OAR 333-560-0130: Expedited Review for Relocation of Long-Term Care Beds to Hospitals

(1) Under certain circumstances, the Public Health Division may approve relocation of existing long-term care beds to a hospital-based setting under the expedited review process set forth in this rule without the analysis of service area need specified in OAR 333-610-0030, provided that all of the following conditions are met: (a) The long-term beds are relocated from one existing long-term care facility to not more than one location which is or will be licensed as a long-term care facility at the time of the relocation and is within the same standard metropolitan statistical area or within 15 miles of the hospital, whichever is greater. (b) The project involves the relocation of not more than 50 percent of the licensed long-term care beds from one site to another. (c) The applicant shall submit, with the letter of intent, a letter to Seniors and People with Disabilities Division requesting irrevocable delicensure of the remaining long-term beds at the facility from which the beds are transferred pursuant to this rule, which request shall be effective as of the date of licensure of the beds being transferred. The Public Health Division will determine whether this letter provides substantial assurance that the remaining beds will in fact be delicensed. No application will be approved under this rule unless the Public Health Division determines that such assurance exists. (d) The facility from which the long-term care beds are to be transferred shall be closed as a long-term care facility and shall not offer or develop a new skilled nursing or intermediate care service or facility as described in OAR 333-550-0010(3) without approval pursuant to full certificate of need review. (e) Notwithstanding subsections (1)(c) and (1)(d) of this rule, the facility from which beds are relocated may be allowed to continue operation if it can be demonstrated to the satisfaction of the division that the continued operation of the facility is necessary to maintain adequate bed capacity in the service area and provided that it reduces its current licensed bed capacity by twice as many beds as are relocated. (f) The design and construction of the renovated space must either meet all Seniors and People with Disabilities Division criteria for new construction standards in long-term care facilities or receive a waiver from Seniors and People with Disabilities Division based on a showing that full compliance with the new construction standards is not appropriate. The applicant shall submit schematic plans for the proposed project. (g) Serious structural and fire and life safety problems, or other problems significantly affecting the care and well-being of patients must be demonstrated to exist at the facility whose beds are proposed to be relocated. The procedure for demonstrating these physical problems is the same as that set out in OAR 333-560-0110(7)(a) through (d). (h) The applicant must demonstrate to the satisfaction of the division that projected per diem inpatient routine service costs in the hospital-based setting (calculated in conformance with Medicare cost report parameters) will not exceed 125 percent of the per diem routine service cost limitation computed by the Medicare fiscal intermediary for freestanding skilled nursing facilities in its urban or rural location during the first two years of operation. The routine cost limitation may be adjusted, as appropriate, to allow for reasonable inflation as measured by the DRI (HCFA) McGraw Hill Nursing Facility Market Basket Index. Notwithstanding anything to the contrary in the two immediately preceding sentences, if the hospital has owned or controlled the long-term care facility from which it proposes to move beds for at least three years, the applicant must demonstrate to the satisfaction of the Division that projected per diem actual inpatient routine service costs in the hospital-based setting will either not exceed 125 percent of actual per diem inpatient routine service costs experienced in its current setting during the first two years of operation or will not exceed 125 percent of the per diem routine service cost limitation computed by the Medicare fiscal intermediary for freestanding skilled nursing facilities in its urban or rural location during the first two years of operation. (i) The applicant shall submit a completed copy of Forms CN-3 and CN-11. The applicant shall also submit a summary for the first two years of operation of projected revenue, expenses, operating income, non-operating revenue and net income with and without the project. (j) Projects approved under this rule are subject to the full review process detailed in division 570 of this chapter and to the application and review criteria established in division 580, or if applicable, an expedited review under this chapter, if the cost limitations required under subsection (1)(h) of this rule are not maintained for the first two years of operation of the relocated beds. (2) For the purposes of this rule, relocation shall include the conversion of existing space within a hospital building to house the relocated long-term care beds. (3) The procedure for expedited review set out in OAR 333-560-0120 is not applicable to projects proposed under this rule. For the purposes of OAR 333-560-0130 the following procedure shall be followed: (a) The expedited review process shall be initiated upon the written request of the applicant, payment of the fee specified in OAR 333-565-0000(4) and submission of the information and materials necessary to support the request for expedited review as specified in section (1) of this rule. Within 5 working days of the date that the division notifies the applicant that the necessary information and materials have been provided, the division shall rule the project eligible for expedited review. Notwithstanding the previous sentence, however, a project shall not be ruled to be eligible for expedited review sooner than the date of the division’s ruling on the letter of intent for the project. (b) If all of the conditions specified in section (1) of this rule have been met, the division shall issue a proposed order granting the certificate of need for the project. The date of this proposed order shall be no later than 20 working days from the date of the division’s finding under OAR 333-560-0110(7)(c) or (d), as applicable. Such an order shall contain findings to justify the granting of a certificate of need under this rule but need contain no other findings. (c) Projects undergoing expedited review under this rule are exempt from the full review process detailed in division 570 of this chapter, with the exception of OAR 333-570-0070(4) through (10); and from the application and review criteria established in division 580. (d) Projects undergoing expedited review under this rule are not exempt from the monitoring and reporting requirements of OAR 333-575-0000 and 333-575-0010.