A. Prior to initiating a reviewable medical care facility project, the owner or sponsor shall obtain a certificate of public need from the commissioner, except as provided in subsection B of this section. In the case of an acquisition of an existing medical care facility, the notification requirement set forth in 12VAC5-220-120 shall be met.

B. Projects Provided that an existing hospital or nursing home complies with subsections C, D, and F of this section, a project involving a temporary increase in the total number of beds in an existing hospital or nursing home shall be exempt from the requirement for a certificate, for a period of no more than 30 days, if the:

1. The commissioner has determined that a natural disaster or man-made disaster has caused the evacuation of a hospital or nursing home and that a public health emergency exists due to a shortage of hospital or nursing home beds.; or

2. The board has entered an emergency order pursuant to § 32.1-13 of the Code of Virginia or if the commissioner has entered an emergency order pursuant to §§ 32.1-13 and 32.1-20 of the Code of Virginia for the purpose of suppressing:

a. A nuisance dangerous to public health;

b. A communicable, contagious, or infectious disease; or

c. Other danger to the public life and health.

C. An existing hospital or nursing home may request a temporary increase in its total number of beds by filing a Request for Temporary Beds form with the department that includes:

1. The name of the hospital or nursing home;

2. The license number of the hospital or nursing home;

3. The name of the nursing home administrator, the hospital chief executive officer, or the chief executive officer's designee;

4. The telephone number of the nursing home administrator, the hospital chief executive officer, or the chief executive officer's designee;

5. The email address of the nursing home administrator, the hospital chief executive officer, or the chief executive officer's designee;

6. The number and type of temporary beds the hospital or nursing home anticipates adding;

7. The planned use of the temporary beds;

8. The plans for staffing the temporary beds;

9. The efforts undertaken or to be undertaken to reduce or eliminate the number of temporary beds needed;

10. The address of the building, temporary structure, or satellite location where the hospital or nursing home intends to locate the temporary beds;

11. The specific locations within the building, temporary structure, or satellite location where the hospital or nursing home intends to locate the temporary beds;

12. Whether the locations identified in subdivision 11 of this subsection meet life safety code requirements for the type of patients or residents expected to occupy those temporary beds;

13. If life safety code requirements are not currently met for the locations identified in subdivision 11 of this subsection, what action the hospital or nursing home will take to meet life safety code requirements; and

14. Any other information that the board or commissioner may request.

D. The hospital or nursing home shall provide additional information as may be requested or required by the commissioner to evaluate the temporary bed request.

E. The commissioner shall notify the hospital or nursing home in writing of the commissioner's decision on the temporary bed request. If granted, the commissioner may attach conditions to the approval that, in the sole judgment of the commissioner, protects public, patient, or resident health, safety, or welfare.

F. The hospital or nursing home may not add temporary beds unless its request has been granted and may not operate temporary beds more than 30 days after the expiration of:

1. The commissioner's determination pursuant to subdivision B 1 of this section; or

2. The board's or the commissioner's emergency order pursuant to subdivision B 2 of this section.

G. The department shall promptly inform the Department of Medical Assistance Services and the Centers for Medicare and Medicaid Services of the identity of any hospital or nursing home certified as a Medicare provider or Medicaid provider that fails to comply with subsection F of this section.

H. The commissioner may rescind or modify the approval of a temporary bed request if:

1. Additional information becomes known that alters the basis for the original approval, including if the hospital or nursing home added temporary beds prior to receiving the approval; or

2. The hospital or nursing home fails to meet any conditions attached to the approval.

I. No certificate of public need shall be required for use of up to 10 beds per day among the medical care facility's inpatient hospital beds as swing beds for the furnishing of services of the type that if furnished by a nursing home or certified nursing facility would constitute skilled care services by a medical care facility described in § 32.1-102.1:3 A 1 of the Code Virginia that is certified as a critical access hospital by the Centers for Medicare and Medicaid Services pursuant to Title XVIII of the Social Security Act (42 USC § 1395 et seq.). For purposes of this subsection, a critical access hospital may calculate the 10-swing-bed-per-day limitation as an average over the fiscal year of the hospital. In the event the calculation exceeds an average of equal to or fewer than 10 swing beds in any fiscal year, the critical access hospital shall have the following fiscal year to reduce the fiscal year average to equal to or fewer than 10 swing beds. Any critical access hospital that fails to reduce the fiscal year average to equal to or fewer than 10 swing beds during the second fiscal year shall no longer be able to calculate the 10-swing-bed limitation by averaging on a fiscal year basis and shall calculate the limitation on a daily basis until such time as it has met the 10-swing-bed-per-day limit for two consecutive fiscal years, at which time averaging may resume. No critical access hospital shall have more than 15 swing beds per day for more than five consecutive days. A critical access hospital shall make a good faith effort and document the efforts made to place each additional patient in a certified nursing facility prior to exceeding the 10-swing-bed-per-day limit.

Application for Expedited Review for Certificate of Public Need (eff. 6/94).

Registration Form for Capital Expenditures of $1,000,000 or More But Less than $2,000,000 Which are Not Defined as a Project on or After July 1, 1993.

Request for Extension of a Certificate of Public Need Beyond Two Years from Date of Issuance.

Request for Extension of a Certificate of Public Need Beyond One Year, But Less then than Two Years from Date of Issuance (Rev. rev. 7/26/93).

Application for a Medical Care Facilities Certificate of Public Need - Outpatient Facilities (Rev. rev. 12/10/92).

Application for a Medical Care Facilities Certificate of Public Need - Hospitals (Rev. rev. 12/10/92).

Application for a Medical Care Facilities Certificate of Public Need - Long-Term Care Facilities (Rev. rev. 10/2007).

Request for Temporary Beds, OLC-1009-F (eff. 6/2022)