Sec.19a-639a-3. Certificate of need application

(a) The application shall consist of the following:

(1) The appropriate application form which should be filled out in its entirety and all supporting documents should be attached to the application and referenced as either an attachment or exhibit in the order in which they appear in the application for the specific type of proposal, as follows, which are available and may be downloaded from the Office’s website:

(A) Establishment of a new health care facility as defined in section 19a-630 of the Connecticut General Statutes;

(B) Establishment of an outpatient surgical facility;

(C) Establishment of a freestanding emergency department;

(D) Transfer of ownership of a health care facility;

(E) Termination of inpatient or outpatient services by a short-term acute care general hospital or children’s hospital;

(F) Termination of surgical services by an outpatient surgical facility or a facility that provides outpatient surgical services as part of the outpatient surgery department of a hospital pursuant to section 19a-638 of the Connecticut General Statutes;

(G) Termination of an emergency department by a short-term acute care general hospital;

(H) Establishment of cardiac services;

(I) Acquisition of any of the equipment enumerated in section 19a-638 of the Connecticut General Statutes;

(J) Increase in licensed bed capacity; and

(K) Increase in operating rooms by an outpatient surgical facility pursuant to section 19a-638 of the Connecticut General Statutes.

(2) A copy of the notice of the certificate of need application demonstrating that such notice was published for at least three consecutive days in a newspaper having substantial circulation in the town in which the project is going to be located pursuant to section 19a-639a of the Connecticut General Statutes;

(3) A description of the project setting forth the proposal in as much detail as possible. The description shall reference the applicable requirement for a certificate of need under section 19a-638 of the Connecticut General Statutes;

(4) The specific location of the facility, service or equipment;

(5) A detailed description of how the proposal relates to each of the guidelines and principles enumerated in section 19a-639 of the Connecticut General Statutes and any supporting documentation; and

(6) All other information as required by the specific application form, which is available on the Office’s website.

(b) One original and four copies of the application shall be submitted to the Office at 410 Capitol Avenue, MS#13HCA, Hartford, CT 06134. The application shall be accompanied by the five hundred dollar filing fee pursuant to section 19a-639a of the Connecticut General Statutes. If the application including attachments or exhibits does not exceed fifty pages, it may be filed electronically in accordance with subsection (c) of this section.

(c) Applications not exceeding fifty pages may be filed electronically in PDF format. All applications exceeding fifty pages must be filed in accordance with subsection (b) of this section.

(d) Applications shall be deemed received on the date and time at which the Office receives the document or the complete electronic version of the document. Any documents received after normal business hours shall be deemed received on the following business day.

(Effective April 9, 2013)