50-5-301. When certificate of need is required -- definitions. (1) Unless a person has submitted an application for and is the holder of a certificate of need granted by the department, the person may not initiate any of the following:
     (a) the incurring of an obligation by or on behalf of a health care facility for any capital expenditure, other than to acquire an existing health care facility or to replace major medical equipment with equipment performing substantially the same function and in the same manner, that exceeds the expenditure thresholds established in subsection (4). The costs of any studies, surveys, designs, plans, working drawings, specifications, and other activities (including staff effort, consulting, and other services) essential to the acquisition, improvement, expansion, or replacement of any plant or equipment with respect to which an expenditure is made must be included in determining if the expenditure exceeds the expenditure thresholds.
     (b) a change in the bed capacity of a health care facility through an increase in the number of beds or a relocation of beds from one health care facility or site to another, unless:
     (i) the number of beds involved is 10 or less or 10% or less of the licensed beds, if fractional, rounded down to the nearest whole number, whichever figure is smaller, in any 2-year period;
     (ii) a letter of intent is submitted to the department; and
     (iii) the department determines the proposal will not significantly increase the cost of care provided or exceed the bed need projected in the state health plan;
     (c) the addition of a health service that is offered by or on behalf of a health care facility that was not offered by or on behalf of the facility within the 12-month period before the month in which the service would be offered and that will result in additional annual operating and amortization expenses of $150,000 or more;
     (d) the acquisition by any person of major medical equipment, provided the acquisition would have required a certificate of need pursuant to subsection (1)(a) or (1)(c) if it had been made by or on behalf of a health care facility;
     (e) the incurring of an obligation for a capital expenditure by any person or persons to acquire 50% or more of an existing health care facility unless:
     (i) the person submits the letter of intent required by 50-5-302(2); and
     (ii) the department finds that the acquisition will not significantly increase the cost of care provided or increase bed capacity;
     (f) the construction, development, or other establishment of a health care facility that is being replaced or that did not previously exist, by any person, including another type of health care facility;
     (g) the expansion of the geographical service area of a home health agency;
     (h) the use of hospital beds in excess of five to provide services to patients or residents needing only skilled nursing care, intermediate nursing care, or intermediate developmental disability care, as those levels of care are defined in 50-5-101; or
     (i) the provision by a hospital of services for ambulatory surgical care, home health care, long-term care, inpatient mental health care, inpatient chemical dependency treatment, or inpatient rehabilitation.
     (2) For purposes of subsection (1)(b), a change in bed capacity occurs on the date new or relocated beds are licensed pursuant to part 2 of this chapter and the date a final decision is made to grant a certificate of need for new or relocated beds, unless the certificate of need expires pursuant to 50-5-305.
     (3) For purposes of this part, the following definitions apply:
     (a) "Health care facility" or "facility" means a nonfederal ambulatory surgical facility, home health agency, long-term care facility, medical assistance facility, mental health center with inpatient services, inpatient chemical dependency facility, rehabilitation facility with inpatient services, or residential treatment facility. The term does not include:
     (i) a hospital, except to the extent that a hospital is subject to certificate of need requirements pursuant to subsection (1)(i); or
     (ii) an office of a private physician, dentist, or other physical or mental health care professionals, including chemical dependency counselors.
     (b) (i) "Long-term care facility" means an entity that provides skilled nursing care, intermediate nursing care, or intermediate developmental disability care, as defined in 50-5-101, to a total of two or more individuals.
     (ii) The term does not include residential care facilities, as defined in 50-5-101; community homes for persons with developmental disabilities, licensed under 53-20-305; community homes for persons with severe disabilities, licensed under 52-4-203; boarding or foster homes for children, licensed under 41-3-1142; hotels, motels, boardinghouses, roominghouses, or similar accommodations providing for transients, students, or individuals not requiring institutional health care; or juvenile and adult correctional facilities operating under the authority of the department of corrections.
     (c) "Obligation for capital expenditure" does not include the authorization of bond sales or the offering or sale of bonds pursuant to the state long-range building program under Title 17, chapter 5, part 4, and Title 18, chapter 2, part 1.
     (4) Expenditure thresholds for certificate of need review are established as follows:
     (a) For acquisition of equipment and the construction of any building necessary to house the equipment, the expenditure threshold is $750,000.
     (b) For construction of health care facilities, the expenditure threshold is $1,500,000.
     (5) This section may not be construed to require a health care facility to obtain a certificate of need to undertake any activity that would not be subject to a certificate of need if undertaken by a person other than a health care facility.

     History: En. Sec. 170, Ch. 197, L. 1967; amd. Sec. 21, Ch. 366, L. 1969; amd. Sec. 2, Ch. 447, L. 1975; R.C.M. 1947, 69-5212(1); amd. Sec. 3, Ch. 37, L. 1979; amd. Sec. 12, Ch. 347, L. 1979; amd. Sec. 2, Ch. 329, L. 1983; amd. Sec. 2, Ch. 140, L. 1985; amd. Sec. 3, Ch. 450, L. 1987; amd. Sec. 2, Ch. 477, L. 1987; amd. Sec. 14, Ch. 330, L. 1989; amd. Sec. 1, Ch. 377, L. 1989; amd. Sec. 1, Ch. 244, L. 1991; amd. Sec. 1, Ch. 262, L. 1991; amd. Sec. 2, Ch. 764, L. 1991; amd. Sec. 4, Ch. 590, L. 1993; amd. Sec. 21, Ch. 255, L. 1995; amd. Sec. 7, Ch. 366, L. 1995; amd. Sec. 3, Ch. 398, L. 1995; amd. Sec. 257, Ch. 546, L. 1995.