N.Y. Comp. Codes R. & Regs. tit. 10, § 401.1 – Issuance of operating certificates.

(a) For new facilities, an establishment/construction application will contain the information necessary for automatic issuance of the initial operating certificate following final approval of the establishment/construction application. For purposes of this subdivision, final approval of the establishment/construction application shall consist of all final approvals, surveys and satisfaction of any contingency conditions.
(b) An operating certificate issued pursuant to subdivision (a) of this section shall remain in force until revised, annulled, revoked or surrendered, unless an expiration date is specified in the operating certificate as a result of a determination that a subsequent evaluation is necessary to ensure that the facility is operating in compliance with Public Health Law, article 28 and the rules and regulations promulgated thereunder.
(c) Upon the death of any person, party or member of a partnership to whom an operating certificate has been issued, the commissioner may permit the facility to continue operating under the existing operating certificate for such time as in his or her discretion shall be required for the transfer of such decedent's interest in the facility, for the processing of an application to the State Public Health Council for approval of establishment of a transferee of such decedent's interest and for the processing of an operating certificate on behalf of such transferee.
(d) Medical facilities not under the direction of the same governing authority, with each facility separately incorporated or owned and each operated by separate governing authorities, even though located on the same premises, shall each require a separate operating certificate.
(e) In addition to the operating certificate issued to each municipal hospital in a municipality having more than one such hospital, the municipality operating such hospital system shall have a separate operating certificate.
(f) Notwithstanding the limitations of this section, the commissioner upon a showing that efficiency of operations and services will result, may issue one operating certificate to a hospital when the facility is operated by one governing authority. A determination of efficiency of operation shall be based upon the following:
1. (1) Operational elements:
  1. (i) existence of a single medical staff organization;
  2. (ii) existence of a single credentialing, appointment, and privileges process for medical staff;
  3. (iii) one chief executive officer accountable to the governing body;
  4. (iv) uniform hospital policies;
  5. (v) uniform patient care policies; and
  6. (vi) uniform medical education and allied health programs, if applicable.
2. (2) Economic elements:
  1. (i) demonstrable long-term economies in construction;
  2. (ii) demonstrable long-term economies in volume purchasing;
  3. (iii) demonstrable long-term economies resulting from an enhanced ability to afford specialized management and related expertise;
  4. (iv) demonstrable long-term economies resulting from standardization of hotel-type services, supplies and equipment; or
  5. (v) demonstrable long-term economies resulting from improved utilization of services and programs, staffing and financial viability of the hospital.
(g) Extension clinic shall mean a clinic which is a component of a general hospital sponsored ambulatory care program, or a diagnostic and treatment center sponsored ambulatory care program, offering services of a nonemergent nature and located on premises other than those of the hospital or diagnostic and treatment center which operates it. An extension clinic of a hospital or diagnostic and treatment center may be certified to provide services, authorized to be provided by a diagnostic and treatment center, other than or in addition to the services provided at the sponsoring hospital or center.
(h) A multi-site facility shall mean two or more general hospitals operated by a single governing authority or operator and located in separate premises.
(i) Except for part-time clinic sites as defined in section 700.2(a)(22) of this Title, an operating certificate shall be issued to each certified site of health care delivery, including extension clinics and shall indicate the specific services approved to be provided at that site.
(j) An established article 28 network shall mean any arrangement in which operating authority, including, but not necessarily limited to, any of the functions listed under section 405.1(c) of this Title, is legally delegated to a corporation or other entity by hospitals participating in such arrangement and in which the corporation or other entity has received establishment approval by the Public Health Council under article 28 of the Public Health Law as operator or co-operator of the participating hospitals. An established article 28 network may, but need not, be a multi-site facility, as such term is defined in subdivision (h) of this section.