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C ER TI F ICAT E O F NEED RE VI EW S TA ND A RDS F O R H O S P ITAL BEDS
(By auth ority conferr ed on th e Cert ificat e of Need Comm ission by sections 22215 an d 22217 of Act No. 368 of th e Pu blic Act s of 1978 , as am ended, an d sections 7 an d 8 of Act No. 306 of th e Pu blic Act s of 1969 , as am ended, being sections 333 .22215 , 333 .22217 , 24.207 , an d
24.208 of th e Michigan Compiled Laws.)
Section 1. App li ca bility
Sec. 1. (1) These stan dar ds ar e requirement s for app roval an d delive ry of services for all project s app roved an d cert ificat es of need iss ued un der Part 222 of th e Code that involve
(a) increasing licensed beds in a hospita l licensed un der Part 215 or (b) physically relocat ing hospita l beds from one licensed site to anoth er geogra phic locat ion or (c) repl acing beds in a hospita l or (d) acquiring a hospita l or (e) begi nn ing operat ion of a new hospital.
(2) A hospita l licensed un der Part 215 is a cove red health facility for pur poses of Part 222 of th e Code.
(3) An increase in licensed hospita l beds is a chan ge in bed capacity for pur poses of Part 222 of th e Code.
(4) The physical relocat ion of hospita l beds from a licensed site to anoth er geogra phic locat ion is a chan ge in bed capacity for pur poses of Part 222 of th e Code.
(5) An increase in hospita l beds cert ified for long-term car e is a chan ge in bed capacity for pur poses of Part 222 of th e Code an d sha ll be subject to an d reviewed un der th e Cert ificat e of Need Review Stan dar ds for Long-Term-Car e Services.
(6) The Dep artm ent shall use sections 3, 4, 5, 6, 7, 9, an d 14 of th ese stan dar ds an d Section 2 of th e Adde ndum for Pr oject s for HIV Infected Individua ls, as applicable, in applying Section 22225 (1) of th e Code, being Section 333 .22225 (1) of th e Michigan Compiled Laws.
(7) The Dep artm ent sha ll use Section 8 of th ese stan dar ds an d Section 3 of th e Adde ndum for Pr oject s for HIV Infected Individua ls, as applicable, in applying Section 22225 (2)(c) of th e Code, being Section 333 .22225 (2)(c) of th e Michigan Compiled Laws.
Section 2. De fin itio ns
Sec. 2. (1) As used in th ese stan dar ds:
(a) "Acqu ir ing a hospita l" mean s th e issuan ce of a new hospita l license as th e result of th e acquisition (including pur cha se, lease, donat ion, or oth er com para ble arran gement s) of a hospita l with a valid license an d which does not involve a chan ge in bed capacity.
(b) "Acut e car e bed need meth odology" or "ACBNM" mean s th e meth odology an d applicable formu la(s) for determ ining th e needed supply of hospita l beds referenced in th e docum ent ent itled "Re comm e n d at ion s of th e Mich igan Acut e C ar e Bed N eed Me th od ology Pr oje ct for th e P lann in g of H osp ita l Beds in Mich igan" published in J un e 1977 , except as modified in th ese stan dar ds. The docum ent is available for review at th e Dep artm ent .
(c) "Alcoh ol an d substan ce abuse hospita l," for pur poses of th ese stan dar ds, mean s a licensed hospita l with in a long-term (acut e) car e hospita l that exclusively provides inpat ient medical detoxificat ion an d medical sta bilizat ion an d relat ed out pat ient services for persons who ha ve a primar y diagnosis of substan ce depe ndence cover ed by DRGs 433 - 437 .
(d) "Avera ge length of sta y" or "ALOS " mean s th e avera ge length of an inpat ient 's sta y in a hospita l per admission or dischar ge (including inpat ient death s). It is calculat ed as follows: tota l num ber of days of inpat ient car e in th e facility for all admissions or dischar ges (including inpat ient death s) dur ing a
des ignat ed period divided by th e num ber of admissions or dischar ges (including inpat ient death s) dur ing th e sam e period.
(e) "Base year " mean s th e 1987 calendar year of MIDB data unt il oth erwise chan ged by th e Comm ission.
(f) "Code" mean s Act No. 368 of th e Pu blic Act s of 1978 , as am ended , being Section 333 .1101 e t seq. of th e Michigan Compiled Laws.
(g) "Dep artm ent invent ory of beds " mean s th e curr ent list ma inta ined for each hospita l subar ea on a cont inu ing basis by th e Dep artm ent of (i) licensed hospita l beds an d (ii) hospita l beds approved by a valid cert ificat e of need issued un der eith er Part 221 or Part 222 of th e Code that ar e not yet licensed . The term does not include hospita l beds cert ified for long-term -car e in hospita l long-term car e un it s.
(h) "Existing hospita l beds " mean s, for a specific hospita l subar ea, th e tota l of all of th e followin g: (i) hospita l beds licensed by th e Dep artm ent of Consum er & Industr y Services;
(ii) hospita l beds with valid cert ificat e of need approval but not yet licensed; (iii) proposed hospita l beds un der appe al from a fina l decision of th e Dep artm ent ; an d (iv) proposed hospita l beds that ar e part of a com pleted applicat ion un der Part 222 (oth er than th e applicat ion un der review) for which a proposed decision ha s been issued an d which is pending fina l Dep artm ent decision.
(i) "Health service ar ea" mean s th e geogra phic ar ea esta blished for a health systems agency pur suant to form er Section 1511 of th e Pu blic Health Service Act .
(j) "Hospita l bed " mean s a bed with in th e licensed bed com plement at a licensed site of a hospita l licensed un der Part 215 of th e Code, excluding (i) hospita l beds cert ified for long-term car e as defined in Section 20106 (6) of th e Code an d (ii) un licensed newborn bassinets.
(k) "Hospita l" mean s a hospita l as defined in Section 20106 (5) of th e Code being Section 333 .20106 (5) of th e Michigan Compiled Laws an d licensed un der Part 215 of th e Code. The term does not include a hospita l or hospita l un it licensed or operat ed by th e Dep artm ent of Menta l Health .
(l) "Hospita l long-term -car e un it " or "HLTCU" mean s a nur sing car e un it , owned or operat ed by an d as part of a hospita l, licensed by th e Dep artm ent of Consum er & Industr y Services, an d providing organ ized nur sing car e an d medical tr eatm ent to 7 or more unr elat ed individua ls su ffer ing or recover ing from illness , injur y, or infirm it y.
(m) "Hospita l su bar ea " or "su bar ea" mean s a cluster or grouping of hospita ls an d th e relevant port ion of th e stat e's populat ion served by that cluster or grouping of hospita ls. For pur poses of th ese stan dar ds, hospita l subar eas an d th e hospita ls assigned to each subar ea ar e set forth in Appe ndix A.
(n) “Host hospita l,” for pur poses of th ese stan dar ds, mean s an existing licensed hospita l, which delicenses hospita l beds , an d which leases pat ient car e space an d oth er space with in th e physical plant of th e host hospita l, to allow a long-term (acut e) car e hospita l, or alcoh ol an d substan ce abuse hospita l, to begin operat ion.
(o) "Licensed site" mean s eith er (i) in th e case of a single site hospita l, th e locat ion of th e facility auth orized by license an d listed on that licensee's cert ificat e of licensur e or (ii) in th e case of a hospita l with mu lt iple sites, th e locat ion of each sep arat e an d distinct inpat ient un it of th e health facility as auth orized by license an d listed on that licensee's cert ificat e of licensur e.
(p) "Long-term (acut e) car e hospita l," for pur poses of th ese stan dar ds, mean s a hospita l ha s been approved to part icipat e in th e Title XVIII (Medi car e) program as a prospe ctive payment system (PP S) exempt hospita l in accordan ce with 42 CFR Part 412 .
(q) "Michigan inpat ient data base" or "MIDB " mean s th e data base com piled by th e Michigan Health Data Corporat ion. The data base con sists of inpat ient dischar ge recor ds from all Michigan hospita ls for a specific calendar year .
(r) "New beds in a hospita l" mean s hospita l beds that meet at least one of th e followin g: (i) ar e not curr ent ly licensed as hospita l beds , (ii) ar e curr ent ly licensed hospita l beds at a licensed site in one subar ea which ar e proposed for relocat ion in a differ ent subar ea a s determ ined by th e Dep artm ent pur suant to Section 3 of th ese stan dar ds, (iii) ar e curr ent ly licensed hospita l beds at a licensed site in one subar ea which ar e proposed for relocat ion to an oth er geogra phic site which is in th e sam e subar ea as determ ined by th e Dep artm ent , but which ar e not in th e replacement zone, or (iv) ar e curr ent ly licensed hospita l beds that ar e proposed to be licensed as part of A new hospita l in a ccor dan ce with Section 6(2) of th ese stan dar ds.
(s) "New hospita l" mean s one of th e followin g: (i) th e esta blishm ent of a new facility that sha ll be issued a new hospita l license, (ii) for curr ent ly licensed beds , th e esta blishm ent of a new licensed site that is not in th e sam e hospita l subar ea as th e curr ent ly licensed beds , (iii) curr ent ly licensed hospita l beds at a licensed site in one subar ea which ar e proposed for relocat ion to an oth er geogra phic site which is in th e sam e subar ea as determ ined by th e Dep artm ent , but which ar e not in th e replacement zone, or (iv) curr ent ly licensed hospita l beds that ar e proposed to be licensed as part of a new hospita l in a ccor dan ce with section 6(2) of th ese stan dar ds.
(t) ) "Overbedded subar ea" mean s a hospita l subar ea in which th e tota l num ber of exis t ing hospita l beds in that subar ea exceeds th e subar ea needed hospita l bed supply as set forth in Appe ndix C.
(r ) "Plann ing year " mean s th e year in th e futur e, esta blished by th e Cert ificat e of Need Comm ission, for which hospita l bed needs ar e developed . The plann ing year sha ll be a year for which officia l populat ion pr oject ions from th e Dep artm ent of Mana gement an d Budget ar e available.
(v) "Repl acement beds in a hospita l" mean s hospita l beds that meet all of th e followin g conditions; (i) an equa l or great er num ber of hospita l beds ar e curr ent ly licensed to th e applicant at th e licensed site at which th e proposed replacement beds ar e curr ent ly licensed; (ii) th e hospita l beds ar e proposed for replacement in new physical plant space being developed in new con stru ct ion or in newly acquired space (pur cha se, lease, donat ion, etc.); an d (iii) th e hospita l beds to be replaced will be locat ed in th e replacement zone.
(w) "Repl acement zone" mean s a proposed licensed site that is (i) in th e sam e subar ea as th e existing licensed site as determ ined by th e Dep artm ent in a ccor d with Section 3 of th ese stan dar ds an d (ii) on th e sam e site, on a cont iguous site, or on a site with in 2 miles of th e existing licensed site if th e existing licensed site is locat ed in a count y with a populat ion of 200 ,000 or more, or on a site with in 5 miles of th e existing licensed site if th e existing licensed site is locat ed in a count y with a populat ion of less than 200 ,000 .
(x) "Rura l count y" mean s a count y in Michigan that is not with in a Consolidat ed Metr opolitan Stat ist ical Area (CMS A), Pr imar y Metr opolitan Stat ist ical Area (PMS A), or Metr opolitan Stat ist ical Area (MS A) as defined by th e U. S. Dep artm ent of Comm erce, Bur eau of Census an d as shown in Appe ndix B.
(y) "Ut ilizat ion rat e" or "use rat e" mean s th e num ber of days of inpat ient car e per 1,000 populat ion dur ing a one-year period.
(z) "Zip code populat ion" mean s th e lat est populat ion a llocat ions prepar ed by th e Michigan Health Data Corporat ion, based on th e most recent ly available Michigan Dep artm ent of Mana gement an d Budget populat ion pr oject ions an d U.S. Census populat ion estimat es.
(2) The definitions in Part 222 sha ll apply to th ese stan dar ds.
Section 3. Hospital suba reas
Sec. 3. (1)(a ) Ea ch existing hospita l is assigned to a hospita l subar ea as set forth in Appe ndix A which is in cor porat ed as part of th ese stan dar ds.
(b) For an applicat ion involving a proposed new licensed site for a hospita l (wheth er new or replacement ), th e proposed new licensed site sha ll be assigned to an existing hospita l subar ea ut ilizi ng a mark et sur vey con ducted by th e applicant an d submitt ed with th e applicat ion. The mark et sur vey sha ll provide, at a minimum , for ecasts of th e num ber of inpat ient dischar ges for each zip code that th e proposed new licensed site sha ll provide service. The for ecasted num bers mu st be for th e sam e year as th e base year MIDB data . The mark et sur vey sha ll be com pleted by th e applicant using a ccep ted stan dar d stat ist ical meth ods. The mark et sur vey, if determ ined by th e Dep artm ent to be reasona ble pur suant to Section 13, sha ll be used by th e Dep artm ent to assign th e proposed new site to an exis t ing subar ea as follows :
(i) For th e proposed new site, a mark et for ecast factor for each of th e zip codes ident ified in th e applicat ion sha ll be com put ed using th e num ber of tota l inpat ient dischar ges indicat ed by th e mark et sur vey for ecasts in th e num erat or an d th e base year MIDB dischar ges for th e denominat or. These zip
code specific mark et for ecast factors will be nam ed %N. Zip codes with a mark et for ecast factor of less than .05 sha ll be deleted from con siderat ion.
(ii) The base year MIDB data sha ll be used to com put e mark et shar e factors (%Zs) for each hospita l subar ea for each of th e zip codes ident ified in step (i) above. Mark et shar e factor mean s a com putat ion where th e num erat or is th e inpat ient hospita l dischar ges for a specified hospita l subar ea from a specific zip code an d th e denominat or is th e inpat ient hospita l dischar ges for an y hospita l from that specific zip code. Hospita l subar eas with a mark et shar e factor of less than .05 for all zip codes ident ified in step (i) will be deleted from considerat ion.
(iii) For each of th e zip codes ident ified in step (i), com par e %Zs between subar eas ident ified in step (ii). The hospita l subar ea with th e lar gest %Z sha ll ha ve th e ent ire zip code assigned to that subar ea.
(iv) The base year tota l zip code populat ion a llocat ions corr esp onding to th e assignm ent s in step (iii) to a specific hospita l subar ea ar e mu lt iplied by th e %N calculat ed in step (i) for that zip code . The results of all mu lt iplicat ions with in a hospita l subar ea ar e added togeth er to obta in a subar ea tota l.
(v) The hospita l subar ea with th e lar gest tota l calculat ed in step (iv) sha ll ha ve th e proposed new licensed site assigned to that subar ea.
(2) The Dep artm ent sha ll am end Appe ndix A to reflect:
(a) approved new licensed site(s) assigned to a specific hospita l subar ea; (b) hospita l closur es; an d (c) licensur e action(s) as appropriat e.
Section 4. Dete rm ina tio n of the needed hosp ital bed supp ly
Sec. 4. (1) The determ inat ion of th e needed hospita l bed supply for a hospita l subar ea for a plann ing year sha ll be ma de using th e acut e-car e bed need meth odology (ACBNM) except as modified as follows :
(a) The medical/sur gical plann ing use rat e sha ll be th e lesse r of: (i) th e actua l use rat e for a hospita l subar ea using data for th e base year for which verifiable data ar e available to th e Dep artm ent , or (ii) 735 pat ient days of car e per 1000 populat ion.
(b) The plann ing avera ge length -of-sta y for obstetr ical beds sha ll be th e lesse r of th e actua l avera ge post-partum length -of-sta y for a hospita l subar ea for th e base year for which verifiable data ar e available to th e Dep artm ent , or 3.37 days.
(c) The medical/sur gical use rat e sha ll not be adjusted for low populat ion density.
(2) Wherever th e acut e-car e bed need meth odology refers to or ut ilize s th e pat ient origin an d hospita l use stu dy (POHU S), th e Dep artm ent sha ll ut ilize th e base year Michigan Inpat ient Data Base.
Section 5. Bed Need
Sec. 5. (1) The bed-need num bers in cor porat ed as part of th ese stan dar ds as Appe ndix C sha ll apply to pr oject s subject to review un der th ese stan dar ds, except where a specific cert ificat e of need review stan dar d stat es oth erwise .
(2) The Comm ission ma y direct th e Dep artm ent to apply th e acut e-car e bed need meth odology in Section 4.
(3) The Comm ission sha ll des ignat e th e base year an d th e futur e plann ing year which sha ll be ut ilize d in applying th e meth odology pur suant to subse ct ion (2).
(4) When th e Dep artm ent is directed by th e Comm ission to apply th e meth odology pur suant to subsection (2), th e effect ive dat e of th e bed -need num bers sha ll be esta blished by th e Comm ission.
(5) New bed-need num bers esta blished by subsections (2) an d (3) sha ll supersede th e bed- need num bers shown in Appe ndix C an d sha ll be included as an am ended appe ndix to th ese stan dar ds.
Section 6. Re qu iremen ts for app rova l -- ne w beds in a hosp ital
Sec. 6. (1) An applicant proposing new beds in a hospita l, except an applicant meeting th e requirement s of subsection 2, sha ll demonstrat e that it meets all of th e following:
(a) The new beds in a hospita l sha ll result in a hospita l of at least 200 beds in a non-rura l count y or 50 beds in a rura l count y. This subse ct ion ma y be waived by th e Dep artm ent if th e Dep artm ent determ ines, in it s sole discretion, that a sma ller hospita l is necess ar y or appropriat e to assur e a ccess to health -car e services.
(b) The tota l num ber of existing hospita l beds in th e subar ea to which th e new beds will be assigned does not curr ent ly exceed th e needed hospita l bed supply as set forth in Appe ndix
C. The Dep artm ent sha ll determ ine th e subar ea to which th e beds will be assigned in a ccor d with Section 3 of th ese stan dar ds.
(c) Approval of th e proposed new beds in a hospita l sha ll not result in th e tota l num ber of existing hospita l beds , in th e subar ea to which th e new beds will be assigned, exceedi ng th e needed hospita l bed supply as set forth in Appe ndix C. The Dep artm ent sha ll determ ine th e subar ea to which th e beds will be assigned in a ccor d with Section 3 of th ese stan dar ds.
(2) An applicant proposing to begin operat ion as a new long-term (acut e) car e hospita l or alcoh ol an d substan ce abuse hospita l with in an existing licensed , host hospita l sha ll demonstrat e that it meets all of th e requirement s of th is subsection:
(a) If th e long-term (acut e) car e hospita l applicant described in th is subsection does not meet th e Title XVIII requirement s of th e Social Secur ity Act for exemption from PP S as a long-term (acut e) car e hospita l with in 12 month s after beginn ing operat ion, th en it ma y
apply for a six-month extension in a ccor dan ce with R325 .9403 of th e cert ificat e of need ru les. If th e applicant fa ils to meet th e Title XVIII requirement s for PP S exemption as a long-term (acut e) car e hospita l with in th e 12 or 18-month period, th en th e cert ificat e of need grant ed pur suant to th is section sha ll expire aut omat ically.
(b) The pat ient car e space an d oth er space to esta blish th e new hospita l is being obta ined thr ough a lease arran gement between th e applicant an d th e host hospita l. The initial, renewed , or an y subseq uent lease sha ll specify at least a ll of th e followin g:
(i) That th e host hospita l sha ll delicense th e sam e num ber of hospita l beds proposed by th e applicant for licensur e in th e new hospita l.
(ii) That th e proposed new beds sha ll be for use in space curr ent ly licensed as part of th e host hospita l.
(iii) That upon non-renewal an d/or term inat ion of th e lease, upon term inat ion of th e license issued un der Part 215 of th e act to th e applicant for th e new hospita l, or upon non com plian ce with th e pr oject delivery requirement s or an y oth er applicable requirement s of th ese stan dar ds, th e beds licensed as part of th e new hospita l mu st be disposed of by one of th e followin g mean s:
(A) Relicensur e of th e beds to th e host hospita l. The host hospita l mu st obta in a cert ificat e of need to acquire th e "new" hospita l;
(B) Delicensur e of th e hospita l beds ; or
(C) Acqu isit ion by an oth er ent ity that obta ins a cert ificat e of need to acquire th e new hospita l in it s ent irety an d that ent ity mu st meet an d sha ll stipulat e to th e requirement s specified in Section 6(2).
(c) The applicant or th e curr ent licensee of th e new hospita l sha ll not apply, initially or subseq uent ly, for cert ificat e of need approval to initiat e an y oth er cert ificat e of need cover ed clinical services.
(d) The new licensed hospita l sha ll rema in with in th e host hospita l.
(e) The new hospita l sha ll be assigned to th e sam e subar ea as th e host hospita l.
(f) The proposed pr oject to begin operat ion of a new hospita l, un der th is subsection, sha ll con st itut e a chan ge in bed capacity un der Section 1(3) of th ese stan dar ds.
(g) The lease will not result in an increase in th e num ber of licensed hospita l beds in th e subar ea.
(h) Applicat ions proposing a new hospita l un der th is subse ct ion sha ll not be subject to com parat ive review .
Section 7. Re qu ir emen ts for app rova l -- rep lacement beds in a hosp ital in a rep lacement zo ne
Sec. 7. (1) If th e applicat ion involves th e development of a new licensed site, an applicant proposing replacement beds in a hospita l in th e replacement zone sha ll demonstrat e that th e proposed pr oject meets th e requirement s of Section 6(1)(a ).
(2) In order to be approved, th e applicant sha ll propose to (i) replace an equa l or lesse r num ber of beds curr ent ly licensed to th e applicant at th e licensed site at which th e proposed replacement beds ar e locat ed, an d (ii) that th e proposed new licensed site is in th e replacement zone.
(3) An applicant proposing replacement beds in th e replacement zone sha ll not be required to be in com plian ce with th e needed hospita l bed supply set forth in Appe ndix C if th e applicat ion meets all oth er applicable cert ificat e of need review stan dar ds an d agrees an d assur es to com ply with all applicable pr oject delivery requirement s.
Section 8. P rojec t de li ve ry re qu ir emen ts -- te rms of app rova l for all app li cants
Sec. 8. (1) An applicant sha ll agree that , if approved, th e pr oject sha ll be delivered in com plian ce with th e followin g term s of cert ificat e of need approval:
(a) Complian ce with th ese stan dar ds
(b) Complian ce with applicable operat ing stan dar ds
(c) Complian ce with th e followin g qua lity assuran ce stan dar ds:
(i) The applicant sha ll notify th e Dep artm ent with in 10 days of th e dat e th e hospita l beds ar e placed in operat ion.
(ii) The applicant sha ll assur e com plian ce with Section 20201 of th e Code, being Section 333 .20201 of th e Michigan Compiled Laws.
(iii) The applicant sha ll part icipat e in a data colle ct ion network esta blished an d administered by th e Dep artm ent . The data ma y include, but is not limited to, annua l budget an d cost in format ion an d demogra phic, diagnostic, morbidity, an d morta lity in format ion, as well as th e volum e of car e provided to pat ient s from all payor sour ces. The applicant sha ll provide th e required data on a sep arat e basis for each licensed site, in a format esta blished by th e Dep artm ent , an d in a mutua lly agreed upon media. The Dep artm ent ma y elect to verify th e data thr ough on-site review of appropriat e recor ds.
(2) The agreement s an d assuran ces required by th is section sha ll be in th e form of a cert ificat ion auth orized by th e govern ing body of th e applicant or it s auth orized agent .
Section 9. Ru ral Mic h iga n counties
Sec. 9. Rura l Michigan count ies, for pur poses of th ese stan dar ds, ar e in cor porat ed as part of th ese stan dar ds as Appe ndix B. The Dep artm ent ma y am end Appe ndix B as appropriat e to reflect chan ges by th e U.S. Dep artm ent of Comm erce, Bur eau of Census.
Section 10 . Depa rt men t inven tory of beds
Sec. 10. The dep artm ent sha ll ma inta in an d provide on request a list ing of th e dep artm ent invent ory of beds for each subar ea.
Section 11 . Effec t on pri or planning po li cies ; compa rative rev ie w s
Sec. 11. (1) These cert ificat e of need review stan dar ds supersede an d replace th e cert ificat e of need stan dar ds for hospita l beds approved by th e Cert ificat e of Need Comm ission on October 12, 1989 an d effect ive November 20, 1989 .
(2) Pr oject s reviewed un der th ese stan dar ds sha ll be subject to com parat ive review except th ose pr oject s meeting th e requirement s of Section 22229 (1)(c) of th e Code, being Section 333 .22229 (1)(c) of th e Michigan Compiled Laws an d pr oject s involving acquisition (including pur cha se, lease, donat ion or com para ble arran gement s) of a hospita l.
Section 12 . Additiona l re qu ir emen ts for app li cations inc luded in compa rative rev ie w s
Sec. 12. (1) Any applicat ion subject to com parat ive review un der Section 22229 of th e Code being Section 333 .22229 of th e Michigan Compiled Laws or th ese stan dar ds sha ll be grouped an d reviewed with oth er applicat ions in a ccor dan ce with th e cert ificat e of need ru les applicable to com parat ive reviews .
(2) Ea ch applicat ion in a comparat ive review group sha ll be individua lly reviewed to determ ine wheth er th e applicat ion ha s sat isfied all th e requirement s of Section 22225 of th e Code being Section 333 .22225 of th e Michigan Compiled Laws an d all oth er applicable requirement s for approval in th e Code an d th ese stan dar ds. If th e Dep artm ent determ ines that one or more of th e com peting applicat ions sat isfies all of th e requirement s for approval, th ese pr oject s sha ll be con sidered qua lifying pr oject s. The Dep artm ent sha ll approve th ose qua lifying pr oject s which, tak en togeth er, do not exceed th e need , as defined in Section 22225 (1), in th e order th e Dep artm ent determ ines th e pr oject s most fully promote th e availability of qua lity health services at reasona ble cost .
Section 13 . Documentation of ma rket su rvey
Sec. 13. An applicant required to con duct a mark et sur vey un der Section 3 sha ll specify how th e mark et sur vey was developed. This specificat ion sha ll include a description of th e data sour ce(s) used, assess ment s of th e a ccura cy of th ese data , an d th e stat istical meth od(s) used. Based on th is docum entat ion, th e Dep artm ent sha ll determ ine if th e mark et sur vey is reasona ble.
Section 14 . Re qu iremen ts for app rova l -- acquisition of a hosp ital
Sec. 14. (1) An applicant proposing to acquire a hospita l sha ll not be required to be in com plian ce with th e needed hospita l bed supply set forth in Appe ndix C for th e subar ea in which th e hospita l subject to th e proposed acquisition is assigned if th e applicant demonstrat es that all of th e followin g ar e met:
(a) th e acquisition will not result in a chan ge in bed capacity,
(b) th e licensed site does not chan ge as a result of th e acquisition,
(c) th e pr oject is limited solely to th e acquisition of a hospita l with a valid license, AND
(d) if th e applicat ion is to acquire a hospita l, which was proposed in a prior applicat ion to be esta blished as a long-term (acut e) car e hospita l (LTAC) an d which received cert ificat e of need approval, th e applicant mu st also meet th e requirement s of Section 6(2). Those hospita ls that received such prior approval ar e so ident ified in Appe ndix A.
