Use the links below for easy navigation` Letters of Intent Expired Letters of Intent New CON Applications Pending Review/Incomplete Applications Pending Review/Complete Applications Pending Review/Complete/Joined Applications Recently Approved Applications Recently Denied Applications Withdrawn CON Applications Appealed LNRs Appealed Determinations Appealed CON Projects CERTIFICATE OF NEED Requests for LNR for Establishment of Physician-Owned Ambulatory Surgery Facilities Requests for LNR for Diagnostic or Therapeutic Equipment Requests for Miscellaneous Letters of Determination Requests for Extended Implementation/Performance Period March 27, 2013 April 2, 2013 Batching Notifications - Spring Need Projection Analyses New Batching Review Winter cycle Spring Cycle Non-Filed or Incomplete Surveys Indigent-Charity Shortfalls Legislation Affecting CON New CON Filing Requirements (effective July 1, 2008) New Reporting Requirements (effective July 1, 2008) Certificate of Need Appeal Panel Contact Information Open Record Request Form Georgia Department of Community Health Healthcare Facility Regulation Division/ Office of Health Planning 2 Peachtree Street 5th Floor Atlanta, Georgia 30303-3159 (404) 656-0409 (404) 656-0442 Fax www.dch.georgia.gov www.GaMap2Care.info Letters of Intent LOI2013016 Athens Regional Medical Center Single Console Da Vinci Si Robotic Surgery System Received: 3/13/2013 Application must be submitted on: 4/12/2013 Site: 1199 Prince Avenue, Athens, GA 30606 (Clarke County) Estimated Cost: $2,250,000 LOI2013017 Memorial Health University Medical Center, Inc. Renovation and Expansion of Emergency Department Received: 3/26/2013 Application must be submitted on: 4/25/2013 Site: 4700 Waters Avenue, Savannah, GA 31404 (Chatham County) Estimated Cost: $16,500,000 LOI2013018 Regional Open MRI, LLC Conversion of its LNR to an approved DTRC Received: 3/25/2013 Application must be submitted on: 4/24/2013 Site: 1014 Augusta Road SE, Suite 1, Thomson, GA 30824 (McDuffie County) Estimated Cost: $10,000 LOI2013019 Open MRI of Milledgeville, LLC Conversion of its LNR to an approved DTRC Received: 3/25/2013 Application must be submitted on: 4/24/2013 Site: 1850 N. Columbus Street, Suite 3, Milledgeville, GA 31061 (Baldwin County) Estimated Cost: $10,000 LOI2013020 Johns Creek Diagnostic Center Conversion of its LNR to an approved DTRC Received: 3/25/2013 Application must be submitted on: 4/24/2013 Site: 6920 McGinnis Ferry Road, Suwanee, GA 30024 (Forsyth County) Estimated Cost: $10,000 Expired Letters of Intent none New Applications 2013-017 West Georgia Medical Center, Inc. Purchase an MRI Unit and Replace the Existing Mobile MRI Filed: 3/25/2013 Site: 1514 Vernon Road, LaGrange, GA 30240 (Troup County) Contact: Carol Todd, General Counsel 706-882-1411 Estimated Cost: $2,413,263 Pending Review/Incomplete Applications 2013-015 MRI & Imaging of NE Georgia Replace one of its Existing MRI Scanner Filed: 3/4/2013 Deemed Incomplete: 3/12/2013 Site: 425 Broad Street, Gainesville, GA 30501 (Hall County) Contact: Per B. Normark 678-992-7311 Estimated Cost: $2,211,513 2013-016 Phoebe Putney Memorial Hospital Renovation of Seventh-Floor 2 Filed: 3/13/2013 Deemed Incomplete: 3/27/2013 Site: 7TH Third Avenue, Albany, GA 31701 (Dougherty County) Contact: Lori Jenkins, Manager of Planning 229-312-1432 Estimated Cost: $5,107,436 Pending Review/Complete/Joined Applications none Pending Review/Complete Applications 2012-053 Augusta Diagnostic Imaging Conversion of Existing Approved LNR to CON Approved DTRC Filed: 11/16/2012 Deemed Incomplete: 12/4/2012 Deemed Complete: 1/7/2013 60th Day Deadline: 3/7/2013 Decision Deadline: 5/6/2013 Site: 1211 West Medical Park Drive, Augusta, GA 30909 (Richmond County) Contact: Klara Joseph, COO 706-364-2603 Estimated Cost: $2,346,770 2012-061 Wynfield Park Health & Rehabilitation Renovation of the Existing Center Filed: 12/3/2012 Deemed Incomplete: 12/17/2012 Deemed Complete: 1/8/2013 60th Day Deadline: 3/8/2013 Decision Deadline: 5/7/2013 Site: 223 West 3rd Street, Albany, GA 31701 (Dougherty County) Contact: Stelling Nelson 478-986-7484 Estimated Cost: $8,285,651 2012-062 Winship Cancer Institute of Emory University Acquisition of Siemens Magnatom Aera 1.5T MRI Filed: 12/3/2012 Deemed Complete: 12/17/2012 60th Day Deadline: 2/14/2013 Decision Deadline: 4/15/2013 Site: 1365-C Clifton Road, Atlanta, GA 30322 (DeKalb County) Contact: Toni Wimby, Associate Administrator 404-686-2450 Estimated Cost: $3,175,000 2012-063 Northside Hospital - Forsyth 16 Bed Expansion Filed: 12/13/2012 Deemed Complete: 12/31/2012 60th Day Deadline: 2/28/2013 Decision Deadline: 4/29/2013 Site: 1200 Northside Forsyth Drive, Cumming, GA 30041 (Forsyth County) Contact: Brian Toporek, Senior Planner 404-851-6821 Estimated Cost: $0 2012-064 WellStar Kennestone Hospital Renovate Cancer Support Center Filed: 12/13/2012 Deemed Complete: 12/31/2012 60th Day Deadline: 2/28/2013 Decision Deadline: 4/29/2013 Site: 677 Church Street, Marietta, GA 30060 (Cobb County) Contact: Caroline C. Aultman 678-331-6887 Estimated Cost: $6,785,000 2012-065 Cartersville Medical Center New Off-Site Emergency Facility Filed: 12/13/2012 Deemed Incomplete: 12/19/2012 Deemed Complete: 2/19/2013 60th Day Deadline: 4/19/2013 3 Decision Deadline: 6/18/2013 Site: Cherokee Village East, Acworth, GA 30102 (Cherokee County) Contact: Lori E. Rakes, COO 770-387-8181 Estimated Cost: $9,267,743 2013-001 MRI & Imaging of Douglasville Convert Existing Diagnostic Imaging Facility to a CON DTRC Filed: 1/7/2013 Deemed Incomplete: 1/18/2013 Deemed Complete: 2/4/2013 60th Day Deadline: 4/4/2013 Decision Deadline: 6/3/2013 Site: 6095 Professional Parkway, Suite 101B, Douglasville, GA 30134 (Douglas County) Contact: Per B. Normark 770-330-0101 Estimated Cost: $0 2013-002 MRI & Imaging of Habersham Convert Existing Diagnostic Imaging Facility to a CON DTRC in Habersham Filed: 1/7/2013 Deemed Incomplete: 1/18/2013 Deemed Complete: 2/4/2013 60th Day Deadline: 4/4/2013 Decision Deadline: 6/3/2013 Site: 638 Historic Highway 441 North, Suite D, Demorest, GA 30535 (Habersham County) Contact: Per B. Normark 770-300-0101 Estimated Cost: $0 2013-003 Northwest Imaging, LLC Convert one (1) existing MRI unit LNR-DTRC to a CON-approved DTRC Filed: 1/7/2013 Deemed Incomplete: 1/22/2013 Deemed Complete: 2/14/2013 60th Day Deadline: 4/14/2013 Decision Deadline: 6/13/2013 Site: 4460 Austell Road, Austell, GA 30106 (Cobb County) Contact: Robert Bashuk, MD 770-941-4716 Estimated Cost: $15,000 2013-004 Piedmont Atlanta Hospital Acquisition of Third Robotic Surgery Center Filed: 1/18/2013 Deemed Complete: 1/31/2013 60th Day Deadline: 3/31/2013 Decision Deadline: 5/30/2013 Site: 1968 Peachtree Road, NW, Atlanta, GA 30309 (Fulton County) Contact: Davis Dunbar 404-788-3638 Estimated Cost: $1,777,000 2013-005 MRI & Imaging of Hapeville Convert Existing Diagnostic Imaging Facility to a CON DTRC Filed: 1/22/2013 Deemed Incomplete: 1/31/2013 Deemed Complete: 2/13/2013 60th Day Deadline: 4/13/2013 Decision Deadline: 6/12/2013 Site: 535 North Central Avenue, Hapeville, GA 30354 (Fulton County) Contact: Per B. Normark 770-300-0101 Estimated Cost: $0 2013-006 Open MRI of Georgia, LLC dba MRI & Imaging of Duluth Convert Existing Diagnostic Imaging to a CON DTRC Filed: 1/22/2013 Deemed Incomplete: 1/31/2013 Deemed Complete: 2/13/2013 60th Day Deadline: 4/13/2013 Decision Deadline: 6/12/2013 Site: 10670-A Medlock Bridge Road, Duluth, GA 30097 (Gwinnett County) Contact: Per B. Normark 770-300-0101 Estimated Cost: $0 2013-007 Piedmont Atlanta Hospital Renovate an Existing ICU 4 Filed: 1/28/2013 Deemed Complete: 2/11/2013 60th Day Deadline: 4/11/2013 Decision Deadline: 6/10/2013 Site: 1968 Peachtree Road, NW, Atlanta, GA 30309 (Fulton County) Contact: Davis Dunbar 404-788-3638 Estimated Cost: $8,917,000 2013-008 Riverside Imaging Specialist, LLC Establish a Freestanding Diagnostic Imaging Center Filed: 2/6/2013 Deemed Complete: 2/21/2013 60th Day Deadline: 4/21/2013 Decision Deadline: 6/20/2013 Site: 2140 Riverside Drive, Macon, GA 31204 (Bibb County) Contact: Howard Williams III, MD DABPM 404-538-7246 Estimated Cost: $1,416,400 2013-009 Emory University dba Emory University Hospital Acquisition of a CT Scanner Filed: 2/14/2013 Deemed Complete: 2/28/2013 60th Day Deadline: 4/28/2013 Decision Deadline: 6/27/2013 Site: 1364 Clifton Road, Atlanta, GA 30322 (DeKalb County) Contact: Toni Wimby, Associate Administrator 404-686-2450 Estimated Cost: $1,589,957 2013-010 Northside Hospital - Forsyth Megavoltage Radiation Therapy - Gamma Knife - Batching Filed: 2/19/2013 Deemed Complete: 2/19/2013 60th Day Deadline: 4/19/2013 Decision Deadline: 6/18/2013 Site: 1200 Northside Hospital Forsyth Drive, Cumming, GA 30041 (Forsyth County) Contact: Brian J. Toporek 404-851-6821 Estimated Cost: $8,163,620 2013-011 Southeast Georgia Health System Camden Campus PET/CT Services - Mobile - Batching Filed: 2/19/2013 Deemed Complete: 2/19/2013 60th Day Deadline: 4/19/2013 Decision Deadline: 6/18/2013 Site: 2000 Dan Proctor Drive, St. Mary's, GA 31558 (Camden County) Contact: Marjorie Mathieu, Vice President 912-466-7055 Estimated Cost: $154,227 2013-012 Atlanta Medical Center (AMC - South Campus) Add 15 Geriatric Psychiatric Beds - Batching Filed: 2/19/2013 Deemed Complete: 2/19/2013 60th Day Deadline: 4/19/2013 Decision Deadline: 6/18/2013 Site: 1170 Cleveland Avenue, East Point, GA 30344 (Fulton County) Contact: Todd Goodall, Chief Business Development Officer 404-265-4202 Estimated Cost: $524,089 2013-013 North Georgia Medical Center Add 10-bed Senior Mental Health Program - Batching Filed: 2/19/2013 Deemed Complete: 2/19/2013 60th Day Deadline: 4/19/2013 Decision Deadline: 6/18/2013 Site: 1362 South Main Street, Ellijay, GA 30540 (Gilmer County) Contact: Debbie Self, Chief Financial Officer 706-276-4741 Estimated Cost: $370,000 5 2013-014 Emory University Hospital Construct a new Clinical Tower Filed: 3/1/2013 Deemed Incomplete: 3/15/2013 Deemed Complete: 3/20/2013 60th Day Deadline: 5/18/2013 Decision Deadline: 7/17/2013 Site: 1365 Clifton Road, Atlanta, GA 30322 (DeKalb County) Contact: Toni Wimby 404-686-2450 Estimated Cost: $312,030,000 Recently Approved Applications 2012-051 Polk Medical Center, Inc. To Build a Replacement Hospital Filed: 10/5/2012 Deemed Incomplete: 10/22/2012 Deemed Complete: 11/8/2012 60th Day Deadline: 1/6/2013 Decision Deadline: 3/7/2013 APPROVED: 3/7/2013 Site: US 278 and Kelly Road, Cedartown, GA 30125 (Polk County) Contact: Stephen Weed, Director of Planning 706-509-3257 Estimated Cost: $39,767,867 2012-052 Saint Joseph's Hospital of Atlanta, Inc. Replacement of a Previously LNR-approved da Vinci S Robotic Surgical System Filed: 11/9/2012 Deemed Complete: 11/26/2012 60th Day Deadline: 1/24/2013 Decision Deadline: 3/25/2013 APPROVED: 3/25/2013 Site: 5665 Peachtree Dunwoody Road, NE, Atlanta, GA 30342 (Fulton County) Contact: Heather Dexter, VP Planning 678-843-7001 Estimated Cost: $1,830,000 2012-054 Memorial Health University Medical Center, Inc. Add Four (4) Neonatal Intermediate Care Bassinets BATCHING Filed: 11/24/2012 Deemed Complete: 11/24/2012 60th Day Deadline: 1/22/2013 Decision Deadline: 3/23/2013 APPROVED: 3/22/2013 Site: 4700 Waters Avenue, Savannah, GA 31404 (Chatham County) Contact: Laura Dow 912-350-8613 Estimated Cost: $2,249,500 2012-055 Rockdale Medical Center Establish a Four (4) Bed Neonatal Intensive (Level III) Care Service BATCHING Filed: 11/24/2012 Deemed Complete: 11/24/2012 60th Day Deadline: 1/22/2013 Decision Deadline: 3/23/2013 APPROVED: 3/22/2013 Site: 1412 Milstead Avenue, Conyers, GA 30012 (Rockdale County) Contact: James Atkins 770-918-3755 Estimated Cost: $532,168 2012-056 Memorial Health University Medical Center, Inc. Add Eight (8) Neonatal Intensive Care Bassinets BATCHING Filed: 11/24/2012 Deemed Complete: 11/24/2012 60th Day Deadline: 1/22/2013 Decision Deadline: 3/23/2013 APPROVED: 3/22/2013 Site: 4700 Waters Avenue, Savannah, GA 31404 (Chatham County) Contact: Laura Dow 912-350-8613 6 Estimated Cost: $1,645,500 2012-057 The Medical Center, Inc. Add Five (5) Neonatal Intensive Care Beds BATCHING Filed: 11/24/2012 Deemed Complete: 11/24/2012 60th Day Deadline: 1/22/2013 Decision Deadline: 3/23/2013 APPROVED: 3/22/2013 Site: 710 Center Street, Columbus, GA 31901 (Muscogee County) Contact: Donald E. Elder 706-660-6342 Estimated Cost: $867,720 2012-058 Associates Surgery Center, Inc. Convert from PO Single Specialty ASC to CON Single Specialty ASC BATCHING Filed: 11/24/2012 Deemed Complete: 11/24/2012 60th Day Deadline: 1/22/2013 Decision Deadline: 3/23/2013 APPROVED: 3/22/2013 Site: 864 First Street, Macon, GA 31201 (Bibb County) Contact: Dr. J. Gregory Jones 478-741-6522 Estimated Cost: $30,000 2012-059 Neurological Institute Ambulatory Surgery Center, LLC Convert from a PO Single Specialty ASC to CON Single Specialty ASC BATCHING Filed: 11/24/2012 Deemed Complete: 11/24/2012 60th Day Deadline: 1/22/2013 Decision Deadline: 3/23/2013 APPROVED: 3/22/2013 Site: 1 Jackson Boulevard, Suite 101, Savannah, GA 31405 (Chatham County) Contact: Randolph C. Bishop, M.D. 912-355-1010 Estimated Cost: $50,000 2012-060 Thomasville Surgery Center, Inc. Convert from PO Single Specialty ASC to Single Specialty CON ASC BATCHING Filed: 11/24/2012 Deemed Complete: 11/24/2012 60th Day Deadline: 1/22/2013 Decision Deadline: 3/23/2013 APPROVED: 3/22/2013 Site: 2282 East Pinetree Boulevard, Suite B, Thomasville, GA 31792 (Thomas County) Contact: Leslie Harvey, RN 229-228-4988 Estimated Cost: $15,000 Recently Denied Applications none CON Applications Withdrawn None Appealed LNRs LNR-ASC2011-021 Meadows Gynecology Surgery Center, Inc. and Meadows Surgical Arts, Inc. ("Meadows") Requested Letter of Non-Reviewability for the establishment of a Physician-Owned, Single Specialty, Office Based Ambulatory Surgery Center, 11/16/2011. Determination of "denied" issued on ,4/3/2012. Meadows Gynecology Surgery Center, Inc. and Meadows Surgical Arts, Inc. filed request for Administrative Appeal Hearing, 05/02/2012. Administrative Hearing Date: To be Determined. 7 Appealed Determinations DET2012181 Meadows Regional Cancer Center, LLC - Toombs Requested Determination for modification of approved Certificate of Need project, 11/15/2012. Determination of "non-reviewable as proposed" issued on 2/25/2013. Satilla Regional Cancer Treatment Center, LLC ("Satilla") and Statesboro Cancer Care, LLC d/b/a South Georgia Center ("South Georgia") collectively filed request for Administrative Appeal Hearing, 3/26/2013. Appealed CON Projects 2010-025 WellStar Kennestone at East Cobb (Cobb) Development of an Ambulatory Surgery Facility - Batching Agency Decision: Approved, 9/20/2010 Appealed By: St. Joseph's Hospital of Atlanta, 10/19/2010; Northside Hospital-Atlanta and Northside Alpharetta Surgery Center, 10/19/2010; Applicant (Kennestone) requests to intervene, 10/19/2010. St. Joseph's Hospital withdrew request for appeal, 1/20/2011. Hearing postponed pending Order from Hearing Officer. Application is remanded to Department by Hearing Officer, April 6, 2011 for the Department to conduct an additional alternative review under the specific review criteria for ambulatory surgery centers. Department requests, and is granted, extension on Remand decision date, 5/6/2011. On remand, the application for alternative review only is denied, 5/16/2011. The original application remains approved, 9/20/2010. Hearing Officer: Ellwood Oakley, III, Esq. Hearing Date: 8/8/2011 8/11/2011; proposed orders from parties due 9/23/2011. Hearing Decision: Hearing Officer affirms Department decision approving application, 10/20/ 2011. Northside Hospital, Inc. requests Commissioner Review, 11/18/2011. Commissioner Review Decision: Affirmed Hearing Officer Decision to award CON to WellStar, 1/18/2012. Northside filed petition for judicial review, 2/16/2012. Superior Court Decision: The Superior Court reversed DCH's decision to grant a CON to Kennestone, 7/30/2012. Court of Appeals: granted Kennestone Hospital, Inc. and DCH's Applications for Discretionary Appeal on 09/21/12. 2011-027 HealthSouth of Georgia, LLC (Coweta) Develop 50-Bed Comprehensive Inpatient Physical Rehab Hospital (CIPR)-Batching Agency Decision: Denied, 9/19/2011 Appealed By: HealthSouth appealed the denial of their application, 10/14/2011; Southern Regional Health System, Inc. d/b/a Southern Regional Medical Center filed request to intervene, 9/27/2011. Hearing Officer: Ellwood F. Oakley, III, Esq. Hearing Date: 5/15/2012 5/18/2012 Hearing Decision: Hearing Officer reversed Department's decision, 9/5/2012. Department and Southern Regional Medical Center filed request for Commissioner Review, 10/5/2012 Commissioner Review Decision: Commissioner Review affirms Hearing Officer decision,12/18/2012. Southern Regional Medical Center (SRMC) filed petition for judicial review, 1/18/2013. Superior Court Decision: Pending 2012-032 Eastside Medical Center (Walton) New Off-Site Emergency Facility Agency Decision: Denied, 12/19/2012 Appealed By: Eastside Medical Center, 1/15/2013; Clearview Regional Medical Center files request to intervene in appeal, 1/16/2013. Eastside Medical Center withdrew appeal, 3/12/2013. 2012-037 Doctors Hospital Radiation Oncology Center (Richmond) Megavoltage Radiation Therapy, CyberKnife Agency Decision: Approved, 12/18/2012 Appealed By: Georgia Health Science Medical Center, 1/16/2013; Doctors Hospital of Augusta files request to intervene in appeal, 1/15/2013. Hearing Officer: Melvin Goldstein, Esq. Hearing Date: 6/4/2013 6/6/2013 Hearing Decision: Pending 2012-043 Doctors Hospital of Augusta, LLC (Columbia) 2012-047 University Health Services, Inc. (Richmond) New Off-Site Emergency Facility 8 Agency Decision: GA2012043 denied, 1/25/2013 - GA2012047 denied, 1/25/2013 Appealed By: Doctors (2012043) appealed the denial of their application with request to intervene in the University (2012047) appeal, 2/21/2013. University (2012047) appealed the denial of their application with request to intervene in the Doctors (2012043) appeal, 2/22/2013. Hearing Officer: William "Bill" C. Joy, Esq. Hearing Date: TBD Hearing Decision: Pending Requests for LNR for Diagnostic or Therapeutic Equipment LNR-EQT2012030 Dalton Diagnostic Associates, L.P. Fixed MRI Request received: 12/19/2012 Contact Person: John C. Church, M.D. 706-278-9729 Determination: Approved Determination Date: 3/5/2013 LNR-EQT2012031 Medical Center of Central Georgia, Inc Da Vinci Surgical Robot Request received: 12/21/2012 Contact Person: H. Bryan Forlines 478-633-6966 Determination: Approved Determination Date: 3/5/2013 LNR-EQT2012032 Ankle and Foot Associates, LLC Fixed MRI Request received: 12/26/2012 Contact Person: Jeanne Tucker 912-283-6471 Determination: Pending LNR-EQT2013001 EHCA Johns Creek, LLC dba Emory Johns Creek Hospital Fixed CT Scanner Request received: 1/4/2013 Contact Person: Laurie Hansen 678-474-7012 Determination: Approved Determination Date: 3/11/2013 LNR-EQT2013002 Houston Hospital, Inc. d/b/a Perry Hospital Fixed CT Scanner Request received: 1/8/2013 Contact Person: Tim Sisco 478-542-7837 Determination: Approved Determination Date: 3/11/2013 LNR-EQT2013004 Bone & Joint Institute of South Georgia, P.C. Fixed MRI Request received: 1/16/2013 Contact Person: J. Lex Kenerly, III, M.D. 912-427-0800 Determination: Approved Determination Date: 3/13/2013 LNR-EQT2013005 Kennestone Hospital, Inc. dba WellStar Windy Hill Hospital Fixed CT, Mammography, Ultrasound, Bone Density, Diagnostic Radiology Request received: 1/25/2013 Contact Person: Stephen Vault 678-331-6887 Determination: Pending LNR-EQT2013006 Urology Specialists of Georgia, P.C. Fixed CT Scanner Request received: 1/25/2013 Contact Person: Joshua A. Perkel, M.D. 478-745-6576 Determination: Approved Determination Date: 3/27/2013 LNR-EQT2013007 Resurgens, P.C. Fixed MRI Request received: 1/31/2013 Contact Person: Dr. Steven B. Wertheim 404-531-8452 9 Determination: Approved Determination Date: 4/1/2013 LNR-EQT2013008 CPM Imaging, LLC Fixed MRI Request received: 2/6/2013 Contact Person: Mary W. Hardwick 770-948-6824 Determination: Pending LNR-EQT2013009 Candler County Hospital Fixed CT Scanner Request received: 2/12/2013 Contact Person: Stephen C. Shepherd 912-685-5741 Determination: Pending LNR-EQT2013010 Orthopaedic & Sports Medicine Associates, P.C. Fixed MRI Request received: 2/15/2013 Contact Person: James F. Hammesfahr, MD 770-565-0011 Determination: Pending LNR-EQT2013011 Thomasville Orthopedic Center, P.C. Fixed MRI Request received: 3/11/2013 Contact Person: Necia Ross 229-226-9141 Determination: Pending LNR-EQT2013012 Houston Hospitals, Inc. dba Perry Hospital Mobile MRI Request received: 3/28/2013 Contact Person: Tim Sisco 478-542-7837 Determination: Pending Requests for LNR for Establishment of Physician-Owned Ambulatory Surgery Facilities LNR-ASC2012022 Hillcrest Surgery Associates, LLC Hillcrest Surgery Associates Site: 1110 Hillcrest Parkway Suite D, Dublin, GA 31021 Number of OR's: Specialty: Physician Owned Single Specialty Project costs as submitted: $1,126,000.00 Request received: 10/18/2012 Contact Person: Edward Luke 770-951-8427 Determination: Pending LNR-ASC2012026 Georgia Pain Management ASC, LLC Single Specialty Ambulatory Surgery Center Site: 530 Spring Street, Gainesville, GA 30501 Number of OR's: 1 Specialty: Pain Management Project costs as submitted: $76,000.00 Request received: 12/13/2012 Contact Person: Kathryn Herndon 770-503-7222 Determination: Pending LNR-ASC2012028 Panola Endoscopy Center, LLC. Single Specialty Ambulatory Surgery Center Site: 5403 Hillandale Park Court, Suite B, Lithonia 30058 Number of OR's: 2 Specialty: Gastroenterology Project costs as submitted: $0.00 Request received: 12/26/2012 Contact Person: Victor L. Moldovan 404-443-5708 Determination: Approved Determination 3/22/2013 10 LNR-ASC2013001 Thomas Eye Surgery Center, LLC Single Specialty Ambulatory Surgery Center Site: 5874 Peachtree Dunwoody Road, 4th Floor, Atlanta, GA Number of OR's: 2 Specialty: Ophthalmology Project costs as submitted: $0.00 Request received: 1/16/2013 Contact Person: Gayle R. Evans, RN MBA 770-794-4944 Determination: Pending LNR-ASC2013002 Advanced Urology Institute of Georgia, P.C. Physician Single Specialty Treatment Center Site: 1557 Janmar Road, Snellville, 30078 Number of OR's: 2 Specialty: Urology Project costs as submitted: $1,791,600.00 Request received: 1/25/2013 Contact Person: Dr. Jitesh V. Patel 678-344-8900 Determination: Pending LNR-ASC2013003 Colon & Digestive Health Specialists, LLC Physician-Owned Single-Special Ambulatory Surgery Center Site: Tract Two Norton Road, Conyers, GA 30012 Number of OR's: 3 Specialty: Gastroenterology Project costs as submitted: $2,207,591.00 Request received: 2/26/2013 Contact Person: Everette G. Jenkins 678-625-4720 Determination: Pending LNR-ASC2013004 The Interventional Spine and Pain Management Center, PC Physician-Owned Single-Specialty ASC Site: 3885 Princeton Lakes Way, Suite 400, Atlanta, GA 30331 Number of OR's: 2 Specialty: Pain Management Project costs as submitted: $259,110.98 Request received: 1/9/2013 Contact Person: Stephen Rosenbaum 404-920-4950 Determination: Pending LNR-ASC2013005 Peachtree Buckhead Surgery Center, LLC Physician-Owned Single Specialty Ambulatory Surgery Center Site: 2061 Peachtree Road, Suite 300, Atlanta, GA 30309 Number of OR's: 2 Specialty: General Surgery Project costs as submitted: $1,278,635.00 Request received: 3/15/2013 Contact Person: Josh Belinfante 678-701-9374 Determination: Pending LNR-ASC2013006 Center for Spine Interventions ASC 1, LLC Physician-Owned, Single-Specialty Ambulatory Surgery Center Site: 4586 Timber Ridge Drive, Suite 141, Douglasville, GA 30135 Number of OR's: 1 Specialty: Physiatry, Anesthesiology and Pain Project costs as submitted: $905,210.93 Request received: 3/15/2013 Contact Person: Joseph R. Ross 912-651-8941 Determination: Pending Requests for Miscellaneous Letters of Determination DET2011040 Smith of Georgia, LLC d/b/a Smith Northview Hospital Cardiac Cath Acquisition and Cardiac Cath Lab and OB Renovation Request received: 4/1/2011 Contact Person: Shamb Purohit 229-671-2002 11 Determination: Pending DET2012062 CareSouth HHA Holdings of Washington, LLC dba CareSouth Homecare Reorganization of CareSouth's Washington service area Request received: 5/3/2012 Contact Person: Rick W. Griffin 706-854-7460 Determination: Pending DET2012131 GYN Resources, Inc. Mobile Ambulatory Surgical Treatment Centers Request received: 8/8/2012 Contact Person: Vickey Worthy 404-605-7087 Determination: Pending DET2012139 AFA Equipment Corp, LLC Replacement of Open Magnetic Resonance Imaging Machine Request received: 8/21/2012 Contact Person: Jeanne Tucker 912-283-6471 Determination: Pending DET2012161 Houston Hospitals, Inc. dab Perry Hospital Replace existing fixed based CT unit Request received: 10/3/2012 Contact Person: Tim Sisco 478-542-7837 Determination: Withdr/Appl Prior to Dec Date of Withdrawal: 3/14/2013 DET2012183 Southern Regional Health System, Inc, Combine Hospital Permit Request received: 11/20/2012 Contact Person: James E. Crissey 770-991-9000 Determination: Pending DET2012207 Gwinnett Hospital System, Inc. dba Gwinnett Medical Center Renovation of Diagnostic Cardiology Department Request received: 12/21/2012 Contact Person: Mark M. Mullin 678-312-4193 Determination: Non-reviewable as proposed Determination Date: 3/4/2013 DET2012208 Floyd Healthcare Management, Inc. dba Floyd Medical Center Replacement of CON Approved Hospital Based MRI Request received: 12/21/2012 Contact Person: Stephen Weed 706-509-3257 Determination: Non-reviewable as proposed Determination Date: 3/5/2013 DET2013001 St. Mary's Health Care System, Inc. Addition of Sterile Processing Area Request received: 1/2/2013 Contact Person: Nina Evans 706-389-3947 Determination: Non-reviewable as proposed Determination Date: 3/5/2013 DET2013002 Piedmont Hospital, Ind. dba Piedmont Atlanta Hospital Renovation of the McDonnell Outpatient Surgery Center Request received: 1/3/2013 Contact Person: Davis Dunbar 404-788-3638 Determination: Non-reviewable as proposed Determination Date: 3/7/2013 DET2013003 Hidden Lake Assisted Living & Memory Care Assisted Living Community for Private Pay Residents Request received: 1/4/2013 Contact Person: John M. Pascoe/Brian P. Sticker 770-366-6600 Determination: Non-reviewable as proposed Determination Date: 3/19/2013 12 DET2013004 Phoebe Putney Health System, Inc. Development of Medical Office Building Request received: 1/4/2013 Contact Person: Lori Jenkins 229-312-1432 Determination: Non-reviewable as proposed Determination Date: 3/7/2013 DET2013005 Diagnostic Services, L.C. dba OMI Diagnostics - Alpharetta Relocation of DTRC and Replacement of One Existing MRI Unit Request received: 1/9/2013 Contact Person: Thomas Brown 770-664-7777 ext 4601 Determination: Non-reviewable as proposed Determination Date: 3/20/2013 DET2013006 HLTC, Inc dba Quinton Memorial and Rehabilitation Capital Expenditure Below CON Threshold Request received: 1/15/2013 Contact Person: Dennis Stout 706-226-4642 Determination: Non-reviewable as proposed Determination Date: 3/13/2013 DET2013007 Fayette Community Hospital, Inc. dba Piedmont Fayette Hospital Increase in Bed Capacity Request received: 1/17/2013 Contact Person: Davis Dunbar 404-788-3638 Determination: Non-reviewable as proposed Determination Date: 3/20/2013 DET2013008 Northside Hospital, Inc. dba Northside Hospital - Forsyth Replace CON approved Radiology Equipment Request received: 1/18/2013 Contact Person: Brian Toporek 404-851-6821 Determination: Non-reviewable as proposed Determination Date: 3/25/2013 DET2013009 Kennestone Hospital, Inc. Transfer of Ownership of East Cobb Imaging Center Request received: 1/28/2013 Contact Person: Stephen Vault 678-331-6887 Determination: Pending DET2013010 The Emory Clinic, Inc. Addition of two procedure rooms Request received: 1/29/2013 Contact Person: W. Wilkes Mason 404-778-5639 Determination: Pending DET2013011 Emory Orthopaedic & Spine Physiatry Outpatient Surgery Center Addition of two procedure rooms Request received: 1/29/2013 Contact Person: W. Mike Mason 404-778-5639 Determination: Pending DET2013012 Grady Health System Office Build-Out from Shell Space Request received: 1/31/2013 Contact Person: Sameul L. Williams 404-616-3228 Determination: Pending DET2013013 North Fulton medical Center, Inc. dba North Fulton Hospital Relocation of Hospital-Based ORs Request received: 2/1/2013 Contact Person: Debbie Keel 770-751-2515 Determination: Pending DET2013014 Summerhill Elderliving Home and Care Renovation of existing Nursing Facility below CON threshold Request received: 2/8/2013 13 Contact Person: Chip Davis 478-988-1294 Determination: Pending DET2013015 The Montclair Personal Care Home Increase in Licensed Bed Capacity Request received: 2/12/2013 Contact Person: Paul McGough 404-633-8875 Determination: Pending DET2013016 Floyd Healthcare Management, Inc. dba Floyd Medical Center Addition and Replacement of Computer Information System Request received: 2/15/2013 Contact Person: Stephen Weed 706-509-3257 Determination: Pending DET2013017 Floyd Healthcare Management, Inc. dba Floyd Medical Center Addition and Replacement of Computer or Information System Request received: 2/15/2013 Contact Person: Stephen Weed 706-509-3257 Determination: Pending DET2013018 Henry Medical Center, Inc. dba Piedmont Henry Hospital Establish Inpatient Hospice Services Request received: 2/19/2013 Contact Person: Davis Dunbar 404-788-3638 Determination: Pending DET2013019 Heavenly Living Center Increase Living Space from 24 to 42 Request received: 2/25/2013 Contact Person: Hamid Nikfarjam 770-726-9630 Determination: Pending DET2013020 Diagnostic Services, L.C. dba OMI Diagnostic - Marietta Relocation of DTRC with MRI Replacement Request received: 2/22/2013 Contact Person: Thomas Brown 770-664-7777 Ext 4601 Determination: Pending DET2013021 Wesley Woods Long Term Hospital, Inc. Add 10 hospital Beds Request received: 2/25/2013 Contact Person: William Such 404-728-6315 Determination: Pending DET2013022 Phoebe Putney Health System, Inc. Development of Medical Office Building Request received: 3/1/2013 Contact Person: Lori Jenkins 229-312-1432 Determination: Pending DET2013023 Fountain Crest at Lake Oconee, LLC Establishment of a Personal Care Home Request received: 3/4/2013 Contact Person: Michael C. Harris 706-868-9299 Determination: Pending DET2013024 Scepter Health and Rehab of Snellville, LLC New Emergency Generator Request received: 3/4/2013 Contact Person: Andy Garrett Shafer 903-875-5096 Determination: Pending 14 DET2013025 South Atlanta Medical Clinic, P.C. CON ASC LNR Endoscopy Center Conversion to Single Specialty/Limited Request received: 3/4/2013 Contact Person: Jay R. Prakash, M.D. 770-692-0100 Determination: Pending DET2013026 RCOG Cancer Centers, LLC dba Radiotherapy Clinics of Georgia Replacement of a Linear Accelerator Request received: 3/8/2013 Contact Person: Joe Chang, VP, Controller 310-335-4011 Determination: Pending DET2013027 DeKalb Medical Center Exemption for Adult Cardiac Catheterization Laboratory Request received: 3/8/2013 Contact Person: Don Fears 404-501-5790 Determination: Pending DET2013028 Floyd Healthcare Management, Inc. dba Floyd Medical Center Fire Alarm System Upgrade Request received: 3/8/2013 Contact Person: Stephen Weed 706-509-3257 Determination: Pending DET2013029 Gwinnett Hospital System, Inc. dba Gwinnett Medical Center - Lawrenceville CT Unit Replacement Request received: 3/12/2013 Contact Person: Mark M. Mullins 678-312-4193 Determination: Pending DET2013030 Tift County Hospital Authority dba Tift Regional Medical Center Enlargement of Two Endoscopy Procedure Rooms Request received: 3/13/2013 Contact Person: Sarah S. Thompson 229-353-6102 Determination: Pending DET2013031 Wayne County. Health Department, Hospital Authority of Wayne County Transfer of Home Health Agency County Request received: 3/15/2013 Contact Person: Rosemarie D. Parks, MD, MPH 912-285-6002 Determination: Pending DET2013032 Wayne County. Health Department, Hospital Authority of Wayne County Transfer of Home Health Agency Counties Request received: 3/15/2013 Contact Person: Rosemarie D. Parks, MD, MPH 912-285-6002 Determination: Pending DET2013033 Wayne County. Health Department, Hospital Authority of Wayne County Transfer of Home Health Agency Counties Request received: 3/15/2013 Contact Person: Rosemarie D. Parks, MD, MPH 912-285-6002 Determination: Pending DET2013034 CHMG of Griffin, LLC Fayette County Become Parent Site, Spalding County Becomes Branch Site Request received: 3/18/2013 Contact Person: Donna van der Does 913-814-2831 Determination: Pending DET2013035 Emory University dba Emory University Hospital Relocate the Care Initiation Unit (CIU) Request received: 3/19/2013 15 Contact Person: Toni Wimby 404-686-2809 Determination: Pending DET2013036 Lane Dermatology and Dermatologic Surgery, LLC. Renovations of Existing Facility Request received: 3/20/2013 Contact Person: Renee Blanton 706-322-1717 Determination: Pending DET2013037 Bacon County Health Services, Inc. dba Bacon County Hospital Upgrade the existing MRI Request received: 3/20/2013 Contact Person: Cindy R. Tuner 912-632-8961 ext 1017 Determination: Pending DET2013038 Athens Orthopedic Clinic, P.A. Fixed MRI Request received: 3/21/2013 Contact Person: Kayo Elliott 706-549-1663 Determination: Pending DET2013039 Northeast Georgia Medical Center, Inc. Replace Existing CON-Approved Cardiac Cath Lab on Main Campus Request received: 3/22/2013 Contact Person: Chad T. Bolton 770-219-6630 Determination: Pending Requests for Extended Implementation/Effective Period 2010088 Open MRI of Georgia, LLC Replacement of MRI Scanner Request to extend Performance Period Site: 6630 McGinnis Ferry Road, Suite D, Johns Creek Project Approved: 4/27/2011 Request Received: 3/12/2013 Contact: Per Normark, VP, Deputy GC (678-992-7311) Approved Cost: $1,846,835 Determination: Approved, 3/14/2013 Extended Completion Date: 4/27/2014 Need Projection Analyses Updated 3/29/2013 Current Status of Official Division of Health Planning Need Projection Analyses and Other Data Resources Need Projections and Maps for CON Regulated Services 2017 Non-Special MegaVoltage Radiation Therapy - 12/20/2012 2017 Positron Emission Tomography Services - 12/20/2012 2017 Ambulatory Surgery Center Services - 3/26/2013 2015 Home Health Agency Services - 3/26/2013 2017 Inpatient Physical Rehabilitation Services - 3/28/2013 2017 Neonatal Intensive Care Beds - 3/28/2013 2017 Neonatal Intermediate Care Beds - 3/28/2013 16 2017 Obstetric Services Beds - 3/28/2013 2015 Skilled Nursing Home Beds - 3/28/2013 Non-Batched Need Projections 2015 Cardiac Catheterization Labs - Updated 4/6/2010 2017 Long Term Care Hospital Beds - 7/2/2012 Note: Short Stay Hospital Bed Need Projections are facility-specific and completed by DCH on an ad hoc basis upon request. Currently, projections can be obtained for 2016 using 2010 utilization. Non-Filed or Incomplete Division of Health Planning Facility Surveys for Most Recent 3 Years (Survey Status as of 4/2/2013) Survey Completion Status - Survey completion status represents the status of survey filings as of the effective date indicated in each version of the Tracking Report. Surveys filed on the effective date may not be reflected as complete and may be reported as delinquent. Please contact the staff contact indicated in the instruction materials associated with each survey if your facility has filed its survey but continues to be reflected as incomplete. Facility Name County Survey Year Annual Hospital Questionnaire and Addenda (Survey Years 2009 thru 2011) Barrow Regional Medical Center Barrow 2011 Berrien County Hospital Berrien 2011 Burke Medical Center Burke 2011 Charlton Memorial Hospital Charlton 2011 East Central Regional Hospital - Augusta Campus Richmond 2011 Flint River Community Hospital Macon 2011 Georgia Regional Hospital at Savannah Chatham 2009 Georgia Regional Hospital at Savannah Chatham 2011 Georgia Regional Hospital-Atlanta DeKalb 2011 Hutcheson Medical Center Catoosa 2011 Lower Oconee Community Hospital, Inc. Wheeler 2011 Northwest Georgia Regional Hospital Floyd 2010 Northwest Georgia Regional Hospital Floyd 2011 Southern Crescent Hospital for Specialty Care Clayton 2011 Southwest Georgia Regional Medical Center Randolph 2011 Stewart Webster Hospital Stewart 2009 Stewart Webster Hospital Stewart 2010 Youth Villages - Inner Harbour Campus Douglas 2011 Annual Nursing Home Questionnaire (Survey Years 2009 thru 2011) Agape Health & Rehab of Moultrie, LLC Colquitt 2011 Bell Minor Home, The Hall 2011 Brown's Health & Rehabilitation Center Bulloch 2011 Emanuel County Nursing Home Emanuel 2011 Folkston Park Care And Rehabilitation Center Charlton 2011 Golden LivingCenter - Augusta Richmond 2011 Golden LivingCenter - Decatur DeKalb 2011 Golden LivingCenter - Medical Arts Gwinnett 2011 Golden LivingCenter - Northside Fulton 2011 Goodwill Nursing Home Inc Bibb 2011 Hutcheson Medical Center Catoosa 2011 Joe-Anne Burgin Nursing Home Randolph 2011 Lumber City Nursing & Rehabilitation Center Telfair 2011 17 Survey Due 3/9/2012 3/9/2012 3/9/2012 3/9/2012 3/9/2012 3/9/2012 3/12/2010 3/9/2012 3/9/2012 3/9/2012 3/9/2012 3/11/2011 3/9/2012 3/9/2012 3/9/2012 3/12/2010 3/11/2011 3/9/2012 9/16/2011 9/16/2011 9/16/2011 9/16/2011 9/16/2011 9/16/2011 9/16/2011 9/16/2011 9/16/2011 9/16/2011 9/16/2011 9/16/2011 9/16/2011 Manor Care Rehabilitation Center - Decatur Manor Care Rehabilitation Center - Marietta Meadows Nursing Center New London Health Center Northwest Georgia Regional Hospital ICF/MR Oceanside Nursing & Rehab Center Parkside At Hutcheson Medical Center Savannah Beach Nursing & Rehab Center Savannah Specialty Care Center Savannah Square Health Center Scepter Health & Rehab of Snellville, LLC Southland Healthcare And Rehabilitation Center Westminster Commons DeKalb Cobb Toombs Gwinnett Floyd Chatham Walker Chatham Chatham Chatham Gwinnett Laurens Fulton 2011 2011 2011 2011 2011 2011 2011 2011 2011 2011 2011 2011 2011 Cardiac Catheterization Services Survey (Survey Years 2009 thru 2011) Coffee Regional Medical Center Coffee 2011 Gwinnett Medical Center Gwinnett 2011 Hutcheson Medical Center Catoosa 2010 Hutcheson Medical Center Catoosa 2011 Mayo Clinic Health System in Waycross Ware 2011 Meadows Regional Medical Center Toombs 2011 Freestanding Ambulatory Surgery Services Survey (Survey Years 2009 thru 2011) Afa Ambulatory Surgery Center BIBB 2009 Afa Ambulatory Surgery Center BIBB 2010 Afa Ambulatory Surgery Center BIBB 2011 Akstein Eye Center, P.c. CLAYTON 2009 Akstein Eye Center, P.c. CLAYTON 2010 Akstein Eye Center, P.c. CLAYTON 2011 Ambulatory Foot & Leg Surg Ctr COBB 2011 Ambulatory Laser & Surgery Ctr CLAYTON 2009 Ambulatory Laser & Surgery Ctr CLAYTON 2010 Ambulatory Laser & Surgery Ctr CLAYTON 2011 Ambulatory Plastic Surgery Center, Inc MUSCOGEE 2009 American Eye Surgery Center, Inc CLARKE 2010 Associates Physicians Asc BIBB 2009 Associates Physicians Asc BIBB 2010 Associates Physicians Asc BIBB 2011 Athens Plastic Surgery Center CLARKE 2011 Atlanta Aesthetic and Reconstructive Surgery Center, LLC Atlanta Endoscopy Center, Ltd. FULTON DEKALB 2011 2009 Atlanta Plastic & Reconst Surg FULTON 2009 Atlanta South Endoscopy Center, Llc CLAYTON 2009 Atlanta South Endoscopy Center, Llc CLAYTON 2010 Atlanta South Endoscopy Center, Llc CLAYTON 2011 Atlanta Sports Medicine Surgery Center FULTON 2011 Atlanta West Endoscopy Center, Llc Atlanta West Endoscopy Center, Llc DOUGLAS DOUGLAS 2009 2010 Atlanta West Endoscopy Center, Llc DOUGLAS 2011 Augusta Aesthetic Surgery, Llc RICHMOND 2010 Bowman Pain Management, Pc BIBB 2011 Buckhead Mohs Surgical Center, LLC FULTON 2010 Buckhead Mohs Surgical Center, LLC FULTON 2011 Center For Orthopedic Surgery BARTOW 2011 Center For Pl & Recon Surgery CLARKE 2009 Center For Pl & Recon Surgery CLARKE 2010 18 9/16/2011 9/16/2011 9/16/2011 9/16/2011 9/16/2011 9/16/2011 9/16/2011 9/16/2011 9/16/2011 9/16/2011 9/16/2011 9/16/2011 9/16/2011 7/13/2011 7/13/2011 7/1/2011 7/13/2011 7/13/2011 7/13/2011 3/12/2010 3/11/2011 3/9/2012 3/12/2010 3/11/2011 3/9/2012 3/9/2012 3/12/2010 3/11/2011 3/9/2012 3/12/2010 3/11/2011 3/12/2010 3/11/2011 3/9/2012 3/9/2012 3/9/2012 3/12/2010 3/12/2010 3/12/2010 3/11/2011 3/9/2012 3/9/2012 3/12/2010 3/11/2011 3/9/2012 3/11/2011 3/9/2012 3/11/2011 3/9/2012 3/9/2012 3/12/2010 3/11/2011 Center For Pl & Recon Surgery Center For Spine & Pain Medicine Center For Spine & Pain Medicine Clayton Outpatient Surg Ctr Coastal Empire Plastic Surgery Coastal Pain Center, Llc Cobb Endoscopy Center, Llc Cobb Foot And Leg Surgical Center, Llc Coffee County Center For Digestive Disease Columbus Women's Health Organization, Inc. CPMSC Roswell, PC Dalton Plastic Surgery Day Surgery And Recovery Ctr Digestive Healthcare Of Ga Endo Ctr Mountainside Digestive Healthcare Of Ga Endo Ctr Mountainside Digestive Healthcare Of Ga Endoscopy Ctr Dublin Endoscopy Center, LLC Dublin Eye Surgery Center Dublin Orthopaedics Asc, Inc Endoscopy Center Of Middle Georgia, Llc Endoscopy Center, Llc, The Endoscopy Consultants, Llc Endoscopy Consultants, LLC Ent Surgical Center Eye Associates Surgery Ctr Eye Associates Surgery Ctr Eyesight's Laser & Surgery Ctr Foot & Ankle Surgery Ctr, Llc, The Foot & Ankle Surgery Ctr, Llc, The Forsyth Surgical Center, Inc. Forsyth Surgical Center, Inc. GA Urology, PA Cobb Ambulatory Surgery Center Gainesville Endoscopy Center, Llc Gainesville Eye Center, Llc Georgia Endoscopy Center, LLC Georgia Pain Physicians dba Georgia Surgical Centers of North Georgia GEORGIA PAIN SPINE CENTER, LLC Georgia Surgical Ctrs Of N Ga Golden Isles Foot Sur Ctr, Inc Gwinnett Center for Outpatient Surgery Gwinnett Endoscopy Services - Duluth Harbin G I, Llc Island Surgery Center, Inc Island Surgery Center, Inc Jimenez Foot, Ankle & Leg Asc Jimenez Foot, Ankle & Leg Asc Johns Creek Othopedic Surgery Center Macon Pain Center, Pc Macon Pain Center, Pc Macon Pain Center, Pc Metro Atlanta Endoscopy Midtown Urology Surgical Center Newnan Foot & Ankle Surgery Center, Llc Newnan Foot & Ankle Surgery Center, Llc CLARKE WHITFIELD WHITFIELD CLAYTON CHATHAM GLYNN COBB COBB COFFEE Muscogee FULTON WHITFIELD WHITFIELD PICKENS PICKENS FULTON LAURENS LAURENS LAURENS BIBB CHATHAM FULTON FULTON CHATHAM LOWNDES LOWNDES HOUSTON MUSCOGEE MUSCOGEE FORSYTH FORSYTH COBB HALL HALL Forsyth GORDON COBB GORDON GLYNN Gwinnett Gwinnett FLOYD GLYNN GLYNN GWINNETT GWINNETT Fulton BIBB BIBB BIBB FULTON FULTON COWETA COWETA 19 2011 2009 2010 2010 2009 2011 2009 2011 2009 2009 2011 2009 2011 2009 2010 2009 2011 2009 2010 2011 2009 2010 2011 2009 2009 2011 2011 2009 2010 2009 2010 2010 2009 2009 2011 2010 2010 2009 2010 2011 2011 2011 2009 2010 2009 2011 2011 2009 2010 2011 2010 2011 2009 2010 3/9/2012 3/12/2010 3/11/2011 3/11/2011 3/12/2010 3/9/2012 3/12/2010 3/9/2012 3/12/2010 3/12/2010 3/9/2012 3/12/2010 3/9/2012 3/12/2010 3/11/2011 3/12/2010 3/9/2012 3/12/2010 3/11/2011 3/9/2012 3/12/2010 3/11/2011 3/9/2012 3/12/2010 3/12/2010 3/9/2012 3/9/2012 3/12/2010 3/11/2011 3/12/2010 3/11/2011 3/11/2011 3/12/2010 3/12/2010 3/9/2012 3/11/2011 3/11/2011 3/12/2010 3/11/2011 3/9/2012 3/9/2012 3/9/2012 3/12/2010 3/11/2011 3/12/2010 3/9/2012 3/9/2012 3/12/2010 3/11/2011 3/9/2012 3/11/2011 3/9/2012 3/12/2010 3/11/2011 Non-surgical Orthopaedic Pain Center, P C North Columbus Surgery Center, LLC North Georgia Eye Surgery Center, Llc North Georgia Eye Surgery Center, Llc North Georgia Institute For Wound Care, Llc North Georgia Institute For Wound Care, Llc Northeast Endoscopy Center, Llc Northeast Georgia Urological Surgery Center, Llc Northeast Georgia Urological Surgery Center, Llc Northside Foot & Ankle Outpat Northside Surgery Center, Inc. Operating Room Services, Llc Orthopedic Surgery Center, L.P. Orthopedic Surgery Center, L.P. Pain Clinic Of Aimr, P.c. Pain Clinic Of Aimr, P.c. Peachtree Spine And Pain Physicians Asc, Llc Perimeter Surgery Center of Atlanta Perimeter Surgery Center of Atlanta Piedmont Surgery Center Pinnacle Orthopaedics Surgery Center-Austell, LLC Plastic & Reconstructive Surgery Center, Pc Plastic Surgery Ctr Land, The Plastic Surgery Ctr Land, The Plastic Surgery Ctr Land, The Podiatric Surgi Center Professional Eye Surgery Ctr Pulliam Ambulatory Surg Ctr Pulliam Ambulatory Surg Ctr Pulliam Ambulatory Surg Ctr Rome Endoscopy Ctr Inc, The Rome Endoscopy Ctr Inc, The Rome Endoscopy Ctr Inc, The Rome Surgical Center, P C Rome Surgical Center, P C Rome Surgical Center, P C Samson Pain Center, Pc Samson Pain Center, Pc Samson Pain Center, Pc Savannah Outpatient Foot and Ankle Surgery Center, LLC Savannah Outpatient Foot and Ankle Surgery Center, LLC Savannah Pain Center, Llc Savannah Pain Center, Llc Savannah Pain Center, Llc Seaside Surgical, Llc Seaside Surgical, Llc Southeast Treatment Center, Llc Southeast Treatment Center, Llc Southern Bone & Joint, Llc Summit Endoscopy Center, L L C Summit Endoscopy Center, L L C Surgery Center of Athens Surgery Center of BJI, LLC Thomas Eye Surgery Center COBB MUSCOGEE HALL HALL FORSYTH FORSYTH GWINNETT HALL HALL GWINNETT FULTON CHATHAM Chatham Chatham FULTON FULTON FULTON Fulton Fulton BIBB COBB RICHMOND CHATHAM CHATHAM CHATHAM DEKALB WHITFIELD NEWTON NEWTON NEWTON FLOYD FLOYD FLOYD FLOYD FLOYD FLOYD CHEROKEE CHEROKEE CHEROKEE Chatham Chatham CHATHAM CHATHAM CHATHAM GLYNN GLYNN CAMDEN CAMDEN COWETA FAYETTE FAYETTE Clarke WAYNE FULTON 20 2011 2011 2009 2010 2010 2011 2009 2010 2011 2009 2010 2011 2009 2011 2010 2011 2011 2010 2011 2010 2010 2011 2009 2010 2011 2009 2010 2009 2010 2011 2009 2010 2011 2009 2010 2011 2009 2010 2011 2011 2011 2009 2010 2011 2010 2011 2010 2011 2009 2009 2010 2011 2010 2009 3/9/2012 3/9/2012 3/12/2010 3/11/2011 3/11/2011 3/9/2012 3/12/2010 3/11/2011 3/9/2012 3/12/2010 3/11/2011 3/9/2012 3/12/2010 3/9/2012 3/11/2011 3/9/2012 3/9/2012 3/11/2011 3/9/2012 3/11/2011 3/11/2011 3/9/2012 3/12/2010 3/11/2011 3/9/2012 3/12/2010 3/11/2011 3/12/2010 3/11/2011 3/9/2012 3/12/2010 3/11/2011 3/9/2012 3/12/2010 3/11/2011 3/9/2012 3/12/2010 3/11/2011 3/9/2012 3/9/2012 3/9/2012 3/12/2010 3/11/2011 3/9/2012 3/11/2011 3/9/2012 3/11/2011 3/9/2012 3/12/2010 3/12/2010 3/11/2011 3/9/2012 3/11/2011 3/12/2010 Tifton Endoscopy Center, Inc. TIFT Universal Ambulatory Surgery Center, P C MUSCOGEE Universal Ambulatory Surgery Center, P C MUSCOGEE Urology Associates Surgery Center, Llc COBB Urology Center Of Georgia Llc BIBB Urology Center Of Georgia Llc BIBB Urology Surgery Center Of Savannah, Lp CHATHAM Urology Surgical Partners, Llc FULTON V.O.A. Ambulatory Surgical Center LOWNDES Valdosta Endoscopy Center, Llc LOWNDES Valdosta Foot & Ankle Surgery LOWNDES Valdosta Foot & Ankle Surgery Valdosta Foot & Ankle Surgery LOWNDES LOWNDES Wellbrook Endoscopy Center ROCKDALE Wellbrook Endoscopy Center ROCKDALE Wellbrook Endoscopy Center (covington) NEWTON West Georgia Endoscopy Center, Llc CARROLL Westside Endoscopy Center, P C COBB Westside Endoscopy Center, P C COBB WESTSIDE SURGERY CENTER, LLC (d/b/a ENT of Coffee County) Woodhams Laser & Lens Implant COFFEE FULTON Woodhams Laser & Lens Implant FULTON WOOLFSON AMBULATORY SURGERY CENTER, LLC FULTON 2010 2010 2011 2011 2010 2011 2010 2010 2011 2010 2009 2010 2011 2010 2011 2010 2010 2010 2011 2010 2009 2010 2010 Home Health Agency Survey (Survey Years 2009 thru 2011) Appalachian Home Health Care Union Appalachian Home Health Care Union Intrepid USA Healthcare Services Glynn Medside Home Health Agency Fulton Trinity Home Health Richmond Visiting Nurses Association of Greater Tift Co Tift 2010 2011 2010 2011 2011 2011 Hospital Financial Survey (Survey Years 2009 thru 2011) Charlton Memorial Hospital Charlton Mountain Lakes Medical Center Rabun Mountain Lakes Medical Center Rabun Riverwoods Behavioral Health System Clayton Youth Villages - Inner Harbour Campus Douglas Youth Villages - Inner Harbour Campus Douglas 2011 2010 2011 2011 2010 2011 Open Heart Surgery Services Survey (Survey Years 2009 thru 2011) Gwinnett Medical Center Gwinnett 2011 Positron Emission Tomography Services Survey (Survey Years 2009 thru 2011) Battlefield Imaging Center Catoosa 2009 Radiation Therapy Services Survey (Survey Years 2009 thru 2011) Hutcheson Medical Center Catoosa 2010 3/11/2011 3/11/2011 3/9/2012 3/9/2012 3/11/2011 3/9/2012 3/11/2011 3/11/2011 3/9/2012 3/11/2011 3/12/2010 3/11/2011 3/9/2012 3/11/2011 3/9/2012 3/11/2011 3/11/2011 3/11/2011 3/9/2012 3/11/2011 3/12/2010 3/11/2011 3/11/2011 3/11/2011 3/9/2012 3/11/2011 3/9/2012 3/9/2012 3/9/2012 7/13/2012 7/8/2011 7/13/2012 7/13/2012 7/8/2011 7/13/2012 7/13/2011 4/30/2010 4/29/2011 21 Indigent and Charity Care Shortfalls Facilities with Indigent and Charity Care Commitment Shortfalls for Most Recent 3 Years (Commitment status as of 4/2/2013) Facility Name Albany Surgery Center, Llp Albany Surgery Center, Llp Atlanta Eye Surgery Center at Omni West Clayton Cataract and Laser Surgery Center Clayton Cataract and Laser Surgery Center Clayton Outpatient Surg Ctr Dekalb Endoscopy Center Dennis Surgery Center, INC Dennis Surgery Center, Inc. G.I. Endoscopy Center G.I. Endoscopy Center Gastro Specialists Endoscopy Center, LLC Georgia Pain Management Center, LLC ISPM ASC AT COVINGTON, LLC ISPM ASC AT COVINGTON, LLC North Georgia Endoscopy Center, Inc North Georgia Endoscopy Center, Inc North Georgia Outpatient Surg North Georgia Outpatient Surg Northside Foot & Ankle O P Sc Northside Foot & Ankle O P Sc Northside Foot & Ankle Outpat Northside Foot & Ankle Outpat Northside Surgery Center, Inc. Northside Surgery Center, Inc. Savannah Plastic Surgicenter, Inc. Schulze Surgery Center, Inc. Schulze Surgery Center, Inc. South Georgia Surgery Center Specialty Surgery Center, Inc. Specialty Surgery Center, Inc. Summerville Surgical Center Surgical Suite, The Surgical Suite, The Caresouth Homecare Professionals Caresouth Homecare Professionals - Washington Guardian Home Care of Central Georgia Guardian Home Care of Northeast Georgia Guardian Home Care, LLC Southside Medical Home Health Suncrest Home Health County DOUGHERTY DOUGHERTY Fulton Clayton Clayton CLAYTON DEKALB Fulton FULTON CLAYTON CLAYTON DEKALB HENRY NEWTON NEWTON CHEROKEE CHEROKEE GORDON GORDON HALL HALL GWINNETT GWINNETT FULTON FULTON Chatham Chatham Chatham Ware FULTON FULTON Richmond FULTON FULTON Muscogee Elbert Oconee Hall Fulton DeKalb Cobb Year 2010 2011 2009 2010 2011 2011 2011 2011 2010 2010 2011 2011 2011 2010 2011 2010 2011 2010 2011 2010 2011 2010 2011 2009 2011 2009 2010 2011 2010 2010 2011 2011 2010 2011 2011 2011 2011 2011 2011 2010 2011 Shortfall Due Service 38,801.81 Ambulatory Surgery Center 46,106.54 Ambulatory Surgery Center 1,665.20 Ambulatory Surgery Center 13,418.77 Ambulatory Surgery Center 66,531.12 Ambulatory Surgery Center 44,542.67 Ambulatory Surgery Center 83,031.41 Ambulatory Surgery Center 8,719.02 Ambulatory Surgery Center 9,677.25 Ambulatory Surgery Center 75,209.04 Ambulatory Surgery Center 10,731.33 Ambulatory Surgery Center 19,883.76 Ambulatory Surgery Center 4,303.40 Ambulatory Surgery Center 7,283.28 Ambulatory Surgery Center 45,344.20 Ambulatory Surgery Center 26,161.36 Ambulatory Surgery Center 27,510.96 Ambulatory Surgery Center 16,008.93 Ambulatory Surgery Center 26,481.60 Ambulatory Surgery Center 10,443.33 Ambulatory Surgery Center 2,272.71 Ambulatory Surgery Center 19,902.09 Ambulatory Surgery Center 738.00 Ambulatory Surgery Center 4,466.67 Ambulatory Surgery Center 9,470.49 Ambulatory Surgery Center 36,419.70 Ambulatory Surgery Center 25,369.55 Ambulatory Surgery Center 27,490.23 Ambulatory Surgery Center 2,928.20 Ambulatory Surgery Center 9,376.56 Ambulatory Surgery Center 4,035.84 Ambulatory Surgery Center 583.16 Ambulatory Surgery Center 4,689.30 Ambulatory Surgery Center 4,650.87 Ambulatory Surgery Center 5,272.52 Home Health Agency 98,252.02 Home Health Agency 49,938.52 Home Health Agency 35,797.51 Home Health Agency 147,847.14 Home Health Agency 4,224.15 Home Health Agency 6,917.49 Home Health Agency Notes: The provisions of the Provider Payment Act of 2010 exempt eligible hospitals from being required to pay shortfalls associated with CON indigent and charity care commitments while the Act is in force. Critical Access Hospitals, Psychiatric Hospitals, and State-owned hospitals are exempt from the PPA so must still pay shortfalls associated with CON 22 NEW CERTIFICATE OF NEED FILING REQUIREMENTS Notices of Intent Effective July 1, 2008, O.C.G.A. 31-6-40(b) provides that: Any person proposing to develop or offer a new institutional health service or health care facility shall, before commencing such activity, submit a letter of intent and an application to the department and obtain a certificate of need in the manner provided in this chapter unless such activity is excluded from the scope of this chapter. O.C.G.A. 31-6-43(a) further provides that: At least 30 days prior to submitting an application for a certificate of need for clinical health services, a person shall submit a letter of intent to the department. The department shall provide by rule a process for submitting letters of intent and a mechanism by which applications may be filed to compete with and be reviewed comparatively with proposals described in submitted letters of intent. All parties interested in applying for a certificate of need for new institutional health services MUST NOW NOTIFY THE DEPARTMENT 30 DAYS PRIOR TO FILING AN APPLICATION of their intent to do so. This notice must be in writing and must contain the following information: Name and address of legal applicant; Person to whom inquiries may be addressed; Name, address of facility, if different from legal applicant; Proposed Project Site Location; Brief summary description of proposal; Proposed service area; and, Cost of the project. The Department will not accept any notices of intent submitted by either telephone, facsimile or e-mail pursuant to Rule 111-2-2-.06(5). Note: The Department will begin implementing the Letter of Intent requirement on July 15, 2008. Beginning with that date, no CON application will be accepted without a previously filed Letter of Intent. The CON application must be submitted no later than 30 days after the Letter of Intent has been received by the Department. BATCHING REQUIREMENTS The Department will be promulgating rules for services that will now be batched pursuant to O.C.G.A. 31-643(e) which states: To allow the opportunity for comparative review of applications, the department may provide by rule for applications for a certificate of need to be submitted on a timetable or batching cycle basis no less often than two times per calendar year for each clinical health service. Applications for services, facilities, or expenditures for which there is no specified batching cycle may be filed at any time. The requirements for Notices of Intent associated with designated Batching Cycles will be issued at the time of publication of the Batching Notice. 23 New Batching Review The Department will be transitioning many of the reviewable CON services into quarterly Batching Cycles. These services and the Batching Cycles are as follows: FALL Batched Service Batching Notice Home Health, Skilled Nursing Facilities, Intermediate Care Facilities, Perinatal Service, Inpatient Rehabilitation, Ambulatory Surgery September PET, Mega Voltage Radiation Therapy, Pediatric Cath/Open Heart, Adult Open Heart, Psych/Substance Abuse, Birthing Centers December Letter of Intent October January Application Deadline November February WINTER Home Health, Skilled Nursing Facilities, Intermediate Care Facilities, Perinatal Service, Inpatient Rehabilitation, Ambulatory Surgery March April May SPRING PET, Mega Voltage Radiation Therapy, Pediatric Cath/Open Heart, Adult Open Heart, Psych/Substance Abuse, Birthing Centers June July August SUMMER Letters of Intent for services, facilities, or expenditures for which there is no specified batching cycle, or other applicable rule, may be filed at any time. Batching Notifications Posted 3/29/2013 on DCH Website Spring Batching Review Cycle Notifications Ambulatory Surgery Home Health Agencies Obstetrical Services Neonatal Intermediate Services Neonatal Intensive Care Services Comprehensive Inpatient Physical Rehabilitation Services Skilled Nursing Facilities/Intermediate Care Facilities Need Projections can be found on the DHP Need Projections Page 24 BATCHED APPLICATIONS: SEQUENCE OF CERTIFICATE OF NEED APPLICATION REVIEW ACTIVITIES WINTER CYCLE Batching Notice (December 21, 2012) Application Day (application complete when submitted; review cycle begins same day) Due by 12 noon February 19, 2013) 75th Day (applicant provides additional information) (May 4, 2013) 100th Day (last day for letters of support to be submitted to Department) May 29, 2013 120th Day (Department Issues decision) (June 18, 2013) Letter of Intent ( Due by 5pm January 22, 2013) 60-Day Meeting (applicant only); opposition letter(s) due. (April 19, 2013) 90th Day (opposition meeting, applicant can attend, opposing party must provide written copy of argument) (May 19, 2013) 110th Day (applicant provides amended information; applicant provides response to opposition) (June 8, 2013) Batching Notice issued 30 days before Letter of Intent Due Letter of Intent received by Department 30 days before application is submitted Applications submitted; deemed complete; review cycle begins 60-Day meeting (applicant only); deadline for receipt of opposition letter(s) 75th day applicant provides additional information 90th day Opposition Meeting(s) scheduled; applicant can be in attendance; opposing parties must provide written statement of opposition arguments presented (original and one copy to the Department and one copy to the applicant); presentation time will be limited; Department reserves right to make additional inquiries subsequent to 60-day meeting and following opposition meeting. 100th day Last day for letters of support to be submitted to the Department 110th day Applicant deadline for submitting amended information; applicant deadline for providing written response to opposition due to Department; applicant deadline for providing written response to Department's inquiries subsequent to opposition meeting 120th day Decision issued (No discretion to extend) 25 BATCHED APPLICATIONS: SEQUENCE OF CERTIFICATE OF NEED APPLICATION REVIEW ACTIVITIES SPRING CYCLE Batching Notice (March 29, 2013) Application Day (application complete when submitted; review cycle begins same day) May 28, 2013 applications due by 12 noon) 75th Day (applicant provides additional information) (August 10, 2013) 100th Day (last day for letters of support to be submitted to Department) (September 4, 2013) 120th Day (Department Issues decision) (September 24, 2013) Letter of Intent April 28, 2013 (Rollover Day April 29, 2013 LOI due by 5PM) 60-Day Meeting (applicant only); opposition letter(s) due. (July 26, 2013) 90th Day (oppositio n meeting, applicant can attend, opposing party must provide written copy of argument) (August 25, 2013) 110th Day (applicant provides amended information; applicant provides response to opposition) (September 14, 2013) Batching Notice issued 30 days before Letter of Intent Due Letter of Intent received by Department 30 days before application is submitted Applications submitted; deemed complete; review cycle begins 60-Day meeting (applicant only); deadline for receipt of opposition letter(s) 75th day applicant provides additional information 90th day Opposition Meeting(s) scheduled; applicant can be in attendance; opposing parties must provide written statement of opposition arguments presented (original and one copy to the Department and one copy to the applicant); presentation time will be limited; Department reserves right to make additional inquiries subsequent to 60-day meeting and following opposition meeting. 100th day Last day for letters of support to be submitted to the Department 110th day Applicant deadline for submitting amended information; applicant deadline for providing written response to opposition due to Department; applicant deadline for providing written response to Department's inquiries subsequent to opposition meeting 120th day Decision issued (No discretion to extend) 26 NON-BATCHED APPLICATIONS: SEQUENCE OF CERTIFICATE OF NEED APPLICATION REVIEW ACTIVITIES Letter of Intent Application deemed complete (review cycle begins) 75th Day (applicant provides additional information prior to 75th day) 100th Day (last day for letters of support to be submitted to Department) 120th Day (Department Issues decision) Application must be submitted by 3 PM (10 days to review for completeness) 60-Day Meeting (applicant only); deadline for receipt of opposition letter(s) 90th Day (opposition meeting(s) scheduled; applicant can attend, opposing parties must provide written copy of argument) 110th Day (applicant provides amended information; applicant provides response to opposition) 150th Day (project can be extended) Letter of Intent received by Department 30 days before application is submitted Application submitted (10 working days to review for completeness). Applications submitted after 3:00 M PM will be considered received on the next business day. Application deemed complete; 120-day review cycle begins 60-day meeting (applicant only); deadline for receipt of opposition letter(s) 75th day - applicant provides additional information prior to 75th day 90th day Opposition Meeting(s) scheduled; applicant can be in attendance; opposing parties must provide written statement of opposition arguments presented (original and one copy to the Department and one copy to the applicant); presentation time will be limited; Department reserves right to make additional inquiries subsequent to 60-day meeting and following opposition meeting. 100th day Last day for letters of support to be submitted to the Department 110th day Applicant deadline for submitting amended information; applicant deadline for providing written response to opposition; applicant deadline for providing written response to Department's inquiries subsequent to opposition meeting 120th day Decision issued (Department has discretion to extend to 150th day) 27 NEW REPORTING REQUIREMENTS Beginning July 1, 2008, all facilities operating under a previously granted exemption or letter of nonreviewability as provided at O.C.G.A. 31-6-40(c)(2)(A) will be required to: Provide notice to the department by August 15, 2008, of the following: Name Ownership Location Single Specialty Services provided in the exempt facility For purposes of complying with this requirement, notice may be sent through the mail, by facsimile, or e-mail. Information will not be accepted by telephone. Please submit this information to: Georgia Department of Community Health Healthcare Facility Regulation Division c/o Matthew Jarrard 2 Peachtree Street, NW 5th Floor Atlanta, Georgia 30303 Fax Number: 404-656-0654 E-mail address: mjarrard@dch.ga.gov These facilities will also be required to provide annual reports beginning on January 1, 2009, in accordance with the Department's annual reporting requirements for existing CON-approved facilities and services. Further reporting instructions will be provided by the Department. Noncompliance with this information request may result in a fine as authorized under O.C.G.A. 31-6-70(e)(1). These reports will not be due to the Department until the survey instrument has been issued. The survey instrument for ambulatory surgery services is now complete. Further information will be forthcoming by mail. The survey instrument for imaging centers is expected to be released on or before July 1, 2009. LETTERS OF DETERMINATION The Department will require that a determination request be submitted for any proposed activity that may be exempt under O.C.G.A. 31-6. Such requests will be accepted only on the Department's Determination Request form with the required filing fee of $250. Note: Requests for confirmation of the exemptions for a single specialty ambulatory surgical center or a joint venture ambulatory surgical center and equipment below the threshold are considered requests for a Letter of Nonreviewability and require a $500 filing fee. 28 CERTIFICATE OF NEED APPEAL PANEL Sworn by Governor Sonny Perdue on August 20, 2008 Ellwood "Ebb" Oakley (Chair) eoakley@gsu.edu Melvin M. Goldstein goldatty@bellsouth.net William "Bill" C. Joy (Vice Chair) wcjoy@bellsouth.net Legislation - Senate Bill 433 Senate Bill 433 as passed April 4, 2008 Office of Health Planning Contact Information For general questions related to the Office of Health Planning, questions concerning Health Planning surveys, indigent and charity care commitment shortfalls, and all other matters please contact Matthew Jarrard, Director (mjarrard@dch.ga.gov) For questions concerning pending Certificate of Need applications please contact Bruce Henderson, Senior Reviewer (bhenderson@dch.ga.gov) For LNR/DET letters and for CON related matters please contact Roxana Tatman, Legal Director, Health Planning (rtatman@dch.ga.gov ) New Requirements for Verification of Lawful Presence within the United States Effective January 1, 2012 agencies or political subdivisions of the State of Georgia providing or administering a public benefit are required to verify that applicants for a public benefit are in the United States in a lawful manner. See O.C.G.A. 50-36-1(e). Certificates of Need (CON) are considered a public benefit under the new provisions. Therefore, an applicant for a CON must be in compliance with the law for the CON to be awarded. Effective January 1, 2012 all CON applications must include an original signed and notarized affidavit in accordance with O.C.G.A. 50-36-1(e)(2) as well as a copy of a secure and verifiable document in accordance with O.C.G.A. 50-36-2. A copy of the affidavit along with instructions for submitting the affidavit and secure and verifiable document can be located at the following link or by navigating to the CON Applications and Forms page from the CON Information link from www.dch.georgia.gov. http://dch.georgia.gov/vgn/images/portal/cit_1210/23/25/180044217HB87_CON_Instructions_1-1-2012.pdf CONs that are approved and issued after January 1, 2012 for applications that were submitted prior to January 1, 2012 are also subject to these provisions. DCH will contact applicants to provide instruction related to compliance prior to issuing such a CON. Open Record Requests Requests for documents or other information can be obtained using the Open Record Request form found at the following: http://dch.georgia.gov/health-planning-publications-and-data-resources The ORR Form found there can be emailed to HealthPlanningInfo@dch.ga.gov Please also visit www.GaMap2Care.info for healthcare facility and reporting information. 29