Washington Administrative Code

(1) The department shall use the following rules in conjunction with the certificate of need review criteria contained in WAC 246-310-210(1) for applications proposing the following:(a) Construction, development, or other establishment of a new nursing home;(b) Increase in the li…

(1) The department shall use the procedures described in this section to make adjustments to planning area net estimated bed need.(2) For planning areas for which a nursing home review is scheduled or is ongoing, the department shall use the following procedures to adjust a plann…

In the case of a nursing home licensee, requesting to convert some of the nursing home beds to an alternative use, as defined in RCW 70.38.111(8), or reduce the number of beds per room to two or one, or otherwise enhance the quality of life for residents and preserve the right to…

In the case of a nursing home licensee, as defined in WAC 246-310-010 ceasing operation as a nursing home or any other party who has secured an interest in the beds and requesting to retain the nursing home bed allocation, pursuant to RCW 70.38.115 (13)(b), the licensee or other …

In the case of a nursing home licensee wanting to replace nursing home beds pursuant to WAC 246-310-044, the nursing home shall give notice of intent to replace the beds to the department of health.Notice of the nursing home licensees intent to replace the nursing home beds shall…

(1) The department shall use the following rules, in addition to those under WAC 246-310-380 to interpret the certificate of need review criteria contained in WAC 246-310-210, 246-310-220, 246-310-230, and 246-310-240 for applications by hospitals proposing an increase in the num…

(1) Undertakings requiring a certificate of need.A certificate of need shall be required for any undertaking which, in accordance with WAC 246-310-020, is subject to the provisions of chapter 246-310 WAC, unless an exemption has been granted for such undertaking under the provisi…

(1) For the purposes of this section, "correction of deficiencies" shall mean one or more of the following:(a) Eliminating or preventing imminent safety hazards as defined by federal, state, or local fire, building, or life safety codes or regulations; or(b) Complying with state …

(1) Written findings.(a) The findings of the department's review of a certificate of need application shall be stated in writing and include the basis for the decision of the secretary's designee as to whether a certificate of need is to be issued or denied for the proposed proje…

(1) The secretary's designee shall issue a certificate of need to the applicant.(a) The secretary's designee shall issue a certificate of need for:(i) The proposed project, or(ii) A separable portion of the proposed project.(b) When the certificate of need is issued for a separab…

(1) Any interested or affected person may, for good cause shown, request a public hearing for the purpose of reconsideration of the decision of the secretary's designee on a certificate of need application or withdrawal of a certificate of need.1(2) The department shall conduct a…

(1) An amended certificate of need shall be required for any of the following modifications of a project for which a certificate of need was issued and has been submitted in accordance with subsection (2) of this section:(a) An addition of a new service;(b) An expansion of a serv…

(1) A certificate of need shall be valid for two years: Provided, That one six-month extension may be made if the certificate holder can demonstrate that substantial and continuing progress toward commencement of the project has been made.(2) In the case of a project involving co…

(1) The department shall monitor the costs and components of approved projects to assure conformance with certificates of need that have been issued.(2) The department shall require periodic progress reports from those applicants to whom certificates of need have been issued.(a) …

(1) The secretary's designee may withdraw a certificate of need if the department determines that the holder of a certificate is not meeting the timetable specified in the certificate of need application for completing the project and is not making a good-faith effort to meet suc…

(1) An applicant denied a certificate of need or a certificate holder whose certificate was suspended or revoked has the right to an adjudicative proceeding.(2) A certificate applicant or holder contesting a department certificate decision shall within twenty-eight days of receip…

Purpose and applicability. To be granted a certificate of need, an adult elective PCI program must meet the requirements and standards in this chapter and applicable review criteria in WAC 246-310-210, 246-310-220, 246-310-230, and 246-310-240.[Statutory Authority: RCW 43.70.040,…

The definitions in this section apply throughout WAC 246-310-700 through 246-310-760 and chapter 70.38 RCW, unless the context clearly indicates otherwise:(1) "Adult" means persons 18 years of age and older.(2) "Affiliate PCI hospital" means a CN-approved PCI hospital that is own…

(1) An applicant for a certificate of need for an adult elective PCI program shall:(a) Submit a detailed analysis of the projected volume of adult elective PCIs that it anticipates it will perform in years one, two, and three after it begins operations. An elective PCI program mu…

(1) Hospitals approved to operate an elective PCI program shall:(a) Perform a minimum of 200 adult PCIs per year by the end of the third year of operation and each year thereafter; and(b) Have physicians performing a minimum of 50 adult elective PCIs per year.(2) An applicant hos…

The applicant hospital must have, and maintain, a signed written agreement with a hospital providing on-site cardiac surgery. This agreement must include, at minimum, these provisions:(1) The nonsurgical hospital shall coordinate with the backup surgical hospital about the availa…

(1) The applicant hospital must submit a written quality assurance/quality improvement plan specific to the elective PCI program as part of its application.(2) All certificate of need approved PCI programs must submit PCI statistics, adhering to COAP PCI data submittal timelines.…

(1) The following definitions apply throughout this section unless the context clearly requires otherwise:(a) "Base year" means the most recent full calendar year from the cardiac care outcomes assessment program (COAP) data from the foundation for health care quality reports or …

If two or more applicant hospitals are competing to meet the same forecasted net need, the department shall consider which hospital's location provides the most improvement in geographic access. Geographic access means the facility that is located the farthest in statue miles fro…

If the department issues a certificate of need for adult elective PCI, it will be conditioned to require ongoing compliance with the certificate of need standards. A hospital granted a certificate of need must meet the program procedure volume standards within three years from th…

The department may grant a certificate of need for a new adult elective PCI program in a planning area where the forecasting methodology does not identify numeric need. The department may also grant, at its sole discretion, a certificate of need in a concurrent or comparative rev…

The definitions in this section apply to WAC 246-310-800 through 246-310-833, unless the context clearly indicates otherwise:(1) "Affiliate" or "affiliated" means:(a) Having at least a 10 percent but less than 100 percent ownership in a kidney disease treatment center;(b) Having …

(1) By February 15th or the first working day thereafter of each year, each provider will electronically submit the following data elements for each of its kidney disease treatment centers in the state of Washington and each out-of-state kidney disease treatment center that might…

The department will review kidney disease treatment center applications using the concurrent review cycles described in this section, unless the application was submitted as described in subsection (9) of this section. There are four concurrent review cycles each year.(1) Applica…

(1) The department will identify each certificate of need approved kidney dialysis facility and the total number of certificate of need approved stations as of the effective date of these rules.(2) The department will make a one-time administrative station adjustment to each kidn…

A kidney disease treatment center that provides hemodialysis or peritoneal dialysis, training, or backup must meet the following standards in addition to applicable review criteria in WAC 246-310-210, 246-310-220, 246-310-230, and 246-310-240.(1) Applications for new stations may…

(1) The kidney disease treatment center must demonstrate positive net income by the third full year of operation.(a) The calculation of net income is a subtraction of all operating and nonoperating expenses, including appropriate allocated and overhead expenses, amortization and …

(1) The department will approve one or two additional special circumstance stations for an existing kidney disease treatment center (center) if it meets the following criteria, regardless of whether the need methodology in WAC 246-310-812 projects a need for additional stations i…

(1) Columbia, Ferry, Garfield, Klickitat, Lincoln, Pend Oreille, San Juan, Skamania, Stevens, Wahkiakum, and Whitman counties do not have an existing kidney disease treatment center as of the effective date of these rules. The department will award the first project proposing to …

The department will not approve new stations in a planning area if the projections in WAC 246-310-812(4) show no net need, and will not approve more than the number of stations projected as needed unless:(1) The proposed project qualifies under WAC 246-310-818 for special circums…

The department may grant a kidney disease treatment center an exemption to exceed its authorized number of dialysis stations during a temporary emergency situation.(1) In addition to the temporary emergency situations identified in RCW 70.38.280(2), the following are defined as t…

For purposes of determining which of the competing applications should be approved, the criteria in this section will be used as the only means for comparing two or more applications to each other. No other criteria or measures will be used in comparing two or more applications t…

(1) When an existing kidney disease treatment center proposes to relocate any of its stations to another planning area, a new health care facility is considered to be established under WAC 246-310-020 (1)(a).(2) When an existing kidney disease treatment center proposes to relocat…

(1) When an existing owner-operator of a Washington state kidney disease treatment center is also the owner-operator of a kidney disease treatment center in a contiguous Idaho or Oregon county, the department will not consider a center that combines the Washington center and the …

These rules and regulations are adopted pursuant to RCW 70.38.025 (6) and (12) for the purpose of establishing the index to be used and procedures for making adjustments to the "expenditure minimum" for capital expenditures which are subject to the requirements of the certificate…

(1) An application for a certificate of need under chapter 246-310 WAC must include payment of a fee consisting of the following:(a) A review fee based on the facility/project type;(b) If more than one facility/project type applies to an application, the review fee for each type …

The purpose of this chapter is to implement chapter 332, Laws of 1997, the nonprofit hospital sales review program. The legislature has determined that the state has an interest to assure the continued existence of accessible, affordable health care facilities. To achieve this go…

"Acquisition of a nonprofit hospital" means an acquisition by a person of an interest in a nonprofit hospital, whether by a purchase, merger, lease, gift, joint venture, or otherwise, that results in a change of ownership or control of twenty percent or more of the assets of the …

(1) Acquiring persons may obtain an application from the department. (2) An application is determined to be complete when the acquiring person submits a completed application, the documents required in WAC 246-312-040 and required fee(s).(3) The department may subpoena additional…

The applicant may submit amendments to its application at any time. Timelines will begin again from the application stage of the review process. A processing and review fee is required for each amendment.[Statutory Authority: Chapter 70.45 RCW and RCW 70.44.007. WSR 98-14-056, § …

(1) The acquiring person shall submit as part of the application for approval three copies of the required documents to the Department of Health, Office of Health Systems Development, P.O. Box 47851, Olympia, Washington 98504-7851 and one copy to the Attorney General's Office, An…

(1) Chapter 70.45 RCW states that the department may not approve an application unless, at a minimum, it determines that:(a) The acquisition is permitted under chapter 24.03 RCW, the Washington Nonprofit Corporation Act, and other laws governing nonprofit entities, trusts, or cha…

(1) For good cause, the department of health or the attorney general may request a one-time, thirty-day extension to each timeline.(2) The department, in consultation with the attorney general, will determine if an application is complete within fifteen working days of the receip…

(1) The department will hold at least one public hearing in the county where the hospital being acquired is located. Any person may provide written or oral testimony. The department reserves the right to limit the time each presenter may have to make an oral statement.(2) The dep…

(1) The department's decision must be based on the requirements of chapter 70.45 RCW. Any condition or modification must have a direct and rational relationship to the application under review.(2) The written opinion of the attorney general may not constitute a final decision for…