                                 CODE OF VIRGINIA

ADMINISTRATIVE PROCEDURES (§ 32.1-102.6)

A. To obtain a certificate for a project, the applicant shall file a completed
application for a certificate with the Department and the appropriate regional
health planning agency if a regional health planning agency has been designated
for that region. Such application shall be filed in accordance with procedures
established by the Department. An application submitted for review shall be
considered complete when all relevant sections of the application form have
responses. The applicant shall provide sufficient information to prove public
need for the requested project exists without the addition of supplemental or
supporting material at a later date. The Department shall ensure that only data
necessary for review of an application is required to be submitted and that the
application reflects statutory requirements. Nothing in this section shall
prevent the Department from seeking, at its discretion, additional information
from the applicant or other sources.
			Within 10 calendar days of the date on which the document is received, the
Department and the appropriate regional health planning agency, if a regional
health planning agency has been designated, shall determine whether the
application is complete or not and the Department shall notify the applicant, if
the application is not complete, of the information needed to complete the
application. If no regional health planning agency is designated for the health
planning region in which the project will be located, no filing with a regional
health planning agency is required and the Department shall determine if the
application is complete and notify the applicant, if the application is not
complete, of the information needed to complete the application.
			At least 30 calendar days before any person is contractually obligated to
acquire an existing medical care facility, the cost of which is $600,000 or
more, that person shall notify the Commissioner and the appropriate regional
health planning agency, if a regional health planning agency has been
designated, of the intent, the services to be offered in the facility, the bed
capacity in the facility and the projected impact that the cost of the
acquisition will have upon the charges for services to be provided. If clinical
services or beds are proposed to be added as a result of the acquisition, the
Commissioner may require the proposed new owner to obtain a certificate prior to
the acquisition. If no regional health planning agency is designated for the
health planning region in which the acquisition will take place, no notification
to a regional health planning agency shall be required.

B. For projects proposed in health planning regions with regional planning
agencies, the appropriate regional health planning agency shall (i) review each
completed application for a certificate within 60 calendar days of the day that
begins the appropriate batch review cycle as established by the Board by
regulation pursuant to subdivision A 1 of &#xA7; 32.1-102.2, such cycle not to
exceed 190 days in duration; (ii) within 10 calendar days following the start of
the review cycle, solicit public comment on such application by posting notice
of such application and a summary of the proposed project on a website
maintained by the Department; such notice shall include information about how
comments may be submitted to the regional health planning agency and the date on
which the public comment period shall expire, which shall be no later than 45
calendar days following the date of the public notice; and (iii) in the case of
competing applications or in response to a written request by an elected local
government representative, a member of the General Assembly, the Commissioner,
the applicant, or a member of the public, hold one public hearing on each
application in a location in the county or city in which the project is proposed
or a contiguous county or city. Prior to any required public hearing, the
regional health planning agency shall notify the local governing bodies in the
planning district. At least nine days prior to the public hearing, the regional
health planning agency shall cause notice of the public hearing to be published
in a newspaper of general circulation in the county or city where the project is
proposed to be located. The regional health planning agency shall consider the
comments of the local governing bodies in the planning district and all other
public comments in making its decision. Such comments shall be part of the
record. In no case shall a regional health planning agency hold more than two
meetings on any application, one of which shall be the public hearing required
pursuant to clause (iii), if any, conducted by the board of the regional health
planning agency or a subcommittee of the board. The applicant shall be given the
opportunity, prior to the vote by the board of the regional health planning
agency or a committee of the agency, if acting for the board, on its
recommendation, to respond to any comments made about the project by the
regional health planning agency staff, any information in a regional health
planning agency staff report, or comments by those voting members of the
regional health planning agency board; however, such opportunity shall not
increase the 60-calendar-day period designated herein for the regional health
planning agency&#8217;s review unless the applicant or applicants request a
specific extension of the regional health planning agency&#8217;s review period.
			The regional health planning agency shall submit its recommendations on each
application and its reasons therefor to the Department within 10 calendar days
after the completion of its 60-calendar-day review or such other period in
accordance with the applicant&#8217;s request for extension.
			If the regional health planning agency has not completed its review within
the specified 60 calendar days or such other period in accordance with the
applicant&#8217;s request for extension and submitted its recommendations on the
application and the reasons therefor within 10 calendar days after the
completion of its review, the Department shall, on the eleventh calendar day
after the expiration of the regional health planning agency&#8217;s review
period, proceed as though the regional health planning agency has recommended
project approval without conditions or revision.
			If no regional health planning agency has been designated for a region, the
Department shall (a) within 10 calendar days following the start of the review
cycle, solicit public comment on such application by posting notice of such
application and a summary of the proposed project on a website maintained by the
Department; such notice shall include such information about how comments may be
submitted to the Department and the date on which the public comment period
shall expire, which shall be no later than 45 calendar days following the date
of the public notice, and (b) in the case of competing applications or in
response to a written request by an elected local government representative, a
member of the General Assembly, the Commissioner, the applicant, or a member of
the public, hold one hearing on each application in a location in the county or
city in which the project is proposed or a contiguous county or city. Prior to
any required hearing, the Department shall notify the local governing bodies in
the planning district in which the project is proposed. At least nine days prior
to the public hearing, the Department shall cause notice of the public hearing
to be published in a newspaper of general circulation in the county or city
where the project is proposed to be located. The Department shall consider the
comments of the local governing bodies in the planning district and all other
public comments in making its decision. Such comments shall be part of the
record.

C. After commencement of any public hearing and before a decision is made there
shall be no ex parte contacts concerning the subject certificate or its
application between (i) any person acting on behalf of the applicant or holder
of a certificate or any person opposed to the issuance or in favor of revocation
of a certificate of public need and (ii) any person in the Department who has
authority to make a determination respecting the issuance or revocation of a
certificate of public need, unless the Department has provided advance notice to
all parties referred to in clause (i) of the time and place of such proposed
contact.

D. The Department shall commence the review of each completed application upon
the day which begins the appropriate batch review cycle and simultaneously with
the review conducted by the regional health planning agency, if a regional
health planning agency has been designated.
			A determination whether a public need exists for a project shall be made by
the Commissioner within 190 calendar days of the day which begins the
appropriate batch cycle.
			The 190-calendar-day review period shall begin on the date upon which the
application is determined to be complete within the batching process specified
in subdivision A 1 of &#xA7; 32.1-102.2.
			If the application is not determined to be complete within 40 calendar days
from submission, the application shall be refiled in the next batch for like
projects.
			The Commissioner shall make determinations in accordance with the provisions
of the Administrative Process Act (&#xA7; 2.2-4000 et seq.) except for those
parts of the determination process for which timelines and specifications are
delineated in subsection E. Further, if an informal fact-finding conference is
determined to be necessary by the Department or is requested by a person seeking
good cause standing, the parties to the case shall include only the applicant,
any person showing good cause, any third-party payor providing health care
insurance or prepaid coverage to five percent or more of the patients in the
applicant&#8217;s service area, and the relevant health planning agency.

E. Upon entry of each completed application or applications into the appropriate
batch review cycle:

   1. The Department shall establish, for every application, a date between the
   eightieth and ninetieth calendar days within the 190-calendar-day review
   period for holding an informal fact-finding conference, if such conference is
   necessary.

   2. The Department shall review every application at or before the
   seventy-fifth calendar day within the 190-calendar-day review period to
   determine whether an informal fact-finding conference is necessary.

   3. Any person seeking to be made a party to the case for good cause, no later
   than four days after the Department has completed its review and submitted its
   recommendation on an application and has transmitted the same to the
   applicants and to persons who have, prior to the issuance of the report,
   requested a copy in writing, shall notify the Commissioner, all applicants,
   and the regional health planning agency, in writing and under oath, stating
   the grounds for good cause and providing the factual basis therefor.

   4. In any case in which an informal fact-finding conference is held, a date
   shall be established for the closing of the record which shall not be more
   than 30 calendar days after the date for holding the informal fact-finding
   conference.

   5. In any case in which an informal fact-finding conference is not held, the
   record shall be closed on the earlier of (i) the date established for holding
   the informal fact-finding conference or (ii) the date that the Department
   determines an informal fact-finding conference is not necessary.

   6. The provisions of subsection C of &#xA7; 2.2-4021 notwithstanding, if a
   determination whether a public need exists for a project is not made by the
   Commissioner within 45 calendar days of the closing of the record, the
   Commissioner shall notify the applicant or applicants and any persons seeking
   to show good cause, in writing, that the application or the application of
   each shall be deemed approved 25 calendar days after expiration of such
   45-calendar-day period, unless the receipt of recommendations from the person
   performing the hearing officer functions permits the Commissioner to issue his
   case decision within that 25-calendar-day period. The validity or timeliness
   of the aforementioned notice shall not, in any event, prevent, delay or
   otherwise impact the effectiveness of this section.

   7. In any case when a determination whether a public need exists for a project
   is not made by the Commissioner within 70 calendar days after the closing of
   the record, the application shall be deemed to be approved and the certificate
   shall be granted.

   8. If a determination whether a public need exists for a project is not made
   by the Commissioner within 45 calendar days of the closing of the record, any
   applicant who is competing in the relevant batch or who has filed an
   application in response to the relevant Request For Applications issued
   pursuant to &#xA7; 32.1-102.3:2 may, prior to the application being deemed
   approved, petition for immediate injunctive relief pursuant to &#xA7;
   2.2-4030, naming as respondents the Commissioner and all parties to the case.
   During the pendency of the proceeding, no applications shall be deemed to be
   approved. In such a proceeding, the provisions of &#xA7; 2.2-4030 shall apply.

F. Deemed approvals shall be construed as the Commissioner&#8217;s case decision
on the application pursuant to the Administrative Process Act (&#xA7; 2.2-4000
et seq.) and shall be subject to judicial review on appeal as the
Commissioner&#8217;s case decision in accordance with such act.
			Any person who has sought to participate in the Department&#8217;s review of
such deemed-to-be-approved application as a person showing good cause who has
not received a final determination from the Commissioner concerning such attempt
to show good cause shall be deemed to be a person showing good cause for
purposes of appeal of the deemed approval of the certificate.
			In any appeal of the Commissioner&#8217;s case decision granting a
certificate of public need pursuant to a Request for Applications issued
pursuant to &#xA7; 32.1-102.3:2, the court may require the appellant to file a
bond pursuant to &#xA7; 8.01-676.1, in such sum as shall be fixed by the court
for protection of all parties interested in the case decision, conditioned on
the payment of all damages and costs incurred in consequence of such appeal.

G. For purposes of this section, &#8220;good cause&#8221; means that (i) there
is significant relevant information not previously presented at and not
available at the time of the public hearing, (ii) there have been significant
changes in factors or circumstances relating to the application subsequent to
the public hearing, or (iii) there is a substantial material mistake of fact or
law in the Department staff&#8217;s report on the application or in the report
submitted by the health planning agency.

H. The project review procedures shall provide for separation of the project
review manager functions from the hearing officer functions. No person serving
in the role of project review manager shall serve as a hearing officer.

I. The applicants, and only the applicants, shall have the authority to extend
any of the time periods specified in this section. If all applicants consent to
extending any time period in this section, the Commissioner, with the
concurrence of the applicants, shall establish a new schedule for the remaining
time periods.

J. This section shall not apply to applications for certificates for projects
that meet the criteria for the expedited application and review process
established in subdivision A 5 of &#xA7; 32.1-102.2. Such projects shall be
subject to an expedited application and review process developed by the Board in
regulation pursuant to subdivisions A 2 and 5 of &#xA7; 32.1-102.2.

HISTORY: 1982, c. 388; 1984, c. 740; 1991, c. 561; 1999, cc. 899, 922; 2000, c.
931; 2004, cc. 71, 95; 2005, c. 404; 2009, c. 175; 2010, c. 646; 2020, c. 1271;
2025, c. 325.