Section: 197.0305 Definitions. Rsmo 197.305


Published: 2015

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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.



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