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<regulation prefix="Regulation" num=".20" citation="COMAR 10.24.01.20" title_num="10" subtitle_num="24" chapter_num="01" heading="Emergency Certificate of Need.">
  <paragraph num="A.">
    <text>The Executive Director may issue an emergency Certificate of Need under the following circumstances that would otherwise require issuance of a CON:</text>
    <paragraph num="(1)">
      <text>A situation presents hazards to employees or patients of a health care facility, and the project required to address the situation would otherwise require CON review;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The closing of a health care facility by State licensing authorities requires changes or adjustments in other facilities to accommodate displaced patients, and the changes or adjustments would otherwise require that these facilities obtain a CON under these regulations; or</text>
    </paragraph>
    <paragraph num="(3)">
      <text>A project that would require CON review is necessary to address a public health emergency and cannot be delayed.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Procedure for an Emergency Certificate of Need.</text>
    <paragraph num="(1)">
      <text>A health care facility may apply for an emergency CON by sending a signed letter in PDF format by email and hard copy to the Executive Director that contains:</text>
      <paragraph num="(a)">
        <text>A description of the project for which an emergency CON is sought;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>An explanation of the need for emergency action;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The location and current use of the space where the proposed project will be implemented;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>The time frame by which the project can be implemented;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Approximate cost, if known; and</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Status of existing unused physical bed space at the health care facility that could quickly be converted to inpatient or resident care to address the emergency.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>The applicant shall timely provide additional information requested by Commission staff.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Commission Action.</text>
    <paragraph num="(1)">
      <text>The Executive Director may grant or deny an emergency CON application after consultation with the Chair of the Commission and receipt of suitably detailed information from the applicable State licensing agency regarding the need for emergency action. If, upon receipt of this information, the Executive Director agrees that the project is needed to address an emergency situation, the Executive Director shall issue an emergency Certificate of Need. The issuance of an emergency CON shall be on the agenda of the next scheduled Commission meeting for confirmation by the Commission.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The Executive Director may exercise the discretion not to make a decision on an emergency CON application and refer the application for consideration by the Commission. If a quorum of the Commission agrees that the project is needed to address an emergency situation, the Commission shall issue an emergency Certificate of Need.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Duration of Emergency Certificate of Need. The emergency CON is temporary and is valid for a period not to exceed 165 days. The duration of an emergency CON may be extended by the Executive Director for good cause shown by the applicant or at the request of the Secretary.</text>
  </paragraph>
  <paragraph num="E.">
    <text>A health care facility that desires to retain the capacity or project approved in an emergency CON shall, at least 30 days before the termination of the emergency CON, file a letter of intent followed by a CON application in accordance with the provisions in Regulation .08 of this chapter for an unscheduled review. The normal review process and time period set forth in this chapter apply to the review of a CON application filed after issuance of an emergency CON. This filing deadline may be extended by the Executive Director. The duration of an emergency CON shall be extended automatically during any period of time when the applicant has properly and timely sought a CON to retain the capacity or project approved on an emergency basis.</text>
  </paragraph>
  <paragraph num="F.">
    <text>Review of Denied Application. In the event the Executive Director denies an application for an emergency CON, the applicant may submit a written request for Commission review of the decision within 15 days of the denial, stating with particularity the grounds and factual basis for the applicant’s disagreement with the Executive Director’s decision. The Commission shall make a decision on the request for review within 45 days of the request.</text>
  </paragraph>
</regulation>