Current through Register Vol. 50, No. 9, March 1, 2024
RELATES TO:
KRS
216B.015,
216B.020,
216B.061,
216B.332,
216B.990,
42
C.F.R. 482.58,
485.645
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
216B.040(2)(a) 1 requires
the Cabinet for Health and Family Services to administer Kentucky's Certificate
of Need Program and to promulgate administrative regulations as necessary for
the program.
KRS
216B.330 requires the cabinet to promulgate
administrative regulations to establish the procedures and requirements for
obtaining a certificate of compliance for a continuing care retirement
community. This administrative regulation establishes the certificate of need
requirements for critical access hospitals, swing beds, and continuing care
retirement communities.
Section 1.
Definitions.
(1) "Cabinet" is defined by
KRS
216B.015(6).
(2) "Days" means calendar days, unless
otherwise specified.
(3) "Office of
Inspector General" means the office within the Cabinet for Health and Family
Services that is responsible for licensing and regulatory functions of health
facilities and services.
Section
2. Critical Access Hospitals. A certificate of need shall not be
required for a critical access hospital to re-establish the number of acute
care beds that the hospital operated prior to becoming a critical access
hospital if the hospital decides to discontinue operating as a critical access
hospital.
Section 3. Swing Beds.
(1) An acute care hospital or a critical
access hospital that has been designated as a swing bed hospital by the Office
of Inspector General, having met the requirements of
42
C.F.R. 482.58 or
485.645,
shall not be required to obtain a certificate of need to utilize its licensed
acute or critical access hospital beds as swing beds.
(2) For a designated swing bed hospital to
add new acute or critical access hospital beds that may be utilized as swing
beds, the hospital's proposal shall be consistent with the State Health Plan's
review criteria for hospital acute care beds and certificate of need
approval.
Section 4.
Certification of Continuing Care Retirement Communities.
(1) In order to be certified as a continuing
care retirement community, a certificate of compliance shall be obtained from
the Office of Inspector General, Division of Certificate of Need.
(2) In order to obtain a certificate of
compliance, a continuing care retirement community shall complete and file CON
- Form 11, Application for Certificate of Compliance for a Continuing Care
Retirement Community (CCRC), incorporated by reference in
900 KAR
6:055, thereby certifying that:
(a) All residents shall have a written
agreement with the continuing care retirement community;
(b) The continuing care retirement community
shall offer a continuum of residential living options and support services to
its residents age sixty (60) and older and may offer these living options and
services to persons below age sixty (60) on an as needed basis;
(c) None of the health facilities or health
services established by the continuing care retirement community under this
section shall apply for or become certified for participation in the Medicaid
Program, and that this restriction shall be disclosed in writing to each of its
residents;
(d) A claim for Medicaid
reimbursement shall not be submitted for a person for a health service
established by the continuing care retirement community under this section, and
that this restriction shall be disclosed in writing to its residents;
(e) All residents in nursing home beds shall
be assessed using the Health Care Financing Administration approved long-term
care resident assessment instrument. The assessment shall be transmitted to the
state data bank if the nursing home bed is certified for Medicare
participation;
(f) Admissions to
continuing care retirement community nursing home beds shall be exclusively
limited to on-campus residents;
(g)
A resident shall not be admitted to a continuing care retirement community
nursing home bed prior to ninety (90) days of residency in the continuing care
retirement community unless the resident experiences a significant change in
health status documented by a physician;
(h) A resident shall not be involuntarily
transferred or discharged without thirty (30) days prior written notice to the
resident or the resident's guardian;
(i) The continuing care retirement community
shall assist a resident upon move-out notice to find appropriate living
arrangements;
(j) The continuing
care retirement community shall share information on alternative living
arrangements provided by the Department of Aging and Independent Living at the
time a move-out notice is given to a resident; and
(k) Written agreements executed by the
resident and the continuing care retirement community shall contain provisions
for assisting any resident who has received a move-out notice to find
appropriate living arrangements.
(3)
(a) The
Office of Inspector General, Division of Certificate of Need, shall issue a
certificate of compliance within thirty (30) days of receipt of a completed CON
- Form 11 if all conditions are met.
(b) If all conditions are not met, the
cabinet shall advise the applicant of any deficiencies.
(c) Upon correction of the deficiencies, the
cabinet shall issue the certificate of compliance within thirty (30) days of
correction.
(4) A
continuing care retirement community's nursing home beds shall be considered to
have been established for purposes of KRS Chapter 216B upon the issuance of an
authority to occupy by the cabinet.
(5) If, after having obtained an initial
certificate of compliance, a continuing care retirement community wishes to
establish additional nursing home beds, an additional certificate of compliance
shall be obtained from the cabinet.
(6) Upon request, the continuing care
retirement community shall provide the Office of Inspector General, Division of
Certificate of Need the:
(a) Payor source for
each of its nursing home beds; and
(b) Number of each type of bed or living unit
within the continuing care retirement community.
STATUTORY AUTHORITY:
KRS
194A.030(1)(c) 4.,
216B.040(2)(a)1, 216B.330