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 15-8-90-06-603.02 - Certificate of Need Criteria and Standards for Comprehensive Medical Rehabilitation Beds/Services

Universal Citation: MS Code of Rules 15-8-90-06-603.02

Current through September 24, 2024

MSDH will review applications for a CON for the establishment, offering, or expansion of comprehensive medical rehabilitation beds and/or services under the statutory requirements of Sections 41-7-173, 41-7-191, and 41-7-193, Mississippi of Code 1972, Annotated, as amended. MSDH will also review applications for Certificate of Need according to the general criteria listed in the Mississippi Certificate of Need Review Manual, all adopted rules, procedures, and plans of MSDH, and the specific criteria and standards listed below.

In addition, comprehensive rehabilitation services are reviewable if the proposed provider has not provided such services on a regular basis within twelve (12) months prior to the time such services would be offered. The twenty (20) bed hospital-based comprehensive medical rehabilitation facilities which were operational or approved on January 1, 2001, are grandfathered and shall not be required to obtain a Certificate of Need as long as the services are provided continuously by those facilities and are limited to the diagnoses set forth below for Level II comprehensive medical rehabilitation facilities.

Need Criterion 1: Projected Need

a. New/Existing CMR Beds/Services: The need for Level I CMR beds in the state shall be determined using a methodology of 0.08 beds per 1,000 population. The state as a whole shall be considered as a single planning area.

The need for Level II CMR beds in the state shall be determined using a methodology of 0.0623 comprehensive medical rehabilitation beds per 1,000 population. The state as a whole shall be considered a planning area.

b. Projects which do not Involve the Addition of any CMR Beds: The applicant shall document the need for the proposed project. Documentation may consist of, but is not necessarily limited to, citing of licensure or regulatory code deficiencies, institutional long-term plans (duly adopted by the governing board), recommendations made by consultant firms, and deficiencies cited by Accreditation Agencies (JCAHO, CAP).

c. Projects which Involve the Addition of CMR Beds: The applicant shall document the need for the proposed project.

Exception: Notwithstanding the service specific need requirements as stated in "a" above, MSDH may approve additional beds for facilities which 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.

d. Level II Trauma Centers: The applicant shall document the need for the proposed CMR project.

Exception: MSDH may approve the establishment of a twenty (20) bed Level II CMR unit for any hospital without CMR beds which held a Level II Trauma care designation on July 1, 2003, as well as on the date the CON application is filed.

e. Conversion of Level II CMR Beds to Level I CMR Beds: Notwithstanding any other policy statement, standard or criterion, including, but not limited to, Need Criterion 1(a) above, an existing Level II CMR unit may convert no more than eight (8) beds to Level I CMR status if the Level II facility meets the following requirements:

(i) The Level II CMR unit demonstrates high utilization by documenting that it has 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, as reported in the Mississippi State Health Plan.

(ii) The Level II CMR unit establishes the need for Level I CMR status for no more than eight (8) beds by documenting that the facility expects to have a minimum of sixty (60) patient admissions annually with one (1) or more of the following rehabilitation diagnostic categories: spinal cord injuries, congenital deformity, and/or brain injury. This documentation may include, without limitation, the Level II CMR unit's patient data or any other data or documentation acceptable to MSDH.

(iii) The Level II CMR unit shall document compliance with the standards for Level I CMR units set forth below in Criterion 2 (Treatment and Programs) and Criterion 3 (Staffing and Services).

(iv) The Department shall assess the potential of the project on any adverse impact on any Level I CMR facilities operating in the state and such assessment shall be continually reviewed by the Department. The Department may revoke or suspend any Level II CMR unit operating a Level I program for non-compliance or finding of adverse impact to any Level I CMR units or programs in the state.

Need Criterion 2: Level 1 CMR Services

Applicants proposing to establish Level I CMR services shall provide treatment and programs for one (1) or more of the following conditions:

a. Stroke,

b. Spinal cord injury,

c. Congenital deformity,

d. Amputation,

e. Major multiple trauma,

f. Fractures of the femur (hip fracture),

g. Brain injury,

h. Polyarthritis, including rheumatoid arthritis, or neurological disorders, including multiple sclerosis, motor neuron disease, polyneuropathy, muscular dystrophy, and Parkinson's Disease.

Applicants proposing to establish Level II CMR services shall be prohibited from providing treatment services for the following rehabilitation diagnostic categories:

(1) spinal cord injury,

(2) congenital deformity, and

(3) brain injury.

Facilities providing Level I and Level II CMR services shall include on their Annual Report of Hospitals submitted to MSDH the following: total admissions, average length of stay by diagnosis, patient age, sex, race, zip code, payor source, and length of stay by diagnosis.

Need Criterion 3: Staffing and Services

a. Freestanding Level I Facilities

i. Shall have a Director of Rehabilitation who:

(1) Provides services to the hospital and its inpatient clientele on a full-time basis;

(2) Is a Doctor of Medicine or Osteopathy licensed under state law to practice medicine or surgery; and

(3) Has had, after completing a one (1) year hospital internship, at least two (2) years of training in the medical management of inpatients requiring rehabilitation services.

ii. The following services shall be provided by full-time designated staff:

(1) Speech therapy

(2) Occupational therapy

(3) Physical therapy

(4) Social services

iii. Other services shall be provided as required but may be by a consultant or on a contractual basis.

b. Hospital-Based Units

i. Both Level I and Level II hospital-based units shall have a Director of Rehabilitation who:

(1) Is a Doctor of Medicine or Osteopathy licensed under state law to practice medicine or surgery;

(2) Has had, after completing a one (1) year hospital internship, at least two (2) years of training or experience in the medical management of inpatients requiring rehabilitation services; and

(3) Provides services to the unit and its inpatients for at least twenty (20) hours per week.

ii. The following services shall be available full time by designated staff:

(1) Physical therapy

(2) Occupational therapy

(3) Social services

iii. Other services shall be provided as required but may be by a consultant or on a contractual basis.

Disclaimer: These regulations may not be the most recent version. Mississippi may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.

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