Current through Register Vol. 42, No. 5, February 29, 2024
(1) Replacement is
defined as a project for the erection, construction, creation or other
acquisition of a physical plant or facility where the proposed new structure
will replace an existing structure and will be located in the same planning
area and market area. Replacement does not include the modernization or
construction of a non-clinical building, parking facility, or any other
non-institutional health services capital item on the existing campus of a
health care facility, provided that construction or modernization does not
allow the health care facility to provide new institutional health services
subject to review and not previously provided on a regular basis.
(2)
Planning Policies
(a) The applicant must demonstrate that the
proposed replacement is the most cost effective or otherwise most appropriate
alternative to provide patients with needed health care services and/or
facility improvements.
(b) The
applicant must provide evidence that the proposed square footage, construction
cost per square foot, and cost of fixed equipment is appropriate and reasonable
for the types and volumes of patients to be served.
(c) The applicant for the proposed
replacement must be the same as the owner of the facility to be
replaced.
(3)
Needs
Assessment
(a) For replacement of a
health care facility an applicant must submit significant evidence of need for
the project. Evidence of need for the project should include, but is not
limited to, one or more of the following:
1.
The existing structure requires replacement to meet minimum licensure and
certification requirements.
2.
There are operating problems, which can best be corrected by replacement of the
existing facility.
3. The
replacement of the existing structure will correct deficiencies that place the
health and safety of patients and/or employees at significant
risk.
(b) For replacement
of hospitals, the occupancy rate for the most recent annual reporting period
should have been at least 60%. If this occupancy level was not met, the
hospital should agree to a reduction in bed capacity that will increase its
occupancy rate to 60 percent. For example, if a 90-bed hospital had an average
daily census (ADC) of 45 patients, its occupancy rate was 50%. (The ADC of 45
patients divided by 90 beds equals 50 percent). To determine a new bed capacity
that would increase the hospital's occupancy rate to 60%, divide the ADC of 45
patients by 0.60 (a fraction of a bed should be rounded upward to the next
whole bed). The hospital's new capacity should be 75 beds, a 15-bed reduction
to its original capacity of 90 beds.
Author: Statewide Health Coordinating Council
(SHCC)
Statutory Authority:
Code of Ala.
1975, §
22-21-260(4).
