Types of Reviews and Major Elements
I.) PHL Article 28 Providers (hospitals, nursing homes, and diagnostic and treatment centers)
Full Review
Proposals requiring a full review, including a recommendation or decision of the Public Health and Health Planning Council, are those that involve:
- Addition of beds (regardless of cost) ;
- Conversions to a different level of care (regardless of cost);
- Addition of, or changes in method of delivery of, the following services
- Therapeutic radiology
- Cardiac surgery
- Cardiac catheterization
- Certain transplants
- Burn care
- AIDS centers
- Epilepsy services
- Construction/renovation projects over $15M;
- Purchases of major medical equipment with a cost in excess of $15M ;
- Changes in ownership, mergers, consolidations, creation of an active parent;
- Establishment of new facilities, home care agencies or hospice programs;
- A project eligible for administrative review that receives a recommendation of disapproval by Department staff.
In general any proposal with a cost in excess of $15 million is subject to full review. Exceptions to this rule are explained in 10 NYCRR Section 710.1(c).
The Public Health and Health Planning Council (PHPPC)
The PHHPC reviews all proposals subject to full review. It has final decision-making authority over changes in ownership and over the establishment of new facilities, home care agencies and hospice programs. It makes recommendations to the Commissioner of Health concerning major construction, renovation, major medical equipment acquisition, and the addition of beds and specialized services. Learn more about the Public Health and Health Planning Council.
Search NYCRR Title 10, Section 710.1(c)(2)
Administrative Review
Proposals that have total project costs of up to $15M, or do not exceed $25M ($50M for general hospitals) and 10% of annual operating budget thresholds as defined in 10 NYCRR Section 710.1(c)(3), are eligible for an administrative review and do not require a recommendation from the Public Health and Health Planning Council. Examples of proposals eligible for an administrative review are:
- Change in licensed services other than those requiring full review ;
- Conversion of beds within the same level of care;
- Operation of extension clinics, addition of primary care sites, and addition or deletion of part-time clinic services ;
- Purchases of certain types of equipment;
- Addition of dialysis stations by a facility approved to operate dialysis stations; and
- Certain non-substantive amendments to approved projects.
In addition, projects costing over $15M to purchase and implement health information technology or other information systems, as well as projects with a cost of over $15M which do not related to a change in clinical service or space (i.e., "non-clinical"), are eligible for an administrative review and do not require a recommendation from the State Hospital Review and Planning Council.
Search 10 NYCRR Section 710.1(c)(3)
Limited Review
Proposals eligible for a limited review do not require a recommendation from the Public Health and Health Planning Council. These are proposals with a total project cost up to $6M requesting to:
- Perform minor construction projects (if not relating to clinical space, proposal may cost up to $15M);
- Acquire, relocate, install or modify certain medical equipment;
- Decertify a facility's beds and/or services;
- Add certain services;
- Convert beds within approved categories;
- Add electrophysiology (EP) services to an appropriately certified facility;
- Add, upgrade or replace cardiac catheterization laboratory or equipment by an appropriately certified facility;
- Relocate an extension clinic within the same service area; and
- Change services offered by, or relocate, a part-time clinic site.
Further, most non-clinical projects are subject to limited review. These are projects that do not directly impact clinical space or equipment, are not otherwise subject to administrative processing, and whose cost does not exceed $15M.
Likewise, any proposal to purchase and implement health information technology or other information systems with a total project cost between $6M and $15M is also subject to a limited review. Health IT projects with a cost of up to $6M require no Department of Health review at all.
Search NYCRR Title 10, Section 710.1(c)(5)-(7)
II.) PHL Article 36 Providers (home care agencies)
Full Review
Establishment Applications
Proposals requiring a decision by the Public Health and Health Planning Council (PHHPC) are those that relate to:
- Establishment of a new certified home health agency (CHHA) or licensed home care services agency (LHCSA);
- Transfer of ownership of a CHHA or LHCSA, including mergers, consolidations, and creation, or changes in ownership of, a parent entity.
Search NYCRR Title 10, Part 760
Construction/Service Applications
Proposals requiring a recommendation of the Public Health and Health Planning Council (PHHPC) are those that relate to:
- Initiation of a long term home health care program (LTHHCP).
- Change in the geographic service area of a CHHA or LTHHCP.
- Change in the method of providing a service when costs exceed $400,000.
- Acquisition , construction or renovation of a building when costs exceed $400,000.
- Purchase, repair, maintenance or alteration of equipment when costs exceed $400,000.
- Increase in LTHHCP capacity requiring a competitive review.
Search NYCRR Title 10, Part 762
Administrative Review
Proposals requiring an administrative review, without recommendation of the PHHPC are those that relate to:
- Addition or deletion of a service on a CHHA operating certificate.
- Increase in LTHHCP capacity not requiring a competitive review.
- Construction/renovation projects when costs do not exceed $400,000.
- Purchase of equipment when costs do not exceed $400,000.
- Addition of an AIDS Home Care Program.
Search NYCRR Title 10, Part 762
III.) Article 40 Providers (hospice)
Full Review
Establishment Applications
Proposals requiring a decision by the Public Health and Health Planning Council (PHHPC) are those that relate to:
- Establishment of a new hospice.
- Transfer of ownership of a hospice, including mergers, consolidations, and creation of, or changes in ownership of, a parent entity.
Search NYCRR Title 10, Part 790
Construction/Service Applications
Proposals requiring a recommendation of the PHHPC, are those that relate to:
- Change in geographic service area.
- Change in the method of, or arrangement for, hospice inpatient or residence care and services ;
- Addition of certified hospice inpatient or residence beds;
- Purchase, repair, maintenance or alteration of equipment when costs exceed $1 million;
- Construction, relocation, repair or alteration of an administrative office site when costs exceed $1 million;
- Repair, maintenance or alteration of a hospice inpatient unit or residence when costs exceed $1 million;
- Acquisition or construction of a hospice inpatient unit or residence when costs exceed $250,000;
- Approval of any dually certified hospice residence beds, regardless of cost.
Search NYCRR Title 10, Part 791
Administrative Review
Proposals requiring an administrative review, without recommendation of the PHHPC, are those that relate to:
- Purchase, repair, maintenance or alteration of equipment when costs exceed $500,000, but not $1 million.
- Construction, relocation, repair or alteration of an administrative office site when costs exceed $500,000, but not $1 million.
- Repair, maintenance or alteration of a hospice inpatient unit or residence when costs exceed $250,000, but not $1 million.
- Acquisition or construction of a hospice inpatient unit or residence when costs do not exceed $250,000.
Search NYCRR Title 10, Part 791
IV.) Public Comment
During the review process, the Department of Health accepts written comments on Certificate of Need proposals from interested parties. Further opportunity is given for comment on specific CONs at public meetings of the Establishment and Project Review Committee of the Public Health and Health Planning Council.
