Sec. 10.24.01.17. Project Changes After Certificate of Need Approval

A. Notification to the Commission.

(1) If the project sponsor determines that it desires to change a project that has received Certificate of Need approval, the project sponsor shall notify the following parties in writing of the proposed changes:

(a) The Commission;

(b) The local health department; and

(c) In the case of a change in the location or address of a project involving the construction of a new health care facility, all health care facilities of that type located within the health planning region of the project.

(2) Notification shall be submitted through the Health Facilities Coordination Office, and shall be supported by appropriate documentation.

B. Commission Approval Required Before Project Changes. Any of the following changes that would place the project at variance with its Certificate of Need issued under these regulations, including any condition issued under Regulation .09D(1)(b) of this chapter, shall receive approval from the Commission:

(1) Before making a significant change in physical plant design;

(2) Before incurring capital cost increases that exceed the approved capital cost inflated by an amount determined by applying the Building Cost Index published in Health Care Cost Review from the application submission date to the date of the filing of a request for approval of a project change;

(3) When total projected operating expenses or revenue increases exceed the projected expenses or revenues in the approved Certificate of Need Application, inflated by 10 percent per year;

(4) Before changing the financing mechanisms of the project;

(5) Before changing the location or address of the project.

C. Impermissible Modifications. The following proposed modifications to an approved project require a new Certificate of Need, and may not be considered by the Commission:

(1) Changes in the fundamental nature of a facility or the services to be provided in the facility from those that were approved by the Commission;

(2) Increases in the total licensed bed capacity or medical service categories from those approved;

(3) Any change that requires an extension of time to meet the applicable performance requirements specified under Regulation .12 of this chapter, except as permitted under Regulation .12E of this chapter.

D. Commission Action.

(1) Changes subject to review under §B of this regulation shall be reviewed by the Commission.

(2) Within 5 days after the Commission's receipt of a written request to change the address or location of an approved project, which is subject to review under §B(5) of this regulation, the Commission shall:

(a) Arrange to publish notice of receipt of the change request in one newspaper in the appropriate health planning region; and

(b) Provide written notice of receipt of the change request to:

(i) Each member of the General Assembly in whose district the relocation is planned;

(ii) Each member of the governing body for the jurisdiction in which the relocation is planned; and

(iii) The county executive, mayor, or chief executive officer, if any, in whose county or city the relocation is planned.

(3) The Commission shall provide written notification to the applicant within 45 days of the Commission's receipt of the change request that:

(a) The proposed change is approved and is incorporated into a modified Certificate of Need for the project;

(b) The proposed change is approved in part or approved with conditions;

(c) The proposed change is not approved, with explanation; or

(d) The proposed change is of sufficient scope to warrant complete review in accordance with the Certificate of Need review process described in Regulations .08-.10 of this chapter, and may only be considered upon completion of this review.

E. Commission May Seek Advice. The Commission may seek the advice of any agency or person in the performance of a review under this regulation, including each existing health care facility currently operating within the intended service area of the approved or proposed project, and each applicant and interested party in the review that resulted in the grant of the original Certificate of Need.

F. When Commission Action is a New Final Decision. Action taken by the Commission under §D(2)(a) or (b) of this regulation does not constitute a new final decision by the Commission and may not be appealed. Action taken by the Commission following a complete review under §D(3)(d) of this regulation constitutes a new final decision of the Commission.