Current through Register Vol. 24-24, December 15, 2024
The following rules apply to any in-home services agency
licensed to provide hospice services, that is or has declared an intent to
become additionally licensed to provide hospice care center services.
(1) Definitions.
(a) "Applicant" means an in-home services
agency licensed to provide hospice services under chapter 246-335
WAC.
(b) "Hospice care center"
means a homelike, noninstitutional facility where hospice services are
provided, and that meet the requirements for operation under
RCW
70.127.280 and chapter 246-335 WAC.
(2) The department shall review
hospice care center applications using the concurrent review cycle in this
section.
(3) Applications must be
submitted and reviewed according to the following schedule and procedures.
(a) Letters of intent must be submitted
between the first working day and last working day of October of each
year.
(b) Initial applications must
be submitted between the first working day and last working day of November of
each year.
(c) The department shall
screen initial applications for completeness by the last working day of
December of each year.
(d)
Responses to screening questions must be submitted by the last working day of
January of each year.
(e) The
public review and comment for applications begins on February 16 of each year.
If February 16 is not a working day in any year, then the public review and
comment period must begin on the first working day after February 16.
(f) The public comment period is limited to
ninety days, unless extended under WAC
246-310-120(2)(d).
The first sixty days of the public comment period must be reserved for
receiving public comments and conducting a public hearing, if requested. The
remaining thirty days must be for the applicant or applicants to provide
rebuttal statements to written or oral statements submitted during the first
sixty-day period. Any interested person that:
(i) Is located or resides within the applying
hospice agency's health service area;
(ii) Testified or submitted evidence at a
public hearing; and
(iii) Requested
in writing to be informed of the department's decision, shall also be provided
the opportunity to provide rebuttal statements to written or oral statements
submitted during the first sixty-day period.
(g) The final review period is limited to
sixty days, unless extended under WAC
246-310-120(2)(d).
(4) Any letter of intent or
certificate of need application submitted for review in advance of this
schedule, or certificate of need application under review as of the effective
date of this section, shall be held by the department for review according to
the schedule in this section.
(5)
If an application initially submitted under the concurrent review cycle is
deemed not to be competing, the department may convert the review to a regular
review process.
(6) An applicant
must provide the following documentation to demonstrate that the applicant's
existing patient base is sufficient to support the creation of the hospice care
center.
(a) Step 1. Determine the average
total days of care provided in the applicant's preceding three years of
operation. If the applicant has been in operation for less than three years,
assume an ADC of thirty-five to calculate potential days of care;
(b) Step 2. Multiply the above average days
of care by the applicant's annual percentage of patients requiring care in
settings other than their private home to estimate the number of potential
patient days. If the applicant has been in operation for less than three years,
multiply the potential days of care by the statewide percentage of hospice
patients requiring care in settings other than their private home;
(c) Step 3. Divide the estimated number of
patient days by three hundred sixty-five (days per year) to estimate the
average daily census for the applicant;
(d) Step 4. Assume a minimum occupancy of
sixty-five percent to determine the number of beds the applicant could request
in their application.
(7) If applying for more beds than provided
for in subsection (6) of this section, the applicant must provide
documentation, methodology and assumptions that support the applicant's ability
to sustain the additional beds.
(8)
The following occupancy requirements apply to all applicants:
(a) The average occupancy rate of the beds in
the center must be projected to be at least fifty percent for the first three
years following completion of the project;
(b) A minimum occupancy rate of sixty-five
percent should be maintained after the first three years of operation;
and
(c) If applying to add beds to
an existing hospice care center the applicant must document that the average
occupancy of the beds in the hospice care center was at least eighty percent
for the nine months immediately preceding the submittal of the
proposal.
(9) The
applicant must document that they can maintain the minimum occupancy rate and
still meet the following requirements:
(a) No
more than forty-nine percent of the hospice agency's patient care days, in the
aggregate on a biennial basis, can be provided in the hospice care center,
under RCW
70.127.280; and
(b) The maximum number of beds in a hospice
care center is twenty, under chapter 70.127 RCW.
(10) Failure to operate the hospice care
center in accordance with the application relied upon by the department in
making its decision may be grounds for revocation or suspension of a center's
certificate of need, or other appropriate action.
Statutory Authority: Chapters 70.127 and 70.38 RCW.
03-07-096, § 246-310-295, filed 3/19/03, effective
4/19/03.
