Mississippi Administrative Code
Title 15 - Mississippi Department of Health
Part 8 - Office of Health Policy and Planning
Subpart 90 - Planning and Resource Development
Chapter 06 - Comprehensive Medical Rehabilitation Services
Section 15-8-90-06-603 - Certificate of Need Criteria and Standards for Comprehensive Medical Rehabilitation Beds/Services
Section 15-8-90-06-603.01 - Policy Statement Regarding Certificate of Need Applications for Comprehensive Medical Rehabilitation Beds/Services

1. Definition: Comprehensive Medical Rehabilitation (CMR) Services provided in a freestanding CMR hospital or a CMR distinct part unit are defined as an intensive care service providing a coordinated multidisciplinary approach to patients with severe physical disabilities that require an organized program of integrated services. These disabilities include: stroke, spinal cord injury, congenital deformity, amputation, major multiple trauma, fractures of the femur (hip fracture), brain injury, polyarthritis, including rheumatoid arthritis, or neurological disorders, including multiple sclerosis, motor neuron disease, polyneuropathy, muscular dystrophy, and Parkinson's Disease.

2. Planning Areas: The state as a whole shall serve as a single planning area for determining the need of CMR beds/services.

3. CMR Services:

Level I - Level I CMR providers may provide treatment services for all rehabilitation diagnostic categories.

Level II - Level II CMR providers may provide treatment services for all rehabilitation diagnostic categories except:

4. CMR Need Determination:

MSDH shall determine the need for Level I CMR beds/services based upon a formula of 0.08 beds per 1,000 population for the state as a whole.

MSDH shall determine the need for Level II CMR beds/services based upon a formula of 0.0623 beds per 1,000 population for the state as a whole.

Table 6-3 shows the current need for CMR beds.

5. Present Utilization of Rehabilitation Services: When reviewing CON applications, MSDH shall consider the utilization of existing services and the presence of valid CONs for services.

6. Minimum Sized Facilities/Units: Hospital-based Level I CMR units shall not contain less than twenty (20) beds. If the established formula reveals a need for more than ten (10) beds, MSDH may consider a twenty (20) bed (minimum sized) unit for approval. Hospital-based Level II CMR facilities are limited to a maximum of thirty (30) beds.

7. Expansion of Existing CMR Beds: Before any additional CMR beds, for which CON review is required, are approved for any facility presently having CMR beds, the currently licensed CMR beds at said facility shall have maintained an occupancy rate of at least eighty percent (80%) for the most recent twelve (12) month licensure reporting period or at least seventy percent (70%) for the most recent two (2) years.

8. Priority Consideration: When reviewing two or more competing CON applications, MSDH shall use the following factors in the selection process, including, but not limited to, a hospital having a minimum of 160 licensed acute care beds as of January 1, 2000; the highest average daily census of the competing applications; proposed comprehensive range of services; and the patient base needed to sustain a viable CMR service.

9. Children's Beds/Services: Should a CON applicant intend to serve children, the application shall include a statement to that effect.

10. Other Requirements: Applicants proposing to provide CMR beds/services shall meet all requirements set forth in CMS regulations as applicable, except where additional or different requirements as stated in the State Health Plan or in the licensure regulations are required. Level II CMR units are limited to a maximum size of thirty (30) beds.

11. Enforcement: In any case in which MSDH finds a Level II provider has failed to comply with the diagnosis and admission criteria as set forth above, the provider shall be subject to the sanctions and remedies as set forth in Section 41-7-209 of the Mississippi Code 1972, as amended, and other remedies available to MSDH in law or equity.

12. Addition/Conversion of Beds: Effective July 1, 1994, no health care facility shall be authorized to add any beds or convert any beds to another category of beds without a CON under the authority of Section 41-7-191(1)(c) of the Mississippi Code 1972, as amended, unless there is a projected need for such beds in the planning district in which the facility is located.

13. Delicensed Beds: Effective March 4, 2003, if a health care facility has voluntarily delicensed some of its existing bed complement, it may later relicense some or all of its delicensed beds without the necessity of having to acquire a CON. MSDH shall maintain a record of the delicensing health care facility and its voluntarily delicensed beds and continue counting those beds as part of the state's total bed count for health care planning purposes.