Missouri Revised Statutes
Chapter 197
Medical Treatment Facility Licenses
←197.300
Section 197.305.1
197.310→
August 28, 2015
Definitions.
197.305. As used in sections 197.300 to 197.366, the following terms
mean:
(1) "Affected persons", the person proposing the development of a new
institutional health service, the public to be served, and health care
facilities within the service area in which the proposed new health care
service is to be developed;
(2) "Agency", the certificate of need program of the Missouri
department of health and senior services;
(3) "Capital expenditure", an expenditure by or on behalf of a health
care facility which, under generally accepted accounting principles, is not
properly chargeable as an expense of operation and maintenance;
(4) "Certificate of need", a written certificate issued by the
committee setting forth the committee's affirmative finding that a proposed
project sufficiently satisfies the criteria prescribed for such projects by
sections 197.300 to 197.366;
(5) "Develop", to undertake those activities which on their
completion will result in the offering of a new institutional health
service or the incurring of a financial obligation in relation to the
offering of such a service;
(6) "Expenditure minimum" shall mean:
(a) For beds in existing or proposed health care facilities licensed
pursuant to chapter 198 and long-term care beds in a hospital as described
in subdivision (3) of subsection 1 of section 198.012, six hundred thousand
dollars in the case of capital expenditures, or four hundred thousand
dollars in the case of major medical equipment, provided, however, that
prior to January 1, 2003, the expenditure minimum for beds in such a
facility and long-term care beds in a hospital described in section 198.012
shall be zero, subject to the provisions of subsection 7 of section
197.318;
(b) For beds or equipment in a long-term care hospital meeting the
requirements described in 42 CFR, Section 412.23(e), the expenditure
minimum shall be zero; and
(c) For health care facilities, new institutional health services or
beds not described in paragraph (a) or (b) of this subdivision one million
dollars in the case of capital expenditures, excluding major medical
equipment, and one million dollars in the case of medical equipment;
(7) "Health service area", a geographic region appropriate for the
effective planning and development of health services, determined on the
basis of factors including population and the availability of resources,
consisting of a population of not less than five hundred thousand or more
than three million;
(8) "Major medical equipment", medical equipment used for the
provision of medical and other health services;
(9) "New institutional health service":
(a) The development of a new health care facility costing in excess
of the applicable expenditure minimum;
(b) The acquisition, including acquisition by lease, of any health
care facility, or major medical equipment costing in excess of the
expenditure minimum;
(c) Any capital expenditure by or on behalf of a health care facility
in excess of the expenditure minimum;
(d) Predevelopment activities as defined in subdivision (12) hereof
costing in excess of one hundred fifty thousand dollars;
(e) Any change in licensed bed capacity of a health care facility
which increases the total number of beds by more than ten or more than ten
percent of total bed capacity, whichever is less, over a two-year period;
(f) Health services, excluding home health services, which are
offered in a health care facility and which were not offered on a regular
basis in such health care facility within the twelve-month period prior to
the time such services would be offered;
(g) A reallocation by an existing health care facility of licensed
beds among major types of service or reallocation of licensed beds from one
physical facility or site to another by more than ten beds or more than ten
percent of total licensed bed capacity, whichever is less, over a two-year
period;
(10) "Nonsubstantive projects", projects which do not involve the
addition, replacement, modernization or conversion of beds or the provision
of a new health service but which include a capital expenditure which
exceeds the expenditure minimum and are due to an act of God or a normal
consequence of maintaining health care services, facility or equipment;
(11) "Person", any individual, trust, estate, partnership,
corporation, including associations and joint stock companies, state or
political subdivision or instrumentality thereof, including a municipal
corporation;
(12) "Predevelopment activities", expenditures for architectural
designs, plans, working drawings and specifications, and any arrangement or
commitment made for financing; but excluding submission of an application
for a certificate of need.
(L. 1979 H.B. 222 § 2, A.L. 1982 S.B. 481, A.L. 1983 H.B. 825, A.L.
1994 H.B. 1408, A.L. 1996 H.B. 905 merged with H.B. 1362, A.L.
1997 S.B. 373, A.L. 1998 S.B. 963, A.L. 1999 S.B. 326, A.L. 2010
H.B. 1516 Revision merged with H.B. 1965)
CROSS REFERENCE:
Health care facilities, definition, 197.366
(2004) Nursing facility's proposal to add twelve beds constituted a
new institutional health service requiring certificate of need,
even though the proposed capital expenditure was below the
expenditure minimum. McKnight Place v. Missouri Health
Facilities Review Committee, 142 S.W.3d 228 (Mo.App.W.D.).
1999
1999
197.305. As used in sections 197.300 to 197.366, the following terms
mean:
(1) "Affected persons", the person proposing the development of a new
institutional health service, the public to be served, and health care
facilities within the service area in which the proposed new health care
service is to be developed;
(2) "Agency", the certificate of need program of the Missouri department
of health and senior services;
(3) "Capital expenditure", an expenditure by or on behalf of a health
care facility which, under generally accepted accounting principles, is not
properly chargeable as an expense of operation and maintenance;
(4) "Certificate of need", a written certificate issued by the committee
setting forth the committee's affirmative finding that a proposed project
sufficiently satisfies the criteria prescribed for such projects by sections
197.300 to 197.366;
(5) "Develop", to undertake those activities which on their completion
will result in the offering of a new institutional health service or the
incurring of a financial obligation in relation to the offering of such a
service;
(6) "Expenditure minimum" shall mean:
(a) For beds in existing or proposed health care facilities licensed
pursuant to chapter 198, RSMo, and long-term care beds in a hospital as
described in subdivision (3) of subsection 1 of section 198.012, RSMo, six
hundred thousand dollars in the case of capital expenditures, or four hundred
thousand dollars in the case of major medical equipment, provided, however,
that prior to January 1, 2003, the expenditure minimum for beds in such a
facility and long-term care beds in a hospital described in section 198.012,
RSMo, shall be zero, subject to the provisions of subsection 7 of section
197.318;
(b) For beds or equipment in a long-term care hospital meeting the
requirements described in 42 CFR, Section 412.23(e), the expenditure minimum
shall be zero; and
(c) For health care facilities, new institutional health services or
beds not described in paragraph (a) or (b) of this subdivision one million
dollars in the case of capital expenditures, excluding major medical
equipment, and one million dollars in the case of medical equipment;
(7) "Health care facilities", hospitals, health maintenance
organizations, tuberculosis hospitals, psychiatric hospitals, intermediate
care facilities, skilled nursing facilities, residential care facilities and
assisted living facilities, kidney disease treatment centers, including
freestanding hemodialysis units, diagnostic imaging centers, radiation therapy
centers and ambulatory surgical facilities, but excluding the private offices
of physicians, dentists and other practitioners of the healing arts, and
Christian Science sanatoriums, also known as Christian Science Nursing
facilities listed and certified by the Commission for Accreditation of
Christian Science Nursing Organization/Facilities, Inc., and facilities of
not-for-profit corporations in existence on October 1, 1980, subject either to
the provisions and regulations of Section 302 of the Labor-Management
Relations Act, 29 U.S.C. 186 or the Labor-Management Reporting and Disclosure
Act, 29 U.S.C. 401-538, and any residential care facility or assisted living
facility operated by a religious organization qualified pursuant to Section
501(c)(3) of the federal Internal Revenue Code, as amended, which does not
require the expenditure of public funds for purchase or operation, with a
total licensed bed capacity of one hundred beds or fewer;
(8) "Health service area", a geographic region appropriate for the
effective planning and development of health services, determined on the basis
of factors including population and the availability of resources, consisting
of a population of not less than five hundred thousand or more than three
million;
(9) "Major medical equipment", medical equipment used for the provision
of medical and other health services;
(10) "New institutional health service":
(a) The development of a new health care facility costing in excess of
the applicable expenditure minimum;
(b) The acquisition, including acquisition by lease, of any health care
facility, or major medical equipment costing in excess of the expenditure
minimum;
(c) Any capital expenditure by or on behalf of a health care facility in
excess of the expenditure minimum;
(d) Predevelopment activities as defined in subdivision (13) hereof
costing in excess of one hundred fifty thousand dollars;
(e) Any change in licensed bed capacity of a health care facility which
increases the total number of beds by more than ten or more than ten percent
of total bed capacity, whichever is less, over a two-year period;
(f) Health services, excluding home health services, which are offered
in a health care facility and which were not offered on a regular basis in
such health care facility within the twelve-month period prior to the time
such services would be offered;
(g) A reallocation by an existing health care facility of licensed beds
among major types of service or reallocation of licensed beds from one
physical facility or site to another by more than ten beds or more than ten
percent of total licensed bed capacity, whichever is less, over a two-year
period;
(11) "Nonsubstantive projects", projects which do not involve the
addition, replacement, modernization or conversion of beds or the provision of
a new health service but which include a capital expenditure which exceeds the
expenditure minimum and are due to an act of God or a normal consequence of
maintaining health care services, facility or equipment;
(12) "Person", any individual, trust, estate, partnership, corporation,
including associations and joint stock companies, state or political
subdivision or instrumentality thereof, including a municipal corporation;
(13) "Predevelopment activities", expenditures for architectural
designs, plans, working drawings and specifications, and any arrangement or
commitment made for financing; but excluding submission of an application for
a certificate of need.
Top
Missouri General Assembly
Copyright © Missouri Legislature, all rights reserved.