OAR 409-023-0110: Community Benefit Minimum Spending Floor

(1) The community benefit minimum spending floor program is effective January 1, 2021. (2) The Authority shall calculate community benefit minimum spending floors for each hospital and its affiliated clinics in Oregon based on the fiscal year of the hospital, with each floor effective over the next two consecutive fiscal years. The Authority shall recalculate the spending floor every two years. (3) The Authority will collect the data and criteria enumerated in ORS 442.624 on form CBR-3, if it is not already provided by hospitals on forms CBR-1 or FR-3, and from the general public for consideration in establishing hospital minimum community benefit floors. The Authority will post the spending floors for comment from the hospitals and general public as required under OAR 409-023-0110 (9). (4) Community benefit minimum spending floors shall apply to all community benefit net costs reported to the Authority on Community Benefit Reporting Form (CBR-1). (5) Each hospital may select among the following methodologies, as applicable to the hospital’s organizational structure, for the purpose of applying a minimum community benefit floor: (a) By each individual hospital and all of the hospital’s nonprofit affiliated clinics; (b) By a hospital and a group of the hospital’s nonprofit affiliated clinics; (c) By all hospitals that are under common ownership and control and all of the hospitals’ nonprofit affiliated clinics; or (d) By any other grouping of hospitals and their hospital affiliated clinics that is approved by the Authority. (6) The Authority will utilize the methodology selected by the hospital from among those listed in OAR 409-023-0110 (5) to assign each hospital’s community benefit minimum spending floor, subject to the following requirements: (a) Hospitals shall include audited financial statements and other objective data describing the overall financial positions of the hospitals and their affiliated clinics as grouped in the selected methodology on form CBR-3, if such information is not already incorporated into the audited financial reporting of the hospitals. (b) Hospitals shall report the community benefit net costs that occur in their affiliated clinic(s) as grouped in the selected methodology on CBR-1. (c) Hospitals choosing methodologies with multiple groupings shall report objective financial data and community benefit net costs for each facility such that the group totals, taken together, sum to be equal to the cumulative financials and net community benefit costs of all hospitals and affiliated clinics referenced in the chosen methodology. (d) Each hospital shall inform the Authority of its elected organization groupings on form CBR-3 and provide all information requested on CBR-3 no later than 90 days prior to the start of their fiscal year. (e) The elected organization grouping shall be maintained for the two-year duration of the community benefit minimum spending floor assignment, unless a facility within the organizational grouping closes or undergoes a change in ownership or control. (7) The Authority shall publish the formula used to calculate hospitals’ community benefit minimum spending floors by January 1 of every odd numbered year. (8) The Authority shall provide a proposed community benefit spending floor applicable to a hospital and its elected organization grouping no later than 60 days prior to the start of the hospital’s fiscal year. (9) The proposed community benefit spending floor shall be posted to the Authority’s website, and a public comment period of 30 days shall begin the day of posting. All subsequent changes or amendments to the spending floor shall also be posted to the website for comment. (10) The hospital and its affiliates shall have 30 days from receipt of the proposed spending floor to comment or provide additional information which may be used to modify the proposed community benefit spending floor. (11) The Authority shall notify each hospital of the final community benefit spending floor no later than the first business day of the initial fiscal year of the two-year period for which the spending floors are effective. (12) A hospital may ask for a review of its minimum spending floor if the hospital experiences a change in circumstance outside its control that will result in serious financial harm to the hospital if the community benefit minimum spending floor remains unchanged. (13) The authority may amend the formula, if necessary, based on review of community benefit reports and feedback from stakeholders and the general public.