OAR 333-560-0110: Expedited Review for Relocation or Replacement of Long-Term Care Beds

Under certain circumstances, the Public Health Division may approve relocation or replacement of existing long-term care beds under the expedited review process set forth in this rule and OAR 333-560-0120 without the analysis of service area need specified in OAR 333-610-0030 when all of the following conditions are met: (1) Relocation or replacement, under this rule, shall include: (a) Rebuilding of all or part of a long-term care facility within its service area; or (b) Relocation of all or part of the beds in two existing long-term care facilities within the same service area, at either one of the facilities, or at a new location in the service area; or (c) Combinations of the above; (d) For the purposes of this rule, relocation or replacement shall not include the conversion of existing space within a hospital building; (e) Regardless of subsection (b) of this section, if the applicant can demonstrate to the satisfaction of the Public Health Division that a location outside of the original service area is appropriate based upon the unique nature and characteristics of the population served by the facility and can satisfactorily demonstrate the appropriateness of an alternative site for the replaced facility, the Public Health Division may waive the requirement that the beds be relocated or replaced within the original service area. To qualify under this subsection, the applicant must demonstrate to the satisfaction of the Public Health Division that the facility has a statewide or regional service area and that it specializes in serving a distinct population with unique medical needs such as children or ventilator dependent individuals with specific programmatic services. Only beds which serve this type of distinct population are eligible for relocation or replacement under this subsection. (2) The applicant shall submit, with the letter of intent, a copy of a letter that has been sent to Seniors and People with Disabilities requesting irrevocable delicensure of the relocated or replaced beds, effective as of the date of licensure of the replacement beds. The Public Health Division will confirm that Seniors and People with Disabilities has received the letter before ruling the project eligible for expedited review. The applicant must provide a written statement to the Public Health Division stating that it will not withdraw this letter if it is granted a certificate of need for its project. (3) In any event, the relocation or replacement process shall not result in a net increase in the number of licensed long-term care beds in the geographical service area except as provided under OAR 333-550-0010(3)(b) or 333-560-0110(1)(e) when applicable. (4) If the project involves construction of a new facility, the design and construction of the entire relocated or replaced facility must meet all Senior and People with Disabilities criteria for new construction standards in long-term care facilities or has received a waiver from Seniors and People with Disabilities based on a showing that full compliance with new construction standards is not required. If the project involves relocating beds to an existing facility, the patient rooms that will house the relocated beds and areas of the existing facility that support the relocated beds must meet all Seniors and People with Disabilities criteria for new construction standards in long-term care facilities or a waiver must be obtained from Seniors and People with Disabilities based on a showing that full compliance with new construction standards is not required. The applicant must submit schematic plans for the project. (5)(a) The applicant must demonstrate, to the satisfaction of the Public Health Division, that the physical environment for patients and the ability to provide patient care both at the new setting and, if it remains open, at the original setting will significantly improve as a result of the proposed project. The Public Health Division may waive this requirement if the applicant can demonstrate, to Health Service’s satisfaction, that failure to undertake the project will result in serious adverse economic consequences for the applicant that will jeopardize its ability to continue to provide nursing facility services. A waiver under this section will only be granted if the applicant can demonstrate to the satisfaction of the Public Health Division that the physical environment for patients and the ability to provide patient care will remain the same or improve as a result of the project. The Public Health Division may, at its discretion, perform an on-site evaluation of all existing facilities involved. (b) Examples of the types of improvements that the Public Health Division may consider under this section include, but are not limited to: reduction of the number of residents in rooms; increased square footage per resident rooms; increased or remodeled dining, activities, social services, therapy, kitchen, laundry, and nursing station space; improved fire and life safety; improved resident toilet, hand washing and bathing areas; improved electrical systems including alarms and call systems; and improved heating and ventilation systems. (6) The applicant shall demonstrate, to the satisfaction of the Public Health Division, that the applicant’s proposal is financially viable and shall indicate the impact on patient charges. The applicant must demonstrate financial viability and the impact on charges at the new setting. If the original setting remains open, the applicant must demonstrate that reducing the number of beds at the original setting will not adversely impact the financial condition of that facility. Applicants must submit completed Forms CN-3 through CN-12 and a narrative discussion of the items identified in OAR 333-580-0060. Forms or narrative discussion which are not relevant to the proposal need not be completed, however. Applicants should contact the Public Health Division to determine which forms and narrative discussion are relevant to their proposal.