | 222 | | 67 percentoftotallicensedbedcapacity,whicheverisless,overatwo-year |
|---|
| 223 | 223 | | 68 period; |
|---|
| 224 | 224 | | 69 (10)"Nonsubstantiveprojects",projectswhichdonotinvolvethe |
|---|
| 225 | 225 | | 70 addition,replacement,modernizationorconversionofbedsortheprovisionof |
|---|
| 226 | 226 | | 71 anewhealthservicebutwhichincludeacapitalexpenditurewhichexceeds |
|---|
| 227 | 227 | | 72 theexpenditureminimumandareduetoanactofGodoranormal |
|---|
| 228 | 228 | | 73 consequenceofmaintaininghealthcareservices,facilityorequipment; |
|---|
| 229 | 229 | | HB1240 6 74 (11)"Person",anyindividual,trust,estate,partnership,corporation, |
|---|
| 230 | 230 | | 75 includingassociationsandjointstockcompanies,stateorpoliticalsubdivision |
|---|
| 231 | 231 | | 76 orinstrumentalitythereof,includingamunicipalcorporation; |
|---|
| 232 | 232 | | 77 (12)"Predevelopmentactivities",expendituresforarchitectural |
|---|
| 233 | 233 | | 78 designs,plans,workingdrawingsandspecifications,andanyarrangement |
|---|
| 234 | 234 | | 79 orcommitmentmadeforfinancing;butexcludingsubmissionofan |
|---|
| 235 | 235 | | 80 applicationforacertificateofneed.] |
|---|
| 236 | 236 | | [197.310.1.The"MissouriHealthFacilitiesReviewCommittee"is |
|---|
| 237 | 237 | | 2 herebyestablished.Theagencyshallprovideclericalandadministrative |
|---|
| 238 | 238 | | 3 supporttothecommittee.Thecommitteemayemployadditionalstaffasit |
|---|
| 239 | 239 | | 4 deemsnecessary. |
|---|
| 240 | 240 | | 5 2.Thecommitteeshallbecomposedof: |
|---|
| 241 | 241 | | 6 (1)Twomembersofthesenateappointedbythepresidentprotem, |
|---|
| 242 | 242 | | 7 whoshallbefromdifferentpoliticalparties;and |
|---|
| 243 | 243 | | 8 (2)Twomembersofthehouseofrepresentativesappointedbythe |
|---|
| 244 | 244 | | 9 speaker,whoshallbefromdifferentpoliticalparties;and |
|---|
| 245 | 245 | | 10 (3)Fivemembersappointedbythegovernorwiththeadviceand |
|---|
| 246 | 246 | | 11 consentofthesenate,notmorethanthreeofwhomshallbefromthesame |
|---|
| 247 | 247 | | 12 politicalparty. |
|---|
| 248 | 248 | | 13 3.Nobusinessofthiscommitteeshallbeperformedwithouta |
|---|
| 249 | 249 | | 14 majorityofthefullbody. |
|---|
| 250 | 250 | | 15 4.ThemembersshallbeappointedassoonaspossibleafterSeptember |
|---|
| 251 | 251 | | 16 28,1979.Oneofthesenatemembers,oneofthehousemembersandthreeof |
|---|
| 252 | 252 | | 17 themembersappointedbythegovernorshallserveuntilJanuary1,1981,and |
|---|
| 253 | 253 | | 18 theremainingmembersshallserveuntilJanuary1,1982.Allsubsequent |
|---|
| 254 | 254 | | 19 membersshallbeappointedinthemannerprovidedinsubsection2ofthis |
|---|
| 255 | 255 | | 20 sectionandshallservetermsoftwoyears. |
|---|
| 256 | 256 | | 21 5.Thecommitteeshallelectachairmanatitsfirstmeetingwhichshall |
|---|
| 257 | 257 | | 22 becalledbythegovernor.Thecommitteeshallmeetuponthecallofthe |
|---|
| 258 | 258 | | 23 chairmanorthegovernor. |
|---|
| 259 | 259 | | 24 6.Thecommitteeshallreviewandapproveordisapproveall |
|---|
| 260 | 260 | | 25 applicationsforacertificateofneedmadeundersections197.300to197.366. |
|---|
| 261 | 261 | | 26 Itshallissuereasonablerulesandregulationsgoverningthesubmission, |
|---|
| 262 | 262 | | 27 reviewanddispositionofapplications. |
|---|
| 263 | 263 | | 28 7.Membersofthecommitteeshallservewithoutcompensationbut |
|---|
| 264 | 264 | | 29 shallbereimbursedfornecessaryexpensesincurredintheperformanceof |
|---|
| 265 | 265 | | 30 theirduties. |
|---|
| 266 | 266 | | 31 8.Notwithstandingtheprovisionsofsubsection4ofsection610.025, |
|---|
| 267 | 267 | | 32 theproceedingsandrecordsofthefacilitiesreviewcommitteeshallbesubject |
|---|
| 268 | 268 | | 33 totheprovisionsofchapter610.] |
|---|
| 269 | 269 | | [197.311.NomemberoftheMissourihealthfacilitiesreview |
|---|
| 270 | 270 | | 2 committeemayacceptapoliticaldonationfromanyapplicantforalicense.] |
|---|
| 271 | 271 | | [197.312.Acertificateofneedshallnotberequiredforanyinstitution |
|---|
| 272 | 272 | | 2 previouslyownedandoperatedfororinbehalfofacitynotwithinacounty |
|---|
| 273 | 273 | | 3 whichchoosestobelicensedasafacilitydefinedundersubdivision(22)or |
|---|
| 274 | 274 | | HB1240 7 4 (23)ofsection198.006forafacilityofninetybedsorlessthatisownedor |
|---|
| 275 | 275 | | 5 operatedbyanot-for-profitcorporationwhichisexemptfromfederalincome |
|---|
| 276 | 276 | | 6 taxasanorganizationdescribedinsection501(c)(3)oftheInternalRevenue |
|---|
| 277 | 277 | | 7 Codeof1986,whichiscontrolleddirectlybyareligiousorganizationand |
|---|
| 278 | 278 | | 8 whichhasreceivedapprovalbythedepartmentofhealthandseniorservicesof |
|---|
| 279 | 279 | | 9 plansforconstructionofsuchfacilitybyAugust1,1995,andislicensedbythe |
|---|
| 280 | 280 | | 10 departmentofhealthandseniorservicesbyJuly1,1996,asafacilitydefined |
|---|
| 281 | 281 | | 11 undersubdivision(22)or(23)ofsection198.006orforafacility,serving |
|---|
| 282 | 282 | | 12 exclusivelymentallyill,homelesspersons,ofsixteenbedsorlessthatis |
|---|
| 283 | 283 | | 13 ownedoroperatedbyanot-for-profitcorporationwhichisexemptfrom |
|---|
| 284 | 284 | | 14 federalincometaxwhichisdescribedinsection501(c)(3)oftheInternal |
|---|
| 285 | 285 | | 15 RevenueCodeof1986,whichiscontrolleddirectlybyareligiousorganization |
|---|
| 286 | 286 | | 16 andwhichhasreceivedapprovalbythedepartmentofhealthandsenior |
|---|
| 287 | 287 | | 17 servicesofplansforconstructionofsuchfacilitybyMay1,1996,andis |
|---|
| 288 | 288 | | 18 licensedbythedepartmentofhealthandseniorservicesbyJuly1,1996,asa |
|---|
| 289 | 289 | | 19 facilitydefinedundersubdivision(22)or(23)ofsection198.006oranassisted |
|---|
| 290 | 290 | | 20 livingfacilitylocatedinacitynotwithinacountyoperatedbyanotforprofit |
|---|
| 291 | 291 | | 21 corporationwhichisexemptfromfederalincometaxwhichisdescribedin |
|---|
| 292 | 292 | | 22 section501(c)(3)oftheInternalRevenueCodeof1986,whichiscontrolled |
|---|
| 293 | 293 | | 23 directlybyareligiousorganizationandwhichislicensedforonehundredbeds |
|---|
| 294 | 294 | | 24 orlessonorbeforeAugust28,1997.] |
|---|
| 295 | 295 | | [197.315.1.Anypersonwhoproposestodeveloporofferanew |
|---|
| 296 | 296 | | 2 institutionalhealthservicewithinthestatemustobtainacertificateofneed |
|---|
| 297 | 297 | | 3 fromthecommitteepriortothetimesuchservicesareoffered. |
|---|
| 298 | 298 | | 4 2.Onlythosenewinstitutionalhealthserviceswhicharefoundbythe |
|---|
| 299 | 299 | | 5 committeetobeneededshallbegrantedacertificateofneed.Onlythosenew |
|---|
| 300 | 300 | | 6 institutionalhealthserviceswhicharegrantedcertificatesofneedshallbe |
|---|
| 301 | 301 | | 7 offeredordevelopedwithinthestate.Noexpendituresfornewinstitutional |
|---|
| 302 | 302 | | 8 healthservicesinexcessoftheapplicableexpenditureminimumshallbemade |
|---|
| 303 | 303 | | 9 byanypersonunlessacertificateofneedhasbeengranted. |
|---|
| 304 | 304 | | 10 3.AfterOctober1,1980,nostateagencychargedbystatutetolicense |
|---|
| 305 | 305 | | 11 orcertifyhealthcarefacilitiesshallissuealicensetoorcertifyanysuch |
|---|
| 306 | 306 | | 12 facility,ordistinctpartofsuchfacility,thatisdevelopedwithoutobtaininga |
|---|
| 307 | 307 | | 13 certificateofneed. |
|---|
| 308 | 308 | | 14 4.Ifanypersonproposestodevelopanynewinstitutionalhealthcare |
|---|
| 309 | 309 | | 15 servicewithoutacertificateofneedasrequiredbysections197.300to |
|---|
| 310 | 310 | | 16 197.366,thecommitteeshallnotifytheattorneygeneral,andheshallapplyfor |
|---|
| 311 | 311 | | 17 aninjunctionorotherappropriatelegalactioninanycourtofthisstateagainst |
|---|
| 312 | 312 | | 18 thatperson. |
|---|
| 313 | 313 | | 19 5.AfterOctober1,1980,noagencyofstategovernmentmay |
|---|
| 314 | 314 | | 20 appropriateorgrantfundstoormakepaymentofanyfundstoanypersonor |
|---|
| 315 | 315 | | 21 healthcarefacilitywhichhasnotfirstobtainedeverycertificateofneed |
|---|
| 316 | 316 | | 22 requiredpursuanttosections197.300to197.366. |
|---|
| 317 | 317 | | 23 6.Acertificateofneedshallbeissuedonlyforthepremisesand |
|---|
| 318 | 318 | | 24 personsnamedintheapplicationandisnottransferableexceptbyconsentof |
|---|
| 319 | 319 | | 25 thecommittee. |
|---|
| 320 | 320 | | HB1240 8 26 7.Projectcostincreases,duetochangesintheprojectapplicationas |
|---|
| 321 | 321 | | 27 approvedorduetoprojectchangeorders,exceedingtheinitialestimateby |
|---|
| 322 | 322 | | 28 morethantenpercentshallnotbeincurredwithoutconsentofthecommittee. |
|---|
| 323 | 323 | | 29 8.Periodicreportstothecommitteeshallberequiredofanyapplicant |
|---|
| 324 | 324 | | 30 whohasbeengrantedacertificateofneeduntiltheprojecthasbeen |
|---|
| 325 | 325 | | 31 completed.Thecommitteemayordertheforfeitureofthecertificateofneed |
|---|
| 326 | 326 | | 32 uponfailureoftheapplicanttofileanysuchreport. |
|---|
| 327 | 327 | | 33 9.Acertificateofneedshallbesubjecttoforfeitureforfailuretoincur |
|---|
| 328 | 328 | | 34 acapitalexpenditureonanyapprovedprojectwithinsixmonthsafterthedate |
|---|
| 329 | 329 | | 35 oftheorder.Theapplicantmayrequestanextensionfromthecommitteeof |
|---|
| 330 | 330 | | 36 notmorethansixadditionalmonthsbaseduponsubstantialexpendituremade. |
|---|
| 331 | 331 | | 37 10.Eachapplicationforacertificateofneedmustbeaccompaniedby |
|---|
| 332 | 332 | | 38 anapplicationfee.Thetimeoffilingcommenceswiththereceiptofthe |
|---|
| 333 | 333 | | 39 applicationandtheapplicationfee.Theapplicationfeeisonethousand |
|---|
| 334 | 334 | | 40 dollars,orone-tenthofonepercentofthetotalcostoftheproposedproject, |
|---|
| 335 | 335 | | 41 whicheverisgreater.Allapplicationfeesshallbedepositedinthestate |
|---|
| 336 | 336 | | 42 treasury.Becauseofthelossoffederalfunds,thegeneralassemblywill |
|---|
| 337 | 337 | | 43 appropriatefundstotheMissourihealthfacilitiesreviewcommittee. |
|---|
| 338 | 338 | | 44 11.Indeterminingwhetheracertificateofneedshouldbegranted,no |
|---|
| 339 | 339 | | 45 considerationshallbegiventothefacilitiesorequipmentofanyotherhealth |
|---|
| 340 | 340 | | 46 carefacilitylocatedmorethanafifteen-mileradiusfromtheapplyingfacility. |
|---|
| 341 | 341 | | 47 12.Whenanursingfacilityshiftsfromaskilledtoanintermediate |
|---|
| 342 | 342 | | 48 levelofnursingcare,itmayreturntothehigherlevelofcareifitmeetsthe |
|---|
| 343 | 343 | | 49 licensurerequirements,withoutobtainingacertificateofneed. |
|---|
| 344 | 344 | | 50 13.Innoeventshallacertificateofneedbedeniedbecausethe |
|---|
| 345 | 345 | | 51 applicantrefusestoprovideabortionservicesorinformation. |
|---|
| 346 | 346 | | 52 14.Acertificateofneedshallnotberequiredforthetransferof |
|---|
| 347 | 347 | | 53 ownershipofanexistingandoperationalhealthfacilityinitsentirety. |
|---|
| 348 | 348 | | 54 15.Acertificateofneedmaybegrantedtoafacilityforanexpansion, |
|---|
| 349 | 349 | | 55 anadditionofservices,anewinstitutionalservice,orforanewhospital |
|---|
| 350 | 350 | | 56 facilitywhichprovidesforsomethinglessthanthatwhichwassoughtinthe |
|---|
| 351 | 351 | | 57 application. |
|---|
| 352 | 352 | | 58 16.Theprovisionsofthissectionshallnotapplytofacilitiesoperated |
|---|
| 353 | 353 | | 59 bythestate,andappropriationoffundstosuchfacilitiesbythegeneral |
|---|
| 354 | 354 | | 60 assemblyshallbedeemedincompliancewiththissection,andsuchfacilities |
|---|
| 355 | 355 | | 61 shallbedeemedtohavereceivedanappropriatecertificateofneedwithout |
|---|
| 356 | 356 | | 62 paymentofanyfeeorcharge.Theprovisionsofthissubsectionshallnot |
|---|
| 357 | 357 | | 63 applytohospitalsoperatedbythestateandlicensedunderthischapter,except |
|---|
| 358 | 358 | | 64 fordepartmentofmentalhealthstate-operatedpsychiatrichospitals. |
|---|
| 359 | 359 | | 65 17.Notwithstandingotherprovisionsofthissection,acertificateof |
|---|
| 360 | 360 | | 66 needmaybeissuedafterJuly1,1983,foranintermediatecarefacility |
|---|
| 361 | 361 | | 67 operatedexclusivelyfortheintellectuallydisabled. |
|---|
| 362 | 362 | | 68 18.Toassurethesafe,appropriate,andcost-effectivetransferofnew |
|---|
| 363 | 363 | | 69 medicaltechnologythroughoutthestate,acertificateofneedshallnotbe |
|---|
| 364 | 364 | | 70 requiredforthepurchaseandoperationof: |
|---|
| 365 | 365 | | 71 (1)Researchequipmentthatistobeusedinaclinicaltrialthathas |
|---|
| 366 | 366 | | 72 receivedwrittenapprovalfromadulyconstitutedinstitutionalreviewboardof |
|---|
| 367 | 367 | | 73 anaccreditedschoolofmedicineorosteopathylocatedinMissouritoestablish |
|---|
| 368 | 368 | | HB1240 9 74 itssafetyandefficacyanddoesnotincreasethebedcomplementofthe |
|---|
| 369 | 369 | | 75 institutioninwhichtheequipmentistobelocated.Aftertheclinicaltrialhas |
|---|
| 370 | 370 | | 76 beencompleted,acertificateofneedmustbeobtainedforcontinuedusein |
|---|
| 371 | 371 | | 77 suchfacility;or |
|---|
| 372 | 372 | | 78 (2)Equipmentthatistobeusedbyanacademichealthcenteroperated |
|---|
| 373 | 373 | | 79 bythestateinfurtheranceofitsresearchorteachingmissions.] |
|---|
| 374 | 374 | | [197.316.1.Theprovisionsofsubsection10ofsection197.315and |
|---|
| 375 | 375 | | 2 sections197.317and197.318shallnotapplytofacilitieswhicharelicensed |
|---|
| 376 | 376 | | 3 pursuanttotheprovisionsofchapter198,whicharedesignedandoperated |
|---|
| 377 | 377 | | 4 exclusivelyforthecareandtreatmentofpersonswithacquiredhuman |
|---|
| 378 | 378 | | 5 immunodeficiencysyndrome,AIDS. |
|---|
| 379 | 379 | | 6 2.Ifafacilityisgrantedacertificateofneedandisfoundtobeexempt |
|---|
| 380 | 380 | | 7 fromtheprovisionsofsubsection10ofsection197.315andsections197.317 |
|---|
| 381 | 381 | | 8 and197.318pursuanttotheprovisionsofsubsection1ofthissection,then |
|---|
| 382 | 382 | | 9 onlyAIDSpatientsshallberesidentsofsuchfacilityandnoothers. |
|---|
| 383 | 383 | | 10 3.Anyfacilitythatviolatestheprovisionsofsubsection2ofthis |
|---|
| 384 | 384 | | 11 sectionshallbeliableforafineofonehundreddollarsperresidentperdayfor |
|---|
| 385 | 385 | | 12 eachsuchviolation. |
|---|
| 386 | 386 | | 13 4.Theattorneygeneralshall,uponrequestofthedepartmentofhealth |
|---|
| 387 | 387 | | 14 andseniorservices,bringanactioninacircuitcourtofcompetentjurisdiction |
|---|
| 388 | 388 | | 15 forviolationofthissection.] |
|---|
| 389 | 389 | | [197.318.1.Asusedinthissection,theterm"licensedandavailable" |
|---|
| 390 | 390 | | 2 meansbedswhichareactuallyinplaceandforwhichalicensehasbeen |
|---|
| 391 | 391 | | 3 issued. |
|---|
| 392 | 392 | | 4 2.Thecommitteeshallreviewalllettersofintentandapplicationsfor |
|---|
| 393 | 393 | | 5 long-termcarehospitalbedsmeetingtherequirementsdescribedin42CFR, |
|---|
| 394 | 394 | | 6 Section412.23(e)underitscriteriaandstandardsforlong-termcarebeds. |
|---|
| 395 | 395 | | 7 3.Sections197.300to197.366shallnotbeconstruedtoapplyto |
|---|
| 396 | 396 | | 8 litigationpendinginstatecourtonorbeforeApril1,1996,inwhichthe |
|---|
| 397 | 397 | | 9 Missourihealthfacilitiesreviewcommitteeisadefendantinanaction |
|---|
| 398 | 398 | | 10 concerningtheapplicationofsections197.300to197.366tolong-termcare |
|---|
| 399 | 399 | | 11 hospitalbedsmeetingtherequirementsdescribedin42CFR,Section412.23 |
|---|
| 400 | 400 | | 12 (e). |
|---|
| 401 | 401 | | 13 4.Notwithstandinganyotherprovisionofthischaptertothecontrary: |
|---|
| 402 | 402 | | 14 (1)Afacilitylicensedpursuanttochapter198mayincreaseits |
|---|
| 403 | 403 | | 15 licensedbedcapacityby: |
|---|
| 404 | 404 | | 16 (a)Submittingaletterofintenttoexpandtothedepartmentofhealth |
|---|
| 405 | 405 | | 17 andseniorservicesandthehealthfacilitiesreviewcommittee; |
|---|
| 406 | 406 | | 18 (b)Certificationfromthedepartmentofhealthandseniorservicesthat |
|---|
| 407 | 407 | | 19 thefacility: |
|---|
| 408 | 408 | | 20 a.HasnopatientcareclassIdeficiencieswithinthelasteighteen |
|---|
| 409 | 409 | | 21 months;and |
|---|
| 410 | 410 | | 22 b.Hasmaintainedaninety-percentaverageoccupancyrateforthe |
|---|
| 411 | 411 | | 23 previoussixquarters; |
|---|
| 412 | 412 | | 24 (c)Hasmadeanefforttopurchasebedsforeighteenmonthsfollowing |
|---|
| 413 | 413 | | 25 thedatetheletterofintenttoexpandissubmittedpursuanttoparagraph(a)of |
|---|
| 414 | 414 | | HB1240 10 26 thissubdivision.Forpurposesofthisparagraph,an"efforttopurchase"means |
|---|
| 415 | 415 | | 27 acopycertifiedbytheofferorasanoffertopurchasebedsfromanother |
|---|
| 416 | 416 | | 28 licensedfacilityinthesamelicensurecategory;and |
|---|
| 417 | 417 | | 29 (d)Ifanagreementisreachedbythesellingandpurchasingentities, |
|---|
| 418 | 418 | | 30 thehealthfacilitiesreviewcommitteeshallissueacertificateofneedforthe |
|---|
| 419 | 419 | | 31 expansionofthepurchaserfacilityuponsurrenderoftheseller'slicense;or |
|---|
| 420 | 420 | | 32 (e)Ifnoagreementisreachedbythesellingandpurchasingentities, |
|---|
| 421 | 421 | | 33 thehealthfacilitiesreviewcommitteeshallpermitanexpansionfor: |
|---|
| 422 | 422 | | 34 a.Afacilitywithmorethanfortybedsmayexpanditslicensedbed |
|---|
| 423 | 423 | | 35 capacitywithinthesamelicensurecategorybytwenty-fivepercentorthirty |
|---|
| 424 | 424 | | 36 beds,whicheverisgreater,ifthatsamelicensurecategoryinsuchfacilityhas |
|---|
| 425 | 425 | | 37 experiencedanaverageoccupancyofninety-threepercentorgreateroverthe |
|---|
| 426 | 426 | | 38 previoussixquarters; |
|---|
| 427 | 427 | | 39 b.Afacilitywithfewerthanfortybedsmayexpanditslicensedbed |
|---|
| 428 | 428 | | 40 capacitywithinthesamelicensurecategorybytwenty-fivepercentortenbeds, |
|---|
| 429 | 429 | | 41 whicheverisgreater,ifthatsamelicensurecategoryinsuchfacilityhas |
|---|
| 430 | 430 | | 42 experiencedanaverageoccupancyofninety-twopercentorgreateroverthe |
|---|
| 431 | 431 | | 43 previoussixquarters; |
|---|
| 432 | 432 | | 44 c.Afacilityaddingbedspursuanttosubparagraphsa.orb.ofthis |
|---|
| 433 | 433 | | 45 paragraphshallnotexpandbymorethanfiftypercentofitsthenlicensedbed |
|---|
| 434 | 434 | | 46 capacityinthequalifyinglicensurecategory; |
|---|
| 435 | 435 | | 47 (2)Anybedssoldshall,forfiveyearsfromthedateofrelicensureby |
|---|
| 436 | 436 | | 48 thepurchaser,remainunlicensedandunusedforanylong-termcareservicein |
|---|
| 437 | 437 | | 49 thesellingfacility,whethertheydoordonotrequirealicense; |
|---|
| 438 | 438 | | 50 (3)Thebedspurchasedshall,fortwoyearsfromthedateofpurchase, |
|---|
| 439 | 439 | | 51 remaininthebedinventoryattributedtothesellingfacilityandbeconsidered |
|---|
| 440 | 440 | | 52 bythedepartmentofsocialservicesaslicensedandavailableforpurposesof |
|---|
| 441 | 441 | | 53 thissection; |
|---|
| 442 | 442 | | 54 (4)Anyresidentialcarefacilitylicensedpursuanttochapter198may |
|---|
| 443 | 443 | | 55 relocateanyportionofsuchfacility'scurrentlicensedbedstoanyotherfacility |
|---|
| 444 | 444 | | 56 tobelicensedwithinthesamelicensurecategoryifbothfacilitiesareunderthe |
|---|
| 445 | 445 | | 57 samelicensureownershiporcontrol,andarelocatedwithinsixmilesofeach |
|---|
| 446 | 446 | | 58 other; |
|---|
| 447 | 447 | | 59 (5)Afacilitylicensedpursuanttochapter198maytransferorsell |
|---|
| 448 | 448 | | 60 individuallong-termcarelicensedbedstofacilitiesqualifyingpursuantto |
|---|
| 449 | 449 | | 61 paragraphs(a)and(b)ofsubdivision(1)ofthissubsection.Anyfacilitywhich |
|---|
| 450 | 450 | | 62 transfersorsellslicensedbedsshallnotexpanditslicensedbedcapacityin |
|---|
| 451 | 451 | | 63 thatlicensurecategoryforaperiodoffiveyearsfromthedatethelicensureis |
|---|
| 452 | 452 | | 64 relinquished. |
|---|
| 453 | 453 | | 65 5.Anyexistinglicensedandoperatinghealthcarefacilityoffering |
|---|
| 454 | 454 | | 66 long-termcareservicesmayreplaceone-halfofitslicensedbedsatthesame |
|---|
| 455 | 455 | | 67 siteorasitenotmorethanthirtymilesfromitscurrentlocationif,foratleast |
|---|
| 456 | 456 | | 68 themostrecentfourconsecutivecalendarquarters,thefacilityoperatesonly |
|---|
| 457 | 457 | | 69 fiftypercentofitsthenlicensedcapacitywitheveryresidentresidingina |
|---|
| 458 | 458 | | 70 privateroom.Insuchcase: |
|---|
| 459 | 459 | | 71 (1)Thefacilityshallreporttothehealthandseniorservicesvacant |
|---|
| 460 | 460 | | 72 bedsasunavailableforoccupancyforatleastthemostrecentfourconsecutive |
|---|
| 461 | 461 | | 73 calendarquarters; |
|---|
| 462 | 462 | | HB1240 11 74 (2)Thereplacementbedsshallbebuilttoprivateroomspecifications |
|---|
| 463 | 463 | | 75 andonlyusedforsingleoccupancy;and |
|---|
| 464 | 464 | | 76 (3)Theexistingfacilityandproposedfacilityshallhavethesame |
|---|
| 465 | 465 | | 77 ownerorowners,regardlessofcorporateorbusinessstructure,andsuchowner |
|---|
| 466 | 466 | | 78 orownersshallstipulateinwritingthattheexistingfacilitybedstobereplaced |
|---|
| 467 | 467 | | 79 willnotlaterbeusedtoprovidelong-termcareservices.Ifthefacilityisbeing |
|---|
| 468 | 468 | | 80 operatedunderalease,boththelesseeandtheowneroftheexistingfacility |
|---|
| 469 | 469 | | 81 shallstipulatethesameinwriting. |
|---|
| 470 | 470 | | 82 6.Nothinginthissectionshallprohibitahealthcarefacilitylicensed |
|---|
| 471 | 471 | | 83 pursuanttochapter198frombeingreplacedinitsentiretywithinfifteenmiles |
|---|
| 472 | 472 | | 84 ofitsexistingsitesolongastheexistingfacilityandproposedorreplacement |
|---|
| 473 | 473 | | 85 facilityhavethesameownerorownersregardlessofcorporateorbusiness |
|---|
| 474 | 474 | | 86 structureandthehealthcarefacilitybeingreplacedremainsunlicensedand |
|---|
| 475 | 475 | | 87 unusedforanylong-termcareserviceswhethertheydoordonotrequirea |
|---|
| 476 | 476 | | 88 licensefromthedateoflicensureofthereplacementfacility.] |
|---|
| 477 | 477 | | [197.320.Thecommitteeshallhavethepowertopromulgate |
|---|
| 478 | 478 | | 2 reasonablerules,regulations,criteriaandstandardsinconformitywiththis |
|---|
| 479 | 479 | | 3 sectionandchapter536tomeettheobjectivesofsections197.300to197.366 |
|---|
| 480 | 480 | | 4 includingthepowertoestablishcriteriaandstandardstoreviewnewtypesof |
|---|
| 481 | 481 | | 5 equipmentorservice.Anyruleorportionofarule,asthattermisdefinedin |
|---|
| 482 | 482 | | 6 section536.010,thatiscreatedundertheauthoritydelegatedinsections |
|---|
| 483 | 483 | | 7 197.300to197.366shallbecomeeffectiveonlyifitcomplieswithandis |
|---|
| 484 | 484 | | 8 subjecttoalloftheprovisionsofchapter536and,ifapplicable,section |
|---|
| 485 | 485 | | 9 536.028.AllrulemakingauthoritydelegatedpriortoAugust28,1999,isofno |
|---|
| 486 | 486 | | 10 forceandeffectandrepealed.Nothinginthissectionshallbeinterpretedto |
|---|
| 487 | 487 | | 11 repealoraffectthevalidityofanyrulefiledoradoptedpriortoAugust28, |
|---|
| 488 | 488 | | 12 1999,ifitfullycompliedwithallapplicableprovisionsoflaw.Thissection |
|---|
| 489 | 489 | | 13 andchapter536arenonseverableandifanyofthepowersvestedwiththe |
|---|
| 490 | 490 | | 14 generalassemblypursuanttochapter536toreview,todelaytheeffectivedate |
|---|
| 491 | 491 | | 15 ortodisapproveandannularulearesubsequentlyheldunconstitutional,then |
|---|
| 492 | 492 | | 16 thegrantofrulemakingauthorityandanyruleproposedoradoptedafter |
|---|
| 493 | 493 | | 17 August28,1999,shallbeinvalidandvoid.] |
|---|
| 494 | 494 | | [197.325.Anypersonwhoproposestodeveloporofferanew |
|---|
| 495 | 495 | | 2 institutionalhealthserviceshallsubmitaletterofintenttothecommitteeat |
|---|
| 496 | 496 | | 3 leastthirtydayspriortothefilingoftheapplication.] |
|---|
| 497 | 497 | | [197.326.1.Anypersonwhoispaideitheraspartofhisorhernormal |
|---|
| 498 | 498 | | 2 employmentorasalobbyisttosupportoropposeanyprojectbeforethehealth |
|---|
| 499 | 499 | | 3 facilitiesreviewcommitteeshallregisterasalobbyistpursuanttochapter105 |
|---|
| 500 | 500 | | 4 andshallalsoregisterwiththestaffofthehealthfacilitiesreviewcommittee |
|---|
| 501 | 501 | | 5 foreveryprojectinwhichsuchpersonhasaninterestandindicatewhether |
|---|
| 502 | 502 | | 6 suchpersonsupportsoropposesthenamedproject.Theregistrationshallalso |
|---|
| 503 | 503 | | 7 includethenamesandaddressesofanyperson,firm,corporationor |
|---|
| 504 | 504 | | 8 associationthatthepersonregisteringrepresentsinrelationtothenamed |
|---|
| 505 | 505 | | 9 project.Anypersonviolatingtheprovisionsofthissubsectionshallbesubject |
|---|
| 506 | 506 | | 10 tothepenaltiesspecifiedinsection105.478. |
|---|
| 507 | 507 | | HB1240 12 11 2.Amemberofthegeneralassemblywhoalsoservesasamemberof |
|---|
| 508 | 508 | | 12 thehealthfacilitiesreviewcommitteeisprohibitedfromsolicitingoraccepting |
|---|
| 509 | 509 | | 13 campaigncontributionsfromanyapplicantorpersonspeakingforanapplicant |
|---|
| 510 | 510 | | 14 oranyopponenttoanyapplicationorpersonsspeakingforanyopponentwhile |
|---|
| 511 | 511 | | 15 suchapplicationispendingbeforethehealthfacilitiesreviewcommittee. |
|---|
| 512 | 512 | | 16 3.Anypersonregulatedbychapter197or198andanyofficer, |
|---|
| 513 | 513 | | 17 attorney,agentandemployeethereof,shallnotoffertoanycommitteemember |
|---|
| 514 | 514 | | 18 ortoanypersonemployedasstafftothecommittee,anyoffice,appointment |
|---|
| 515 | 515 | | 19 orposition,oranypresent,gift,entertainmentorgratuityofanykindorany |
|---|
| 516 | 516 | | 20 campaigncontributionwhilesuchapplicationispendingbeforethehealth |
|---|
| 517 | 517 | | 21 facilitiesreviewcommittee.Anypersonguiltyofknowinglyviolatingthe |
|---|
| 518 | 518 | | 22 provisionsofthissectionshallbepunishedasfollows:Forthefirstoffense, |
|---|
| 519 | 519 | | 23 suchpersonisguiltyofaclassBmisdemeanor;andforthesecondand |
|---|
| 520 | 520 | | 24 subsequentoffenses,suchpersonisguiltyofaclassEfelony.] |
|---|
| 521 | 521 | | [197.327.1.Ifafacilityisgrantedacertificateofneedpursuantto |
|---|
| 522 | 522 | | 2 sections197.300to197.365basedonanapplicationstatinganeedfor |
|---|
| 523 | 523 | | 3 additionalMedicaidbeds,suchbedsshallbeusedforMedicaidpatientsandno |
|---|
| 524 | 524 | | 4 other. |
|---|
| 525 | 525 | | 5 2.Anypersonwhoviolatestheprovisionsofsubsection1ofthis |
|---|
| 526 | 526 | | 6 sectionshallbeliabletothestateforcivilpenaltiesofonehundreddollarsfor |
|---|
| 527 | 527 | | 7 everydayofsuchviolation.EachnonMedicaidpatientplacedinaMedicaid |
|---|
| 528 | 528 | | 8 bedshallconstituteaseparateviolation. |
|---|
| 529 | 529 | | 9 3.Theattorneygeneralshall,upontherequestofthedepartment,bring |
|---|
| 530 | 530 | | 10 anactioninacircuitcourtofcompetentjurisdictiontorecoverthecivil |
|---|
| 531 | 531 | | 11 penalty.Thedepartmentmaybringsuchanactionitself.Thecivilactionmay |
|---|
| 532 | 532 | | 12 bebroughtinthecircuitcourtofColeCountyor,attheoptionofthedirector, |
|---|
| 533 | 533 | | 13 inanothercountywhichhasvenueofanactionagainstthepersonunderother |
|---|
| 534 | 534 | | 14 provisionsoflaw.] |
|---|
| 535 | 535 | | [197.330.1.Thecommitteeshall: |
|---|
| 536 | 536 | | 2 (1)Notifytheapplicantwithinfifteendaysofthedateoffilingofan |
|---|
| 537 | 537 | | 3 applicationastothecompletenessofsuchapplication; |
|---|
| 538 | 538 | | 4 (2)Providewrittennotificationtoaffectedpersonslocatedwithinthis |
|---|
| 539 | 539 | | 5 stateatthebeginningofareview.Thisnotificationmaybegiventhrough |
|---|
| 540 | 540 | | 6 publicationofthereviewscheduleinallnewspapersofgeneralcirculationin |
|---|
| 541 | 541 | | 7 theareatobeserved; |
|---|
| 542 | 542 | | 8 (3)Holdpublichearingsonallapplicationswhenarequestinwriting |
|---|
| 543 | 543 | | 9 isfiledbyanyaffectedpersonwithinthirtydaysfromthedateofpublication |
|---|
| 544 | 544 | | 10 ofthenotificationofreview; |
|---|
| 545 | 545 | | 11 (4)Withinonehundreddaysofthefilingofanyapplicationfora |
|---|
| 546 | 546 | | 12 certificateofneed,issueinwritingitsfindingsoffact,conclusionsoflaw,and |
|---|
| 547 | 547 | | 13 itsapprovalordenialofthecertificateofneed;provided,thatthecommittee |
|---|
| 548 | 548 | | 14 maygrantanextensionofnotmorethanthirtydaysonitsowninitiativeor |
|---|
| 549 | 549 | | 15 uponthewrittenrequestofanyaffectedperson; |
|---|
| 550 | 550 | | 16 (5)Causetobeservedupontheapplicant,therespectivehealthsystem |
|---|
| 551 | 551 | | 17 agency,andanyaffectedpersonwhohasfiledhispriorrequestinwriting,a |
|---|
| 552 | 552 | | 18 copyoftheaforesaidfindings,conclusionsanddecisions; |
|---|
| 553 | 553 | | HB1240 13 19 (6)Considertheneedsandcircumstancesofinstitutionsproviding |
|---|
| 554 | 554 | | 20 trainingprogramsforhealthpersonnel; |
|---|
| 555 | 555 | | 21 (7)Providefortheavailability,basedondemonstratedneed,ofboth |
|---|
| 556 | 556 | | 22 medicalandosteopathicfacilitiesandservicestoprotectthefreedomofpatient |
|---|
| 557 | 557 | | 23 choice;and |
|---|
| 558 | 558 | | 24 (8)Establishbyregulationprocedurestoreview,orgrantawaiver |
|---|
| 559 | 559 | | 25 fromreview,nonsubstantiveprojects. |
|---|
| 560 | 560 | | 26 |
|---|
| 561 | 561 | | 27 Theterm"filed"or"filing"asusedinthissectionshallmeandeliverytothe |
|---|
| 562 | 562 | | 28 staffofthehealthfacilitiesreviewcommitteethedocumentordocumentsthe |
|---|
| 563 | 563 | | 29 applicantbelievesconstituteanapplication. |
|---|
| 564 | 564 | | 30 2.Failurebythecommitteetoissueawrittendecisiononan |
|---|
| 565 | 565 | | 31 applicationforacertificateofneedwithinthetimerequiredbythissection |
|---|
| 566 | 566 | | 32 shallconstituteapprovalofandfinaladministrativeactionontheapplication, |
|---|
| 567 | 567 | | 33 andissubjecttoappealpursuanttosection197.335onlyonthequestionof |
|---|
| 568 | 568 | | 34 approvalbyoperationoflaw.] |
|---|
| 569 | 569 | | [197.335.Withinthirtydaysofthedecisionofthecommittee,the |
|---|
| 570 | 570 | | 2 applicantmayfileanappealtobehearddenovobytheadministrativehearing |
|---|
| 571 | 571 | | 3 commissioner,thecircuitcourtofColeCountyorthecircuitcourtinthe |
|---|
| 572 | 572 | | 4 countywithinwhichsuchhealthcareserviceorfacilityisproposedtobe |
|---|
| 573 | 573 | | 5 developed.] |
|---|
| 574 | 574 | | [197.340.Anyhealthfacilityprovidingahealthservicemustnotify |
|---|
| 575 | 575 | | 2 thecommitteeofanydiscontinuanceofanypreviouslyprovidedhealthcare |
|---|
| 576 | 576 | | 3 service,adecreaseinthenumberoflicensedbedsbytenpercentormore,or |
|---|
| 577 | 577 | | 4 thechangeinlicensurecategoryforanysuchfacility.] |
|---|
| 578 | 578 | | [197.345.Anyhealthfacilitywithaprojectforfacilitiesorservicesfor |
|---|
| 579 | 579 | | 2 whichabindingconstructionorpurchasecontracthasbeenexecutedpriorto |
|---|
| 580 | 580 | | 3 October1,1980,orhealthcarefacilitywhichhascommencedoperationsprior |
|---|
| 581 | 581 | | 4 toOctober1,1980,shallbedeemedtohavereceivedacertificateofneed, |
|---|
| 582 | 582 | | 5 exceptthatsuchcertificateofneedshallbesubjecttoforfeitureunderthe |
|---|
| 583 | 583 | | 6 provisionsofsubsections8and9ofsection197.315.] |
|---|
| 584 | 584 | | [197.355.Thelegislaturemaynotappropriateanymoneyforcapital |
|---|
| 585 | 585 | | 2 expendituresforhealthcarefacilitiesuntilacertificateofneedhasbeenissued |
|---|
| 586 | 586 | | 3 forsuchexpenditures.] |
|---|
| 587 | 587 | | [197.357.Forthepurposesofreimbursementundersection208.152, |
|---|
| 588 | 588 | | 2 projectcostsfornewinstitutionalhealthservicesinexcessoftenpercentof |
|---|
| 589 | 589 | | 3 theinitialprojectestimatewhetherornotapprovalwasobtainedunder |
|---|
| 590 | 590 | | 4 subsection7ofsection197.315shallnotbeeligibleforreimbursementforthe |
|---|
| 591 | 591 | | 5 firstthreeyearsthatafacilityreceivespaymentforservicesprovidedunder |
|---|
| 592 | 592 | | 6 section208.152.Theinitialestimateshallbethatamountforwhichthe |
|---|
| 593 | 593 | | 7 originalcertificateofneedwasobtainedor,inthecaseoffacilitiesforwhicha |
|---|
| 594 | 594 | | 8 bindingconstructionorpurchasecontractwasexecutedpriortoOctober1, |
|---|
| 595 | 595 | | 9 1980,theamountofthatcontract.Reimbursementfortheseexcesscostsafter |
|---|
| 596 | 596 | | HB1240 14 10 thefirstthreeyearsshallnotbemadeuntilacertificateofneedhasbeen |
|---|
| 597 | 597 | | 11 grantedfortheexcessprojectcosts.Theprovisionsofthissectionshallapply |
|---|
| 598 | 598 | | 12 onlytofacilitieswhichfileanapplicationforacertificateofneedormake |
|---|
| 599 | 599 | | 13 applicationforcost-overrunreviewoftheiroriginalapplicationorwaiverafter |
|---|
| 600 | 600 | | 14 August13,1982.] |
|---|
| 601 | 601 | | [197.366.Theterm"healthcarefacilities"insections197.300to |
|---|
| 602 | 602 | | 2 197.366shallmean: |
|---|
| 603 | 603 | | 3 (1)Facilitieslicensedunderchapter198; |
|---|
| 604 | 604 | | 4 (2)Long-termcarebedsinahospitalasdescribedinsubdivision(3)of |
|---|
| 605 | 605 | | 5 subsection1ofsection198.012; |
|---|
| 606 | 606 | | 6 (3)Long-termcarehospitalsorbedsinalong-termcarehospital |
|---|
| 607 | 607 | | 7 meetingtherequirementsdescribedin42CFR,section412.23(e);and |
|---|
| 608 | 608 | | 8 (4)Constructionofanewhospitalasdefinedinchapter197.] |
|---|
| 609 | 609 | | [197.367.Uponapplicationforrenewalbyanyresidentialcarefacility |
|---|
| 610 | 610 | | 2 orassistedlivingfacilitywhichontheeffectivedateofthisacthasbeen |
|---|
| 611 | 611 | | 3 licensedformorethanfiveyears,islicensedformorethanfiftybedsandfails |
|---|
| 612 | 612 | | 4 tomaintainforanycalendaryearitsoccupancylevelabovethirtypercentofits |
|---|
| 613 | 613 | | 5 thenlicensedbeds,thedepartmentofhealthandseniorservicesshalllicense |
|---|
| 614 | 614 | | 6 onlyfiftybedsforsuchfacility.] |
|---|
| 615 | 615 | | âś” |
|---|
| 616 | 616 | | HB1240 15 |
|---|