Part 791 - Approval of Hospice Construction

Effective Date: 
Thursday, March 22, 1984
Doc Status: 
Complete
Statutory Authority: 
Public Health Law, Section 4010

Section 791.1 - Definitions

Section 791.1 Definitions. (a) For purposes of this Part, construction shall mean a change in a hospice's geographic service area, the erection, building or substantial acquisition or alteration of a hospice inpatient facility or unit, hospice residence or equipment, or a substantial change in the method of providing hospice inpatient or hospice residence services.

(b) For purposes of this Part, total project cost shall mean total costs for construction contracts, if any, including, but not limited to costs for demolition work, site preparation, actual construction and contingencies, total costs for real property, for fixed and movable equipment, architectural and/or engineering fees, construction loan interest costs, and other financing, professional and ancillary fees, charges and allowances. Such costs shall include the cost of all capital items associated with an acquisition, lease arrangement and/or construction. If any acquisition is to be effectuated through a leasing arrangement or by a donation, the relevant cost shall be the cost of the asset if purchased.

Effective Date: 
Wednesday, July 17, 2002
Doc Status: 
Complete

Section 791.2 - General provisions

791.2 General provisions. (a) Hospice construction shall require the prior approval of the commissioner, except that the following shall not constitute construction for purposes of this Part and Article 40 of the Public Health Law and shall not require the submission of an application for approval:

(1) the repair, maintenance, alteration or acquisition of equipment when total project cost does not exceed $500,000;

(2) the relocation of an administrative office site, or repair, maintenance, alteration, acquisition, erection or building of an administrataive office site when total project cost does not exceed $500,000, provided that the governing authority of the hospice shall notify the department of any proposed change in an administrative office site location, which does not require construction approval under this Part, at least 10 days prior to effecting such change; and

(3) the repair, maintenance or alteration of a facility or unit used for hospice inpatient or hospice residence care and services when total project cost does not exceed $250,000, except that proposals for the alteration of systems for facility water supply, fixed dietary, solid waste disposal or fire protection, and structural, mechanical and electrical changes affecting safety and/or sanitary conditions shall require approval.

(b) Any of the following proposals shall constitute construction and shall be the subject of an application submitted for review pursuant to the requirements of this Part and Article 40 of the Public Health Law;

(1) the addition of any Article 40 certified hospice inpatient or hospice residence beds, regardless of cost;

(2) a change in the method of, or arrangement for, providing hospice inpatient or hospice residence care and services, regardless of cost;

(3) a change in the hospice's geographic service area;

(4) the repair, maintenance, alteration or acquisition of equipment when the total project cost exceeds $500,000;

(5) the relocation of any administrative office site or the repair, maintenance, alteration, acquisition, erection or building of an administrative office site when the total project cost exceeds $500,000;

(6) the repair, maintenance or alteration of a facility or unit used for hospice inpatient or hospice residence care and services when the total project cost exceeds $250,000, except that proposals for the alteration of systems for facility water supply, fixed dietary, solid waste disposal or fire protection, and structural, mechanical and electrical changes affecting safety and/or sanitary conditions shall require approval regardless of project cost;

(7) the acquisition, erection or building of a facility or portion thereof used for hospice inpatient or hospice residence care and services, regardless of cost; or (8) the approval of any dually certified hospice residence beds, regardless of cost.
(c) An application may be administratively approved by the commissioner on notice to, but without recommendation of, the State Hospital Review and Planning Council if the health systems agency having jurisdiction has recommended approval and if the application proposes:

(1) a change in the hospice's geographic service area;

(2) the repair, maintenance, alteration or acquisition of equipment when total project cost exceeds $500,000, but does not exceed $1,000,000;

(3) the relocation of an administrative office site or the repair, maintenance, alteration, acquisition, erection or building of an administrative office site when total project cost exceeds $500,000, but does not exceed $1,000,000;

(4) the repair, maintenance or alteration of a facility or unit used for hospice inpatient or hospice residence care and services when total project cost exceeds $250,000, but does not exceed $1,000,000; or

(5) the acquisition, erection or building of a facility or portion thereof used for hospice inpatient or hospice residence care and services when total project cost does not exceed $250,000.

(d) A full review of an application pursuant to the requirements of this Part and Article 40 of the Public Health Law, including a review by the State Hospital Review and Planning Council, shall be required prior to a decision by the commissioner when the application proposes:

(1) a change in the method of or arrangement for providing hospice inpatient or hospice residence care and services;

(2) the addition of any Article 40 certified hospice inpatient or hospice residence beds;

(3) the repair, maintenance, alteration or acquisition of equipment when total project cost exceeds $1,000,000;

(4) the relocation of an administrative office site or the repair, maintenance, alteration, erection or building of an administrative office site when total project cost exceeds $1,000,000;

(5) the repair, maintenance or alteration of a facility or unit used for hospice inpatient or hospice residence care and services when total project cost exceeds $1,000,000; or
(6) the acquisition, erection or building of a facility or portion thereof used for hospice inpatient or hospice residence care and services when total project cost exceeds $250,000; or (7) the approval of any dually certified hospice residence beds, regardless of cost. (e) If a general hospital, residential health care facility or certified home health agency, as defined in Articles 28 and 36, respectively, of the Public Health Law, with which a hospice has or proposes to have an arrangement for the provision of hospice inpatient beds, hospice residence beds or services, or hospice home care services, proposes to undertake any activity which requires construction approval under Article 28 or 36, such approval must be obtained.

Effective Date: 
Wednesday, June 6, 2007
Doc Status: 
Complete

Section 791.3 - Application

791.3 Application.

(a) (1) The applicant shall submit the the department an original and seven copies of the application for construction, in a format determined by the department.

(2) As part of the application, the applicant shall give the following assurances as appropriate:

(i) that the applicant will obtain the approval of the commissioner of all required plan submissions for any hospice inpatient facility or unit, or hospice residence, which shall conform to the applicable standards of construction and equipment of this Subchapter;

(ii) that, prior to contracting for construction, the applicant will obtain the approval of the commissioner of the final working drawings and specifications for any hospice inpatient facility or unit, or hospice residence, which shall conform to the applicable standards of construction and equipment of this Subchapter;

(iii) that the applicant will cause the project to be completed in accordance with the application and approved plans and specifications;

(iv) that the applicant will provide and maintain competent and adequate architectural or engineering supervision and inspection at the construction site to insure that the completed work conforms with the approved plans and specifications;

(v) that all hospice services will be provided, and the hospice inpatient facility or unit, or hospice residence, will be operated and maintained, in accordance with the standards prescribed by law; and

(vi) that the applicant will adequately equip and staff the hospice inpatient facility or unit, or hospice residence, and all hospice programs of service to assure their proper operation.

(b) All applications shall contain the following information and documentation:

(1) a narrative description of the proposed construction, including the following information when relevant to the proposal:

(i) the location and type of construction;

(ii) a description of the proposed program of services;

(iii) a description of the inpatient facility and identification of bed capacity;

(iv) an outline of the hospice's long-range plans;

(v) the need for the proposed project, including its relative priority when compared with other needed equipment, facilities, services or programs of the operator;

(vi) the proposed plan for the organization and operation of the hospice;

(vii) the number and types of personnel to be employed;

(viii) any special or unusual services, programs or equipment to be provided, including a description of educational involvements; and

(ix) a demonstration that the proposed project is feasible and adequate in terms of both short-range and long-range goals;

(2) an analysis demonstrating the need for the proposed construction;

(3) an analysis of equipment, facilities or services which may currently serve as alternatives or substitutes for the whole or any part of the proposed construction;

(4) an outline of the proposed financing of the construction and an analysis demonstrating the financial feasibility of the project including all costs and expenses and sources of revenue, and a line item operating budget; and

(5) such other information and documentation as the commissioner, State Hospital Review and Planning Council or the health systems agency may require.

(c) When the governing authority of a hospice proposes to repair, maintain, alter, acquire, erect or build a physical structure or part thereof to be used for the direct provision of hospice inpatient or hospice residence care and services, the applicant shall also submit five copies of the following information and documentation in a format determined by the department:

(1) an architectural program for the project, including, where applicable:

(i) a list in outline form of the rooms, allocated spaces and service areas;

(ii) a description of the interrelationships that each service area has to another;

(iii) the size of the facility, indicating the total number of beds proposed, the type of rooms, the number of each, and the patient capacity of the facility upon completion of construction;

(iv) a general outline of the type of construction proposed;

(v) a description of proposed alterations or additions to existing structures;

(vi) a statement of the period of time estimated to be required for completion of construction after issuance by the commissioner of approval of the application;

(vii) a general outline description of the energy sources, and the type and location of engineering systems which will be used for heating, cooling, ventilation and electrical distribution;

(viii) a general description of the proposed method of transport of clean and soiled materials and wastes;

(ix) a general outline description of the intended dietary service;

(x) a general description of methods for water supply and sewerage; (xi) cost estimates; and

(xii) such other information as the commissioner may require;

(2) acceptable concept sketches, consisting of single line free hand sketches of each floor in an appropriate scale, showing the relationship of the various services to each other. The major exit corridors and exit stair locations and circulation shall be indicated, along with existing buildings if additions or alterations are part of the project.

(d) An applicant may be given 30 days in which to supply additional information or correct any deficiencies relating to the application, unless such time period is extended by the department. The failure to supply the information requested or correct the deficiencies in the time specified shall constitute an abandonment of the application by the applicant and result in the withdrawal of the application.

Effective Date: 
Wednesday, July 17, 2002
Doc Status: 
Complete

Section 791.4 - Determination by the commissioner

791.4 Determination by the commissioner. After receipt and review of the application and after the State Hospital Review and Planning Council and local health systems agency have had an opportunity to submit their recommendations, as required, the commissioner shall make his determination. If the application is approved, the applicant shall be notified that he is to proceed to implement the project in accordance with the application, the assurances given, the approval granted and the requirements of this Chapter.
 

Doc Status: 
Complete

Section 791.5 - Implementation of an approved application

791.5 Implementation of an approved application. Upon receipt of approval for construction, the governing authority of the hospice shall:

(a) Implement an approved construction application for the addition of any Article 40 certified hospice inpatient or hospice residence beds or a change in the method of, or arrangement for, providing hospice inpatient or hospice residence care and services if no physical construction is required; a change in the hospice's geographic service area; the repair, maintenance, alteration or acquisition of equipment; or the repair, maintenance, alteration, acquisition, erection or building of an administrative office facility that does not provide hospice inpatient or hospice residence care and services within 90 days of receipt of the commissioner's approval of the application, unless such time period is extended by the commissioner. Upon request of the applicant, the commissioner may grant an initial extension not to exceed 60 days and, upon another request of the applicant, the commissioner may grant a final extension not to exceed 30 days. Any request for an extension shall be in writing and shall set forth the reasons why the application could not be implemented within the prescribed time.

(b) Proceed with architectural plans and actual construction to implement an approved construction application for the repair, maintenance, alteration, acquisition, erection or building of a hospice inpatient facility or unit, or hospice residence, or part thereof in accordance with the following:

(1) The applicant shall submit to the department two sets of the design development plans containing the following:

(i) plans of each floor, showing the room arrangement with the designation of each room and area;

(ii) such sections as are applicable to show the structural system;

(iii) site plan indicating proposed and existing roads, service and entrance courts, boundaries of the property, parking and orientation of the buildings and all outside utilities;

(iv) an outline specification, including a general description of construction;

(v) design of heating, cooling, ventilation and electrical systems;

(vi) design of sewage disposal system and all potential air pollution sources;

(vii) design of food service area;

(viii) design of water supply system;

(ix) cost estimates; and

(x) such other information as the commissioner may require.

(2) The applicant shall submit to the department two sets of the final drawings and specifications, including cost estimates.

(3) All drawings and specifications shall bear the seal and signature of an architect or engineer licensed to practice in New York State.

(4) The applicant shall not contract for construction until he has been notified in writing of the approval of final drawings, specifications and cost estimates.

(5) All construction in or of a hospice inpatient facility or unit, or hospice residence, shall be under the supervision of an architect or engineer licensed to practice in New York State.

(6) Upon approval of design development plans and upon the applicant's request and adequate justification, the commissioner may consider giving permission to start early construction of specifically identified phases, such as demolition, excavation, foundations and/or the structural shell. Such construction shall be at the applicant's risk and contingent upon submission of approvable final plans and specifications within a time period specified in the applicant's request. In no case shall phases of construction, other than those specifically identified in the commissioner's approval, start before approval of final plans and specifications.

(7) Prior written approval of any changes relating to the project, the project costs or major items of equipment proposed during construction must be obtained from the commissioner.

(8) Upon completion of the project, an on-site inspection of the construction and equipment will be made to assure that such are in accordance with the prior approval of the commissioner. The applicant shall notify the area administrator requesting such inspection two months prior to the anticipated completion date.

Effective Date: 
Wednesday, July 17, 2002
Doc Status: 
Complete

Section 791.6 - Abandonment of an application and the expiration, withdrawal and annulment of prior approvals

791.6 Abandonment of an application and the expiration, withdrawal and annulment of prior approvals. (a) The failure, neglect or refusal of an applicant to implement in a timely manner an approved application for construction that must be implemented within the time limits set forth in section 791.5(a) of this Part or, with respect to such application, to comply with the provisions of paragraph (1), (7), (8) or (9) of subdivision (b) of this section shall constitute an abandonment of the application by the applicant and result in the expiration, withdrawal and annulment of the commissioner's approval.

(b) The failure, neglect or refusal of an applicant who has received approval for the repair, maintenance, alteration, acquisition, erection or building of a hospice inpatient facility or unit, or hospice residence, or part thereof to conform to the following requirements within the prescribed times, unless otherwise authorized in writing by the commissioner, shall constitute an abandonment of the application by the applicant and result in the expiration, withdrawal and annulment of the commissioner's approval:

(1) amending the application to supply or correct any and all deficiencies in any of the matters required to be set forth therein and to file same within 3O days after issuance of notice of such deficiencies;

(2) obtaining and having such estate or interest in the site, including necessary easements and rights-of-way, sufficient to assure use and possession for the purpose of the construction and operation of the facility;

(3) completing and filing design development drawings and revised project cost estimates within 120 days after approval of the project by the commissioner;

(4) completing and filing final drawings and specifications, including cost estimates within 150 days after issuance of favorable review of design development drawings and revised project cost estimates;

(5) securing approval of final drawings, specifications and cost estimates prior to contracting for construction;

(6) after issuance of the approval of final drawings, specifications and cost estimates:

(i) Initiating construction within 120 days;

(ii) proceeding therewith at a reasonable rate; and

(iii) completing and equipping the project within the completion time specified;

(7) securing approval of any change relating to the project, the project costs, the terms of any permanent financing arrangement or any major item or items of equipment during construction;

(8) applying for a certificate of approval within 30 days after issuance of approval of the completed project when applicable; and

(9) maintaining the assurances given pursuant to section 791.3(a)(2) of this Part.

Effective Date: 
Wednesday, July 17, 2002
Doc Status: 
Complete

Section 791.7 - Nonallowance of costs

791.7 Nonallowance of costs. Costs relating to any proposal, project or application, or any amendment or change thereto, for which approval is required under this Part and for which such approval was not obtained, shall not be considered allowable costs for reimbursement pursuant to any of the Subparts contained within Part 86 of this Title.
 

Doc Status: 
Complete

Section 791.8 - Determination of public need

791.8 Determination of public need. The factors and methodology for determining public need with respect to a hospice construction application shall, as applicable, include, but need not be limited to, the criteria and methodology set forth in section 790.16 of this Title.
 

Doc Status: 
Complete