Missouri Revised Statutes













Chapter 197

Medical Treatment Facility Licenses

←197.314

Section 197.315.1

197.316→

August 28, 2015

Certificate of need granted, when--forfeiture, grounds--application for certificate, fee--certificate not required, when.

197.315. 1. Any person who proposes to develop or offer a new

institutional health service within the state must obtain a certificate of

need from the committee prior to the time such services are offered.



2. Only those new institutional health services which are found by

the committee to be needed shall be granted a certificate of need. Only

those new institutional health services which are granted certificates of

need shall be offered or developed within the state. No expenditures for

new institutional health services in excess of the applicable expenditure

minimum shall be made by any person unless a certificate of need has been

granted.



3. After October 1, 1980, no state agency charged by statute to

license or certify health care facilities shall issue a license to or

certify any such facility, or distinct part of such facility, that is

developed without obtaining a certificate of need.



4. If any person proposes to develop any new institutional health

care service without a certificate of need as required by sections 197.300

to 197.366, the committee shall notify the attorney general, and he shall

apply for an injunction or other appropriate legal action in any court of

this state against that person.



5. After October 1, 1980, no agency of state government may

appropriate or grant funds to or make payment of any funds to any person or

health care facility which has not first obtained every certificate of need

required pursuant to sections 197.300 to 197.366.



6. A certificate of need shall be issued only for the premises and

persons named in the application and is not transferable except by consent

of the committee.



7. Project cost increases, due to changes in the project application

as approved or due to project change orders, exceeding the initial estimate

by more than ten percent shall not be incurred without consent of the

committee.



8. Periodic reports to the committee shall be required of any

applicant who has been granted a certificate of need until the project has

been completed. The committee may order the forfeiture of the certificate

of need upon failure of the applicant to file any such report.



9. A certificate of need shall be subject to forfeiture for failure

to incur a capital expenditure on any approved project within six months

after the date of the order. The applicant may request an extension from

the committee of not more than six additional months based upon substantial

expenditure made.



10. Each application for a certificate of need must be accompanied by

an application fee. The time of filing commences with the receipt of the

application and the application fee. The application fee is one thousand

dollars, or one-tenth of one percent of the total cost of the proposed

project, whichever is greater. All application fees shall be deposited in

the state treasury. Because of the loss of federal funds, the general

assembly will appropriate funds to the Missouri health facilities review

committee.



11. In determining whether a certificate of need should be granted,

no consideration shall be given to the facilities or equipment of any other

health care facility located more than a fifteen-mile radius from the

applying facility.



12. When a nursing facility shifts from a skilled to an intermediate

level of nursing care, it may return to the higher level of care if it

meets the licensure requirements, without obtaining a certificate of need.



13. In no event shall a certificate of need be denied because the

applicant refuses to provide abortion services or information.



14. A certificate of need shall not be required for the transfer of

ownership of an existing and operational health facility in its entirety.



15. A certificate of need may be granted to a facility for an

expansion, an addition of services, a new institutional service, or for a

new hospital facility which provides for something less than that which was

sought in the application.



16. The provisions of this section shall not apply to facilities

operated by the state, and appropriation of funds to such facilities by the

general assembly shall be deemed in compliance with this section, and such

facilities shall be deemed to have received an appropriate certificate of

need without payment of any fee or charge.



17. Notwithstanding other provisions of this section, a certificate

of need may be issued after July 1, 1983, for an intermediate care facility

operated exclusively for the intellectually disabled.



18. To assure the safe, appropriate, and cost-effective transfer of

new medical technology throughout the state, a certificate of need shall

not be required for the purchase and operation of research equipment that

is to be used in a clinical trial that has received written approval from a

duly constituted institutional review board of an accredited school of

medicine or osteopathy located in Missouri to establish its safety and

efficacy and does not increase the bed complement of the institution in

which the equipment is to be located. After the clinical trial has been

completed, a certificate of need must be obtained for continued use in such

facility.



(L. 1979 H.B. 222 § 4, A.L. 1982 S.B. 481, A.L. 1983 H.B. 825, A.L.

1987 S.B. 1, A.L. 1999 S.B. 326, A.L. 2014 H.B. 1064)





1999



1999



197.315. 1. Any person who proposes to develop or offer a new

institutional health service within the state must obtain a certificate of

need from the committee prior to the time such services are offered.



2. Only those new institutional health services which are found by the

committee to be needed shall be granted a certificate of need. Only those

new institutional health services which are granted certificates of need

shall be offered or developed within the state. No expenditures for new

institutional health services in excess of the applicable expenditure minimum

shall be made by any person unless a certificate of need has been granted.



3. After October 1, 1980, no state agency charged by statute to license

or certify health care facilities shall issue a license to or certify any

such facility, or distinct part of such facility, that is developed without

obtaining a certificate of need.



4. If any person proposes to develop any new institutional health care

service without a certificate of need as required by sections 197.300 to

197.366, the committee shall notify the attorney general, and he shall apply

for an injunction or other appropriate legal action in any court of this

state against that person.



5. After October 1, 1980, no agency of state government may appropriate

or grant funds to or make payment of any funds to any person or health care

facility which has not first obtained every certificate of need required

pursuant to sections 197.300 to 197.366.



6. A certificate of need shall be issued only for the premises and

persons named in the application and is not transferable except by consent of

the committee.



7. Project cost increases, due to changes in the project application as

approved or due to project change orders, exceeding the initial estimate by

more than ten percent shall not be incurred without consent of the committee.



8. Periodic reports to the committee shall be required of any applicant

who has been granted a certificate of need until the project has been

completed. The committee may order the forfeiture of the certificate of need

upon failure of the applicant to file any such report.



9. A certificate of need shall be subject to forfeiture for failure to

incur a capital expenditure on any approved project within six months after

the date of the order. The applicant may request an extension from the

committee of not more than six additional months based upon substantial

expenditure made.



10. Each application for a certificate of need must be accompanied by an

application fee. The time of filing commences with the receipt of the

application and the application fee. The application fee is one thousand

dollars, or one-tenth of one percent of the total cost of the proposed

project, whichever is greater. All application fees shall be deposited in

the state treasury. Because of the loss of federal funds, the general

assembly will appropriate funds to the Missouri health facilities review

committee.



11. In determining whether a certificate of need should be granted, no

consideration shall be given to the facilities or equipment of any other

health care facility located more than a fifteen-mile radius from the

applying facility.



12. When a nursing facility shifts from a skilled to an* intermediate

level of nursing care, it may return to the higher level of care if it meets

the licensure requirements, without obtaining a certificate of need.



13. In no event shall a certificate of need be denied because the

applicant refuses to provide abortion services or information.



14. A certificate of need shall not be required for the transfer of

ownership of an existing and operational health facility in its entirety.



15. A certificate of need may be granted to a facility for an expansion,

an addition of services, a new institutional service, or for a new hospital

facility which provides for something less than that which was sought in the

application.



16. The provisions of this section shall not apply to facilities operated

by the state, and appropriation of funds to such facilities by the general

assembly shall be deemed in compliance with this section, and such facilities

shall be deemed to have received an appropriate certificate of need without

payment of any fee or charge.



17. Notwithstanding other provisions of this section, a certificate of

need may be issued after July 1, 1983, for an intermediate care facility

operated exclusively for the mentally retarded.



18. To assure the safe, appropriate, and cost-effective transfer of new

medical technology throughout the state, a certificate of need shall not be

required for the purchase and operation of research equipment that is to be

used in a clinical trial that has received written approval from a duly

constituted institutional review board of an accredited school of medicine or

osteopathy located in Missouri to establish its safety and efficacy and does

not increase the bed complement of the institution in which the equipment is

to be located. After the clinical trial has been completed, a certificate of

need must be obtained for continued use in such facility.



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