Section 17-311-167 - Requests for increases in self-pay charges(a) In the event of any unforeseen or material change in circumstances, a facility may submit an application for an increase in the self-pay charges established by the commissioner pursuant to the procedure set forth in section 17-311-160 through 17-311-163, supra, by making application for permission to impose charges to self-pay patients in excess of the authorized self-pay charges. Such application must clearly set forth that the application is made pursuant to subsection 1 (c) of Public Act 79-182.(b) In reviewing and evaluating a facility's request for permission to impose self-pay charges in excess of those authorized by the commissioner pursuant to section 17-311-160, et seq. supra, whenever applicable the commissioner shall consider, but not be limited to, the following:(1) The cost impact of compliance with any statute, regulation, ordinance, or tax, lawfully promulgated or imposed by any federal, state of local governmental authority having jurisdiction over the operations of the facility, including but not limited to increases in local real estate taxes and changes in the public health code mandated by the Connecticut department of health services;(2) Changes in the level of care provided by the facility;(3) The cost of substantial additions, renovations, and improvements to real property not included in the cost year base data used to establish the facility's self-pay charges;(4) Unforeseen changes in the general economy significantly affecting the system under which the state rates were determined as the basis for establishing the self-pay charges;(5) In the case of a facility where self-pay charges were determined pursuant to section 17-311-161(e) above, evidence from the department of health services establishing that the conditions which led to the imposition of the provisions of section 17-311-161(e) have been remedied.(c) The considerations set forth in subsection (b), above, shall be used by the commissioner whenever applicable to determine a facility's need for a self-pay charge in excess of the self-pay charges established annually by the commissioner, and shall not be applicable to a facility's request for an increase in its state rates.(d) In addition to the requirements herein above stated, each rate application shall, if required by the commissioner, contain either in the statement of application or as exhibits annexed thereto and accompanying the application, data such as, but not limited to, the following: (1) The date on which each proposed charge would become effective.(2) The levels of care or accommodations to which each proposed charge would apply.(3) Statements of financial operations for the prior fiscal year, the current year, and the budgeted year at the present and at the proposed charges.(4) A schedule of existing charges in effect prior to the date of application showing actual revenues and numbers of patients and other users of the facility, categorized by rates, by classification of patient and by other appropriate classification for the periods covered by the prior year and by the current year. The schedule will show such revenues at the existing charges and budgeted at the proposed charges.(5) Statement of the proposed increased charges or changes which will result in increased self-pay charges which the applicant proposed to make effective. Such statement shall also set forth the proposed charge structure with reasonable clarity and with appropriate rate classifications, where applicable.(6) Actual and budgeted expenses with supporting detail set forth by the accounts affected.(e) The applicant may file as prefiled testimony and as exhibits any data which it offers the commissioner as proof in support for the proposed rate application. Such evidence shall not be incorporated in any of the prescribed components but shall be presented separately as annexed materials and received as offers of proof to the extent such evidence is relevant to the applicant's case.(f) The commissioner may decide on such an application with or without a hearing in accordance with section 1 (c) of Public Act 79-182.Conn. Agencies Regs. § 17-311-167