reglab/statecodes huggingface dataset:
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 580 - CERTIFICATE OF NEED APPLICATION INSTRUCTIONS AND FORMS › Section 333-580-0010 - Application Format

Current through Register Vol. 63, No. 7, July 1, 2024
The application should be presented in four sections:
(1) Section A -- Introduction;
(2) Section B -- Narrative discussion
			 addressing the proposal's relationship to the statutory certificate of need
			 review criteria as defined in OAR
			 333-580-0040  through
			 333-580-0060;
(3) Section C -- Completed required forms;
			 and
(4) Section D --
			 Appendices.
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) &
				  442.315
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 580 - CERTIFICATE OF NEED APPLICATION INSTRUCTIONS AND FORMS › Section 333-580-0020 - Section A - Introduction

Current through Register Vol. 63, No. 7, July 1, 2024
The applicant shall provide a short introductory narrative of
				the proposal outlining the major aspects of the proposal.
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) &
				  442.315
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 580 - CERTIFICATE OF NEED APPLICATION INSTRUCTIONS AND FORMS › Section 333-580-0030 - Section B - Review Criteria

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 The applicant must demonstrate in narrative form that its proposal satisfies
			 the criteria specified in OAR
			 333-580-0040  to
			 333-580-0060  and the applicable service-specific need methodologies and standards in
			 Divisions 585 through 645. The application must have narrative sections
			 corresponding to each section of OAR
			 333-580-0040  to
			 333-580-0060  [those statements labeled "(1)", "(2)" etc.]. In each section, the criterion to
			 be addressed is shown in italics. An explanation of the way in which the
			 criterion is to be addressed and specific issues to be discussed is then
			 provided. The narrative should address each of these issues.
(2) The division will make findings and base
			 its decision on the extent to which the applicant demonstrates that the
			 criteria and standards referenced in section (1) of this rule are met. Criteria
			 will be considered to have been met if the applicant can demonstrate that the
			 questions posed in the criteria can be answered in the affirmative. An
			 application will be decided in accordance with the statutes and rules in effect
			 at the time of filing of a completed letter of intent for that application. A
			 completed letter of intent will be considered to have been filed only if the
			 division finds that it includes all of the information required under OAR
			 333-555-0020(1).
(3) Each relevant issue in the outline of
			 criteria must have a written explanatory response which includes supporting
			 evidence and identifies the source of evidence, assumptions, methodologies used
			 in projections, estimates, etc.
(4)
			 Applicants are encouraged to include any additional information relevant to the
			 review criteria which was not specifically requested by the state, but which
			 would further support the proposal.
(5) Applicants must demonstrate to the
			 division that a proposal is approvable. All other application sections are
			 supportive of this section.
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) &
				  442.315
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 580 - CERTIFICATE OF NEED APPLICATION INSTRUCTIONS AND FORMS › Section 333-580-0040 - Need

Current through Register Vol. 63, No. 7, July 1, 2024
Applicants must provide a narrative discussion of each of the
				following:
(1) Criterion: Does the
			 service area population need the proposed project?
(a) The applicant must identify the service
			 area's need for the proposal in the past, present and future;
(b) In establishing the magnitude of present
			 and future need for each service element, the applicant will:
(A) Use appropriate indicators of a
			 population's need (i.e., population-based use-rates, population-based "medical
			 necessity" rates, or established productivity standards);
(B) Use the standards and need methodologies
			 specified in divisions 585 through 645 of OAR chapter 333 applicable to the
			 services or facilities being proposed;
(C) Consider industry standards and
			 historical experience as appropriate comparisons where plans are
			 silent;
(D) In the case of nursing
			 home beds, determine whether the added beds are consistent with plans adopted
			 by the relevant area agency on aging and the state Seniors and People with
			 Disabilities Division.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 580 - CERTIFICATE OF NEED APPLICATION INSTRUCTIONS AND FORMS › Section 333-580-0070 - Special Requirements for Certain Types of Proposals

Current through Register Vol. 63, No. 7, July 1, 2024
(1) As required by ORS 442.584, applications
			 proposing any of the technologies or services selected for assessment by the
			 Health Resources Commission must include the information specified in section
			 (2) of this rule. This requirement shall not apply until such time as the
			 Health Resources Commission has selected the technologies that it will assess
			 under ORS 442.583.
(2) Applications
			 for projects involving any equipment or services selected for assessment by the
			 Health Resources Commission must include the following information in a
			 separately identified section or appendix to the application:
(a) The estimated number of patients needing
			 the service or procedure who are not currently being served and who cannot be
			 served by existing programs in the service area;
(b) The anticipated number of procedures to
			 be performed per year for a five-year period commencing on the date the service
			 is started or the technology is acquired;
(c) The anticipated number of patients to be
			 served by the applicant, based on the incidence in the population to be served
			 or the conditions for which the technology or service will be used;
(d) Clinical indications for ordering use of
			 the technology or service, with appropriate references to relevant
			 literature;
(e) An estimate of the
			 treatment decisions likely to result from the technology or service;
(f) A proposed method for collecting data on
			 the patients served, costs engendered directly or indirectly and the health
			 outcomes resulting from use of the technology or service.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 580 - CERTIFICATE OF NEED APPLICATION INSTRUCTIONS AND FORMS › Section 333-580-0080 - General Instructions for Section C - Completion of Forms

Current through Register Vol. 63, No. 7, July 1, 2024
Applicants must complete Forms CN-1 through CN-12 and include
				these forms with the application, except that forms which are not relevant to
				the proposal need not be completed. Applicants should contact the Public Health
				Division to determine which forms are relevant to their proposal. Additional
				tables and graphs may be provided, and should appear as appendices in Section D
				and be referenced to the applicable discussion and criteria in Section B. Form
				CN-1 should be included as the first page of the application (after any cover
				pages and table of contents).
The Forms referenced are available from the
				  agency.
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) &
				  442.315
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 580 - CERTIFICATE OF NEED APPLICATION INSTRUCTIONS AND FORMS › Section 333-580-0090 - Completion of Architectural Forms

Current through Register Vol. 63, No. 7, July 1, 2024
In completing Form CN-3, "Capital Expenditure Estimate", all
				costs identified on this form, which will be incurred at a future date, must
				reflect the effects of inflation.
The Forms referenced are available from the
				  agency.
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) &
				  442.315
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 580 - CERTIFICATE OF NEED APPLICATION INSTRUCTIONS AND FORMS › Section 333-580-0100 - Completion of Financial Forms

Current through Register Vol. 63, No. 7, July 1, 2024
The applicant must submit financial information regarding the
				proposed service and the facility or organization as a whole on Forms CN-4
				through CN-12. Projects with costs of under $1,000,000 need only forecast three
				years financial information. Other projects should forecast five years. If
				there is more than one entity with a financial interest in a proposal, the
				entity actually proposing to implement the project must submit the required
				financial data. Additional financial data may be required to be presented
				regarding other entities with an involvement in the project. All forms should
				be filled out using the accrual basis of accounting, unless the division has
				specifically approved another method:
(1) In completing Form CN-4, "Project Cost
			 Estimate", the applicant should fill in all of the appropriate fund
			 sources.
(2) In completing Form
			 CN-5, "Income Statement", Form CN-6, "Balance Sheet", and Form CN-7, "Statement
			 of Changes in Financial Position", the applicant should provide all line items
			 requested. The applicant may use its own facility format if it includes all the
			 line items requested, but in such cases the format used by the applicant should
			 include a reference to the appropriate certificate of need form
			 number.
(3) In completing Form
			 CN-8, "Debt Service Coverage", the applicant should forecast debt service
			 coverage using the accrual basis of accounting. Debt service coverage is to be
			 computed as follows:
Net Income + Depreciation + Interest
			 Expense
Principal + Interest Expense
(4) The applicant should complete Form CN-9,
			 "Ratio Analyses", for the years requested. Financial performance of the
			 applicant organization proposing the project will be evaluated by commonly
			 accepted health care industry indicators related to financial soundness,
			 plausibility of economic assumptions used, and overall effect on patient
			 charges. These financial ratios are listed in
Table 1
. Applicants
			 must use the formulas shown in
Table 1
in completing Form CN-9:
(a) If an applicant believes that some
			 analysis, in addition to the Ratio Analysis, gives a more appropriate measure,
			 the applicant may present such other analysis, together with an explanation of
			 why it is more appropriate. The division will determine whether or not such
			 alternative analysis is acceptable;
(b) As used in this rule:
(A) "Net Operating Income" means total
			 operating revenue less total operating expenses;
(B) Total operating revenue is exclusive of
			 nonoperating revenue;
(C) "Fund
			 Balance" means the unrestricted fund balance at the end of the
			 period;
(D) Average annual
			 outpatient revenue and inpatient days should be taken from the applicant's
			 audited financial data.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 585 - GENERAL CRITERIA FOR DEMONSTRATION OF NEED IN CERTIFICATE OF NEED APPLICATIONS › Section 333-585-0000 - General Criteria for Demonstration of Need in Certificate of Need Applications

Current through Register Vol. 63, No. 7, July 1, 2024
The applicant is responsible for providing information to the
				Public Health Division to adequately demonstrate that the applicant's proposal
				satisfies criteria specified in applicable rules:
(1) General criteria, application
			 instructions and forms are contained in Division 580 of this chapter. As part
			 of meeting these criteria and requirements for a particular health service, the
			 applicant must provide an analysis using the applicable methodology for
			 demonstration of need for that service as adopted by the division elsewhere in
			 this chapter.
(2) In the event that
			 an applicant, at the time of filing a letter of intent, is proposing a service
			 for which the division has not adopted, as rule, a methodology for
			 demonstration of need; or for which the adopted methodology may appear to
			 require modification or clarification; the applicant may request, or the
			 division or the applicant may initiate, rulemaking procedures under the state
			 Administrative Procedure Act. In such circum-stances, the division will make
			 reasonable efforts to complete rulemaking procedures prior to the first
			 possible filing date for the proposed application under this chapter, based on
			 the letter of intent and other information received However, the actual
			 application may raise unanticipated issues necessitating additional rulemaking
			 procedures prior to written findings and decision by the division.
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) &
				  442.315
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 590 - DEMONSTRATION OF NEED FOR ACUTE INPATIENT BEDS AND FACILITIES › Section 333-590-0000 - General

Current through Register Vol. 63, No. 7, July 1, 2024
The applicant, in providing information to the Public Health
				Division to demonstrate need for a proposed new hospital, must satisfy the
				criteria specified in the Certificate of Need Application Instructions
				(division 580). This response will include completing an analysis using the
				methodology of the division (division 590).
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) &
				  442.315
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 590 - DEMONSTRATION OF NEED FOR ACUTE INPATIENT BEDS AND FACILITIES › Section 333-590-0010 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
As used in is division:
(1) "Acute Inpatient Care" means care
			 provided in hospital beds, involving at least one overnight use of a bed. Acute
			 inpatient care does not include skilled nursing facility, intermediate care
			 facility, long-term care or supportive routine care for chronic disease or
			 disability, convalescent care, or rest cures. Neither does acute inpatient care
			 include outpatient or clinic care, emergency room care, outpatient laboratory
			 tests, or ambulatory surgery. Acute inpatient care does include general
			 medical/surgical care and short-stay specialty and sub-specialty acute care,
			 including but not limited to gynecological, obstetrical, pediatric, ICU/CCU,
			 psychiatric, alcoholism, chemical dependency, and rehabilitation
			 care.
(2) "Acute Inpatient Bed"
			 means a space with physical facilities which is being used to provide inpatient
			 care to a patient located in a hospital and is intended primarily for occupancy
			 by a patient who will be fed, lodged and treated on an overnight basis, except
			 that newborn nursery bassinets, neonatal intensive care and labor room beds are
			 not included.
(3) "Acute Inpatient
			 Bed Capacity" is defined in OAR
			 333-545-0020(6),
			 and means any space which could be made readily available for use as an acute
			 inpatient bed, even if this space is not presently being used for this
			 purpose.
(4) "Population-Based
			 Discharge and Use-Rates" means rates based on geographical area patient origins
			 and population rather than on the statistics of utilization of a single
			 facility.
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) &
				  442.315
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 590 - DEMONSTRATION OF NEED FOR ACUTE INPATIENT BEDS AND FACILITIES › Section 333-590-0020 - Estimates of Need

Current through Register Vol. 63, No. 7, July 1, 2024
The assumptions and methods described in this division are
				applicable to the interpretation of OAR
				333-580-0040. Their
				practical purpose is to generate a range of quantitative estimates, against
				which to weigh the impact of qualitative factors, in determining bed need. This
				composite approach is necessary, in the absence of theoretically perfect and
				complete information about past, present and future.
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) &
				  442.315
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 590 - DEMONSTRATION OF NEED FOR ACUTE INPATIENT BEDS AND FACILITIES › Section 333-590-0040 - Determination of Service Area for Existing Hospitals

Current through Register Vol. 63, No. 7, July 1, 2024
For purposes of Divisions 545 through 670 of OAR chapter 333,
				the service area for an existing general hospital will be defined as including
				those zip codes from which either ten percent or more of the hospital's
				discharges originate, or in which the hospital has at least a 20 percent market
				share. Minor adjustments to the boundaries of the hospital service area may be
				made to create a contiguous service area or to conform more closely to the
				boundaries of demographic units for which census data are reported (county,
				county census division, enumeration district, or zip codes if conversion has
				been done).
(1) Discharge and patient
			 day market shares in the service area of the applicant facility should be
			 calculated from the most recent statewide patient origin studies. Changes in
			 relative market shares should be examined if two or more such studies are
			 available. Appropriate steps should be taken to adjust for comparability
			 between these studies if they differ in number of hospitals included, and/or
			 other pertinent factors. More recent patient origin data on a less than
			 statewide basis may also be considered if a method of adjustment for
			 balance-of-state origins and utilization acceptable to the division and the
			 applicant can be developed prior to filing the application.
(2) Federal (V.A.) hospitals may be excluded
			 from the calculation of discharge and patient day market shares, and from other
			 steps in this methodology, but if federal hospitals are excluded from any step,
			 they must be excluded from all steps. For instance, market shares cannot be
			 calculated using nonfederal patient days when the service area use-rate is
			 calculated based on combined federal and nonfederal patient days. If explicit
			 adjustments for projected declines in users eligible for care in federal
			 facilities acceptable to the division and the applicant can be developed prior
			 to filing the application, this factor must be considered.
(3) In the absence of evidence to the
			 contrary, current market shares will be expected to be stable. Factors to which
			 consideration may be given include population shifts; different rates of
			 population growth among subareas within the hospital service area; changes in
			 hospital location service mix, age mix, reimbursement mix, transportation
			 patterns, locations of physician specialists; projected changes in amount or
			 types of utilization among other providers with market shares in the hospital
			 service area; and documented commitments to develop procompetitive initiatives
			 such as alternative delivery systems, selective contracting, successful
			 competitive bidding, and other market oriented changes.
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) &
				  442.315
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 590 - DEMONSTRATION OF NEED FOR ACUTE INPATIENT BEDS AND FACILITIES › Section 333-590-0060 - Relationship of Proposed New Hospitals to Existing Health Care System

Current through Register Vol. 63, No. 7, July 1, 2024
An applicant proposing a new acute inpatient facility, rather
				than replacement or expansion of an existing facility, must weigh its plans
				against the availability of beds at existing, reasonably accessible facilities,
				especially those within the proposed service area of the applicant; and against
				the feasibility of development of alternative facilities and services. To
				develop a quantitative estimate of the situation, the following methodology
				will be used. Its results are to be evaluated against factors such as quality
				of care; types of services; levels of care available; anticipated changes in
				hospital locations, patient origins, service mix, age mix, reimbursement mix,
				transportation patterns, population shifts, and locations of physician
				specialists; and documented commitments to develop pro-competitive initiatives
				such as alternative delivery systems, selective contracting, successful
				competitive bidding, and other market oriented changes:
(1) Identify as other significant providers,
			 those hospitals located within the service area of the applicant
			 facility.
(2) For the applicant and
			 for each other significant provider, estimate the anticipated commitment ratio,
			 considering the ratio of each facility's patient days originating from the
			 service area of the applicant facility, to the total patient days originating
			 from that service area, using the most recent available statewide patient
			 origin data, or a more recent less than statewide study, properly adjusted for
			 balance-of-state origins and utilizations.
(3) Calculate expected first year average
			 daily census at the applicant facility, based on OAR
			 333-590-0050(7),
			 and for each other significant provider for that year.
(4) Calculate peak daily census for that year
			 at each facility by applying the methodology in OAR
			 333-590-0050(6)
			 through (9)  to the service area and
			 utilization statistics for these facilities, using a multiplier of 2.33 in
			 order to adjust for the low probability that all facilities will simultaneously
			 be full.
(5) Estimate the
			 commitment of beds by each facility to the hospital service area at peak
			 occupancy as defined in section (4) of this rule, by multiplying the results of
			 section (4) of this rule by the commitment ratios calculated in section (2) of
			 this rule.
(6) To estimate
			 available beds at each facility, subtract the peak occupancy of each, as
			 defined in section (4) of this rule, from:
(a)
			 The capacity defined in OAR
			 333-590-0010(3);
			 and
(b) The measure in subsection
			 (a) of this section, plus "shelled space", that is, convertible space which
			 requires construction rather than merely changing furniture.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 600 - DEMONSTRATION OF NEED FOR 24-HOUR HEALTH FACILITY INPATIENT CHEMICAL DEPENDENCY SERVICES › Section 333-600-0000 - General

Current through Register Vol. 63, No. 7, July 1, 2024
In providing information to the Public Health Division to
				demonstrate need for various types of chemical dependency treatment services,
				the applicant must satisfy the criteria in the Certificate of Need Application
				Instructions (division 580). In completing the discussion of service area needs
				required by OAR
				333-580-0040, the applicant
				should use the methodology in this division (division 600).
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) &
				  442.315
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 600 - DEMONSTRATION OF NEED FOR 24-HOUR HEALTH FACILITY INPATIENT CHEMICAL DEPENDENCY SERVICES › Section 333-600-0010 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
The definitions of OAR
				333-590-0010  also
				apply to this division. The following definitions categorize specific types of
				chemical dependency treatment services. Certificate of need is required for
				sections (1) and (3) of this rule if the project involves the establishment of
				a new facility:
(1) "Medical
			 Facility-Based Detoxification" means a short-term treatment, provided in a
			 hospital during which medication is used under continuous medical supervision
			 to restore physiological functioning.
(2) "Nonmedical Facility-Based
			 Detoxification" means primarily nonmedical treatment by means of rest and
			 fluid, with intermittent or limited medical supervision, not provided in a
			 hospital, to restore physiological functioning.
(3) "Inpatient Hospital Services" means all
			 medical and nursing services provided to persons who require 24-hour
			 supervision as a result of acute or chronic medical and/or psychiatric
			 illnesses associated with chemical dependency. Inpatient services may be
			 delivered in a general or specialty hospital.
(4) "Residential Treatment Services" means
			 services designed to facilitate treatment and rehabilitation of the chemically
			 dependent person by creating a structured, therapeutic environment. Residential
			 treatment services may be provided in the following:
(a) "Twenty-four hour residential treatment"
			 means treatment in a residential treatment facility, non-hospital based,
			 housing individuals who require 24-hour support and supervision;
(b) "Partial residential treatment" means a
			 part-time day and night and/or weekend residential treatment facility for
			 people who are able to work, or able to live at home, but not both, and who may
			 need further support or supervision.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 600 - DEMONSTRATION OF NEED FOR 24-HOUR HEALTH FACILITY INPATIENT CHEMICAL DEPENDENCY SERVICES › Section 333-600-0020 - Principles

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Chemical
			 dependency service systems should provide a continuum of care which gradually
			 increases demands for personal responsibility.
(2) Chemical dependency services systems
			 should allow entry at any point in the treatment continuum based on individual
			 need.
(3) All levels of chemical
			 dependency treatment should be readily available for use with no person
			 remaining too long at one level because of the lack of services at the next
			 level.
(4) The chemical dependency
			 service system should be designed to allow people to remain in less intensive
			 treatment modes longer than in the initial, more intensive modes.
(5) Chemical dependency services should be
			 delivered in the least expensive, least restrictive setting required to produce
			 the desired results.
(6) Chemical
			 dependency services systems should provide a variety of treatment approaches to
			 meet any given level of need.
(7)
			 Quick geographical access is considered essential for outpatient care,
			 detoxification care and day treatment. If 90 percent of the
			 chemically-dependent persons in the proposed service area who need to use a
			 specific non-24-hour treatment program such as outpatient, day treatment, or
			 detoxification are more than 35 miles by road from existing programs of the
			 type that is needed, then more treatment capacity may be needed in a location
			 accessible to the population.
(8)
			 Quick geographical access is not considered essential for inpatient hospital
			 care or other types of 24-hour treatment programs. If 90 percent of the
			 chemically-dependent persons in the proposed service area who need to use a
			 specific 24-hour treatment program such as inpatient hospital, residential
			 treatment, rehabilitation, or residential maintenance care are more than 75
			 miles by road from existing programs of the type that is needed, then more beds
			 may be needed in a location more accessible to the population.
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) &
				  442.315
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 610 - DEMONSTRATION OF NEED FOR LONG-TERM CARE SERVICES › Section 333-610-0000 - General

Current through Register Vol. 63, No. 7, July 1, 2024
In order to demonstrate need for nursing home beds, an
				applicant must satisfy the criteria specified in the Certificate of Need
				Application Instructions (division 580). Where appropriate, responses to these
				instructions shall be based on the methodology of this division (division
				610).
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) &
				  442.315
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 610 - DEMONSTRATION OF NEED FOR LONG-TERM CARE SERVICES › Section 333-610-0020 - Principles

Current through Register Vol. 63, No. 7, July 1, 2024
The following principles will be applied in the review of
				applications for certificate of need for nursing home beds:
(1) Clinical and epidemiological research
			 indicates that, on the average, 30 nursing home beds per 1,000 persons age 65
			 and over would be sufficient to meet the need for care for those functional
			 deficits for which nursing home care is medically necessary and cost effective.
			 This does not include utilization which is socially convenient rather than
			 medically necessary. The experience of some states and some Oregon counties
			 indicates that when sufficient alternatives are available, a ratio of less than
			 30 nursing home beds per 1,000 persons age 65 and over may be sufficient to
			 meet the population's needs.
(2)
			 Oregon data are consistent with section (1) of this rule. Because about ten
			 percent of Oregon nursing home residents are not age 65 and over, and to allow
			 for local variations, a goal of 40 beds (actually, a range of 35 to 45) (per
			 1,000 persons age 65 and older is hereby set, 33 percent greater than the
			 research figure in section (1) of this rule. No county should exceed this bed
			 ratio; although, as noted in section (1) of this rule, ratios well under 40
			 beds per 1,000 persons age 65 and over are often sufficient to meet community
			 needs.
(3) By 1991, there shall be
			 no more than 40 nursing home beds per 1,000 persons age 65 and over in any
			 Oregon county:
(a) For counties which had 54
			 or fewer beds per 1,000 in 1980, the goal is to be reached by 1986;
(b) For counties which had more than 54 beds
			 in 1980, or have population densities below the state median, up to five
			 additional years are allowed (see
Tables 1, 2,
and
3
), recognizing the greater amount of time required to organize the
			 expansion of alternative care under such circumstances.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 610 - DEMONSTRATION OF NEED FOR LONG-TERM CARE SERVICES › Section 333-610-0030 - Need

Current through Register Vol. 63, No. 7, July 1, 2024
The following method is an extension of the general
				requirements for analysis of need set forth in OAR
				333-580-0040(1):
(1) Determine service area:
(a) Except as provided in subsections (b) and
			 (c) of this section, the geographical service area of the applicant will be
			 considered to be the county in which the facility is located;
(b) Service areas in health service area III
			 are defined as follows: Hood River, Sherman and Wasco Counties; Crook,
			 Deschutes and Jefferson Counties; Gilliam, Morrow and Wheeler Counties; Union
			 and Wallowa Counties; Baker County; Malheur County; Grant County; Harney
			 County; Lake County; Umatilla County; and Klamath County;
(c) An applicant may propose an alternative
			 service area to that specified in subsection (a) or (b) of this section. Such
			 alternative service area, if accepted by the division, will be applied only to
			 the review of the applicant's proposal, and shall not affect the applicability
			 of subsections (a) and (b) of this section to other applications. The
			 appropriateness of such an alternative service area must be demonstrated by the
			 applicant to the division's satisfaction. In demonstrating the appropriateness
			 of the proposed alternative service area, the applicant shall discuss and
			 provide data on the following:
(A) Patient
			 origin and length of stay by zip code for admissions for the most recent
			 completed fiscal or calendar year for all nursing homes in the proposed service
			 area. The applicant should list zip code of origin and length of stay for each
			 admission, but should not use any patient names. The proposed service area
			 should account for at least 75 percent of all admissions to service area
			 nursing homes. It is recognized that nursing homes other than the applicant may
			 sometimes be unwilling to provide such data but at a minimum data must be
			 provided for the applicant facility, and documentation must be submitted to
			 show that other facilities were asked to provide data;
(B) Travel patterns and highways between the
			 proposed service area and adjacent areas;
(C) Historical market patterns for health and
			 other services; and
(D) Geographic
			 or other considerations that might delineate the proposed areas as a distinct
			 service area.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 610 - DEMONSTRATION OF NEED FOR LONG-TERM CARE SERVICES › Section 333-610-0060 - Hospital Long-Term Care Beds

Current through Register Vol. 63, No. 7, July 1, 2024
(1)
			 Long-term care facility services and beds offered in or through a hospital must
			 be separately licensed by the Seniors and People with Disabilities Division.
			 Therefore, the creation of a long-term care facility by a hospital will be
			 considered to constitute the establishment of a new health care facility,
			 subject to review under OAR
			 333-550-0010(1).
			 Additions to the bed capacity of such facilities will be subject to review if
			 such additions are greater than 10 percent of the existing capacity of the
			 long-term care facility, or greater than 10 beds, whichever is less, as
			 provided in OAR
			 333-550-0010(3).
(2) When a hospital proposes to create a new
			 long-term care facility which will either be associated with, or located in,
			 the hospital; or increase the number of long-term care beds (as defined in OAR
			 333-610-0010(12)) in such a facility by more than 10 beds or 10 percent of the facility's bed
			 capacity, whichever is less, or when a hospital proposes to relocate long-term
			 care beds to such a facility, the project will be subject to certificate of
			 need on the same basis as any freestanding nursing home project would be under
			 OAR
			 333-610-0000  to
			 333-610-0030.
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) &
				  442.315
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 610 - DEMONSTRATION OF NEED FOR LONG-TERM CARE SERVICES › Section 333-610-0070 - Swing Long-Term Care Beds in Hospitals

Current through Register Vol. 63, No. 7, July 1, 2024
When a hospital proposes to utilize a given number of its
				licensed hospital acute beds intermittently as skilled nursing facility swing
				beds under applicable federal regulations, the hospital is expected to submit a
				letter of intent to the Public Health Division. The organized and regular
				provision of skilled nursing facility services within the licensed physical
				plant of the hospital may be subject to review as a new long-term care facility
				under OAR
				333-550-0010(3)(a).
				In addition:
(1) The proposal will not
			 be subject to county-specific nursing home bed need criteria under OAR
			 333-610-0000  to
			 333-610-0030  because it will
			 not create permanent new nursing home beds. The division, in reviewing the
			 proposal for need under OAR
			 333-580-0040  and for
			 alternative uses of resources under OAR
			 333-580-0050,
			 will take into consideration such factors as:
(a) Health policy of the state, as reflected
			 in ORS 410.010, 410.020, 410.050 and 410.060; ORS Chapter 442 generally; and
			 other applicable statutes;
(b)
			 Interpretation of that policy, as reflected in the plans and administrative
			 rules of the Public Health Division and the Seniors and People with
			 Disabilities Division. In considering strategies for increasing the
			 accessibility of nursing home beds, priority will be given to increasing the
			 utilization of appropriate alternative care (thereby freeing up existing
			 nursing home beds), rather than increasing the number of nursing home
			 beds;
(c) Comparative experience
			 with, and quality of, long-term care provided by staff in licensed acute care
			 hospitals and in licensed long-term care facilities.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 610 - DEMONSTRATION OF NEED FOR LONG-TERM CARE SERVICES › Section 333-610-0080 - Residential Care Beds in Long-Term Care Facilities

Current through Register Vol. 63, No. 7, July 1, 2024
When a long-term care facility chooses to obtain a Seniors and
				People with Disabilities Division license as a "licensed residential care
				facility" as described in OAR
				333-610-0010(11)  for all, or for a separate and distinct part
				of its currently licensed long-term care facility bed capacity, it is not
				required, under statute, to accept a correspondingly reduced Seniors and People
				with Disabilities Division "long-term care facility" license as described in
				OAR
				333-610-0010(12).
				Federal regulations, however, may require this under some circumstances. The
				following certificate of need rules will apply at such time that appropriate,
				coordinated licensing rules are adopted by the Seniors and People with
				Disabilities Division:
(1) Future
			 reconversion of such beds from residential care to long-term care (nursing
			 home) beds will be considered an expansion of the then existing Seniors and
			 People with Disabilities Division licensed long-term care facility service, and
			 may be subject to the certificate of need law under applicable thresholds
			 regarding expansions in long-term care bed capacity; and
(2) In evaluating a reconversion project, the
			 division shall give strong consideration to the costs, compared to new
			 construction, and to the comparative quality and cost of care currently
			 provided at the facility; and
(3)
			 Reconversion projects as described in this rule will be subject to
			 county-specific bed need criteria under OAR
			 333-610-0020  to
			 333-610-0030.
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) &
				  442.315
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 610 - DEMONSTRATION OF NEED FOR LONG-TERM CARE SERVICES › Section 333-610-0090 - Intermediate Care Facilities for the Mentally Retarded

Current through Register Vol. 63, No. 7, July 1, 2024
Distinct part intermediate care beds for mentally retarded or
				developmentally disabled individuals, when the facility houses any individuals
				who require nursing care services of a level, frequency and duration equivalent
				to intermediate facility care nursing as defined by the Seniors and People with
				Disabilities Division, must be licensed by the Seniors and People with
				Disabilities Division, rather than by the Addictions and Mental Health
				Division, and are subject to certificate of need according to ORS Chapter 442.
				In determining need, the division shall take into account long-range plans of
				the Addictions and Mental Health Division; shall consider comparative bed
				ratios in other states; and shall search, review and analyze existing
				professional literature and reports. The division shall evaluate local,
				substate, regional and statewide need, considering access, quality and costs.
				Public and private facility beds shall be considered as equivalent for purposes
				of meeting the limited need for this category of care.
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) &
				  442.315
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 610 - DEMONSTRATION OF NEED FOR LONG-TERM CARE SERVICES › Section 333-610-0100 - Intermediate Care Facilities for the Mentally or Emotionally Disturbed

Current through Register Vol. 63, No. 7, July 1, 2024
Distinct part intermediate care beds for mentally or
				emotionally disturbed individuals, when the facility houses any such
				individuals who require nursing care services of a level, frequency and
				duration equivalent to intermediate care facility nursing as defined by the
				Seniors and People with Disabilities Division, must be licensed by the Seniors
				and People with Disabilities Division, rather than by the Addictions and Mental
				Health Division, and are subject to certificate of need according to ORS
				Chapter 442. In determining need, the division shall take into account
				long-range plans of the Addictions and Mental Health Division; shall consider
				comparative bed ratios in other states; and shall search, review and analyze
				existing professional literature and reports. The division shall evaluate
				local, substate, regional and statewide need, considering access, quality and
				costs. Public and private facility beds shall be considered as equivalent for
				purposes of meeting the limited need for this category of
				care.
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) &
				  442.315
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 610 - DEMONSTRATION OF NEED FOR LONG-TERM CARE SERVICES › Section 333-610-0110 - Intermediate Care Facilities for Chemically Dependent Persons, Including Alcoholics

Current through Register Vol. 63, No. 7, July 1, 2024
Distinct part intermediate care beds for Chemically dependent
				persons, including alcoholics, when the facility houses any such individuals
				who require nursing care services of a level, frequency and duration equivalent
				to intermediate care facility nursing as defined by the Seniors and People with
				Disabilities Division, must be licensed by the Seniors and People with
				Disabilities Division, rather than by the Addictions and Mental Health
				Division, and are subject to certificate of need according to ORS Chapter 442.
				In determining need, the division shall take into account long-range plans of
				the Addictions and Mental Health Division; shall consider comparative bed
				ratios in other states; and shall search, review and analyze existing
				professional literature and reports. The division shall evaluate local,
				substate, regional and statewide need, considering access, quality and costs.
				Public and private facility beds shall be considered as equivalent for purposes
				of meeting the limited need for this category of care.
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) &
				  442.315
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 615 - DEMONSTRATION OF NEED FOR PSYCHIATRIC INPATIENT BEDS › Section 333-615-0010 - Definitions

Current through Register Vol. 63, No. 7, July 1, 2024
The definitions of OAR
				333-590-0010  shall
				apply, in addition to the following:
(1) As used in this division, "alternatives"
			 include, but need not be limited to, the following:
(a) Nonhospital, 24-hour residential
			 treatment;
(b) Hospital or
			 nonhospital day or partial hospitalization programs;
(c) Outpatient treatment by a qualified
			 mental health professional (a licensed psychiatrist or clinical psychologist, a
			 psychiatric nurse practitioner within the legal scope of practice, or licensed
			 or registered clinical social worker); and
(d) Outpatient treatment through a mental
			 health program approved by the Addictions and Mental Health Division.
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 615 - DEMONSTRATION OF NEED FOR PSYCHIATRIC INPATIENT BEDS › Section 333-615-0040 - Availability of Alternative Uses for Resource

Current through Register Vol. 63, No. 7, July 1, 2024
The following principles shall be applicable to the
				interpretation of OAR
				333-580-0050(1)
				and (2). The term "quality unit" is explained
				in OAR
				333-615-0050:
(1) The methods of meeting acute psychiatric
			 bed need, in order of preference, shall be:
(a) Conversion of existing licensed space to
			 purposes of psychiatric treatment where such conversion is feasible to provide
			 an adequate inpatient program at less cost than building new licensed space,
			 especially when the average daily census for the facility as a whole for the
			 most recent year ending September 30, converted to expected peak occupancy
			 under the methods of OAR
			 333-590-0050(8)
			 and (9), does not exceed the current licensed
			 number of beds at the facility;
(b)
			 A project resulting in the smallest feasible net increase in acute licensed
			 capacity within an existing general hospital or specialty hospital license,
			 especially when the average daily census to the facility as a whole, for the
			 most recent year ending September 30, converted to expected peak occupancy
			 under the methods of OAR
			 333-590-0050(8)
			 and (9), equals or exceeds the current
			 licensed number of beds at the facility;
(c) A separately licensed new psychiatric
			 hospital, not part of a general hospital, that will provide adequate
			 psychiatric inpatient care at the most reasonable charges per day and per spell
			 of treatment, for care that must be rendered on an inpatient basis, taking into
			 consideration the factors in OAR
			 333-615-0000(2).
Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 615 - DEMONSTRATION OF NEED FOR PSYCHIATRIC INPATIENT BEDS › Section 333-615-0050 - Quality and Costs

Current through Register Vol. 63, No. 7, July 1, 2024
All proposed psychiatric beds must meet the licensure,
				certification and accreditation criteria of the Public Health Division,
				Medicare and the Joint Commission on on Accreditation of Health-care
				Organizations, as appropriate. "Quality" for purposes of review of certificate
				of need proposals is a description of threshold factors to be considered, not a
				presumption of clinical judgment, nor a substitute for the licensing or
				accreditation functions. A proposal for a quality psychiatric unit shall
				include explicit policies, and specific examples and detail regarding each
				factor below:
(1) Triage criteria and
			 mechanisms, including documentation that such criteria and mechanisms will be
			 consistent with the level of placement criteria developed by the Office of
			 Health Policy and insurers under ORS 743.556(16)(b);
(2) Data and record systems;
(3) Length of stay related to treatment
			 goals, and averaging no more than 15 days for treatment of adults;
(4) Nonmaintenance, high-level treatment
			 goals beyond mere restoration to the level just permitting release;
(5) Low recidivism; compare to data
			 available;
(6) Rates which reflect
			 low capital and operating costs and a justifiable rate of return; and
(7) Rapid access to quality general and
			 multispecialty medical inpatient care.
Stat. Auth.: ORS 431.120(6), 442.315 & 743.556(16)
Stats. Implemented: ORS 431.120(6) &
				  442.315