900 KAR 6:055. Certificate of Need forms.

 

RELATES TO: KRS 216B.010-216B.130, 216B.330-216B.339, 216B.455, 216B.990

STATUTORY AUTHORITY: KRS 194A.030, 194A.050, 216B.040(2)(a)1, 216B.330

NECESSITY, FUNCTION, AND CONFORMITY: KRS 216B.040(2)(a)1 requires the Cabinet for Health and Family Services to administer Kentucky's Certificate of Need Program and to promulgate administrative regulations as necessary for the program. This administrative regulation establishes the forms necessary for the orderly administration of the Certificate of Need Program.

 

Section 1. Definitions. (1) "Administrative escalation" means an approval from the cabinet to increase the capital expenditure authorized on a previously issued certificate of need.

(2) "Cabinet" is defined by KRS 216B.015(5).

 

Section 2. Forms. (1) OHP - Form 1, Letter of Intent, shall be filed by all applicants for a certificate of need.

(2) OHP - Form 2A, Certificate of Need Application, shall be filed by applicants for a certificate of need other than ground ambulance providers or change of location, replacement, or cost escalation.

(3) OHP - Form 2B, Certificate of Need Application For Ground Ambulance Service, shall be filed by applicants for a certificate of need for ground ambulance providers.

(4) OHP - Form 2C, Certificate of Need Application For Change of Location, Replacement, Cost Escalation, or Acquisition, shall be filed by applicants for a certificate of need for change of location, replacement, cost escalation or acquisition.

(5) OHP - Form 3, Notice of Appearance, shall be filed by persons that wish to appear at a hearing.

(6) OHP - Form 4, Witness List, shall be filed by persons that elect to call witnesses at a hearing.

(7) OHP - Form 5, Exhibit List, shall be filed by persons that elect to introduce evidence at a hearing.

(8) OHP - Form 6, Cost Escalation Form, shall be filed by facilities that elect to request an administrative escalation.

(9) OHP - Form 7, Request for Advisory Opinion, shall be filed by anyone electing to request an advisory opinion.

(10) OHP - Form 8, Certificate of Need Six Month Progress Report, shall be filed by a holder of a certificate of need whose project is not fully implemented.

(11) OHP - Form 9, Notice of Intent to Acquire a Health Facility or Health Service, shall be submitted by a person proposing to acquire an existing licensed health facility or service.

(12) OHP - Form 10A, Notice of Addition or Establishment of a Health Service or Equipment, shall be filed by any health facility which adds equipment or makes an addition to a health service for which there are review criteria in the State Health Plan but for which a certificate of need is not required.

(13) OHP Form 10B, Notice of Termination or Reduction of a Health Service or Reduction of Bed Capacity, shall be filed by a health facility which reduces or terminates a health service, or reduces bed capacity.

(14) OHP - Form 11, Application for Certificate of Compliance for a Continuing Care Retirement Community (CCRC), shall be filed by a facility to obtain a certificate of compliance as a continuing care retirement community.

 

Section 3. Incorporation by Reference. (1) The following material is incorporated by reference:

(a) "OHP - Form 1, Letter of Intent", 05/2009;

(b) "OHP - Form 2A, Certificate of Need Application", 05/2009;

(c) "OHP - Form 2B, Certificate of Need Application For Ground Ambulance Providers", 05/2009;

(d) "OHP - Form 2C, Certificate of Need Application For Change of Location, Replacement, Cost Escalation, or Acquisition ", 05/2009;

(e) "OHP - Form 3, Notice of Appearance", 05/2009;

(f) "OHP - Form 4, Witness List", 05/2009;

(g) "OHP - Form 5, Exhibit List", 05/2009;

(h) "OHP - Form 6, Cost Escalation Form", 05/2009;

(i) "OHP - Form 7, Request for Advisory Opinion", 05/2009;

(j) "OHP - Form 8, Certificate of Need Six Month Progress Report", 05/2009;

(k) "OHP - Form 9, Notice of Intent to Acquire a Health Facility or Health Service", 05/2009;

(l) "OHP - Form 10A, Notice of Addition or Establishment of a Health Service or Equipment", 05/2009;

(m) "OHP - Form 10B, Notice of Termination of a Health Service or Reduction of Bed Capacity", 05/2009; and

(n) "OHP - Form 11, Application for Certificate of Compliance for a Continuing Care Retirement Community (CCRC)", 05/2009.

(2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Cabinet for Health and Family Services, Office of Health Policy, 275 East Main Street, Frankfort, Kentucky 40621, Monday through Friday, 8 a.m. to 4:30 p.m. (36 Ky.R. 230; Am. 803; eff. 10-21-2009.)