Oregon Administrative Rules › Chapter 333 - OREGON HEALTH AUTHORITY, PUBLIC HEALTH DIVISION › Division 560 - ABBREVIATED CERTIFICATE OF NEED REVIEW, DELAY OF REVIEW, WAIVER OF REVIEW FOR FACILITIES, AND EXPEDITED REVIEW › Section 333-560-0130 - Expedited Review for Relocation of Long-Term Care Beds to Hospitals

Current through Register Vol. 63, No. 7, July 1, 2024
(1) Under certain
			 circumstances, the Public Health Division may approve relocation of existing
			 long-term care beds to a hospital-based setting under the expedited review
			 process set forth in this rule without the analysis of service area need
			 specified in OAR
			 333-610-0030, provided that
			 all of the following conditions are met:
(a)
			 The long-term beds are relocated from one existing long-term care facility to
			 not more than one location which is or will be licensed as a long-term care
			 facility at the time of the relocation and is within the same standard
			 metropolitan statistical area or within 15 miles of the hospital, whichever is
			 greater.
(b) The project involves
			 the relocation of not more than 50 percent of the licensed long-term care beds
			 from one site to another.
(c) The
			 applicant shall submit, with the letter of intent, a letter to the Seniors and
			 People with Disabilities Division requesting irrevocable delicensure of the
			 remaining long-term beds at the facility from which the beds are transferred
			 pursuant to this rule, which request shall be effective as of the date of
			 licensure of the beds being transferred. The Public Health Division will
			 determine whether this letter provides substantial assurance that the remaining
			 beds will in fact be delicensed. No application will be approved under this
			 rule unless the Public Health Division determines that such assurance
			 exists.
(d) The facility from which
			 the long-term care beds are to be transferred shall be closed as a long-term
			 care facility and shall not offer or develop a new skilled nursing or
			 intermediate care service or facility as described in OAR
			 333-550-0010(3)
 
			 without approval pursuant to full certificate of need review.
(e) Notwithstanding subsections (1)(c) and
			 (1)(d) of this rule, the facility from which beds are relocated may be allowed
			 to continue operation if it can be demonstrated to the satisfaction of the
			 division that the continued operation of the facility is necessary to maintain
			 adequate bed capacity in the service area and provided that it reduces its
			 current licensed bed capacity by twice as many beds as are relocated.
(f) The design and construction of the
			 renovated space must either meet all Seniors and People with Disabilities
			 Division criteria for new construction standards in long-term care facilities
			 or receive a waiver from the Seniors and People with Disabilities Division
			 based on a showing that full compliance with the new construction standards is
			 not appropriate. The applicant shall submit schematic plans for the proposed
			 project.
(g) Serious structural and
			 fire and life safety problems, or other problems significantly affecting the
			 care and well-being of patients must be demonstrated to exist at the facility
			 whose beds are proposed to be relocated. The procedure for demonstrating these
			 physical problems is the same as that set out in OAR
			 333-560-0110(7)(a)
			 through (d).
(h) The applicant must demonstrate to the
			 satisfaction of the division that projected per diem inpatient routine service
			 costs in the hospital-based setting (calculated in conformance with Medicare
			 cost report parameters) will not exceed 125 percent of the per diem routine
			 service cost limitation computed by the Medicare fiscal intermediary for
			 freestanding skilled nursing facilities in its urban or rural location during
			 the first two years of operation. The routine cost limitation may be adjusted,
			 as appropriate, to allow for reasonable inflation as measured by the DRI (HCFA)
			 McGraw Hill Nursing Facility Market Basket Index. Notwithstanding anything to
			 the contrary in the two immediately preceding sentences, if the hospital has
			 owned or controlled the long-term care facility from which it proposes to move
			 beds for at least three years, the applicant must demonstrate to the
			 satisfaction of the Division that projected per diem actual inpatient routine
			 service costs in the hospital-based setting will either not exceed 125 percent
			 of actual per diem inpatient routine service costs experienced in its current
			 setting during the first two years of operation or will not exceed 125 percent
			 of the per diem routine service cost limitation computed by the Medicare fiscal
			 intermediary for freestanding skilled nursing facilities in its urban or rural
			 location during the first two years of operation.
(i) The applicant shall submit a completed
			 copy of Forms CN-3 and CN-11. The applicant shall also submit a summary for the
			 first two years of operation of projected revenue, expenses, operating income,
			 non-operating revenue and net income with and without the project.
(j) Projects approved under this rule are
			 subject to the full review process detailed in division 570 of this chapter and
			 to the application and review criteria established in division 580, or if
			 applicable, an expedited review under this chapter, if the cost limitations
			 required under subsection (1)(h) of this rule are not maintained for the first
			 two years of operation of the relocated beds.