PURPOSE: This rule outlines the criteria and standards against which a project involv- 19 CSR 60-50

ing a health care facility would be evaluated relative to the financial feasibility of the project in a Certificate of Need (CON) review.

PUBLISHER’S NOTE: The secretary of state has determined that the publication of the entire text of the material which is incorporated by reference as a portion of this rule would be unduly cumbersome or expensive. This material as incorporated by reference in this rule shall be maintained by the agency at its headquarters and shall be made available to the public for inspection and copying at no more than the actual cost of reproduction. This note applies only to the reference material. The entire text of the rule is printed here.

1. (1) Proposals for any new hospital, nursing home, residential care facility, or assisted living facility construction must include documentation that the proposed costs per square foot are reasonable when compared to the latest RS Means Cost Data Percentile Limit Total New Construction Project Costs (Form MO 580-1866, incorporated by reference) available from the Certificate of Need Program (CONP). Any proposal with costs in excess of the three-fourths (3/4) percentile must include justification for the higher costs.
2. (2) Document that sufficient financing will be available to assure completion of the project by providing a letter from a financial institution saying it is willing to finance the project, or an auditor’s statement that unrestricted funds are available for the project.

3. (3) Document financial feasibility by including—

   1. (A) The Service-Specific Revenues and Expenses (Form MO 580-1865, incorporated by reference) as a financial pro forma for each revenue generating service affected by the project for the past three (3) years projected through three (3) years beyond project completion; and
   2. (B) For existing services, a copy of the latest available audited financial statements or the most recent Internal Revenue Service
4. (IRS) 990 Form or similar IRS filing for facilities not having individual audited financial statements.

5. (4) Show how the proposed service will be affordable to the population in the proposed service area:

   1. (A) Document how the proposal would impact current patient charges, and disclose the method for deriving charges for this service, including both direct and indirect components of the charge; and SENIOR SERVICES
   2. (B) Demonstrate that the proposed service will be responsive to the needs of the medically indigent through such mechanisms as fee waivers, reduced charges, sliding fee scales, or structured payments.

6. (5) The following forms cited in this rule are incorporated by reference and published by the Certificate of Need Program (CONP), October 1, 2009, and may be downloaded from http://www.dhss.mo.gov/CON/Forms.html, obtained by mailing a written request with a self-addressed stamped envelope to CONP, PO Box 570, Jefferson City, MO 65102- 0570, or acquired in person at the CONP Office, 3418 Knipp Drive, Jefferson City, Missouri, (573) 751-6403. This rule does not include any later amendments or additions.

   1. (A) Service-Specific Revenues and Expenses (Form MO 580-1865).
   2. (B) RS Means Cost Data Percentile Limit Total New Construction Project Costs (Form MO 580-1866).

AUTHORITY: section 197.320, RSMo 2000.* Emergency rule filed Aug. 29, 1997, effective Sept. 8, 1997, expired March 6, 1998. Original rule filed Aug. 29, 1997, effective March 30, 1998. Amended: Filed Oct. 19, 1999, effective April 30, 2000. Emergency rescission and rule filed Dec. 14, 2001, effective Jan. 1, 2002, expired June 29, 2002. Rescinded and readopted: Filed Dec. 14, 2001, effective June 30, 2002. Emergency amendment filed Aug. 14, 2006, effective Aug. 28, 2006, expired Feb. 23, 2007. Amended: Filed Aug. 14, 2006, effective March 30, 2007. Amended: Filed Oct. 1, 2010, effective May 30, 2011. *Original authority: 197.320, RSMo 1979, amended 1993, 1995, 1999.