Oklahoma Administrative Code
Title 310 - Oklahoma State Department of Health
Chapter 4 - Certificate of Need Regulations
Subchapter 7 - Standards for Licensed Nursing Facility Beds
Section 310:4-7-2 - Standards for LNF beds
Universal Citation: OK Admin Code 310:4-7-2
Current through Vol. 42, No. 1, September 16, 2024
(a) The applicant must demonstrate that existing licensed nursing facility beds are not and will not be adequate in the service area described in 310:4-7-1, based on the need of the population.
(1) The applicant must
demonstrate that there are persons who need services in the area but are unable
to obtain those services due to the inadequacy of existing LNF facilities in
the area.
(2) The applicant must
demonstrate the probable impact of the proposed beds on the ratio of LNF beds
to the number of persons age seventy-five (75) and over statewide. The
applicant must show that the proposed new beds likely will not cause the
statewide ratio to exceed one hundred seventy-nine (179) beds per one thousand
(1000) persons age seventy-five (75) and over, and that the project is
consistent with the achievement of an optimal target ratio of one hundred
fifty-two (152) beds per one thousand (1000) persons age seventy-five (75) and
over.
(3) The applicant must
demonstrate the probable impact of the proposed beds on the ratio of LNF beds
to the number of persons age seventy-five (75) and over in the service area.
The application cannot cause an excessive increase in the bed to population
ratio of a service area. The determination of whether or not an increase is
excessive is based on the percentage of increase a project will cause in an
area's bed to population ratio, and on a comparison of the area's bed to
population ratio against the statewide ratio.
(4) The most recent population data published
at the time the application is filed must be used. The source of population
projections for current and future years is based on year 2000 census data as
published by the Oklahoma Department of Commerce.
(5) If the applicant proposes a special
service area under 310:4-7-1, then the applicant must demonstrate that the
target population will have access to the proposed services through public or
private transportation.
(b) The applicant must demonstrate that alternative or substitute services are not and will not be available or are and will be inadequate to meet the needs of the population.
(1) An overall mean occupancy rate of
eighty-five percent (85%) should be maintained in LNF beds in the service area
described in OAC 310:4-7-1.
(A) This mean is
based on data from all similarly-licensed facilities in the service area using
monthly reports filed with the Department of Health, taking into consideration
the following:
(i) any specialized facility
for individuals with intellectual disabilities or intermediate care facility
for individuals with intellectual disabilities in the area is excluded;
(ii) in the case of a nursing
facility application, any hospital-based skilled nursing unit shown to serve a
different health service need is excluded;
(iii) in the case of a hospital-based skilled
nursing unit application, any nursing facility shown to serve a different
health service need is excluded;
(iv) in the case of a facility demonstrating
a special service area under OAC 310:4-7-1(b), each facility not shown to be
adequate or appropriate to meet the needs of the facility's special population
is excluded.
(B) The mean
is calculated using data for the most recent six (6) month period reports are
published by the Department of Health, as of the first day of the month during
which an application is initially filed.
(i)
Beds reserved for residents who were temporarily absent from facilities for
hospitalization or other therapeutic purposes is considered to have been
occupied.
(ii) The area bed
capacity used to calculate the occupancy rate is reduced by the number of beds
that are not available because rooms licensed for multiple occupants have been
reserved for single occupants throughout the six (6) month
period.
(C) In
determining the service area's conformity to the occupancy goal specified in
this subsection, the Department will investigate the causes for low-occupancy
operation of other facilities in the service area. The Department must exclude
such low-occupancy facility from the service area calculations if the facility
has been in operation continuously under the current licensee for 24 or more
months and:
(i) The facility's state license
or federal certification during the sixty (60) months preceding the filing of
the application has been revoked, rescinded, canceled, terminated,
involuntarily suspended or refused renewal;
(ii) The facility has a history of
noncompliance as defined in 63 O.S. Section 1-851.1(6); or
(iii) The facility has not complied with all
lawful orders of suspension, temporary management, or administrative penalty
issued by the Department, another state agency, or by the federal Health Care
Financing Administration;
(iv) The
facility's owner, operator, manager, or medical director has been convicted of
a criminal offense related to the operation or management of a long-term care
facility; or
(v) The facility has
been assessed an administrative penalty above the level of deficiency with one
or more of the following unfavorable factors:
(I) The administrative penalty included a
citation of immediate jeopardy or actual harm to a resident;
(II) The circumstance cited in connection
with a civil money penalty or other administrative penalty resulted in the
death of a resident; or
(III)
Multiple civil money penalties, denials of payment, or other administrative
penalty have been assessed based on findings of substandard quality of care,
actual harm, or potential for more than minimal harm, at the facility within
the preceding sixty (60) months.
(2) The applicant must demonstrate that the
proposed beds are needed in addition to any beds previously approved under the
State Certificate of Need laws but not yet in operation in the service area.
(3) The applicant's demonstration
must include consideration of the adequacy of such alternative services as
residential care facilities, eldercare, home health care, hospice, assisted
living and adult day care.
(c) The applicant must demonstrate adequate financial resources for the new or expanded long-term care services and for the continued operation thereof.
(1)
Reimbursement is structured to realistically provide for care and services to
persons living in the service area.
(2) The proposed charges must be in line with
the prevailing rate of similar institutions and services within the health
service area.
(3) The projected
utilization rates are sufficient to maintain cost-effectiveness.
(4) The projected cash flow must give the
proposed project financial viability within three years.
(5) The relationship of the institution's
assets to liabilities cannot be increased by the proposed project to the point
of threatening the financial viability of the institution.
(6) The applicant must supply a cost/benefit
analysis to justify the cost-effectiveness of the proposed project.
(d) The applicant must demonstrate that sufficient personnel will be available to properly staff and operate the proposed new or expanded long-term care service.
(1) A proposal to provide new or expanded
long-term care service must provide assurances that the appropriate numbers and
types of staff will be available to comply with licensure requirements.
(2) Professional and
paraprofessional staffing of new or expanded long-term care services must not
compromise the staffing of existing long-term care services.
(3) The applicant must disclose all current
and prior experience in the operation of health care facilities, giving names
of facilities, locations, and dates. If the applicant has less than sixty (60)
months experience in health care facility operations immediately preceding the
filing of the application, then the applicant must:
(A) Provide a plan that details how
experienced and competent staffing and leadership, including but not limited to
the director of nursing, the medical director, the administrator, and the
applicant's policy body, will be placed in charge of facility operations; and
(B) Agree to advise the
Department, before any change in the staffing and leadership during the first
six (6) months of operation of the new or expanded facility.
Disclaimer: These regulations may not be the most recent version. Oklahoma 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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