11 (5) An application is not considered submitted to the department until it is submitted to the appropriate regional certificate of need review agency.

 

 

 

R  325.9125 Extensions.

Rule 125. (1) The department may grant an extension to extend the date to issue a proposed or final decision shall be issued for on an application for not less than 30 days, but not more than 90 days, either pursuant to under R 325.9229 or upon receipt of a written request from an applicant.

(2)   An applicant’s written request for an extension shall that specifies specify either a the date or the number of days being requested for an extension.  The department may extend the date to issue a proposed or final decision if in either case, all both of the following requirements, as applicable, are met:

(i)   The extension will not result in a delay in the start of the review of similar applications filed subsequently as provided by R 325.9207(2)(a) (b).

(3)     (iii) The extension requested is for not less than 30 days but not more than 90 days.  The department may grant an extension for longer than 90 days if the applicant provides justification that the department considers satisfactory.  The department’s decision to deny an extension request is not subject to administrative hearing or appeal.

 

PART 2. APPLICATIONS; REVIEWS

 

R 325.9201 Letters of intent; applications; forms; copies; attachments and supplements; content; completeness; additional information; department's authority to consider relevant information not limited; notification of information considered relevant; public availability.

Rule 201. (1) A person Before applying for a certificate of need for a project, except for projects that are covered by section 22235 of the code, a person shall simultaneously submit a letter of intent simultaneously to the department and the appropriate regional certificate of need review agency. The letter of intent shall be on a form supplied by the department. Within 15 days of receipt of a letter of intent, the department, after consultation with the appropriate regional certificate of need review agency shall notify the person proposing the project of whether the project requires a certificate of need and, if so, the type of review (nonsubstantive, substantive, potential comparative) and shall provide the applicant with appropriate forms. The department shall not process a letter of intent if the same covered service or beds already exists at that site under a different entity that has submitted a letter of intent or application or has previous certificate of need approval before the new letter of intent, except where the department deems it appropriate.  An application form supplied by the department may be submitted at any time. A person may request an informational copy of an application form at any time. The department shall not review any application it receives before the department finishes processing the letter of intent for that application.  A letter of intent shall expires if an application has not been submitted to the department within 1 year after of receipt of the letter of intent by the department. The department also shall provide the applicant and any person requesting certificate of need review standards with a copy of the current work plan of the certificate of need commission . The work plan shall indicateing the timing by which the certificate of need review standards are being revised or are scheduled to be revised by the commission, an explanation of when and how the work plan is periodically modified by the commission, and how an individual can be notified of all commission meetings.

 

 

(2)   At the time of submission of an application, a person applying for a certificate of need shall simultaneously submit 3 copies of an completed application, or 3 copies of any supplemental documents for an electronic application, for a single project to the department and, if applicable, not more than 3 1 additional copy to copies as required by the appropriate regional certificate of need review agency. An application shall not be considered submitted to the department until it is submitted to the appropriate regional certificate of need review agency. For mental health services, 4 copies of a completed application shall be submitted. The application shall be made on the application forms authorized and provided by the department. The application forms may include requirements for attachments and supplements specified by the department in the forms. An applicant may submit information prepared or collected for other purposes as an attachment. An application shall clearly state the persons, buildings and properties to which it applies and clearly define the scope, nature, cost, time limits, and other aspects of the proposal in the data included in and with the application as specified by the department in the application forms. A letter of intent, application, or an amendment to an approved certificate of need shall be accompanied by the fee, if any, required by law and these rules. A letter of intent or an amendment not accompanied by the required fee if any, shall will not be processed by the department until the bureau receives the required fee, if any is received. An application not accompanied by the required fee shall will not be considered timely and shall will be deemed submitted on the next designated application date after receipt of the required fee. An application received, including electronic submissions, that does not include statements addressing each of the review criteria listed in section 22225 of the code is not timely and will be deemed submitted on the next designated application date after receipt of the required documents.  Statements addressing section 22225 are not required for proposed projects eligible for nonsubstantive reviews under R 325.9205.

(4) The department, within 15 days of the designated application date, shall have the right to request additional information regarding an individual application to assist in determining whether substantive or nonsubstantive review is indicated and to assist in determining the necessity for comparative review. When the additional information requested is not provided within 15 days or is inadequate as determined by the department, the department shall make a decision based on the information available.

 

 

(4)(5) This rule shall does not limit the department's authority to consider all available information relevant to the department's review of an application.

(5) An applicant may request, and the department may allow, the submission of information after the date the application is deemed complete if the application is not subject to comparative review and if the applicant authorizes an extension to the date a decision must be issued.

(6) The department's review shall be conducted using the completed application and any other information the department considers relevant to the decision and pursuant to under all applicable provisions in the certificate of need review standards and the code, including information which becomes available or developments which occur after the date an application is deemed complete.

(7)   Before issuing a proposed decision, the bureau shall notify an applicant of other all information upon which it that the department relied upon in conducting the department's review. If the department relies on information other than submitted by the applicant in its application, the bureau or department shall cite in the proposed or final decision letter, as applicable, what the information was it relied upon. The department shall make all other this information available to the public upon request.

(8)   The department’s decision to request additional information is not subject to administrative hearing or appeal.

 

R  325.9203 Determination of covered capital expenditures.   Rescinded.

Rule 203. (1) For purposes of determining whether a capital expenditure is a covered capital expenditure in excess of the threshold for review under the code, predevelopment expenditures shall not be included.

 (2) A site acquisition or a donation shall not be considered a covered capital expenditure until it is dedicated to be used to undertake an activity for which a certificate of need is required.

 

R 325.9204 Data and physician commitments.

Rule 204.  (1) If a certificate of need review standard requires the  a data commitment, including of Michigan inpatient data base (MIDB) information, data or cancer registry data, in order for the department to consider a data commitment the health facility or freestanding facility hospital committing the data shall be regularly admitting patients and providing services as of the date the director makes the final decision on an application under section 22231 of the code. Further, the department shall not consider any commitment of Michigan inpatient data base information if a health facility or freestanding facility hospital withdrew its commitment before the final decision on an application.

(2)   If a certificate of need review standard requires a physician commitment, then all of the following apply:

(a)   The commitments shall be submitted at the time the application is submitted to the department.

(b)   A commitment shall not be withdrawn after the date an application is deemed complete by the department and after a proposed decision to approve an application has been issued by the department.

(c)   The department shall not consider any commitment submitted by an applicant after the date an application is deemed complete by the department, unless the applicant is notified by the department that 1 or more of the original commitments is determined invalid according to the applicable review standards.

(d)   If an applicant is notified that 1 or more physician commitments is determined invalid by the department, the department will consider commitments submitted after the date the application is deemed complete only to the extent necessary to replace the invalid commitments.

 

 

 

R  325.9205 Nonsubstantive reviews; eligibility.

Rule 205. (1) A person may submit a letter of intent an application requesting a nonsubstantive certificate of need review on a form supplied by the department.

(a)   The completed project will not result in any of the following:

(i)   An increase in the number of beds licensed to the applicant at the licensed site at which the project is proposed.

(ii)   The initiation or expansion of a covered clinical service.

(iii)   Beginning operation of a new health facility at a site that is not currently licensed for that type of health facility.

(iv)   A covered capital expenditure in excess of a covered capital expenditure as defined in the code. (b)  The completed project will meet an already demonstrated and established need as provided by section 22225(1) of the code.

(b) (c) The proposed project is not subject to comparative review pursuant to under the code or the applicable certificate of need review standards.

(3)   The department may shall have the right to accept other projects for nonsubstantive review pursuant to under section 22233 of the code. The department shall maintain, and provide a copy of on request, a public list of the types of projects eligible for nonsubstantive review under this rule.

 

R  325.9206 Nonsubstantive review; procedure; time for decision; notice; effect of denial of request for review; department decision to deny review not subject to administrative appeal; review period; submittal of regional certificate of need review agency's recommendations.

Rule 206. (1) The department shall, after seeking the advice of the appropriate regional certificate of need review agency, determine whether an application submitted for requesting nonsubstantive review is complete as provided by R 325.9201(3) and shall concurrently determine whether the application is accepted for nonsubstantive review. The department shall notify the applicant of its decision and send a copy of the decision to the appropriate regional certificate of need review agency. The department's decision to deny nonsubstantive review of a project is not subject to administrative hearing or appeal.

(2) If a request for nonsubstantive review is denied, the application shall be is deemed submitted for the purposes of substantive review on the next designated application date after the date of denial and the time frames to determine completeness for substantive review shall be those set forth in R 325.9201(3).

(3)   The department shall consider only those applications that are filed on or before the designated application date and will determine whether the application is complete or incomplete. The department shall provide notification of a determination to the applicant and the appropriate regional certificate of need review agency within 15 days of receipt of the application. The applicant has 15 days from receipt of the department's notice to provide additional information or otherwise complete the application. If additional information is not requested by the department, the department will consider the application to be complete as submitted by the applicant on the designated application date. If additional information is requested, the department will consider the application to be complete on the date the department receives the applicant’s responses. If the additional information requested is not received within 15 days, the application will be deemed complete.

 

 

(4)   (3) The period for the review of a nonsubstantive application shall be not more than 45 days from the date the application is accepted for nonsubstantive review deemed complete by the department. The appropriate  regional certificate of need review agency shall submit its recommendations with respect to a nonsubstantive application within 30 days after of the date the application is accepted for nonsubstantive review by the department so that the recommendations can be included in the department's review process. If new or revised certificate of need review standards applicable to a proposed project become effective before the issuance of a final decision by the director of the department, the review and issuance of  proposed  and final decisions shall be made in accordance with according to the provisions of R 325.9229.

(5)   (4) The department's review shall be conducted using the completed application and any other information the department considers relevant to the decision and pursuant  to under all applicable provisions in the certificate of need review standards and the code, including information which becomes available or developments which occur after the date an application is deemed complete.

(6)   Before issuing a proposed decision, the bureau shall notify an applicant of other all information upon which it that the department relied upon in conducting the department's review.  If the department relies on information, other than submitted by the applicant in its application, the bureau or department shall cite in the proposed or final decision letter, as applicable, what the information was it relied upon. The department shall make all other this information available to the public upon request.

 

R  325.9207 Procedures for s Substantive individual or comparative project review; scheduling of reviews.; procedures.

Rule 207. (1) Projects subject to comparative review shall be designated pursuant to under the provisions of section 22229 of the code or the applicable certificate of need review standards.  Proposed projects that are not subject to comparative review and are not eligible for nonsubstantive review shall will be subject to substantive individual review under this subrule and not subrule (2) of this rule.  The bureau shall will issue a proposed decision on a certificate of need application within 120 days after of the date an application is deemed completed pursuant to under R 325.9201(3). The appropriate regional certificate of need review agency shall will concurrently review the application and submit its recommendations to the department within 90 days after of the date the department determines the application  is complete and the review period has commenced.  If new or revised certificate of need review standards applicable to a proposed project become effective before the issuance of a final decision by the director of the department, the review and issuance of proposed and final decisions shall be made in accordance with R 325.9229. A review shall commence on the date an application is deemed complete by the department.  The department, with the advice of the regional certificate of need review agency shall will determine if an application filed by each applicant meets all applicable requirements for approval under part 222 of the code.

(2)   Both of t The following provisions shall apply to projects subject to comparative review under section 22229 of the code:

(a)   Projects can only be submitted when a planning area has a demonstrated need as of the designated application date.

(b)   (a) Within 30 days after the date that all of the applications are deemed complete, the  department with  the  advice of the appropriate regional certificate  of  need  review  agency shall place the timely applications into comparative groups and shall notify the appropriate regional certificate of need review agency and each applicant of whether each  comparative group will be subject to comparative review. For comparative reviews, the review period shall commence begins on the date of the notice under this subrule., except that In cases where a proposed final decision on a prior review of similar projects, services  or facilities in the same planning area has not yet been issued by the director bureau, the

 

 

review period shall commence begins only upon the issuance of after the director issues a bureau's proposed final decision on such prior review. Applications which are subject to the provisions of this subrule and which are not subject  to  comparative review shall be reviewed individually in the same manner  as  a project submitted under subrule (1) of this rule, with the 120-day and concurrent 90-day review periods commencing on the date on which the department  determines  that  the applications are not subject to comparative review.

(i)   For each comparative group subject to comparative review, the notice shall also include all of the following findings by the department:

(A)  (i) The projections of need for the proposed facilities, beds, or services.

(B)  (ii) That the total proposed facilities beds or services in the comparative group is are more than the projections of need.

(C)    (iii) That the applications, when taken together, are mutually exclusive in that, under existing certificate of need review standards, the approval of 1 or more of the applications will necessarily result in the denial of other applications.

(ii)   Applications that are not subject to comparative review shall be reviewed individually in the same manner as a project submitted under subrule (1) of this rule, with the 120-day and concurrent 90-day review periods commencing on the date on which the department determines that the applications are not subject to comparative review.  This exemption is when a final decision on a prior review of similar projects, services, or facilities in the same planning area has not been issued by the director.  In this case, the review period begins only after the director issues a final decision on such prior review.

(c)   (b) If upon review under subdivision (a) of this subrule, the department determines that an application could fall into more than l comparative group the department shall notify the applicant.  The applicant shall notify the department that the project is amended so that the proposed project involves only services, facilities, equipment, or beds relative to a single comparative group or notify the department that the project in its entirety is withdrawn. If the applicant advises the department that it is amending the application, additional information related to the amendment may be submitted in accordance with the provisions of  under R 325.9201(3). In the absence of notification by an applicant, the original application shall be is subject to comparative review in the comparative group determined by the department and the portion of the application involving the other comparative group or groups shall will not be considered by the department in its review of the application. The applicant may submit in accordance with according to these rules, a separate application for the portion of the application not being considered.

(3)   This rule shall does not limit the department's authority to consider all available information relevant to the department's review of an application.

(4)   The department's review shall be conducted using the completed application and any other information the department considers relevant to the decision and under pursuant  to all applicable provisions in the certificate of need  review standards and the code, including information which becomes available or developments which occur after the date an  application is deemed complete.

(5) Before issuing a proposed decision, the bureau shall notify an applicant of all other information upon which it that the department relied in upon in conducting the department's review. If the department relies on information other than submitted by the applicant in its application, the bureau or department shall cite in the proposed or final decision letter, as applicable, what the information was it relied upon. The department shall make all other information available to the public upon request.

 

R  325.9208 Comparative reviews; procedures.

 

 

Rule 208. (1) For a comparative group, the department, with the advice of the regional certificate of need review agency, shall review the applications within the comparative group pursuant to the following procedure:

(a)   A regional certificate of need review agency shall concurrently review the applications and submit its recommendations to the department as soon as practicable, but not later than 90 days after the notification of the start of a comparative review.

(b)   The bureau shall concurrently review and issue a single proposed decision regarding the applications in the comparative group subject to comparative review as soon as practicable, but not later than 120 days after notification of the start of a comparative review. If new or revised certificate of need review standards applicable to a proposed project become effective before the issuance of a final decision by the director issues a final decision of the department, then R 325.9229 applies to the review and issuance of proposed and final decisions shall be  made in accordance with the provisions of R 325.9229.

(c)   The bureau, with the advice of the regional certificate of need review agency, shall determine if the application filed by each applicant meets all applicable requirements for approval under part 222 of the code.

(d)  The bureau shall rank all qualifying projects in the comparative group as provided by the applicable certificate of need review standards and shall issue a single proposed decision  to approve only those applications ranked highest that, in total, do not exceed the  needs of  the population as determined by section 22225(1) of the code. The remaining applications in the comparative group shall be The bureau shall issued a proposed disapproval as part of the single decision for the remaining applications in the comparative group.

(2)   The provisions of This rule and R 325.9207 shall do not apply to certificates of need applied for and issued under sections 22233 and 22235 of the code.

 

R 325.9210 Finance Reviews; procedures.

Rule 210.  (1) A person applying for a certificate of need for a project shall provide all of the following information as applicable:

(a)   Audited financial statements for existing providers including balance sheet, income statement, statement of cash flow, and footnotes to the financial statements.

(b)   Evidence of secured capital funding for new providers.

(c)   Verification for all sources of funds dated within 30 days of submission of the application.

(d)   Signed vendor quote dated within 6 months of application submission for applications involving medical equipment.

(e)   All applicable lease and purchase agreements.

(f)  Designated funds specifying what type of funds are used (for example, cash, bond, etc.).

(g)   The market value for any asset verifiable by an unrelated party.

(2)   For construction projects, the applicant will competitively bid capital expenditures among qualified contractors or alternatively, the applicant is proposing an alternative to competitive bidding that will achieve substantially the same results as competitive bidding.

(3)   An applicant utilizing future operations (for example, capital operating lease) as a source of funds shall provide both of the following:

(a)   Current bank or financial institution statement or balance and dated within 30 days of submission of the application.

(b)   Third party verification of a bank loan, HELP loan, or other equivalent source of funding.

(4)   The department’s finance review shall be conducted using the completed application and any other information the department considers relevant to the decision and under all applicable

 

 

provisions in the certificate of need review standards and the code, including information which becomes available or developments which occur after the date an application is deemed complete.

(5)   Before issuing a proposed decision, the bureau must notify an applicant of all information that the department relied upon in conducting the department's review. If the department relies on information, other than submitted by the applicant in its application, the bureau or department must cite in the proposed or final decision letter, as applicable, the information it relied upon. The department shall make this information available to the public upon request.

(6)   This rule does not limit the department's authority to consider all available financial information relevant to the department's review of an application.

 

R  325.9215 Amendments to applications before a proposed decision is issued by the bureau.

Rule 215. (1) An applicant shall not amend an application scheduled subject for to a comparative review shall  not be amended after the designated application date established  pursuant to under R 325.9123, except to the extent that additional information is requested  by the department to make the application complete pursuant to under R 325.9201 or R 325.9229(6) or as provided for in R 325.9207(2)(b).  A person desiring to amend an application shall may do any of the following:

(a)   have the choice of Withdrawing the amendment.

(b)   orHaveing the project considered under a new application on a subsequent designated application date.

(c)   If the application is subject to comparative review, amend the application if all applicants in the comparative group agree to allow an amendment, if the amendment does not increase the scope of the project.

(2)   An amendment shall not modify the person, the building, or the purpose of the property.

(3)   A request to amend an application shall be accompanied by the required fee if the amendment request results in higher costs under the fee schedule in section 20161 of the code for the proposed project that would have required a higher application fee when submitted originally. An amendment not accompanied by the required fee will not be processed by the department until the required fee is received.

(4)   (2) An application that is not subject to comparative review may be amended by the applicant up to 30 days in advance of the proposed  decision date established by these rules. If the department, with the advice of the appropriate regional certificate of need review agency, determines that the proposed amendment substantially changes the original application and that additional review by the department and the regional certificate of need review agency is required to adequately evaluate the proposal according to in accordance with the code and these rules, the department shall require, as a condition of the amendment, that the applicant agree to extend the date for proposed decision as required to permit the additional review.

(5)   (3) The department may consider new or revised information submitted  by an applicant  for an application that is not being reviewed on a comparative basis, within 30 days of the proposed decision date or at any time after the proposed decision and before a final decision is issued, if an applicant requests an extension to the proposed or final decision date sufficient to allow the department and the appropriate regional certificate review agency, up to 30 days to review the new or revised information. The department may request from an applicant a longer extension, if necessary to review new or revised information. The applicant shall also simultaneously submit the new or revised information to the appropriate regional certificate of need review agency. The department shall make the new or revised information available to the public upon request.

(6)   (4) If an applicant for a project not originally subject to comparative review proposes to amend the application in such a way as to make it subject to a comparative review, the bureau shall notify the

 

 

applicant shall be notified of the need for comparative review. The applicant may then either and shall have the choice of withdrawing the amendment or haveing the project considered under a new application on a subsequent designated application date.

 

R 325.9227 Emergency review; request; denial; submission of formal application.

Rule 227. (1) A request for an emergency certificate of need review under section 22235 of the code may be made electronically by telegram or in paper format other abbreviated written form. The request shall include justification for the project and a statement of the nature and extent of the claimed emergency.

(2) If the department determines that a request filed under subrule (1) of this rule is not covered by section 22235 of the code, it shall so inform the applicant, in writing, within 10 working days of receipt of the request, and shall deny the request for emergency review. Pursuant to section 22235 of the code, an applicant for a project granted emergency approval shall submit a formal application for a certificate of need within 30 days of the requested emergency review.

(3) The department’s decision to deny emergency review is not subject to administrative hearing or appeal.

 

R 325.9228 Short-term nursing care program (swing bed) review; maximum number of patient days variation.

Rule 228. (1) A request for a short-term nursing care program certificate of need review under section 22210 of the code may be made electronically or in paper format. The request shall include justification for the project and demonstration of compliance with the requirements in section 22210 of the code.

(2)   Evidence that the hospital has had difficulty in placing patients in skilled nursing home beds during the 12 months immediately preceding the date of application include, but not limited to, evidence that the average occupancy rate for all existing and operating nursing homes within a 20 mile radius of the hospital has been at least 85% for the last 4 quarters based upon the department’s staffing/bed utilization ratios report.

(3)   The department may grant a 1-year variation from the maximum number of patient days established under section 22210(3)(e) of the code if the applicant demonstrates immediate need for the project by showing that the average occupancy rate for all existing and operating nursing homes within a 100-mile radius of the hospital has been at least 85% for the last 4 quarters based upon the department’s Staffing/Bed Utilization Ratios Report.

 

R 325.9229  New or revised certificate of need review standards approved by certificate of need commission.

Rule 229. (1) If new or revised certificate of need review standards become effective between the time an application is filed and when the director issues a final decision on the application, then the bureau shall consider and process the application according to this rule. Pursuant to section 22215(4) of the  code  new  or  revised certificate of need review  standards  shall  apply  to  the  review of  all certificate of need applications for which the director of the department has not issued a final decision as of the effective date of the  new or  revised certificate of need review standards.

  (2) Applications pending a final decision by the director of the department at the time new or revised certificate  of need  review  standards  become effective shall be considered as having been submitted subject to the new  or revised certificate of need  review  standards  and  shall  be  processed  in accordance with subrule (3), (4), (5), or (6) of this rule, as  applicable.

 

 

(2)    (3) If the bureau is reviewing an application, other than on a comparative review basis, is being reviewed on a substantive individual basis and the bureau has not issued a proposed decision as all  of  before the effective date of the new or revised certificate of need review standards then either of the following apply:

(b)   If an applicant requests an extension under this rule to submit additional information is requested, the bureau shall issue a proposed decision on the completed application, including any additional information submitted pursuant to  this

subrule in accordance with using the new or revised certificate of need review standards, on or before 45 days for nonsubstantive applications or 120 days for substantive applications, after receipt of the additional information.

(c)   If the applicant does not make a request an extension under this subrule, the bureau shall issue a proposed decision on the completed application reviewed in accordance with according to the new or revised certificate all of need standards and the proposed decision shall be issued in accordance according to with the date established under pursuant to R 325.9207.

(3)   (4) If the bureau has reviewed an application is being reviewed , other than on a comparative basis, substantive individual basis, and the bureau has issued a proposed decision, then either of the following applies:

(b)   It If the applicant does not make a request a remand under this subrule, the director of the department shall issue a final decision on the completed application reviewed in accordance with according to the new or revised certificate of need standards and the final  decision shall be issued in accordance with the date established pursuant to under these rules and the code.

(a)   The applicant may request that the matter be remanded to the bureau for further review  in accordance with according to subrule (3) of this rule or.

(b)   If the applicant does not make  a  request a remand under this subrule, the applicant shall may, within be  allowed  60 days following the effective date of the new or revised certificate of need review standards to augment, for introduction in the hearing its testimony  evidence and exhibits in support of its application with regard to the new or revised certificate of need review standards.

 

 

(c)   If an applicant does not make a request for a remand under this subrule, the department shall submit, to the hearing officer, within 60 days of the effective date of the knew or  revised certificate of need review standards, or 60 days  after  of the date an applicant has augmented the record, whichever comes later, an analysis of the applicant's compliance with the new or revised certificate of need review standards.

(5)   (6) If an application is in a comparative review, regardless of whether it is in the process of being reviewed by the bureau or in any stage of a hearing, by the director of the department, any applicant in the comparative group, within 15 days  after  of the effective date of the new or revised certificate of need standards, may request, and the department  shall may grant, either an extension or a remand and extension to the  bureau  to review and issue a proposed decision on the comparative group in accordance with according to the new or revised certificate of need review standards.  Upon extension or remand and extension, each applicant in the comparative group shall be considered as having made the request and shall be permitted may submit, within 60 days following the effective date of the new or revised certificate of need review standards to  submit to the department and the appropriate regional certificate of need review agency, additional information to demonstrate that its application is in  compliance complies with the new or revised certificate of need review standards.  Upon such an extension or remand and extension, the bureau shall issue a single proposed decision on the completed applications, with the addition of any information submitted pursuant to under this subrule from the comparative group  in  accordance with according to the new or revised certificate of need review standards on or before 120 days after of the last date on which additional information may be submitted under this subrule.  If none of the applicants request an extension or a remand and extension, for the review and issuance of a single decision on the comparative group shall will be based on each completed application reviewed  in accordance with pursuant to the new or revised certificate of need standards and the decision shall will be issued in accordance with the date established pursuant  to under these rules and the code.

(6)     (7) The department bureau shall consider the recommendation of the appropriate regional certificate of needed review agency if the recommendation is received not more than 30 days before the bureau or department decision dates established pursuant to under this rule.

(8) After the director  has  issued  a  final  decision  to  disapprove  an application that is not subject to comparative  review  an  applicant  main submit, within 60 days of the final decision date  and  the department  may accept, additional information to demonstrate a need for the project pursuant to section 22225(1) of the code. An applicant shall also simultaneously submit any additional information to the appropriate regional certificate of need review agency. If new or revised certificate of need review standards applicable to the project become effective after the final decision is issued by the director, and if  an  applicant  submits  additional  information  to demonstrate a need for the project for which the disapproval was issued  the director's reconsideration shall be based on the new or  revised  certificate of need review standards.

  (9) If an applicant submits additional information pursuant to subrule(8) of this subrule, the department shall incorporate the additional  information into the department's file for that application.

  (10) If an applicant submits additional information pursuant to subrule(8) of this subrule, and if the department determines that an application  is  in compliance with the requirements for approval in the code  and  the  new  or revise to certificate of need review standards  the  bureau  shall  issue  a revised proposed decision and the director shall  issue  date  revised  final decision in accordance with the applicable procedures for scheduling  reviews and decisions set forth in the code and these rules for the type  of  review applicable to the project.

 

PART 3. APPROVAL AND ISSUANCE; DISAPPROVAL

 

 

 

R 325.9301 Bureau and department decision to be written; issuance of 1 decision for all applications in comparative review; conditions and stipulations as integral parts  of certificate of need; request for hearing deemed request for hearing on entire decision; issuance of final decision.

Rule 301. (1) The certificate of need bureau shall issue only 1 proposed and final decisions for all applications, including qualifying and nonqualifying projects, when a comparative group is determined to be subject to comparative review shall be in writing.

(2)   The bureau and department shall director shall issue only 1 decision for all applications including qualifying and nonqualifying projects, in when a comparative group is determined to be subject to comparative review. review.

(3)   Conditions and stipulations are integral parts of the certificate of need. A request for hearing filed pursuant to  under section 22231 or 22232 of the code related to any part of a decision, including conditions and stipulations, shall will be deemed a request for hearing on the entire decision.

(4)   The director of the department shall issue a final decision pursuant to under all applicable requirements and provisions of the code.

 

R 325.9303 Effective date of certificate.

Rule 303. Unless otherwise specified by the department in the final decision, a certificate of need shall be is effective on the date director issues the final decision approval is issued by the director.

 

PART 4. TERMS AND CONDITIONS

 

R  325.9401 Validity of certificate.

Rule 401. (1) A certificate of need shall be is valid only as long as there is compliance with the provisions in the final or amended application, including project timetables except as expressly modified in the certificate of need and the its amendments thereto.

(2)   As provided by section 20164(2) of the code, the certificate of need is not transferable and shall be valid only for the persons, buildings and properties stated in the certificate. The recipient of a certificate of need shall comply with all of the following provisions:

(a)   The certificate of need.

(b)   The amendments to the certificate of need.

(c)   The application to the extent it has not been modified by the certificate of need and its amendments.

(3) Only the persons authorized by the certificate of need may offer the covered clinical services or beds listed in the certificate of need.

 

R  325.9403 Term of certificate.

(2)   The bureau department, upon written request of the recipient, applicant, shall have the right to may extend the implementation period established in subrule (1) of this rule or in a certificate of need review standard by not more than 6 months if the bureau determines all of the following: all of the following provisions are satisfied:

(a)   The terms of the certificate are not changed.

(b)   Substantial progress has been made.

 

 

(c)    If applicable an obligation for capital expenditure or establishment of a force account is likely The requirements of R 325.9103(b) will to occur within the extended time period.

(3)   Any extension granted under subrule (2) of this rule does not change the effective date of the certificate of need.

(4)     (3) At any time, Tthe department may request, and the person holding the certificate of need shall immediately provide, any has the right to make unscheduled periodic reviews and surveys of the project for which a certificate of need is issued and all related documentation, including project schedules, to determine whether progress is being made in accordance with the project is on schedule and within the timetable and estimated costs of for the project.

(5)     (4) For projects subject to the provisions of R 325.9103(b)(i), (ii), or (vi), a certificate of need review standard may establish a term of the  certificate other than as established in subrules (1) and (2) of this rule, in which case the certificate of need shall expires at the end  of the time period specified in the standard.

 

R  325.9413 Amendments to approved certificates of need.

Rule 413. (1) An applicant recipient may make a written request to the department to for an amendment to an approved certificate of need if the project is not a completed project. If the approved certificate of need involves mental health services, a copy of the request and all subsequent information submitted to the department  shall  simultaneously  be submitted to the Michigan department  of  mental  health.  After consultingation with the appropriate regional certificate of need review agency, the department shall decide a determination shall be made by the department whether the amendment does or does not requires another review. The department's decision to require another review or deny a request is shall not be subject to the administrative hearing process set forth in 1969 PA 306, MCL 24.201 Act No. 306 of the Public Acts of 1969, as amended, being S§24.201 et seq. of the Michigan Compiled Laws. A certificate of need issued after a comparative review shall  cannot be amended to increase change the scope of the project or to increase the cost of the  project.  A certificate of need issued after a comparative review shall cannot be amended to change the method of financing the project, or the terms of financing the project, except where an  applicant  a recipient demonstrates to the satisfaction of the department, an amendment to change the method or terms of financing offers a less costly alternative to the approved method or terms of financing the project.  An amendment cannot change the site of an approved health facility or covered clinical service or increase the number of beds or covered clinical services approved in a certificate of need.  Unless waived by the department, amendments to a certificate of need shall be are subject to the same conditions and stipulations imposed on the original certificate and any new conditions and stipulations imposed on the amendment.

(2)   A request to amend a certificate of need shall be accompanied by the required fee if the amendment request results in higher costs under the fee schedule in section 21601 of the code for the proposed project that would have required a higher fee when submitted originally.  An amendment not accompanied by the required fee will not be processed by the department until the required fee is received.

(3)     (2) The department may allow Aan amendment authorizing requesting a change in the method and terms of financing, approved capital expenditures (e.g. medical equipment), or operating other costs shall  be  made only in those instances where the facility recipient is able to demonstrate that the need for amendment arises from circumstances beyond its control or the amendment offers a better alternative as determined by the department with the advice of the appropriate regional certificate of need review agency.

(3) A completed project shall not be amended.

 

 

(4)   An amendment shall modify the person, the building, or purpose of the property.

(5)   (4) The department may request additional information regarding a proposed  amendment  pursuant to the time periods set forth in R 325.9201(3).

(6)   (5) The review period for a request to amend an approved certificate of need shall not be longer than the original review period for the application. When reviewing a proposed amendment to an approved certificate of need, the bureau shall use the standards in effect at the time of the original approval of the certificate of need.

(7)   The department may grant an extension to the date a decision will be issued for an amendment upon written request from a recipient.  An extension may be granted for not less than 30 days, but not more than 90 days.

 

R 325.9415 Amendment to approved certificates for an increase in project costs.

Rule 415. Due to the  difficulty  in  estimating, in advance, finance costs, construction delays, the need for minor  construction  change  orders, and other similar  unforeseeable  events  an An amendment to an approved certificate of need for increased project costs shall will not be required if the total amount of excess does not exceed the sum of 15% of the approved project costs up to $1,000,000.00 and 10% of the approved project costs in

excess of $1,000,000.00.

 

R  325.9417 Certificate timetables.

Rule 417. (1) An application for a certificate of need shall specify the timetable the applicant will follow in making the health facility, beds, services or equipment available or for beginning and completing construction.

(2) The recipient shall period of time allowed to begin any construction shall be not more than within 24 months from of the effective date of approval the certificate of need. except that the A recipient may request to extend the time to begin any construction beyond the 24 month period, with an amendment request to the department.  The department may approve to extend the a longer period of time to begin construction through  written  amendment to the certificate of need if the department determines that circumstances justify an extension.  Extending the 24-month period does not change the effective date of the certificate of need.

(3)   The recipient shall install the medical equipment specified in the certificate of need within 24 months of the effective date of the certificate of need. A recipient may request to extend an installation beyond the 24-month period, with an amendment request to the department. The department may approve to extend the period of time for installation if the department determines that circumstances justify an extension. Extending the 24-month period does not change the effective date of the certificate of need.

(4)   For medical equipment, the first procedure must be performed within 6 months of the installation date of the equipment specified in R 325.9103(b)(ii). The department may approve to extend the period of time for the first procedure to be performed if the department determines that circumstances justify an extension. This does not change the effective date of the certificate of need.

 

R 325.9419 Monitoring compliance with approved certificates of need under section 22247 of the code. Rule 419. (1) If the department determines that a recipient has not complied with the terms, conditions, or stipulations of an approved certificate of need, the department shall notify the recipient. The department shall also specify the period of time during which the noncompliance occurred.

(2)   In determining the appropriate action to take according to section 22247(2) of the code, the

 

 

department shall consider the extent and duration of the noncompliance.

(3)   The department shall make available, to the public, on request, a list of all certificates of need determined not to be in compliance with the terms, conditions, or stipulations approved in a certificate of need. If required by the department, the recipient shall notify all payers of services provided by the recipient that the approved services are not being provided in compliance with the terms, conditions, or stipulations of an approved certificate of need.

(4) The department decision is final and binding.

 

 

PART 5. ADMINISTRATIVE APPEALS

 

R 325.9501 Hearing request; eligibility; effect. Rescinded.

  Rule 501. (1) An applicant that receives either of the following:

  (a) a proposed decision of the bureau which disapproves 1 or more certificates of need, or

  (b) a notice of reversal by the director of a proposed decision that is an approval, may request a hearing, as authorized by the code, to demonstrate that the completed application filed by the applicant meets the requirements for approval under part 222 of the code.

  (2)  If an applicant files a request for hearing, the department cannot issue a final decision until the hearing is finished .

 

R 325.9503 Hearing procedure. Rescinded.

  Rule 503. (1) An applicant requesting a hearing must file the request for hearing with the department’s Administrative Tribunal Appeals Section.

  (2) A request for a hearing  must be filed 15 days after receipt of the bureau's proposed decision or  the date of the reversal by the director of a proposed decision that is an approval.

  (3) A request for a hearing  must be in writing and  must include all of the following:

  (a) a statement of the grounds for a hearing;

  (b) a clear and concise statement of the facts and law relied on; and

  (c) the relief sought.

  (4) The applicant must serve a  copy of the request for a hearing on the appropriate regional certificate of need review agency. In addition, if the request for a hearing is filed by an applicant in a comparative review, the applicant must serve a copy of the request for a hearing on all other applicants in the comparative group when the request for hearing is filed.

  (5) The hearing  must commence within 90 days from the date that the department received the request for a hearing, unless waived in writing by the parties. Not less than 10 days before the date set in the notice, the  tribunal  must serve notice of the hearing upon the person who filed the request for a hearing, the assistant attorney general assigned to represent the department, and all other persons on whom the request for a hearing was required to be served. The first hearing day  will be utilized as a prehearing conference and may be used for hearing preliminary motions.

  (6) If more than 1 request for a hearing is filed with respect to the same bureau decision, the hearings so commenced  must be consolidated and  must be heard and decided as a single hearing. A party  must not be severed from a hearing on a comparative review.

  (7) In all hearings by aggrieved applicants, the necessary parties are the department and any aggrieved applicant that  filed its request for a hearing in a timely manner. The bureau  is not required to file a response to a request for a hearing. In comparative reviews, approved applicants are necessary parties to any hearing and must receive notice of all hearings.

 

 

R 325.9505 Service of documents. Rescinded.

  Rule 505. Unless otherwise specified, service of a document upon any party  be made by personal delivery or by mailing, by registered, certified, or first-class mail, to the last known address of the party or the authorized representative of a party as indicated on the records of the department. Proof of service be filed with the department.

 

R 325.9509 Form of hearing request.  Rescinded.

  Rule 509. (1) A request for a hearing  be titled "In the matter of (name of appellant or appellants)." caption appear at the upper left side of the first page of each filed pleading or document other than an exhibit.

(2) The first page of a pleading or document, other than an exhibit,  show the case number, if assigned, at its upper right side opposite the caption.

 

R 325.9517 Withdrawal of request for hearing; agreement. Rescinded.

  Rule 517. (1) At any time before a final decision is issued by the director, a party may withdraw its request for a hearing.

(2) The party or parties to a hearing may negotiate an agreement disposing of the whole case or a part of the case in compliance with Part 222 of the code, but that agreement is not effective unless it is approved by the department.

 

R 325.9525 Issuance of final decision by the department director. Rescinded.

 Rule 525. (1) After the conclusion of a hearing, the hearing officer deliver, to the director, the official case file and the hearing officer's proposal for decision. The hearing officer  serve the proposal for decision upon the parties by first-class or certified mail or by personal service. Each party  20 days from the date of service of the proposal for decision to file exceptions or present written arguments to the director. Exceptions and written arguments  be served on all parties, who  have 10 days to file their replies to the exceptions with the director and serve the replies on the parties.

  (2) After review of the record the proposal for decision, exceptions , and replies, if any, the director issue a final decision stating the findings of fact, conclusions of law, and the final decision or an order for further proceedings. The director  serve copies of the final decision upon all parties.

  (3) All applications that are part of a comparative review be decided in final decision.

  (4) he final decision of the director directly to the circuit court for the county where the applicant has its principal place of business in this state or the circuit court for Ingham county. Judicial review is governed by sections 101 to 106 of Act No. 306 of the Public Acts of 1969, as amended, being §§24.301 to 24.306 of the Michigan Compiled Laws.

 

R 325.9551 Hearing request; eligibility; effect.

Rule 551. (1) An applicant that receives either of the following may request a hearing, as authorized by the code, to demonstrate that the completed application filed by the applicant meets the requirements for approval under part 222 of the code:

(a)   A proposed decision of the bureau which disapproves 1 or more certificates of need.

(b)   A notice of reversal by the director of a proposed decision that is an approval.

(2) If an applicant files a request for hearing, the department shall not issue a final decision until the hearing is finished.

 

R 325.9552 Hearing procedure.

Rule 552. (1) An applicant requesting a hearing shall file the request for hearing with the

 

 

department’s administrative tribunal appeals section.

(2)   A request for a hearing must be filed 15 days after receipt of the bureau's proposed decision or the date of the reversal by the director of a proposed decision that is an approval.

(3)   A request for a hearing shall be in writing and include all of the following:

(a)   A statement of the grounds for a hearing.

(b)   A clear and concise statement of the facts and law relied on.

(c)   The relief sought.

(4)   The applicant must serve a copy of the request for a hearing on the appropriate regional certificate of need review agency. In addition, if the request for a hearing is filed by an applicant in a comparative review, the applicant must serve a copy of the request for a hearing on all other applicants in the comparative group when the request for hearing is filed.

(5)   If more than 1 request for a hearing is filed with respect to the same bureau decision, the hearings so commenced must be consolidated and shall be heard and decided as a single hearing. A party shall not be severed from a hearing on a comparative review.

(6)   In all hearings by aggrieved applicants, the necessary parties are the department and any aggrieved applicant that filed its request for a hearing in a timely manner. The bureau is not required to file a response to a request for a hearing. In comparative reviews, approved applicants are necessary parties to any hearing and shall receive notice of all hearings.

 

R 325.9553 Reconsideration.

Rule 553. At any time during the appeals process the department may reconsider the original decision to determine compliance with applicable review standards and code.

 

R 325.9554 Withdrawal of request for hearing; agreement.

Rule 554. (1) At any time before a final decision is issued by the director, a party may withdraw its request for a hearing.

(2)   The party or parties to a hearing may negotiate an agreement disposing of the whole case or a part of the case in compliance with Part 222 of the code, but that agreement is not effective unless it is approved by the department.

 

R 325.9555. Issuance of final decision by the department director.

Rule 555. (1) After review of the record and the proposal for decision, exceptions if any, and replies, if any, the director shall issue a final decision stating the findings of fact, conclusions of law, and the final decision or an order for further proceedings. The director shall serve copies of the final decision upon all parties.

(2)   All appeals of applications that are part of a comparative review shall be decided in 1 final decision.

(3)   An applicant may appeal the final decision of the director directly to the circuit court for the county where the applicant has its principal place of business in this state or the circuit court for Ingham county. Judicial review is governed by sections 101 to 103 of 1969 PA 306, MCL 24.301 to 24.306.