Title 31, Chapter 6, Section 2
As used in this chapter, the term:
(1) "Ambulatory surgical or obstetrical facility" means a public
or private facility, not a part of a hospital, which provides
surgical or obstetrical treatment performed under general or
regional anesthesia in an operating room environment to patients
not requiring hospitalization.
(2) "Application" means a written request for a certificate of
need made to the department, containing such documentation and
information as the department may require.
(3) "Bed capacity" means space used exclusively for inpatient
care, including space designed or remodeled for inpatient beds
even though temporarily not used for such purposes. The number of
beds to be counted in any patient room shall be the maximum number
for which adequate square footage is provided as established by
rules of the Department of Human Resources, except that single
beds in single rooms shall be counted even if the room contains
inadequate square footage.
(4) "Certificate of need" means an official determination by the
department, evidenced by certification issued pursuant to an
application, that the action proposed in the application satisfies
and complies with the criteria contained in this chapter and rules
promulgated pursuant hereto.
(5) "Clinical health services" means diagnostic, treatment, or
rehabilitative services provided in a health care facility, or
parts of the physical plant where such services are located in a
health care facility, and includes, but is not limited to, the
following: radiology and diagnostic imaging, such as magnetic
resonance imaging and positron emission tomography; radiation
therapy; biliary lithotripsy; surgery; intensive care; coronary
care; pediatrics; gynecology; obstetrics; general medical care;
medical/surgical care; inpatient nursing care, whether
intermediate, skilled, or extended care; cardiac catheterization;
open-heart surgery; inpatient rehabilitation; and alcohol, drug
abuse, and mental health services.
(6) "Consumer" means a person who is not employed by any health
care facility or provider and who has no financial or fiduciary
interest in any health care facility or provider.
(6.1) "Department" means the Department of Community Health
established under Chapter 5A of this title.
(7) "Develop," with reference to a project, means:
(A) Constructing, remodeling, installing, or proceeding with a
project, or any part of a project, or a capital expenditure
project, the cost estimate for which exceeds $900,000.00; or
(B) The expenditure or commitment of funds exceeding $500,000.00
for orders, purchases, leases, or acquisitions through other
comparable arrangements of major medical equipment.
Notwithstanding subparagraphs (A) and (B) of this paragraph, the
expenditure or commitment or incurring an obligation for the
expenditure of funds to develop certificate of need applications,
studies, reports, schematics, preliminary plans and
specifications, or working drawings or to acquire, develop, or
prepare sites shall not be considered to be the developing of a
(7.1) "Diagnostic, treatment, or rehabilitation center" means any
professional or business undertaking, whether for profit or not
for profit, which offers or proposes to offer any clinical health
service in a setting which is not part of a hospital.
(8) "Health care facility" means hospitals; other special care units, including but not limited to podiatric facilities; skilled nursing facilities; intermediate care facilities; personal care homes; ambulatory surgical or obstetrical facilities; health maintenance organizations; home health agencies; diagnostic, treatment, or rehabilitation centers, but only to the extent that subparagraph (G) or (H), or both subparagraphs (G) and (H), of paragraph (14) of this Code section are applicable thereto; and facilities which are devoted to the provision of treatment and rehabilitative care for periods continuing for 24 hours or longer for persons who have traumatic brain injury, as defined in Code Section 37-3-1.
(9) "Health maintenance organization" means a public or private
organization organized under the laws of this state which:
(A) Provides or otherwise makes available to enrolled
participants health care services, including at least the
following basic health care services: usual physicians'
services, hospitalization, laboratory, X-ray, emergency and
preventive services, and out-of-area coverage;
(B) Is compensated, except for copayments, for the provision of
the basic health care services listed in subparagraph (A) of
this paragraph to enrolled participants on a predetermined
periodic rate basis; and
(C) Provides physicians' services primarily:
(i) Directly through physicians who are either employees or
partners of such organization; or
(ii) Through arrangements with individual physicians organized
on a group practice or individual practice basis.
(10) "Health Strategies Council" or "council" means the body
created by this chapter to advise the Department of Community
Health and adopt the state health plan.
(11) "Home health agency" means a public agency or private
organization, or a subdivision of such an agency or organization,
which is primarily engaged in providing to individuals who are
under a written plan of care of a physician, on a visiting basis
in the places of residence used as such individuals' homes,
part-time or intermittent nursing care provided by or under the
supervision of a registered professional nurse, and one or more of
the following services:
(A) Physical therapy;
(B) Occupational therapy;
(C) Speech therapy;
(D) Medical social services under the direction of a physician;
(E) Part-time or intermittent services of a home health aide.
(12) "Hospital" means an institution which is primarily engaged in
providing to inpatients, by or under the supervision of
physicians, diagnostic services and therapeutic services for
medical diagnosis, treatment, and care of injured, disabled, or
sick persons or rehabilitation services for the rehabilitation of
injured, disabled, or sick persons. Such term includes public,
private, psychiatric, rehabilitative, geriatric, osteopathic, and
other specialty hospitals.
(13) "Intermediate care facility" means an institution which
provides, on a regular basis, health related care and services to
individuals who do not require the degree of care and treatment
which a hospital or skilled nursing facility is designed to
provide but who, because of their mental or physical condition,
require health related care and services beyond the provision of
room and board.
(14) "New institutional health service" means:
(A) The construction, development, or other establishment of a
new health care facility;
(B) Any expenditure by or on behalf of a health care facility in
excess of $900,000.00 which, under generally accepted accounting
principles consistently applied, is a capital expenditure,
except expenditures for acquisition of an existing health care
facility not owned or operated by or on behalf of a political
subdivision of this state, or any combination of such political
subdivisions, or by or on behalf of a hospital authority, as
defined in Article 4 of Chapter 7 of this title or certificate
of need owned by such facility in connection with its
(C) Any increase in the bed capacity of a health care facility except as provided in Code Section 31-6-47;
(D) Clinical health services which are offered in or through a
health care facility, which were not offered on a regular basis
in or through such health care facility within the 12 month
period prior to the time such services would be offered;
(E) Any conversion or upgrading of a facility such that it is
converted from a type of facility not covered by this chapter to
any of the types of health care facilities which are covered by
(F) The purchase or lease by or on behalf of a health care
facility of diagnostic or therapeutic equipment with a value in
excess of $500,000.00. The acquisition of one or more items of
functionally related diagnostic or therapeutic equipment shall
be considered as one project;
(G) Clinical health services which are offered in or through a
diagnostic, treatment, or rehabilitation center which were not
offered on a regular basis in or through that center within the
12 month period prior to the time such services would be
offered, but only if the clinical health services are any of the
(i) Radiation therapy;
(ii) Biliary lithotripsy;
(iii) Surgery in an operating room environment, including but
not limited to ambulatory surgery; provided, however, this
provision shall not apply to surgery performed in the offices
of an individual private physician or single group practice of
private physicians if such surgery is performed in a facility
that is owned, operated, and utilized by such physicians who
also are of a single specialty and the capital expenditure
associated with the construction, development, or other
establishment of the clinical health service does not exceed
the amount of $1 million; and
(iv) Cardiac catheterization; or
(H) The purchase, lease, or other use by or on behalf of a
diagnostic, treatment, or rehabilitation center of diagnostic or
therapeutic equipment with a value in excess of $500,000.00.
The acquisition of one or more items of functionally related
diagnostic or therapeutic equipment shall be considered as one
The dollar amounts specified in subparagraphs (B), (F), and (H) of
this paragraph, division (iii) of subparagraph (G) of this
paragraph, and of paragraph (7) of this Code section shall be
adjusted annually by an amount calculated by multiplying such
dollar amounts (as adjusted for the preceding year) by the annual
percentage of change in the composite construction index, or its
successor or appropriate replacement index, if any, published by
the Bureau of the Census of the Department of Commerce of the
United States government for the preceding calendar year,
commencing on July 1, 1991, and on each anniversary thereafter of
publication of the index. The department shall immediately
institute rule-making procedures to adopt such adjusted dollar
amounts. In calculating the dollar amounts of a proposed project
for purposes of subparagraphs (B), (F), and (H) of this paragraph,
division (iii) of subparagraph (G) of this paragraph, and of
paragraph (7) of this Code section, the costs of all items subject
to review by this chapter and items not subject to review by this
chapter associated with and simultaneously developed or proposed
with the project shall be counted, except for the expenditure or
commitment of or incurring an obligation for the expenditure of
funds to develop certificate of need applications, studies,
reports, schematics, preliminary plans and specifications or
working drawings, or to acquire sites.
(15) "Nonclinical health services" means services or functions
provided or performed by a health care facility, and the parts of
the physical plant where they are located in a health care
facility that are not diagnostic, therapeutic, or rehabilitative
services to patients and are not clinical health services defined
in this chapter.
(16) "Offer" means that the health care facility is open for the
acceptance of patients or performance of services and has
qualified personnel, equipment, and supplies necessary to provide
specified clinical health services.
(16.1) "Operating room environment" means an environment which meets the minimum physical plant and operational standards specified on January 1, 1991, for ambulatory surgical treatment centers in Section 290-5-33-.10 of the rules of the Department of Human Resources.
(17) "Person" means any individual, trust or estate, partnership,
corporation (including associations, joint-stock companies, and
insurance companies), state, political subdivision, hospital
authority, or instrumentality (including a municipal corporation)
of a state as defined in the laws of this state.
(18) "Personal care home" means a residential facility having at
least 25 beds and providing, for compensation, protective care and
oversight of ambulatory, nonrelated persons who need a monitored
environment but who do not have injuries or disabilities which
require chronic or convalescent care, including medical, nursing,
or intermediate care. Personal care homes include those
facilities which monitor daily residents' functioning and
location, have the capability for crisis intervention, and provide
supervision in areas of nutrition, medication, and provision of
transient medical care. Such term does not include:
(A) Old age residences which are devoted to independent living
units with kitchen facilities in which residents have the option
of preparing and serving some or all of their own meals; or
(B) Boarding facilities which do not provide personal care.
(20) "Project" means a proposal to take an action for which a
certificate of need is required under this chapter. A project or
proposed project may refer to the proposal from its earliest
planning stages up through the point at which the new
institutional health service is offered.
(21) "Review board" means the Health Planning Review Board created
by this chapter.
(22) "Skilled nursing facility" means a public or private
institution or a distinct part of an institution which is
primarily engaged in providing inpatient skilled nursing care and
related services for patients who require medical or nursing care
or rehabilitation services for the rehabilitation of injured,
disabled, or sick persons.
(23) "State health plan" means a comprehensive program adopted by
the Health Strategies Council, approved by the Governor, and
implemented by the State of Georgia for the purpose of providing
adequate health care services and facilities throughout the state.