(1) The Small Community Hospital Pilot Program is established.
(2) As used in this section, “hospital in a small community” or “small community hospital” means a hospital, as that term is defined in Section 41-7-173(h)(i), which is located:(a) In a county that does not contain a municipality whose population exceeds fifteen thousand (15,000) according to the 2020 decennial census, and that also does not contain any portion of a municipality whose population exceeds fifteen thousand (15,000) according to the 2020 decennial census; or(b) Within the region designated by the Mississippi State Department of Health as the Delta Public Health Region as of January 1, 2026.A “small community hospital” shall not include licensed Rural Emergency Hospitals as designated by the federal Centers for Medicare and Medicaid Services.
(a) In a county that does not contain a municipality whose population exceeds fifteen thousand (15,000) according to the 2020 decennial census, and that also does not contain any portion of a municipality whose population exceeds fifteen thousand (15,000) according to the 2020 decennial census; or
(b) Within the region designated by the Mississippi State Department of Health as the Delta Public Health Region as of January 1, 2026.
A “small community hospital” shall not include licensed Rural Emergency Hospitals as designated by the federal Centers for Medicare and Medicaid Services.
(3) The State Health Officer shall issue an exemption to operate a geriatric psychiatric unit to any hospital in a small community. The exemption to operate a geriatric psychiatric unit shall be limited to the main building campus of the small community hospital, as of January 1, 2026, and to a five (5) mile radius around the main building campus of the small community hospital. An exemption to operate a geriatric psychiatric unit under this subsection (3) shall not be counted toward the exemption allotment under subsection (4)(a) of this section.
(4) (a) Subject to the restriction in paragraph (b) of this subsection (4), each hospital in a small community under subsection (2)(a) of this section shall receive one (1) exemption, and each hospital in a small community under subsection (2)(b) of this section shall receive two (2) exemptions, from the requirement to obtain a certificate of need under Section 41-7-171 et seq. for an activity that would otherwise require a certificate of need. An exemption issued under this subsection (4) shall be limited to the main building campus of the small community hospital, as of January 1, 2026, and to a five (5) mile radius around the main building campus of the small community hospital. Such exemption shall not extend to clinics or other facilities owned or operated by the small community hospital that are not located on the main campus of the small community hospital. Such exemption shall not apply to:(i) A service for which there is a general certificate of need moratorium; or(ii) Applications for a certificate of need that would place the licensed hospital receiving the exemption within thirty-five (35) miles of another licensed hospital or otherwise jeopardize a licensed hospital’s federal critical access hospital designation.(b) The State Health Officer may issue an exemption to operate an end-stage renal disease (ESRD) facility for not more than eight (8) hospitals in a small community. No more than two (2) such ESRD facilities may be located within each of the four (4) Public Health Regions designated by the Mississippi State Department of Health as of January 1, 2026. If more than two (2) small community hospitals within the same Public Health Region apply for an exemption to operate an ESRD facility, the small community hospitals in areas most remote from existing dialysis units shall be issued exemptions. An exemption obtained under this paragraph (b) shall be counted toward the exemption allotment under paragraph (a) of this subsection. If a small community hospital applies for an exemption to operate an ESRD facility under this paragraph (b) but is not granted an exemption, such hospital may use its exemption under paragraph (a) of this subsection for another service.
(a) Subject to the restriction in paragraph (b) of this subsection (4), each hospital in a small community under subsection (2)(a) of this section shall receive one (1) exemption, and each hospital in a small community under subsection (2)(b) of this section shall receive two (2) exemptions, from the requirement to obtain a certificate of need under Section 41-7-171 et seq. for an activity that would otherwise require a certificate of need. An exemption issued under this subsection (4) shall be limited to the main building campus of the small community hospital, as of January 1, 2026, and to a five (5) mile radius around the main building campus of the small community hospital. Such exemption shall not extend to clinics or other facilities owned or operated by the small community hospital that are not located on the main campus of the small community hospital. Such exemption shall not apply to:(i) A service for which there is a general certificate of need moratorium; or(ii) Applications for a certificate of need that would place the licensed hospital receiving the exemption within thirty-five (35) miles of another licensed hospital or otherwise jeopardize a licensed hospital’s federal critical access hospital designation.
(i) A service for which there is a general certificate of need moratorium; or
(ii) Applications for a certificate of need that would place the licensed hospital receiving the exemption within thirty-five (35) miles of another licensed hospital or otherwise jeopardize a licensed hospital’s federal critical access hospital designation.
(b) The State Health Officer may issue an exemption to operate an end-stage renal disease (ESRD) facility for not more than eight (8) hospitals in a small community. No more than two (2) such ESRD facilities may be located within each of the four (4) Public Health Regions designated by the Mississippi State Department of Health as of January 1, 2026. If more than two (2) small community hospitals within the same Public Health Region apply for an exemption to operate an ESRD facility, the small community hospitals in areas most remote from existing dialysis units shall be issued exemptions. An exemption obtained under this paragraph (b) shall be counted toward the exemption allotment under paragraph (a) of this subsection. If a small community hospital applies for an exemption to operate an ESRD facility under this paragraph (b) but is not granted an exemption, such hospital may use its exemption under paragraph (a) of this subsection for another service.
(5) An exemption issued under subsection (3) or (4) of this section shall be specific to and solely for the hospital to which it was issued and may not be transferred to another entity unless the hospital itself is transferred. If a small community hospital does not apply for an exemption on or before June 30, 2027, then the small community hospital’s eligibility for an exemption shall expire.
(6) The decision of the State Health Officer to issue an exemption under this section is final, and not subject to judicial review. Any person or entity which wishes to challenge the issuance of an exemption may file with the State Health Officer a request for reconsideration within seven (7) calendar days of the decision of the State Health Officer. If such a request is filed, the State Health Officer or his or her designee shall conduct a hearing no sooner than fourteen (14) days from the original decision, and no later than twenty-one (21) days from the original decision, at which hearing the interested parties may be heard. The hearing shall be informal in nature, and there shall be no right to engage in discovery. The purpose of the hearing is to allow a party to offer an objection to the issuance of the exemption, or to present, in a summary fashion, matters which may have been overlooked. After the hearing, the State Health Officer may decide not to issue the exemption, to further consider the issuance of the exemption or to reaffirm his or her original decision. Notwithstanding the foregoing, the State Hearing Officer’s decision to issue an exemption under this section is final, and not subject to judicial review.