Oklahoma Administrative Code
Title 310 - Oklahoma State Department of Health
Chapter 630 - Certificate of Need Standards for Licensed Nursing Facility Beds
Section 310:630-1-3 - Standards
Universal Citation: OK Admin Code 310:630-1-3
Current through Vol. 42, No. 1, September 16, 2024
(a) The applicant shall demonstrate that existing licensed nursing facility beds are not and will not be adequate in the service area described in 310:630-1-2, based on the need of the population.
(1) The
applicant shall 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 shall demonstrate the probable impact of the proposed beds on the
ratio of LNF beds to the number of persons age 75 and over statewide. The
applicant must show that the proposed new beds likely will not cause the
statewide ratio to exceed 179 beds per 1000 persons age 75 and over, and that
the project is consistent with the achievement of an optimal target ratio of
152 beds per 1000 persons age 75 and over.
(3) The applicant shall demonstrate the
probable impact of the proposed beds on the ratio of LNF beds to the number of
persons age 75 and over in the service area. No application shall cause an
excessive increase in the bed to population ratio of a service area. The
determination of whether or not an increase is excessive shall be 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 shall be
used. The source of population projections for current and future years shall
be based on year 2000 census data as published by the Oklahoma Department of
Commerce.
(5) If the applicant
proposes a special service area under
310:630-1-2, then
the applicant shall demonstrate that the target population will have access to
the proposed services through public or private transportation.
(b) The applicant shall 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 85%
should be maintained in LNF beds in the Service Area described in OAC
310:630-1-2.
(A) This mean shall be based upon 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 mentally
retarded persons or intermediate care facility for mentally retarded persons in
the area shall be excluded;
(ii) in
the case of a nursing facility application, any hospital-based skilled nursing
unit shown to serve a different health service need shall be
excluded;
(iii) in the case of a
hospital-based skilled nursing unit application, any nursing facility shown to
serve a different health service need shall be excluded;
(iv) in the case of a facility demonstrating
a special service area under OAC
310:630-1-2(b),
each facility not shown to be adequate or appropriate to meet the needs of the
facility's special population shall be excluded.
(B) The mean shall be calculated using data
for the most recent six month period for which 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 shall be considered to have been
occupied.
(ii) The area bed
capacity used to calculate the occupancy rate shall be 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-month period.
(C) In determining the service
area's conformity to the occupancy goal specified in this subsection, the
Department shall investigate the causes for low-occupancy operation of other
facilities in the service area. The Department shall exclude such low-occupancy
facility from the service area calculations if the facility has been in
operation continuously under the current licensee for twenty-four (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 63:1-851.1(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 60 months.
(2) The applicant shall 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 shall 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 shall demonstrate adequate financial resources for the new or expanded long-term care services and for the continued operation thereof.
(1)
Reimbursement shall be structured to realistically provide for care and
services to persons living in the service area.
(2) The proposed charges shall be in line
with the prevailing rate of similar institutions and services within the health
service area.
(3) The projected
utilization rates shall be sufficient to maintain cost-effectiveness.
(4) The projected cash flow shall give the
proposed project financial viability within three years.
(5) The relationship of the institution's
assets to liabilities shall not be increased by the proposed project to the
point of threatening the financial viability of the institution.
(6) The applicant shall supply a cost/benefit
analysis to justify the cost-effectiveness of the proposed project.
(d) The applicant shall 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 shall 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 shall:
(i) Provide a plan which 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
(ii) Agree to advise the OSDH,
prior to any change in the staffing and leadership during the first six months
of operation of the new or expanded facility.
Amended at 18 Ok Reg 2498, eff 6-25-01; Amended at 19 Ok Reg 2080, eff 6-27-02; Amended at 22 Ok Reg 2416, eff 7-11-05
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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