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SECOND REGULAR SESSION
SENATE BILL NO. 1143
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR SCHNELTING.
5192S.01I KRISTINA MARTIN, Secretary
AN ACT
To repeal section 197.315, RSMo, and to enact in lieu thereof one new section relating to
certificates of need for long-term care facilities.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Section 197.315, RSMo, is repealed and one new 1
section enacted in lieu thereof, to be known as section 197.315, 2
to read as follows:3
197.315. 1. Any person who proposes to develop or 1
offer a new institutional health service within the state 2
must obtain a certificate of need from the committee prior 3
to the time such services are offered. 4
2. Only those new institutional health services which 5
are found by the committee to be needed shall be granted a 6
certificate of need. Only those new institutional health 7
services which are granted certificates of need shall be 8
offered or developed within the state. No expenditures for 9
new institutional health services in excess of the 10
applicable expenditure minimum shall be made by any person 11
unless a certificate of need has been granted. 12
3. After October 1, 1980, no state agency charged by 13
statute to license or certify health care facilities shall 14
issue a license to or certify any such facility, or distinct 15
part of such facility, that is developed without obtaining a 16
certificate of need. 17
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4. If any person proposes to develop any new 18
institutional health care service without a certificate of 19
need as required by sections 197.300 to 197.366, the 20
committee shall notify the attorney general, and he shall 21
apply for an injunction or other appropriate legal action in 22
any court of this state against that person. 23
5. After October 1, 1980, no agency of state 24
government may appropriate or grant funds to or make payment 25
of any funds to any person or health care facility which has 26
not first obtained every certificate of need required 27
pursuant to sections 197.300 to 197.366. 28
6. A certificate of need shall be issued only for the 29
premises and persons named in the application and is not 30
transferable except by consent of the committee. 31
7. Project cost increases, due to changes in the 32
project application as approved or due to project change 33
orders, exceeding the initial estimate by more than ten 34
percent shall not be incurred without consent of the 35
committee. 36
8. Periodic reports to the committee shall be required 37
of any applicant who has been granted a certificate of need 38
until the project has been completed. The committee may 39
order the forfeiture of the certificate of need upon failure 40
of the applicant to file any such report. 41
9. A certificate of need shall be subject to 42
forfeiture for failure to incur a capital expenditure on any 43
approved project within six months after the date of the 44
order. The applicant may request an extension from the 45
committee of not more than six additional months based upon 46
substantial expenditure made. 47
10. Each application for a certificate of need must be 48
accompanied by an application fee. The time of filing 49
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commences with the receipt of the application and the 50
application fee. The application fee is one thousand 51
dollars, or one-tenth of one percent of the total cost of 52
the proposed project, whichever is greater. All application 53
fees shall be deposited in the state treasury. Because of 54
the loss of federal funds, the general assembly will 55
appropriate funds to the Missouri health facilities review 56
committee. 57
11. In determining whether a certificate of need 58
should be granted, no consideration shall be given to the 59
facilities or equipment of any other health care facility 60
located more than a fifteen-mile radius from the applying 61
facility. 62
12. When a nursing facility shifts from a skilled to 63
an intermediate level of nursing care, it may return to the 64
higher level of care if it meets the licensure requirements, 65
without obtaining a certificate of need. 66
13. In no event shall a certificate of need be denied 67
because the applicant refuses to provide abortion services 68
or information. 69
14. A certificate of need shall not be required for 70
the transfer of ownership of an existing and operational 71
health facility in its entirety, except for any assisted 72
living facility, intermediate care facility, residential 73
care facility, or skilled nursing facility, as such terms 74
are defined in section 198.006. 75
15. A certificate of need may be granted to a facility 76
for an expansion, an addition of services, a new 77
institutional service, or for a new hospital facility which 78
provides for something less than that which was sought in 79
the application. 80
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16. The provisions of this section shall not apply to 81
facilities operated by the state, and appropriation of funds 82
to such facilities by the general assembly shall be deemed 83
in compliance with this section, and such facilities shall 84
be deemed to have received an appropriate certificate of 85
need without payment of any fee or charge. The provisions 86
of this subsection shall not apply to hospitals operated by 87
the state and licensed under this chapter, except for 88
department of mental health state-operated psychiatric 89
hospitals. 90
17. Notwithstanding other provisions of this section, 91
a certificate of need may be issued after July 1, 1983, for 92
an intermediate care facility operated exclusively for the 93
intellectually disabled. 94
18. To assure the safe, appropriate, and cost- 95
effective transfer of new medical technology throughout the 96
state, a certificate of need shall not be required for the 97
purchase and operation of: 98
(1) Research equipment that is to be used in a 99
clinical trial that has received written approval from a 100
duly constituted institutional review board of an accredited 101
school of medicine or osteopathy located in Missouri to 102
establish its safety and efficacy and does not increase the 103
bed complement of the institution in which the equipment is 104
to be located. After the clinical trial has been completed, 105
a certificate of need must be obtained for continued use in 106
such facility; or 107
(2) Equipment that is to be used by an academic health 108
center operated by the state in furtherance of its research 109
or teaching missions. 110
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