CHAPTER
He-Hea 1100 CARDIAC SERVICES
PART
He-Hea 1101 DEFINITIONS
He-Hea 1101.01 Definitions.
(a)
“ACCF/SCA&I” means
the American
(b)
“Adult cardiac catheterization laboratory services” means those cardiac
catheterization procedures that are performed
on adults in a cardiac catheterization laboratory and includes, but is
not limited to diagnostic and interventional cardiac catheterization procedures
identified by ICD-9-CM procedure code codes 36.04, 36.06-36.07, 36.09,
37.21, 37.22, and 37.23.
(c) “Adult elective interventional cardiac catheterization” means those catheter-based procedures that involve modification of the coronary arterial system under routine or non-emergency conditions.
(d) “Adult interventional cardiac catheterization services” means those catheter-based procedures that involve modification of the coronary arterial system.
(e) “Adult primary interventional cardiac catheterization” means those catheter-based procedures that involve modification of the coronary arterial system under emergency conditions.
(f) “Adult open heart surgery (OHS)” means cardiac surgery on the heart as identified by ICD-9-CM procedures codes 35.10-35.51, 35.53 35.54, 35.60-35.95, 35.98, 35.99, 36.03, 36.10-36.20, 36.31, 36.39, 36.91, 36.99, 37.10, 37.11, and 37.31-37.33.
(g)
“Board” means “board” as defined in RSA 151-C:2, IV.
(h)
“Board certified” means the confirmation given by a national or regional
association to a physician as having passed special examinations for his/her
medical specialty.
(i)
“Cardiac care unit (CCU)” means a special unit within the hospital,
which provides maximum surveillance and support of vital functions for cardiac
care and recovery.
(j)
“Cardiac catheterization laboratory” means a unit in an acute care
facility that provides adult cardiac catheterization laboratory services.
(k)
“Case” means the instance of disease or injury for which heart surgery
services are required.
(l)
“Certificate of need (CON)” means “certificate of need” as defined in
RSA 151-C:2, VIII.
(m) “Coronary artery bypass graft
surgery (CABG)” means a surgical procedure that includes revascularization to
improve blood supply to the myocardium, where veins or arteries are used to
bypass significant blockage in coronary arteries. It also includes the term
“bypass surgery”.
(n)
“Family centered rehabilitation service” means a program of exercise,
health and dietary education or other cardiac related seminars directed to a
heart surgery patient and his/her family members involved in the patient’s care
following discharge from the hospital.
(o)
“ICD-9-CM” means International Classification of Diseases - 9th Revision
- Clinical Modifications.
(p)
“Marshall Valuation Service (MVS)” means an appraisal guide for the
development and reporting of replacement building and equipment costs used to
determine construction costs of commercial buildings.
(q) “Story height multiplier” means the number by which the base cost of a building is multiplied to adjust for any variation in average story height from the base of 12 feet.
Source. #4326, eff 10-21-87; ss by #4345, eff
12-17-87; ss by #4457, eff 7-25-88; ss by #4923, eff 8-23-90; ss by #5237, eff
9-27-91, EXPIRED: 9-27-97
New. #6931, eff 1-14-99; ss by #8375, eff 6-21-05;
ss by #10448, eff 10-25-13
PART He-Hea
1102 STANDARDS FOR ADULT CARDIAC CATHETERIZATION LABORATORY SERVICES
He-Hea
1102.01 Mandatory Standards.
(a) Adult cardiac catheterization laboratory services shall only be provided at
a licensed acute care facility.
(b)
Licensed acute care facilities providing adult interventional cardiac
catheterization laboratory services shall secure and maintain a formal transfer
agreement with a facility performing adult open heart surgery, in accordance
with He-Hea 1102.02(c)(2).
(c)
Licensed acute care
facilities providing adult primary interventional cardiac catheterization
laboratory services shall make such services available 24 hours per day, 7 days
per week either:
(1) On-site: or
(2) With a formal transfer agreement to:
a. Another licensed acute care facility
providing adult primary interventional cardiac laboratory services; or
b. The facility performing adult open heart
surgery as in (b) above.
(d)
Adult elective interventional cardiac catheterization laboratories shall
also provide adult primary interventional cardiac catheterization laboratory
services on –site 24 hours per day, 7 days per week within 12 months of
commencement of adult elective interventional cardiac catheterization
laboratory services.
(e)
Adult cardiac catheterization laboratories shall subscribe, for the
purposes of an external quality review, to a confidential quality data registry
such as the:
(1) Northern
(2)
Source. #4326, eff 10-21-87; ss by #4923, eff
8-23-90; ss by #5237, eff 9-27-91, EXPIRED: 9-27-97
New. #6931, eff 1-14-99; ss by #8375, eff 6-21-05;
ss by #10448, eff 10-25-13
He-Hea 1102.02 Quality Assurance Requirements.
(a)
Any applicant for adult cardiac catheterization laboratory services
shall demonstrate the availability of a quality assurance plan to objectively
and systematically monitor patient care.
(b)
Demonstration of a quality assurance plan shall be made by submitting
with the application a copy of an existing or proposed plan specific to the
adult cardiac catheterization laboratory services being offered which is
consistent with the hospital-wide quality assurance plan.
(c)
The quality assurance plan shall:
(1) Contain patient selection criteria by
procedures;
(2) Contain formal transfer agreements per He-Hea
1102.01(c) (2), and emergency protocols for transfer to another facility which:
a. Specify the protocol for transfer to another
facility; and
b. Include the following:
(i) Signature of both hospitals; and
(ii) Dated within the past 12 months of submission
with the application;
(3) Describe the mentoring program for licensed
physicians, which shall include operator volume requirements; and
(4) Describe the process of cross-facility case review and outcomes analysis with the receiving facility for patients that have been transferred.
Source. #4326, eff 10-21-87; ss by #4923, eff
8-23-90; ss by #5237, eff 9-27-91, EXPIRED: 9-27-97
New. #6931, eff 1-14-99; ss by #8375, eff 6-21-05;
ss by #10448, eff 10-25-13
He-Hea 1102.03 Staffing Requirements.
(a)
Staffing for adult cardiac catheterization laboratory services shall be
in accordance with Section 6 of the “ACCF/SCA&I Expert Consensus
document on Cardiac Catheterization Laboratory Standards Update” dated 2012, as
referenced in Appendix II of these rules.
(b)
Adult cardiac catheterization laboratory service programs shall be
directed by a board certified cardiologist with training and experience, which
meets or exceeds the requirements of section 6.1.4 of the “ACCF/SCA&I Expert Consensus
document on Cardiac Catheterization Laboratory Standards Update” dated 2012, as
referenced in Appendix II of these rules.
Source. #4326, eff 10-21-87; ss by #4923, eff 8-23-90;
ss by #5237, eff 9-27-91, EXPIRED: 9-27-97
New. #6931, eff 1-14-99; ss by
#8375, eff 6-21-05; ss by #10448, eff 10-25-13
He-Hea 1102.04 Data Reporting Requirement - REPEALED
Source. #4326, eff 10-21-87; ss by #4923, eff
8-23-90; ss by #5237, eff 9-27-91, EXPIRED: 9-27-97
New. #6931, eff 1-14-99; ss by #8375, eff 6-21-05;
rpld by #9823, eff 11-23-10
PART He-Hea
1103 CRITERIA FOR EVALUATING ADULT
CARDIAC CATHETERIZATION SERVICES
He-Hea 1103.01 General Criteria. In addition to the criteria included in RSA
151-C:7 and He-Hea 303.02 through He-Hea 303.09, each applicant shall meet the
following criteria when applying for a CON for adult cardiac catheterization
laboratory services:
(a)
Applicants shall demonstrate that the anticipated proposed construction
cost per square foot shall be comparable within a 10% margin to the 2013 edition of Marshall Valuation Service,
section 15, as referenced in Appendix II of these rules;
(b)
Demonstration of project costs shall be made in the form of a report
included with the application which provides:
(1) A detail of
the costs and space by department or area affected by the proposed project;
(2) A
comparison of these costs which shall be within 10% of the 2013 edition of
Marshall Valuation Service, section 15, as referenced in Appendix II of these
rules, for the proposed class and type of construction; and
(3) An
identification of the square footage for each department or area before and
after the project;
(c) Applicants shall include a report in the
application which provides:
(1) An analysis
of the class and quality of construction pursuant to section one of the 2013
(2) The
allocation of costs within a multiple use building;
(3) The
allocations of site costs and land costs where facilities are proposed to have
multiple uses;
(4) The
methodology used in calculating construction costs for renovations;
(5) The
methodology used in calculating construction costs involving leasehold
improvements; and
(6) The
anticipated useful life of the building for depreciation purposes;
(d) The following construction costs shall be
compared with the 2013 Marshall Valuation Service, section 15, as
referenced in Appendix II of these rules:
(1) Total costs
associated with:
a. Labor;
b. Materials;
and
c. Fixed
equipment;
(2) Building
permits;
(3) Architectural
and engineering fees;
(4) Site
preparation for the building;
(5) Utilities
from structure to lot line;
(6) Insurance
costs during construction; and
(7) Interest
costs during construction;
(e) The applicant shall follow the outline of the
calculator method set forth in section 10 of the 2013 Marshall Valuation
Service, as referenced in Appendix II of these rules, to determine construction
costs;
(f) The costs and factors to take into account pursuant
to (e) above shall include:
(1) The base
cost found in the general hospital table in section 15, page 24 of the 2013
Marshall Valuation Service, as referenced in Appendix II of these rules;
(2) An
adjustment to heating, ventilation and air-conditioning costs for extreme
climate;
(3) Sprinkler
system costs;
(4) Story
height multipliers;
(5) Perimeter
multipliers; and
(6) Cost
multipliers from section 99 of the 2013
(g) Applicants shall describe anticipated
operational cost savings that may occur as a result of the project due to:
(1)
Consolidation of services;
(2) Improved
heating and maintenance costs;
(3)
Environmental design of the constructed or renovated space;
(4) Space for
future expansion; or
(5) Other factors not listed above;
(h)
The expansion, renovation or replacement of the acute care facility
shall be financially feasible;
(i)
In order to assess the current and long-range financial feasibility of
the proposed project, applicants shall demonstrate that resources:
(1) Are
available to fund the proposed capital costs and operating costs;
(2) Will be
available to maintain operations in the event of interruptions to cash flow;
and
(3) Will be
available to ensure the continued operation of the proposed project;
(j) Demonstration of financial feasibility shall
be made by providing with the application:
(1) Copies of
the facility’s 3-year historical and 3-year projected financial statements;
(2) A statement
of the sources of funds to finance the proposed project; and
(3)
Documentation from the applicant’s lender, underwriter or other
anticipated source of capital, which includes:
a. Financed
amount;
b. Rate of
interest; and
c. Term of
debt;
(k) Applicants shall document the assumptions
used to determine the overall financial feasibility of the proposed project;
(l) Documentation of assumptions shall be made in
the form of a report including the following:
(1) The
assumptions used to prepare the projected financial statements; and
(2) Other
assumptions the applicant considers pertinent to the project’s feasibility;
(m) Applicants shall identify the source of any
data or information provided pursuant paragraphs (c) through (l) above;
(n)
Financial resources shall be available to ensure the continued operation
of the proposed project. Documentation
shall include an analysis of the existing market for cardiac catheterization
services and proposed project’s projected market share and utilization; and
(o)
Applicants shall document the existence of market share for new or
expanded diagnostic cardiac catheterization services by providing with the application an
analysis of the existing market for cardiac catheterization services and
projected utilization figures.
Source. #4326, eff 10-21-87; ss by #4923, eff
8-23-90; ss by #5237, eff 9-27-91, EXPIRED: 9-27-97
New. #6931, eff 1-14-99; ss by #8375, eff 6-21-05;
ss by #10448, eff 10-25-13
PART He-Hea 1104
APPLICATION PROCEDURES FOR ADULT CARDIAC CATHETERIZATION LABORATORY
SERVICES
He-Hea 1104.01 Request for Applications. The board shall issue a request for
applications for adult cardiac catheterization laboratory services upon
notification by a provider that they meet the requirements of He-Hea 1102 and
He-Hea 1103.
Source. #4457, eff 7-25-88; ss by #4923, eff 8-23-90;
ss by #5237, eff 9-27-91, EXPIRED: 9-27-97
New. #6931, eff 1-14-99; ss by #8375, eff 6-21-05;
ss by #10448, eff 10-25-13
He-Hea
1104.02 Processing of Applications. Applications
shall be processed in accordance with the requirements of RSA 151-C:8.
Source. #4345, eff 12-17-87; ss by #4457, eff 7-25-88;
ss by #4923, eff 8-23-90; ss by #5237, eff 9-27-91, EXPIRED: 9-27-97
New. #6931, eff 1-14-99; ss by #8375, eff 6-21-05;
ss by #10448, eff 10-25-13
He-Hea 1104.03 Board
Action.
(a) If an applicant demonstrates full compliance
with the requirements of He-Hea 1102 and He-Hea 1103 for adult cardiac catheterization services, a certificate of need shall be issued.
(b) Notice of the board’s action shall be given pursuant to RSA 151-C:9.
Source. #8375, eff 6-21-05; ss by #10448, eff
10-25-13
PART He-Hea 1105
STANDARDS FOR ADULT OPEN HEART SURGERY SERVICES
He-Hea
1105.01 Application for New Adult Open Heart Surgery Services.
(a) Any applicant for new adult open heart surgery
services shall demonstrate the availability of existing services in the proposed service area.
(b) Demonstration
shall be in the form of a
statistical report which provides a detail of the number of adult open heart surgery
procedures performed, by ICD-9-CM codes, by each existing facility in the
applicant’s proposed service area for the last 2 consecutive years.
Source. #4345, eff 12-17-87; ss by #4457, eff 7-25-88;
ss by #4923, eff 8-23-90; ss by #5237, eff 9-27-91, EXPIRED: 9-27-97
New. #6931, eff 1-14-99; ss by #8375, eff 6-21-05;
ss by #10448, eff 10-25-13
He-Hea
1105.02 Expansion of Existing
Services. The addition of new
operating rooms for open heart surgery resulting in a major construction or renovation project shall be subject
to review if any one or all of the thresholds in RSA 151-C:5, II are applicable
to the applicant’s proposed project and will be exceeded.
Source. #6931, eff 1-14-99; ss by #8375; eff 6-21-05;
ss by #10448, eff 10-25-13
He-Hea 1105.03 Availability and
Accessibility to Services. Adult
open heart surgery services shall be available and accessible as follows:
(a) Adult
open heart surgery services
shall be available and accessible for a minimum of 80% of the total New
Hampshire population within 1.5 to 2 hours travel time from a patient’s
residence; and
(b) Adult open heart surgery programs shall be
available 24 hours per day, 7 days per week for emergency purposes.
Source. #6931, eff 1-14-99; ss by #8375; eff 6-21-05;
ss by #10448, eff 10-25-13
He-Hea 1105.04 New
Adult Open Heart Surgery Services.
(a) Each new adult open heart surgery program
shall assure that the proposed volume of service shall not be detrimental to
the existing health care system of the state.
(b) Demonstration that the proposed volume of
service will not be detrimental to the state’s health care system shall be made
by providing a statistical report in the application which compares current
project increases for the following elements:
(1)
Utilization;
(2) Patient
charges;
(3) Market
share;
(4) Physician
referral patterns; and
(5) Personnel
resources.
(c) The applicant shall document the need for a new or expanded open heart surgery program.
(d) Documentation of need for a new or expanded
heart surgery program shall be made in the form of a statistical report which provides
a detail of the number of adult open heart surgery procedures by ICD-9-CM codes
performed by each facility currently providing services to residents of the
applicant’s proposed service area for the last 2 consecutive years. The report shall be prepared so that each
patient admission during which cardiac surgery was performed is counted only
once.
(e) Applicants shall also provide a report with
the application that supports the need for new or expanded adult open heart
surgery service in terms of:
(1) Referrals
from area health care providers as evidenced by letters of support;
(2) Historical
trends in volume such as:
a. Admissions;
b. Average
length of stay;
c. Patient
days; and
d. Occupancy
rates;
(3) Changes in
market share;
(4) The
addition of new services with different market patterns;
(5) The
addition of specialized services with different market patterns; and
(6) Any other
causes presented to support the anticipated need for adult cardiac surgery
services.
(f) The applicant shall demonstrate the
availability of a quality assurance plan for the proposed heart surgery
program.
(g) Demonstration
of the availability of a quality assurance plan shall be made in the form of a report
in the application, which includes an outline of a utilization or peer review
and control programs or both.
(h) The report
outlined in He-Hea 1105.04 (g) shall indicate how the program will be
established in order to:
(1) Establish
protocols governing referrals, admissions and discharges of adult open heart
surgery patients;
(2) Establish
and review a list of indications and contraindications to govern patient
selection for adult open heart surgery;
(3) Establish
and review guidelines governing the admission of open heart surgery patients to
the intensive care, coronary care and progressive care units, and of discharge
from these units;
(4) Review
morbidity and mortality rates and other indicators of patient outcomes,
compared with regional or national averages; and
(5) Establish
mechanisms for follow-up surveillance of discharged patients.
Source. #6931, eff 1-14-99; ss by #8375; eff 6-21-05;
ss by #10448, eff 10-25-13
He-Hea
1105.05 Volume of Cases.
(a) No new adult open heart surgery program shall
be approved unless it can be demonstrated that the proposed program can retain
the number of patients needed to assure a minimum volume of 250 cases annually
per facility.
(b) No new services shall be approved if the
introduction of any new services causes the volume in any facility dedicated
for adult open heart surgery in the State to drop below 350 adult open heart
surgery cases per year.
Source. #6931, eff 1-14-99; ss by #8375; eff 6-21-05;
ss by #10448, eff 10-25-13
He-Hea
1105.06 Staffing Requirements. Each adult open heart surgery program shall
comply with the following personnel and staffing requirements:
(a) At least 2
board-certified cardiothoracic surgeons;
(b) At least 2
board-certified anesthesiologists with special training through residency in
the management of open heart surgery patients;
(c) At least 2
cardio-pulmonary bypass perfusionists who have been certified in their
specialty by the American Board of Cardiovascular Perfusionists;
(d) At least one
board-certified nephrologist, who shall be available on a 24-hour basis;
(e) At least one
board-certified cardiologist, who shall be available on a 24-hour basis;
(f) At least one
board-certified pulmonologist, who shall be available on a 24-hour basis; and
(g) At least one
board-certified infectious disease specialist, who shall be available on a
24-hour basis.
Source. #6931, eff 1-14-99; ss by #8375; eff 6-21-05;
ss by #10448, eff 10-25-13
He-Hea
1105.07 Ancillary Services. Each adult open heart surgery program shall
include, at minimum, the following:
(a) A total of 4 beds dedicated and segregated in
a CCU;
(b) A telemetry unit proximate to the CCU;
(c) An acute renal dialysis service;
(d) A
family-centered rehabilitation service;
(e) A minimum of 2 operating rooms available as
needed for cardiac surgery patients;
(f) An in-house cardiac catheterization service
to which a CON was issued; and
(g) The availability and accessibility of a blood supply as well as platelets in-house or through an affiliation with an established blood bank network.
Source. #6931, eff 1-14-99; ss by #8375; eff 6-21-05;
ss by #10448, eff 10-25-13
PART He-Hea 1106
CRITERIA FOR EVALUATING PROPOSALS FOR ADULT CARDIAC SURGERY SERVICES
He-Hea
1106.01 Criteria. In addition to the criteria included in RSA
151-C:7 and He-Hea 303.02 through He-Hea 303.09, applicants shall meet the
following criteria when applying for a CON for adult cardiac surgery services:
(a)
In order to assess the current
and long-range financial feasibility of the proposed project, applicants shall
demonstrate that resources:
(1) Are
available to fund the proposed capital costs and operating costs;
(2) Will be available
to maintain operations in the event of interruptions to cash flow; and
(3) Will be
available to ensure the continued operation of the proposed project;
(b) Demonstration
of financial feasibility shall be made by providing with the application:
(1) Copies of
the facility’s 3-year historical and 3-year projected financial statements;
(2) A statement
of the sources of funds to finance the proposed project; and
(3)
Documentation from the applicant’s lender, underwriter or other
anticipated source of capital, which includes:
a. Financed
amount;
b. Rate of
interest; and
c. Term of
debt;
(c) Applicants
shall provide a description of the proposed service area, which includes the
following:
(1) Geographic boundaries
of the proposed primary and secondary service area;
(2) Demographic
characteristics of the service area by age and sex compositions;
(3) Income
characteristics of the area populations; and
(4) Anticipated
payor source by population totals and percentages expressed as:
a. Medicare;
b. Medicaid;
c. Private
insurance companies;
d. Self-pay;
and
e. Health
maintenance organizations;
(d) Applicants shall demonstrate the utilization
patterns of the proposed service area;
(e) Demonstration
of utilization patterns of the proposed service area shall be made by supplying
a report with the application which provides an outline of the assumptions that
the historical utilization patterns will be altered as a result of the proposed
new or expanded adult heart surgery program;
(f) Assumptions used to determine the historical
utilization patterns of (e) above shall include historical data on admission of
residents of the proposed service area to existing hospitals in the area for
the last 3 calendar years on the basis of:
(1) Inpatient
admissions by licensed bed category and total hospital;
(2) Adjusted
admissions by total hospital;
(3) Patient
days by licensed bed category and total hospital;
(4) Emergency
room visits; and
(5) Referral
patterns of area physicians and health care providers;
(g) Applicants shall assess the medical needs of
the proposed service area;
(h) Assessment of
the medical needs of the proposed service area shall be made in the form of a
report included with the application, which addresses the issue of the
medically underserved population on the basis of:
(1)
Demographics of the service area population, which shall include:
a. Age;
b. Sex;
c. Race;
d. Ethnicity;
e. Handicap;
and
f. Economic
status;
(2) Geographic
access problems, such as excessive travel times and distances to existing
facilities;
(3) Physicians’
inability to obtain admitting privileges at existing hospitals in adjacent
service area;
(4) Lack of specialized
services in the service area;
(5) Lack of
adult heart surgery services in the proposed service area to meet the medical
need of the current population; and
(6) Cost or
reimbursement barriers for uninsured or underinsured populations;
(i) Applicants
shall demonstrate that the anticipated proposed construction cost per square
foot shall be comparable within a 10% margin to the 2013 edition of Marshall Valuation Service, section 15, as
referenced in Appendix II of these rules;
(j) Demonstration
of project costs shall be made in the form of a report included with the
application, which provides:
(1) A detail of
the costs and space by department or area affected by the proposed project;
(2) A
comparison of these costs which shall be within 10% of the 2013 Marshall
Valuation Service, section 15, as
referenced in Appendix II of these rules, for the proposed class and type of construction;
and
(3) An identification of the square footage for
each department or area before and after the project;
(k)
Applicants shall include a report in the application which provides:
(1) An analysis
of the class and quality of construction pursuant to section one of the 2013
(2) The allocation of costs within a multiple use building;
(3) The allocations of site costs and land costs where facilities are proposed to have multiple uses;
(4) The methodology used in calculating construction costs for renovations;
(5) The methodology used in calculating construction costs involving leasehold improvements; and
(6) The anticipated useful life of the building for depreciation purposes;
(l)
The following construction costs shall be compared with the 2013
Marshall Valuation Service, section 15, as referenced in Appendix II of these
rules:
(1) Total costs associated with:
a.
Labor;
b.
Materials; and
c.
Fixed equipment;
(2) Building permits;
(3) Architectural and engineering fees;
(4) Site preparation for the building;
(5) Utilities from structure to lot line;
(6) Insurance costs during construction; and
(7) Interest costs during construction;
(m)
The applicant shall follow the outline of the calculator method set
forth in section 10 of the 2013 Marshall Valuation Service, as referenced in
Appendix II of these rules, to determine construction costs;
(n)
The costs and factors to take into account pursuant to (m) above shall
include:
(1) The base cost found in the general hospital
table in section 15, page 24 of the 2013
(2) An adjustment to heating, ventilation and
air-conditioning costs for extreme climate:
(3) Sprinkler system costs;
(4) Story height multipliers;
(5) Perimeter multipliers; and
(6) Cost multipliers from section 99 of the 2013
(o)
Applicants shall describe anticipated operational cost savings that
might occur
as a result of the project due to:
(1) Consolidation of services;
(2) Improved heating and
maintenance costs;
(3) Environmental design of the
constructed or renovated space;
(4) Space for future expansion; or
(5) Other factors not listed above;
(p)
Applicants shall document the assumptions used to determine the overall
financial feasibility of the proposed projects to expand, renovate or replace
their respective facilities;
(q)
Documentation of assumptions shall be made in the form of a report
including the following:
(1) The source of the documents used to
determine the population projections of the primary and secondary service
areas, if different than the office of energy and planning,
(2) The changes in market conditions which
would result in a change in market share;
(3) The causes of any anticipated changes
in the overall length of stay in the hospital;
(4) The assumptions used to prepare the
projected financial statements; and
(5) Other assumptions the applicant
considers pertinent to the project’s feasibility; and
(r)
Applicants shall document the sources and methodologies used to
determine the need for the proposed expanded or new adult heart surgery program.
Source. #5237, eff 9-27-91, EXPIRED: 9-27-97
New. #6931, eff 1-14-99; ss by #8375; eff 6-21-05;
ss by #10448, eff 10-25-13
PART
He-Hea 1107 REQUEST FOR APPLICATIONS
He-Hea 1107.01 Issuance of Request for Applications. In accordance with RSA 151-C:8,
requests for applications shall be issued if a need has been delineated for
additional open heart surgery service pursuant to this chapter.
Source. #5237, eff 9-27-91, EXPIRED: 9-27-97
New. #6931, eff 1-14-99; ss by #8375; eff 6-21-05;
ss by #10448, eff 10-25-13
APPENDIX
RULE |
STATE
STATUTE IMPLEMENTED |
He-Hea 1101.01 |
RSA 151-C:2, RSA 151-C:11, I |
He-Hea 1102.01 |
RSA 151-C:5,II(a), RSA 151-C:5,II(c),
RSA 151-C:11,I |
He-Hea 1102.02 |
RSA 151-C:5,II(a), RSA 151-C:5,II(c),
RSA 151-C:11,I, RSA 151-C:7,IV |
He-Hea 1102.03 |
RSA 151-C:5,II(a), RSA 151-C:5,II(c),
RSA 151-C:11,I, RSA 151-C:7,II |
He-Hea 1103 |
RSA 151-C:5,II(a), RSA 151-C:5,II(c),
RSA 151-C:11,I, RSA 151-C:7,I,II |
He-Hea 1104.01 |
RSA 151-C:8,I |
He-Hea 1104.02 |
RSA 151-C:8,I |
He-Hea 1104.03 |
RSA 151-C:9,I, II |
He-Hea 1105.01 |
RSA 151-C:5,II(a), RSA 151-C:5,II(c),
RSA 151-C:11,I |
He-Hea 1105.02 |
RSA 151-C:5,II(a),
RSA 151-C:5,II(c), RSA 151-C:11,I |
He-Hea 1105.03 |
RSA 151-C:5,II(a), RSA 151-C:5,II(c),
RSA 151-C:11,I |
He-Hea 1105.04 |
RSA 151-C:5,II(a),
RSA 151-C:5,II(c), RSA 151-C:11,I |
He-Hea 1105.05 |
RSA 151-C:5,II(a), RSA 151-C:5,II(c),
RSA 151-C:11,I |
He-Hea 1105.06 |
RSA 151-C:5,II(a), RSA 151-C:5,II(c),
RSA 151-C:11,I, RSA 151-C:7,II |
He-Hea 1105.07 |
RSA 151-C:5,II(a), RSA 151-C:5,II(c),
RSA 151-C:11,I |
He-Hea 1106 |
RSA 151-C:5,II(a), RSA 151-C:5,II(c),
RSA 151-C:11,I, RSA 151-C:7, I, II |
He-Hea 1107 |
RSA 151-C:8,I |
APPENDIX II: Incorporation by Reference Information
Rule |
Title |
Obtain at: |
He-Hea 1103.01(a MVS, 2013, section 15. He-Hea 1103.01
(b)(2) MVS, 2013, section 15. He-Hea 1103.01(c)(1) MVS, 2013, section 1. He-Hea 1103.01(d) MVS, 2013, section 15. He-Hea 1103.01(e). MVS, 2013, section 10. He-Hea 1103.01(f)(1) MVS, 2013, section 15, page 24. He-Hea 1103.01 (f)(6) MVS, 2013, section 99. |
Marshall Valuation Service, 2013 edition |
Marshall & Swift/Boeckh, LLC 34th Floor Telephone (800) 544-2678. Cost for the 2013 edition of the manual is $599.95. |
He-Hea 1106.01(i) MVS, 2013, section 15. He-Hea 1106.01 (j)(2) MVS, 2013, section 15. He-Hea 1106.01(k)(1) MVS, 2013, section 1. He-Hea 1106.01(l) MVS, 2013, section 15. He-Hea 1106.01(m) MVS, 2013, section 10. He-Hea 1106.01(n)(1) MVS, 2013, section 15, page 24. He-Hea 1106.01 (n)(6) MVS, 2013, section 99. |
Marshall Valuation Service, 2013 edition |
Marshall & Swift/Boeckh, LLC 34th Floor Telephone (800) 544-2678. Cost for the 2013 edition of the manual is $599.95. |
He-Hea 1102.03(a) He-Hea 1102.03(b) |
2012
|
J. Am Coll Cardiol 2012; 59: 2221-305 February 2012 ISSN 0735-1097 http://content.online.jacc.org Elsevier Inc. Reprint Dept, Fax 212-633-3220 reprints@elsevier.com |