Connecticut General Statutes
Chapter 319y - Long-Term Care
Section 17b-353. - Certificate of need; capital expenditures, application request requirements. Hearings. Exceptions to hearing requirements. Regulations.

(a) Any facility, as defined in subsection (a) of section 17b-352, which proposes to incur (1) capital expenditures exceeding one million dollars, which increases facility square footage by more than five thousand square feet or five per cent of the existing square footage, whichever is greater, or (2) capital expenditures exceeding two million dollars, shall submit a request for approval of such expenditure, with such information as the department requires, to the Department of Social Services.

(b) An applicant, prior to submitting a certificate of need application, shall request, in writing, application forms and instructions from the department. The request shall include: (1) The name of the applicant or applicants; (2) a statement indicating whether the application is for (A) a new, additional, expanded or replacement facility, service or function, (B) a termination or reduction in a presently authorized service or bed capacity or relocation of facility beds, or (C) any new, additional or terminated beds and their type; (3) the estimated capital cost; (4) the town where the project is or will be located; and (5) a brief description of the proposed project. Such request shall be deemed a letter of intent. No certificate of need application shall be considered submitted to the department unless a current letter of intent, specific to the proposal and in accordance with the provisions of this subsection, has been on file with the department for not less than ten business days. For purposes of this subsection, “a current letter of intent” means a letter of intent on file with the department for not more than one hundred eighty days. A certificate of need application shall be deemed withdrawn by the department if a department completeness letter is not responded to within one hundred eighty days.
(c) In conducting its activities pursuant to this section, section 17b-352 or both, except as provided for in subsection (d) of this section, the Commissioner of Social Services or said commissioner's designee may hold a public hearing on an application or on more than one application, if such applications are of a similar nature with respect to the request. At least two weeks' notice of the hearing shall be given to the facility by certified mail and to the public by publication in a newspaper having a substantial circulation in the area served by the facility. Such hearing shall be held at the discretion of the commissioner in Hartford or in the area so served. Prior to the hearing, the department may hold an informal conference with the facility to discuss the certificate of need application. The commissioner or the commissioner's designee shall consider such request in relation to the community or regional need for such capital program or purchase of land, the possible effect on the operating costs of the facility and such other relevant factors as the commissioner or the commissioner's designee deems necessary. In approving or modifying such request, the commissioner or the commissioner's designee may not prescribe any condition, such as, but not limited to, any condition or limitation on the indebtedness of the facility in connection with a bond issued, the principal amount of any bond issued or any other details or particulars related to the financing of such capital expenditure, not directly related to the scope of such capital program and within the control of the facility. If the hearing is conducted by a designee of the commissioner, the designee shall submit any findings and recommendations to the commissioner. If the designee recommends denial of the request, the designee shall issue a proposed final decision in accordance with section 4-179. The commissioner shall grant, modify or deny such request within ninety days, except as provided for in this section. The commissioner may place conditions, as the commissioner deems necessary to address specified concerns, on any decision approving or modifying a request for a certificate of need filed pursuant to this section. Conditions may include, but are not limited to, project and Medicaid reimbursement details and applicant requirements for summary and audit purposes. Upon the request of the applicant, the review period may be extended for an additional fifteen days if the commissioner or the commissioner's designee has requested additional information subsequent to the commencement of the review period. The commissioner or the commissioner's designee may extend the review period for a maximum of thirty days if the applicant has not filed in a timely manner information deemed necessary by the commissioner or the commissioner's designee.
(d) Except as provided in this subsection, no facility shall be allowed to close or decrease substantially its licensed total bed capacity until such time as a public hearing has been held in accordance with the provisions of this subsection and the Commissioner of Social Services has approved the facility's request unless such decrease is associated with a census reduction. The commissioner may impose a civil penalty of not more than five thousand dollars on any facility that fails to comply with the provisions of this subsection. Penalty payments received by the commissioner pursuant to this subsection shall be deposited in the special fund established by the department pursuant to subsection (c) of section 17b-357 and used for the purposes specified in said subsection (c). The commissioner or the commissioner's designee shall hold a public hearing not later than thirty days after the receipt of any certificate of need application. Such hearing shall be held at the facility for which the certificate of need application was submitted. The commissioner or the commissioner's designee shall provide both the facility and the public with notice of the date of the hearing not less than ten days in advance of such date. Notice to the facility shall be sent via electronic mail or first-class mail and notice to the public shall be by publication in a newspaper having a substantial circulation in the area served by the facility. The provisions of this subsection shall not apply to any certificate of need approval requested for the relocation of a facility, or a portion of a facility's licensed beds, to a new or replacement facility.
(e) The Commissioner of Social Services shall adopt regulations, in accordance with chapter 54, to implement the provisions of this section.
(P.A. 93-262, S. 22, 87; P.A. 94-236, S. 2, 10; P.A. 95-257, S. 39, 58; June 18 Sp. Sess. P.A. 97-2, S. 148, 165; P.A. 98-150, S. 13, 17; P.A. 02-135, S. 3; P.A. 07-209, S. 1; P.A. 09-8, S. 9; Sept. Sp. Sess. P.A. 09-3, S. 26; P.A. 10-179, S. 99, 100; June Sp. Sess. P.A. 17-2, S. 183; P.A. 18-91, S. 71; P.A. 22-145, S. 7.)
History: P.A. 93-262 effective July 1, 1993; P.A. 94-236 made technical changes and amended Subsec. (b) to provide that a hearing shall be in accordance with Sec. 4-177 and to add “or his designee” after commissioner, effective June 7, 1994; P.A. 95-257 replaced Commission on Hospitals and Health Care with Office of Health Care Access, effective July 1, 1995; June 18 Sp. Sess. P.A. 97-2 amended Subsec. (a) by replacing a capital expenditure exceeding $1,000,000 with a capital expenditure exceeding $1,000,000 which increases facility square footage by more than 5,000 square feet or 5% of the existing square footage, whichever is greater, and by adding a capital expenditure exceeding $2,000,000 to those facilities required to submit a request for approval of such expenditure, added Subsec. (b) outlining an applicant's required procedure prior to submitting a certificate of need application and redesignated existing Subsecs. accordingly, effective July 1, 1997; (Revisor's note: A reference in Subsec. (a) to “subsection (b) of” Sec. 19a-639, deleted by vetoed P.A. 97-204 and so reflected in June 18 Sp. Sess. P.A. 97-2, was codified since purported deletion was void); P.A. 98-150 amended Subsec. (a) to allow joint or simultaneous review and made a technical change, effective June 5, 1998 (Revisor's note: In Subsec. (a) a reference to “Commissioner of the Department of Social Services” was changed editorially by the Revisors to “Commissioner of Social Services” for consistency with customary statutory language); P.A. 02-135 amended Subsec. (c) by adding provision allowing the commissioner or a designee to hold a public hearing on one or more applications, deleting provisions re mandatory hearing pursuant to Sec. 4-177, re waiver of hearing upon showing of emergency nature and re ten business day time periods, and making technical changes for purposes of gender neutrality; P.A. 07-209 amended Subsec. (c) by adding “except as provided for in subsection (d) of this section,” and making technical changes, added new Subsec. (d) re public hearing and notice requirements for facility that seeks to close or decrease substantially its total bed capacity and re civil penalty for failure to comply with such requirements, and redesignated existing Subsec. (d) as Subsec. (e), effective July 1, 2007; P.A. 09-8 made a technical change in Subsec. (b)(2); Sept. Sp. Sess. P.A. 09-3 amended Subsec. (a) by substituting Commissioner of Public Health for Commissioner of Health Care Access re performance of joint or simultaneous review with Department of Social Services, effective October 6, 2009; P.A. 10-179 amended Subsecs. (a) and (e) by replacing “Office of Health Care Access” with “Office of Health Care Access division of the Department of Public Health” and, in Subsec. (a), by replacing reference to Sec. 19a-639 with reference to Ch. 368z; June Sp. Sess. P.A. 17-2 amended Subsec. (a) by deleting Subdiv. (3) re acquisition of major medical equipment requiring capital expenditure in excess of $400,000, deleting provision re acquisition of imaging equipment requiring capital expenditure of over $400,000, amended Subsec. (b)(2)(B) by adding “or relocation of facility beds”, amended Subsec. (d) by adding provision re applicability of subsection to relocation of facility or facility's licensed beds, and made technical and conforming changes, effective October 31, 2017; P.A. 18-91 amended Subsec. (e) by deleting provision re implementation of standards and procedures until adoption of final regulations, effective May 14, 2018; P.A. 22-145 amended Subsec. (c) by authorizing informal conference before a hearing, requiring proposed final decision in accordance with Sec. 4-179 upon denial recommendation and authorizing commissioner to place conditions on approval and amended Subsec. (d) by inserting “licensed” before “total bed capacity”, requiring public hearing not later than 30 days after application received instead of not later than 30 days after earliest date of letter of intent or application and reduced public hearing notice deadline from 14 to 10 days prior to hearing by electronic or first-class mail instead of by certified mail, effective July 1, 2022.

Structure Connecticut General Statutes

Connecticut General Statutes

Title 17b - Social Services

Chapter 319y - Long-Term Care

Section 17b-337. - Long-Term Care Planning Committee. Long-term care plan.

Section 17b-338. - Long-Term Care Advisory Council. Membership. Duties.

Section 17b-339. - Nursing Home Financial Advisory Committee. Duties. Membership. Reports. Annual meeting.

Section 17b-340. (Formerly Sec. 17-314). - Rates of payment to nursing homes, chronic disease hospitals associated with chronic and convalescent homes, rest homes with nursing supervision, residential care homes and residential facilities for persons...

Section 17b-340a. - Determination of resident day user fee in an intermediate care facility for individuals with intellectual disabilities. Penalty. Delegation of authority to Commissioner of Social Services.

Section 17b-340b. - Intermediate care facilities for individuals with intellectual disabilities. User fee.

Section 17b-340c. - Advance payments to nursing facilities. Recovery of payments. Execution of security agreements by commissioner.

Section 17b-340d. - Acuity-based methodology for Medicaid reimbursement of nursing home services. Regulations.

Section 17b-340e. - Rate increases for nursing home employee wage enhancements. Penalties for failure to apply rate increases to wage enhancements.

Section 17b-341. (Formerly Sec. 17-314a). - Self-pay rates regulated. Provider agreement. Rate adjustments. Appeals.

Section 17b-342. (Formerly Sec. 17-314b). - Connecticut home-care program for the elderly.

Section 17b-342a. - Pilot program to provide personal care assistance under the home-care program for the elderly.

Section 17b-342b. - Waiver application re pilot program to provide personal care assistance under the home-care program for the elderly.

Section 17b-343. (Formerly Sec. 17-314c). - Rates of payment for home care services, transportation, mental health counseling and meals on wheels.

Section 17b-343a. - Payment of claims for home health services provided under Medicare and Medicaid. Liability. Sanctions.

Section 17b-344 and 17b-345. (Formerly Secs. 17-314d and 17b-314e). - Rates of payment to facilities for room, board and services. Self-pay rates in licensed chronic and convalescent nursing homes and rest homes with nursing supervision based on cert...

Section 17b-346. (Formerly Sec. 17-314f). - Chronic and convalescent nursing facility: Title XIX Medicaid program participant. Provider agreement.

Section 17b-347. (Formerly Sec. 17-314g). - Termination of Medicaid provider agreements by nursing home facilities. Rates to be charged self-pay patients.

Section 17b-347e. - Demonstration project for provision of subsidized assisted living services for persons residing in affordable housing. Memorandum of understanding.

Section 17b-348. (Formerly Sec. 17-314h). - Demonstration project: Skilled and intermediate nursing home care for persons with AIDS. Rate. Regulations.

Section 17b-349. (Formerly Sec. 17-314i). - Adjustment of rates of payment to community health centers participating in Medicaid program.

Section 17b-350. (Formerly Sec. 17-314n). - Demonstration program for respite care in nursing homes for self-pay patients.

Section 17b-351. (Formerly Sec. 19a-155a). - Nursing homes. Increased bed capacity. Capital construction project.

Section 17b-352. - Petitions for closure, certificate of need for nursing home facilities; transfer of ownership or control; introduction of additional function or service; relocation of facility beds; termination or decrease of service. Requirements...

Section 17b-353. - Certificate of need; capital expenditures, application request requirements. Hearings. Exceptions to hearing requirements. Regulations.

Section 17b-354. - Moratorium on requests for additional nursing home beds. Exceptions. Continuing care facility. Medicaid nursing facility bed relocation. Construction. Financing. Regulations.

Section 17b-354a. - Judicial enforcement.

Section 17b-354b and 17b-354c. - Relocation of Medicaid certified nursing home beds. Conversion intermediate care facility beds to nursing home beds. Regulations.

Section 17b-355. - Certificate of need for capital expenditures; transfer of ownership or control; criteria.

Section 17b-356. - Health care facility proposing to expand services by adding nursing home beds. Procedures.

Section 17b-357. (Formerly Sec. 17-134v). - Nursing facility: Compliance with federal law. Summary order. Temporary manager. Remedies. Regulations. Penalties. Hearing.

Section 17b-358. (Formerly Sec. 17-134w). - Temporary manager: Powers and duties. Regulations. Certification.

Section 17b-359. (Formerly Sec. 17-134x). - Nursing facility: Preadmission screening process in the case of mentally ill persons. Annual resident review. Appeal.

Section 17b-360. (Formerly Sec. 17-134y). - Nursing facility: Preadmission screening process in the case of persons with intellectual disability or condition related thereto. Appeal.

Section 17b-361. (Formerly Sec. 17-134hh). - Payment for physicians' visits to Medicaid patients in nursing homes.

Section 17b-362. (Formerly Sec. 17-134ii). - Ten-day limit on first time maintenance drug prescription for Medicaid or ConnPACE recipient. Five-day supply of prescription drug may be requested for Medicaid patient.

Section 17b-362a. - Pharmacy review panel established.

Section 17b-363. - Demonstration program for exploring methods of returning and dispensing prescription drugs which have been dispensed in long-term care facilities.

Section 17b-363a. - Return of unused prescription drugs dispensed in long-term care facilities to vendor pharmacies. Requirements. Regulations. Fines. Annual list of drugs in program.

Section 17b-363b. - Reimbursement for pharmacy services for long-term care facilities.

Section 17b-364. - Demonstration program for providing specialized long-term care. Requests for proposals.

Section 17b-365. - Assisted living services pilot program. Medicaid waiver program.

Section 17b-366. - Assisted living services pilot program. State-funded program.

Section 17b-367. - Information on long-term care options. Web site.

Section 17b-368. - Pilot project for diagnosis, care and treatment of persons with chronic or geriatric mental conditions.

Section 17b-369. - Money Follows the Person demonstration project. Reports. Strategic plan to rebalance Medicaid long-term care supports and services. Data collection system. Notice if resident is likely to become eligible for Medicaid. Waivers.

Section 17b-370. - Demonstration project to provide home and community-based long-term care services. Development of plan. Implementation.

Section 17b-371. - Long-Term Care Reinvestment account. Report.

Section 17b-372. - Small house nursing homes pilot program.

Section 17b-372a. - Nursing home for persons transitioning from correctional facility or receiving services from Department of Mental Health and Addiction Services.

Section 17b-373. - Medicaid applications for long-term care. Legal rights of applicants. Department legal rights advisory.

Section 17b-374 to 17b-399. - Reserved for future use.