Compilation of Rules and Regulations of the State of Georgia › Department 111 - RULES OF DEPARTMENT OF COMMUNITY HEALTH › Chapter 111-2 - HEALTH PLANNING › Subject 111-2-2 - CERTIFICATE OF NEED › Rule 111-2-2-.36 - Specific Review Considerations for Long Term Care Hospitals

Current through Rules and Regulations filed through June 27, 2024
(1)
Applicability.
A Certificate of Need ("CON") shall be required
				prior to the establishment of a new or the expansion of an existing Long Term
				Care Hospital. An application for Certificate of Need for a new or expanded
				Long Term Care Hospital shall be reviewed under the General Review
				Considerations of Ga. Comp. R. & Regs. r.
				111-2-2-.09 and the service-specific
				review considerations of this Rule.
(2)
Definitions.
(a) 'Expansion' or 'Expanded' means the
				addition of beds to an existing CON-authorized or grandfathered Long Term Care
				Hospital. A CON-authorized or grandfathered Long Term Care Hospital may
				increase the bed capacity of an existing hospital by the lesser of ten percent
				(10%) of existing capacity or 10 beds if it has maintained an average occupancy
				of eighty-five percent (85%) for the previous twelve (12) calendar months
				provided that there has been no such increase in the prior two years and
				provided that the capital expenditures associated with the increase do not
				exceed the Capital Expenditure Threshold. If such an increase exceeds the
				Capital Expenditure Threshold, the increase will be considered an expansion for
				which a Certificate of Need shall be required under these Rules.
(b) 'Free-standing LTCH' or 'Free-standing
				LTACH' means a Long Term Care Hospital organized and operated as a
				self-contained health care facility.
(c) 'Hospital-within-a-Hospital LTCH' or
				'Hospital-within-a-Hospital LTACH' means a Long Term Care Hospital co-located
				within the same building or the same campus as another CON-Authorized
				hospital.
(d) 'Long Term Care
				Hospital' or 'LTCH' or 'Long Term Acute Care Hospital' or 'LTACH' means a
				hospital that is classified as a long term hospital by the Medicare program
				pursuant to 42 CFR
				412.23(e). These hospitals
				typically provide extended medical and rehabilitative care for patients who are
				clinically complex and may suffer from multiple acute or chronic conditions.
				Services typically include comprehensive rehabilitation, respiratory therapy,
				head trauma treatment, and pain management. For regulatory purposes, the
				definition includes a hospital which asserts its intent to be
				Medicare-classified as a long term hospital within twenty-four (24) months of
				accepting its first patient. If an entity, which has been awarded a CON
				pursuant to this Rule, has not been so classified by Medicare within this
				timeframe, the CON issued to that entity shall be revoked. An entity, which has
				had its CON revoked pursuant to this Rule, shall not have the authority to
				operate as a general acute care hospital. However, an acute care hospital,
				which has been awarded a CON to convert acute care beds for use as a long term
				care hospital, may again use such beds for acute care if such beds have not
				been Medicare-classified as a long term care hospital within twenty-four (24)
				months of accepting its first patient. Furthermore, a hospital that has been
				approved through the Certificate Of Need process to use all of its short-stay
				beds for a Freestanding LTCH shall have such beds removed from the official
				inventory of available short-stay beds when the LTCH is certified by Medicare;
				provided, however, that the hospital's beds will revert to the official
				inventory of available short-stay beds at any point that the facility ceases to
				be certified by Medicare as an LTCH.
(e) 'New' means a hospital that has not been
				classified by the Medicare program as a long term hospital in the previous
				twelve (12) months. For purposes of these Rules, an existing hospital which
				proposes to be relocated to a location more than three miles from its present
				location shall be considered "new".
(f) 'Occupancy Rate' means the ratio of beds
				occupied by inpatients as reported on the most recent Annual Hospital
				Questionnaire divided by the total licensed beds.
(g) 'Official State Health Component Plan'
				means the document related to Long Term Care Hospitals developed by the
				Department, established by the Georgia Health Strategies Council and signed by
				the Governor of Georgia.
(h)
				'Planning Region' means one of the four sub-state regions for Long Term Care
				Hospitals, as follows:
1. LTCH Region 1,
				including the following counties: Dade, Walker, Catoosa, Whitfield, Murray,
				Gilmer, Fannin, Union, Towns, Rabun, Stephens, Habersham, White, Lumpkin,
				Dawson, Pickens, Gordon, Chattooga, Floyd, Bartow, Cherokee, Forsyth, Hall,
				Banks, Franklin, Hart, Elbert, Madison, Jackson, Barrow, Gwinnett, Fulton,
				Cobb, Paulding, Polk, Haralson, Carroll, Douglas, DeKalb, Rockdale, Walton,
				Oconee, Clarke, Oglethorpe, Greene, Morgan, Newton, Butts, Henry, Clayton,
				Fayette, Coweta, Heard, Troup, Meriwether, Pike, Spalding, Lamar, and
				Upson
2. LTCH Region 2, including
				the following counties: Wilkes, Lincoln, Columbia, McDuffie, Warren,
				Taliaferro, Hancock, Glascock, Putnam, Jasper, Monroe, Jones, Baldwin,
				Washington, Jefferson, Richmond, Burke, Screven, Jenkins, Emmanuel, Johnson,
				Treutlen, Montgomery, Wheeler, Telfair, Wilcox, Dodge, Laurens, Pulaski,
				Bleckley, Houston, Peach, Twiggs, Wilkinson, Bibb, and Crawford
3. LTCH Region 3, including the following
				counties: Harris, Talbot, Taylor, Muscogee, Chattahoochee, Marion, Schley,
				Macon, Dooly, Sumter, Webster, Stewart, Quitman, Randolph, Terrell, Lee, Crisp,
				Ben Hill, Irwin, Turner, Worth, Dougherty, Calhoun, Clay, Early, Baker,
				Mitchell, Colquitt, Miller, Cook, Tift, Berrien, Lanier, Echols, Lowndes,
				Brooks, Thomas, Grady, Decatur, and Seminole
4. LTCH Region 4, including the following
				counties: Effingham, Bulloch, Candler, Toombs, Tattnall, Evans, Bryan, Chatham,
				Liberty, Long, Wayne, Appling, Jeff Davis, Coffee, Bacon, Pierce, Brantley,
				McIntosh, Glynn, Camden, Charlton, Ware, Atkinson, and Clinch