Conning the Competition

Category

Moratoria/Types of CONs

Citation

Hospital Beds

Any change in the existing bed complement of the following hospitals, through addition or conversion of beds or alteration, modernizing or refurbishing of any unit or department in which the beds may be located:

1.Hospitals

2.Psychiatric hospitals.

3.Chemical dependency hospitals.

4.Long-term care hospitals.

Miss. Code §§ 41-7-191(1)(c),

41-7-173(h)

5.Change in ownership of existing hospitals if it results in a change in bed capacity—if no letter of intent is filed.

Miss. Code § 41-7-191(1)(g)

6.Using some beds for the “swing-bed” concept.

15 Miss. Admin. Code Pt. 9, Subpt. 91, R. 2.4.

7.Any capital expenditure (over $5 million for clinical health services, or services involving a change in existing bed complement) by a healthcare facility not covered above.

Miss. Code §§ 41-7-173(c),(k),

41-7-191(1)(j)

Beds Outside Hospitals

1.Moratorium on conversion of hospital beds to skilled or intermediate care beds.

15 Miss. Admin. Code Pt. 9, Subpt. 91, R. 2.2.

Any change in the existing bed complement of the following health facilities, through addition or conversion of beds or alteration, modernizing or refurbishing of any unit or department in which the beds may be located:

1.Skilled nursing facilities,

2.End-stage renal disease facilities,

3.Intermediate care facilities,

4.Ambulatory surgical facilities,

5.Intermediate care facilities for the mentally retarded,

6.Home health agencies,

7.Psychiatric residential treatment facilities,

8.Pediatric skilled nursing facilities and

9.Comprehensive medical rehabilitation facilities (including facilities owned or operated by the state or a political subdivision or instrumentality of the state).

Miss. Code §§ 41-7-191(1)(c),

41-7-173(h)

10.Change in ownership of existing health care facilities if it results in a change in bed capacity.

Miss. Code § 41-7-191(1)(g)

11.Any capital expenditure (over $5 million for clinical health services, or services involving a change in existing bed complement) by a healthcare facility not covered above.

Miss. Code §§ 41-7-173(c), (k),

41-7-191(1)(j)

Category

Moratoria/Types of CONs

Citation

Equipment

1.Relocation of major medical equipment, or equipment that costs more than $1.5 million.

Miss. Code §§ 41-7-191(1)(b),

41-7-173(m)

2.Acquisition or control of major medical equipment, or equipment that costs more than $1.5 million (including acquisitions for less than fair market value if the acquisition at fair market value would be subject to review).

Miss. Code §§ 41-7-191(1)(f),

41-7-173(m)

3.Any capital expenditure ($1.5 million for major medical equipment) by a healthcare facility not covered above.

Miss. Code §§ 41-7-173(c),

41-7-191(1)(j)

Facilities/Buildings

1.Moratorium on opening a hospital that will contain child/adolescent psychiatric or child/adolescent chemical dependency beds.

2.Moratorium on opening a psychiatric hospital that will contain child/adolescent psychiatric or child/adolescent chemical dependency beds.

3.Moratorium on opening a chemical dependency hospital that will contain any child/adolescent psychiatric or child/adolescent chemical dependency beds.

Miss. Code § 41-7-191(4)

4.Moratorium on opening a new skilled nursing facility.

15 Miss. Admin. Code Pt. 9, Subpt. 91, R. 2.2

5.Moratorium on opening a new intermediate care facility.

15 Miss. Admin. Code Pt. 9, Subpt. 91, R. 2.2

6.Moratorium on opening a new intermediate care facility for the mentally retarded.

15 Miss. Admin. Code Pt. 9, Subpt. 91, R. 2.2

Opening the following new facilities:

1.Hospitals.

2.Psychiatric hospitals.

3.Chemical dependency hospitals.

4.Skilled nursing facilities.

5.End-stage renal disease facilities (including freestanding hemodialysis units).

6.Intermediate care facilities.

7.Ambulatory surgical facilities.

8.Intermediate care facilities for the mentally retarded.

9.Psychiatric residential treatment facilities.

10.Pediatric skilled nursing facilities.

11.Long-term care hospitals.

12.Comprehensive medical rehabilitation facilities (including facilities owned or operated by the state or a political subdivision or instrumentality of the state).

Miss. Code §§ 41-7-191(1)(a),

41-7-173(h)

Category

Moratoria/Types of CONs

Citation

Facilities/Buildings

Reopening the following healthcare facilities if they have not been in operation for 60 months or more:

13.Hospital.

14.Psychiatric hospital.

15.Chemical dependency hospitals.

16.Skilled nursing facilities.

17.End-stage renal disease facilities (including freestanding hemodialysis units).

18.Intermediate care facilities.

19.Ambulatory surgical facilities.

20.Intermediate care facilities for the mentally retarded,

21.Home health agencies.

22.Psychiatric residential treatment facilities.

23.Pediatric skilled nursing facilities.

24.Long-term care hospitals.

25.Comprehensive medical rehabilitation facilities (including facilities owned or operated by the state or a political subdivision or instrumentality of the state).

Miss. Code §§ 41-7-191(1)(a),(m), 41-7-173(h)

Relocation, in whole or in part, of the following healthcare facilities:

26.Hospital,

27.Psychiatric hospital,

28.Chemical dependency hospitals,

29.Skilled nursing facilities,

30.End-stage renal disease facilities (including freestanding hemodialysis units),

31.Intermediate care facilities,

32.Ambulatory surgical facilities,

33.Intermediate care facilities for the mentally retarded,

34.Home health agencies,

35.Psychiatric residential treatment facilities,

36.Pediatric skilled nursing facilities,

37.Long-term hospitals, and

38.Comprehensive medical rehabilitation facilities (including facilities owned or operated by the state or a political subdivision or instrumentality of the state).

Miss. Code §§ 41-7-191(1)(b),

41-7-173(h)

39.Change in ownership of existing healthcare facilities if a notice of intent has not been filed at least 30 days prior with the State Health Department.

Miss. Code § 41-7-191(1)(g)

40.Change in ownership of healthcare facility if a notice of intent has not been filed, and the Executive Director of the Division of Medicaid in the Office of the Governor has not certified that the change in ownership will not increase allowable costs to Medicaid.

Miss. Code §§ 41-7-191(1)(h), 41-7-173(h)(iv),(vi),(viii)

Category

Moratoria/Types of CONs

Citation

41.The contracting of a healthcare facility to establish a home office, sub-unit or branch office in the space operated as a health care facility through a formal arrangement with an existing healthcare facility.

Miss. Code § 41-7-191(1)(k)

Services

The following health services, if those services have not been provided on a regular basis by the provider within the previous year:

1.Open-heart surgery services,

2.Cardiac catheterization services,

3.Comprehensive inpatient rehabilitation services,

4.Licensed psychiatric services,

5.Licensed chemical dependency services,

6.Radiation therapy services,

7.Diagnostic imaging services of an invasive nature (i.e., invasive digital angiography),

8.Nursing home care at skilled nursing facilities, intermediate care facilities and intermediate care facilities for the mentally retarded.

9.Home health services,

10.Swing-bed services,

11.Ambulatory surgical services,

12.Magnetic resonance imaging services,

13.Long-term care hospital services, and

14.Positron emission tomography (PET) services

Miss. Code §§ 41-7-191(1)(d),

41-7-173(h)

15.Relocation of one or more health services from one physical facility or site to another physical facility or site.

Miss. Code § 41-7-191(e)

16.Change in ownership of existing health care facilities if it results in a change of services.

Miss. Code § 41-7-191(1)(g)

17.Any capital expenditure (over $10 million for nonclinical health services, or services not involving a change in existing bed complement) by a healthcare facility not covered above.

Miss. Code §§ 41-7-173(c), (k),

41-7-191(1)(j)

18.Any activity undertaken by a person, if such action would require a CON if undertaken by a health care facility.

Miss. Code § 41-7-191(1)(i)

Emergency Medical Transport

No CONs in this category.

No CON Required For:

Miss. Code

1.Christian Science sanatoriums operated or listed and certified by the First Church of Christ, Scientist, Boston, Massachusetts.

§ 41-7-173(h)

2.Facilities for the private practice, either independently or by incorporated medical groups, of physicians, dentists or health care professionals, except where such facilities are an integral part of a health service provided by a health facility that requires a CON.

§ 41-7-173(h), (l)

3.Relocation of healthcare facilities, in whole or in part, which do not involve a capital expenditure.

§ 41-7-191(1)(b)

4.Relocation of major medical equipment, or equipment that costs more than $1.5 million, which does not involve a capital expenditure.

§§ 41-7-191(1)(b),

41-7-173(m)

5.Relocation of healthcare facilities, in whole or in part, if the relocation is within 5,280 feet (1 mile) from the main entrance of the healthcare facility.

§ 41-7-191(1)(b)

6.Relocation of major medical equipment, or equipment that costs more than $1.5 million, if the relocation is within 5,280 feet (1 mile) from the main entrance of the healthcare facility.

§§ 41-7-191(1)(b),

41-7-173(m)

7.A healthcare facility relicensing some beds that it voluntarily delicensed, as long as relicensure would not increase its bed count.

§ 41-7-191(1)(c)

8.Relocation of healthcare services if it does not involve a capital expenditure and is either (i) to a physical facility or site within 5,280 feet (1 mile) from the main entrance of the healthcare facility where the healthcare service is located, or (ii) the result of a court order or pending litigation, by order of the Department of Health, or by order of any other agency or legal entity of the state, the federal government or any political subdivision of either, whose order is approved by the Department of Health.

§ 41-7-191(1)(e)

9.Acquisition of medical equipment costing less than $1.5 million.

§ 41-7-173(m)

No CON Required For:

Miss. Code

10.Acquisition of major medical equipment (equipment costing more than $1.5 million) used for research purposes.

§§ 41-7-173(m),

41-7-191(1)(f)

11.Acquisition of major medical equipment (equipment costing more than $1.5 million) to replace equipment for which a facility is already providing medical services and for which the State Dept. of Health has been notified.

§§ 41-7-173(m),

41-7-191(1)(f)

12.The replacement or relocation of a critical access hospital as long as it complied with all applicable federal law and regulation regarding the replacement or relocation.

§ 41-7-191(1)(l)

13.The addition or expansion of healthcare facilities owned and/or operated by the state or its agencies do not need a CON if it is to comply with state licensure law. The exception does not apply to new construction of any building or to facilities owned and/or operated by local governments.

§ 41-7-191(10)

14.New construction, renovation, expansion or addition of any psychiatric hospital, skilled nursing facilities, intermediate care facility, intermediate care facilities for the mentally retarded, or psychiatric facility which is owned by the State, and the addition or conversion of beds in any of those healthcare facilities, does not require a CON.

§ 41-7-191(11)

15.New construction, renovation, expansion or addition of any veterans’ homes or domiciliaries for eligible veterans.

§ 41-7-191(12)

16.Repair or rebuilding of existing, operating healthcare facilities that sustained significant damage from a natural disaster, provided that the repair or rebuild is within 1 mile of the pre-disaster location, it does not increase or change the bed complement, it does not increase or change its levels and types of services and it does not rebuild in a different county.

§ 41-7-191(13)(a)-(b)

17.Planning, design, construction, renovation, addition, furnishing and equipping of a clinical research unit at any healthcare facility that is under the direction and control of the University of Mississippi Medical Center.

§ 41-7-191(18)