Types of Reviews and Major Elements

I.) Article 28 Providers

Full Review

Proposals requiring a full review, including a recommendation of the State Hospital Review and Planning Council and/or the Public Health Council, are those that relate to:

  • 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 $10M;
  • Purchases of major medical equipment with a cost in excess of $10M ;
  • Changes in ownership, mergers, consolidations, creation of an active parent;
  • Establishment of new facilities or programs.

Depending on the nature of the proposal, the application may be reviewed by the either or both councils:

The State Hospital Review and Planning Council (SHRPC)

Reviews all proposals related to construction or renovation with a total cost of over $10M and all proposals related to changes in ownership or establishment of new facilities. Exceptions to this rule are explained in 10 NYCRR Section 710.1(c)(3). The SHRPC makes recommendations to the Public Health Council or the Commissioner of Health (depending on the type of application). It does not have final decision-making authority.

The Public Health Council

(PHC) reviews all proposals related to changes in ownership and/or the establishment of new facilities. It also reviews applications that involve both a change in ownership or establishment and construction or renovation. Unlike the SHRPC, the PHC has final decision-making authority.

Search NYCRR Title 10, Section 710.1(c)(2)

Administrative Review

Proposals that have total project costs of up to $10M, or do not exceed $25M or 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 State Hospital Review and 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 .

Search 10 NYCRR Section 710.1(c)(3)

Limited Architectural Review

Minor construction projects with a total project costs of under $3M are eligible for a limited architectural review and do not require a recommendation from the State Hospital Review and Planning Council. These projects relate to the acquisition, relocation, installation or modification of certain medical equipment and inpatient and clinical areas.

Search NYCRR Title 10, Section 710.1(c)(5)

Prior Review

Proposals eligible for a prior review do not require a recommendation from the State Hospital Review and Planning Council. These are proposals requesting to:

  • decertify a facility's beds and/or services;
  • add services which involve a total project cost under $3M;
  • convert beds within approved categories;
  • change services offered by, or relocate, a part-time clinic site;
  • engage in a construction project, with a total project cost of up to $10M, that is not related to a change in clinical service or equipment, including renovation of non-clinical areas such as administrative offices, renovation of exterior building envelope, and construction of parking garages;
  • purchase and implement health information technology or other information systems with a total project cost of up to $10M.

Search NYCRR Title 10, Section 710.1(c)(6)

II.) Article 36 Providers (Home Care)

Full Review

Establishment Applications

Proposals requiring a recommendation of the State Hospital Review and Planning Council, and a decision by the Public Health Council, are those that relate to:

  • Establishment of a new certified home health agency (CHHA);
  • Transfer of ownership of a CHHA, 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 only the State Hospital Review and Planning Council, 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 either council, 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.

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III.) Article 40 Providers (Hospice)

Full Review

Establishment Applications

Proposals requiring a recommendation of the State Hospital Review and Planning Council, and a decision by the Public Health Council, 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 only the State Hospital Review and Planning Council, 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.

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Administrative Review

Proposals requiring an administrative review, without recommendation of either council, 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 Project Review Committee of the Statewide Hospital Review and Planning Council, and /or the Establishment Committee of the Public Health Council.