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Frequently Asked Questions
1. Is a Construction Permit Needed?
A plan review and construction permit are needed before contracting for and initiating a construction project involving new construction, additions, modernizations, or conversions of a hospital with a capital expenditure of $1,000,000.00 or more, a person shall obtain a construction permit from the department.
To protect the public health, safety, and welfare, the department has promulgated rules to require construction permits for projects other than those described above.
These rules require a permit for nursing home projects involving expenditure in the amount of $25,000.00 or more.
For Homes for the Aged and Hospice Facilities, construction of new buildings, additions, major building changes, and conversion of existing facilities to use as a home shall not begin until the plans and specifications are approved by the department and written approval to begin construction is issued, regardless of cost.
For Freestanding Surgical Outpatient Facilities, a permit is required if the construction or renovation is in the amount of $50,000.00 or more.
Please refer to the following link for more information on Section 33.20145, Public Health Code 368 of 1978: http://www.legislature.mi.gov/mileg.asp?page=getObject&objName=mcl-333-20145&highlight
2. How long will it take to get a permit for our construction/renovation project?
Staff review submittals (plans, specifications, operational narratives, responses, etc.) and issue a permit when the contract documents are in substantial compliance with applicable standards and regulations including plan review/approval by the Bureau of Fire Services and compliance with Certificate of Need. Staff will issue plan review comments if the submittals received to date are deemed not to comply or they appear to be incomplete. The project sponsor and/or designer are then asked to address each plan review comment and resubmit. This plan review process repeats until substantial compliance is achieved and a permit can be issued.
3. How long will it take for you to get to our plans?
Overall, we review about 90% of the plans received within six weeks of receipt. Over 50% of plans received are reviewed within two weeks. Please note that incomplete submittals will result in delayed reviews or delays in issuing a permit.
4. How soon can you come out to inspect our construction/renovation project?
We ask for a 30-day notice to allow scheduling. One week prior to the scheduled date, a punch list with all necessary approvals, test reports, and certifications must be received.
(This one week accomplishes three things: 1) it helps insure that the project will indeed be ready for inspection; 2) gives us time to review these opening survey documents before coming out, thus saving time during the survey; and 3) it minimizes the chance of not being able to issue occupancy approval immediately following the opening survey.) Please note that an opening survey is required prior to patient care use of any portion (or phase) of the healthcare construction/renovation project. Failure to submit these documents on a timely basis results in rescheduling the opening survey inspection.
5. What is involved in rescheduling the opening survey date?
We must give preference to those whose timely submittal of appropriate documentation allows us to hold to their original opening survey dates. In addition, please keep in mind, we have to schedule around federally ordered inspections and other priority appointments.
6. Who has been assigned to my project?
Please call our office number at 517-241-3408 to find out. We try to keep the same staff assigned to the same facilities in order to maintain a knowledge base within facilities. If no one from our office has a history with a particular facility the project will be assigned to an individual who has a relatively small backlog. An email message notifying submitters that their plans, application, fee, etc. have been received, as well as the assigned HFES project number and reviewer, will be sent to the contact person listed on the Application for Plan Review (assuming an accurate email address is listed).
7. What regulations apply to assisted living facilities?
Michigan law has not defined the term "assisted living". The Office of Children & Adult Licensing, Department of Human Services, oversees Adult Foster Care (AFC) and Home For the Aged (HFA) facilities. AFC and HFA rules cover congregate living facilities that provide three meals a day for residents that do not require supervised care on a 24 hours a day basis. Please contact them at 517-373-8580 or visit their web site at the link above. The Health Facilities Engineering Section reviews plans, issues construction permits, and conducts opening survey inspections for HFA's.
Please note that independent senior living centers and facilities that do not provide board are not regulated in Michigan.
8. Where may I find the most current standards?
Please check this site under Health Facility Construction "Publications & Forms" for the most recent standards.
9. Can we start construction before the plans are completed and approved?
The Public Health Code, Act 368, Public Acts of 1978 as amended requires that "before contracting for and initiating a construction project .. a person shall obtain a construction permit from the department (CIS)". A permit will not be issued until plans have been reviewed and approved. This applies to all hospital projects where the total construction cost is $1 million or more, to freestanding surgical outpatient facilities where the total cost is $50,000 or more, to nursing homes where the total cost is $25,000 or more, and to all homes for the aged projects. A construction permit is not required for hospital projects under $1 Million or for any ESRD. However, an opening survey is still required prior to occupancy. While not required, plan review is also highly recommended for smaller hospital projects and ESRD (outpatient dialysis) projects, and should be completed prior to the start of construction.
10. When will the next state/federal survey (of the entire facility) be conducted?
Scheduling of hospital, ESRD, FSOF, and Hospice wide regulatory surveys (which check for compliance with state licensing and/or federal certification requirements) is the responsibility of the Health Facilities Division in conjunction with CMS (Centers for Medicare & Medicaid Services) formerly the Health Care Financing Administration. Historically CMS has selected a percentage of ESRD's to be surveyed nation wide each year along with a number of hospitals to validate accreditation (called validation surveys). For non-accredited hospitals, the department is expected to conduct a biennial visit for the purpose of determining compliance with licensure regulations and conduct a simultaneous federal survey, though federal surveys are on a three year cycle. Surveys can also be triggered by complaints filed against facilities. The Long Term Care Division surveys Nursing Homes, county Medical Care Facilities, and Hospital Long Term Care units at least annually under state and/or federal rules. The Office of Children & Adult Licensing, Department of Human Services, surveys Homes for the Aged under state rules.
11. How much on-site fuel storage capacity must be provided for hospital emergency generators?
For existing generator sets/hospitals sufficient fuel must be provided on-site to provide for peak demand over a 24-hour period. For new generator sets/hospitals located in southern Michigan the requirement is increased to 72 hours worth of fuel. (Refer to the 1996 versions of NFPA 101 and 110 as well as 1996 BOCA). The capacities of on-site fuel storage facilities must be increased to also accommodate boiler peak demand loads for the same required time periods if the boilers use the same on-site fuel storage facilities for back-up fuel. The 2007 Minimum Design Standards for Health Care Facilities in Michigan requires 72 hours of on-site boiler and generator fuel storage capacity.
12. What is a baseline survey?
In order to update our records and make sure this office visits every hospital on a routine basis the HFES has started to conduct environmental (facility) Baseline Surveys. These surveys also serve to provide facility staff with a "heads-up" of what may be cited during a regulatory survey and to assist in establishing priorities for renovation/replacement of buildings and equipment. While non-regulatory in nature, hospitals are strongly encouraged to respond back to the field reports we issue in order to assure that safe and sanitary patient care environments are maintained.
13. Is HFES staff available for consultations?
HFES staff are available to answer specific questions on projects once plans are submitted for review. Staff can be contacted by phone or e-mail. The Public Health Code also provides for consultation visits prior to submittal of plans (Section 333.20155(13)). Fees for such consultations are identified in section 333.20161 (10). Consultation visits are scheduled after CMS certification or State Licensing Surveys and plan reviews and surveys on projects that have been submitted for formal review to the Michigan Department of Licensing & Regulatory Affairs (LARA), Health Facilities Division, Health Facilities Engineering Section, Ottawa Building - 1st Floor, 611 W. Ottawa Street, Lansing, MI 48933
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