900 KAR 6:055. Certificate of need forms

      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(6).

 

      Section 2. Forms. (1) OHP - Form 1, Letter of Intent, shall be filed by an applicant for a certificate of need pursuant to the requirements established in 900 KAR 6:065.

      (2) OHP - Form 2A, Certificate of Need Application, shall be filed by an applicant for a certificate of need unless the application is for ground ambulance services, change of location, replacement, cost escalation, or acquisition.

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

      (4) OHP - Form 2C, Certificate of Need Application For Change of Location, Replacement, Cost Escalation, or Acquisition, shall be filed by an applicant 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 a person who wishes to appear at a hearing.

      (6) OHP - Form 4, Witness List, shall be filed by a person who elects to call a witness at a hearing.

      (7) OHP - Form 5, Exhibit List, shall be filed by a person who elects to introduce evidence at a hearing.

      (8) OHP - Form 6, Cost Escalation Form, shall be filed by a facility that elects 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 that 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 that 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", 07/2015;

      (c) "OHP - Form 2B, Certificate of Need Application For Ground Ambulance Service", 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", 10/2015;

      (f) "OHP - Form 4, Witness List", 10/2015;

      (g) "OHP - Form 5, Exhibit List", 10/2015;

      (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", 07/2015;

      (k) "OHP - Form 9, Notice of Intent to Acquire a Health Facility or Health Service", 07/2015;

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

      (m) "OHP - Form 10B, Notice of Termination or Reduction of a Health Service or Reduction of Bed Capacity", 07/2015; 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 4WE, Frankfort, Kentucky 40621, Monday through Friday, 8 a.m. to 4:30 p.m. (36 Ky.R. 230; Am. 803; eff. 10-21-2009; 42 Ky.R. 542; 1574; 1781; eff. 12-16-2015.)

Notation

      RELATES TO: KRS 216B.015

      STATUTORY AUTHORITY: KRS 216B.040(2)(a)1

      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.