Current through Register Vol. 49, No. 6, March 15, 2024
PURPOSE: The committee is amending this rule to
remove verbiage related to a demonstration project that is no longer effective,
word updates, and to include a CON form within the rule rather than
incorporating it by reference.
(1) The following population-based long-term
care bed need methodology for the fifteen- (15-) mile radius shall be used to
determine the need:
(A) Approval of additional
intermediate care facility/skilled nursing facility (ICF/SNF) beds will be
based on:
1. A service area need determined
to be fifty-three (53) beds per one thousand (1,000) year 2025 population age
sixty-five (65) and older minus the current supply of ICF/SNF beds shown in the
most recent Six-Quarter Occupancy of Hospital and Nursing Home Licensed and
Available Beds report as provided by the Certificate of Need Program (CONP)
which includes licensed and Certificate of Need (CON)-approved beds;
(B) Approval of additional
residential care facilities/assisted living facilities (RCF/ALF) beds will be
based on:
1. A service area need determined to
be twenty-five (25) beds per one thousand (1,000) year 2025 population age
sixty-five (65) and older minus the current supply of RCF/ALF beds shown in the
most recent Six-Quarter Occupancy of Residential Care and Assisted Living
Facility Licensed and Available Beds as provided by the CONP which includes
licensed and CON-approved beds; and
(C) Approval for Long-Term Care Hospital
(LTCH) beds, as described in
42 CFR, section
412.23(e), will be based on
a service area need determined to be one-tenth (0.1) bed per one thousand
(1,000) year 2025 population minus the current supply of LTCH beds shown in the
most recent Six-Quarter Occupancy of Long-Term Care Hospital Facility Licensed
and Available Beds as provided by the CONP which includes licensed beds and
CON-approved beds.
(D) If the
project is to add beds to an existing long-term care facility, the applicant
shall state whether or not the facility received any resident care Class I
deficiencies within the last eighteen (18) months as a result of a survey,
inspection, or complaint investigation and the reason for and status of the
deficiencies.
(2)
Replacement Chapter 198 beds may qualify for an exception to the LTC bed
minimum occupancy requirements (MOR) plus shortened information requirements
and review time frames if an applicant proposes to-
(A) Relocate RCF/ALF beds within a six
(6)-mile radius pursuant to section 197.318.4(4), RSMo;
(B) Replace one-half (1/2) of its licensed
beds within a thirty (30)-mile radius pursuant to section 197.318.5, RSMo;
or
(C) Replace a facility in its
entirety within a fifteen (15)-mile radius pursuant to section 197.318.6, RSMo,
under the following conditions:
1. The
existing facility's beds shall be replaced at only one (1) site;
2. The existing facility and the proposed
facility shall have the same owner(s), regardless of corporate structure;
and
3. The owner(s) shall stipulate
in writing that the existing facility's beds to be replaced will not be used
later to provide long-term care services; or if the facility is operated under
a lease, both the lessee and the owner of the existing facility shall stipulate
the same in writing.
(3) An LTC bed expansion involving a Chapter
198 facility may qualify for shortened information requirements and review time
frames. The applicant shall submit the following information:
(A) If an effort to purchase has been
successful pursuant to section 197.318.4(1), RSMo, a Purchase Agreement (Form
MO 580-2352), included herein, between the selling and purchasing facilities,
and a copy of the selling facility's reissued license verifying the surrender
of the beds sold; or
(B) If an
effort to purchase has been unsuccessful pursuant to section 197.318.4(1),
RSMo, a Purchase Agreement (Form MO 5802352), included herein, between the
selling and purchasing facilities which documents the "effort(s) to purchase"
LTC beds.
(4) An exception
to the CON application filing fee will be recognized for any proposed facility
which is designed and operated exclusively for persons with acquired human
immunodeficiency syndrome (AIDS).
(5) For LTC renovation or modernization projects which
do not include increasing the number of beds, the applicant shall document the
following, if applicable:
(A) The proposed
project is needed to comply with current facility code local, state, or federal
government requirements for licensure, certification, or
accreditation;
(B) Operational
efficiencies will be attained through reconfiguration of space and
functions;
(C) The methodologies
used for determining need and the reallocation of space and functions;
and
(D) The benefits to the
facility because of its age or condition.
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*Original authority: 197.320, RSMo 1979, amended 1993,
1995, 1999.
