OAR 333-610-0070: Temporary rule language in effect until 12/21/2026. Swing Long-Term Care Beds in Hospitals

This rule has an operative date of June 24, 2026. When a hospital proposes to utilize a given number of its licensed hospital acute beds intermittently as skilled nursing facility swing beds under applicable federal regulations, the hospital is expected to submit a letter of intent to the Public Health Division. The organized and regular provision of skilled nursing facility services within the licensed physical plant of the hospital may be subject to review as a new long-term care facility under OAR 333-550-0010(3)(a). In addition: (1) The proposal will not be subject to county-specific nursing home bed need criteria under OAR 333-610-0000 to 333-610-0030 because it will not create permanent new nursing home beds. The division, in reviewing the proposal for need under OAR 333-580-0040 and for alternative uses of resources under OAR 333-580-0050, will take into consideration such factors as: (a) Health policy of the state, as reflected in ORS 410.010, 410.020, 410.050 and 410.060; ORS Chapter 442 generally; and other applicable statutes; (b) Interpretation of that policy, as reflected in the plans and administrative rules of the Health Division and the Senior and Disabled Services Division. In considering strategies for increasing the accessibility of nursing home beds, priority will be given to increasing the utilization of appropriate alternative care (thereby freeing up existing nursing home beds), rather than increasing the number of nursing home beds; (c) Comparative experience with, and quality of, long-term care provided by staff in licensed acute care hospitals and in licensed long-term care facilities. (2) The division, in reviewing the proposal for financial feasibility under OAR 333-580-0060, will take into consideration such factors as: (a) A conservative projection of Medicare utilization according to the current stringent “skilled” level of care criteria of the fiscal intermediaries; (b) Estimated potential for diversion of public and private funds now available for alternative care into facility-based long-term care when the patient needs involved could be met, at equal or lesser cost, through provision of alternative care; (c) Balanced against section (3) of this rule, estimated potential for diversion of public and private funds now available for acute care into facility-based and alternative long-term care; (d) Comparative costs of long-term care provided in licensed hospitals and in licensed long-term care facilities, and the feasibility of the hospitals contracting for skilled care in an existing long-term care facility at equal or lesser cost; and (e) Potential that the proposal will or will not increase Medicare costs, per illness episode, beyond those allowed for under diagnosis-related groups reimbursement.