CHAPTER
He-Hea 900 LONG-TERM CARE FACILITIES
REVISION NOTE:
Document
#10977, effective 11-20-15, readopted with amendments Chapter He-Hea 900 on
long term care facilities. Document #10977
made extensive changes to the wording, format, and numbering of the rules in
the former Chapter He-Hea 900. Document
#10917 combined what had been Part He-Hea 901 through Part He-Hea 909 in the
former Chapter He-Hea 900 into Part He-Hea 901 through Part He-Hea 907 in the
amended Chapter He-Hea 900. The former
Chapter He-Hea 900 had last been filed under Document #8917, effective
6-22-07. The rules in former Chapter
He-Hea 900 did not expire on 6-22-15 since they were extended pursuant to RSA
541-A:14-a until replaced by the rules in Document #10977, effective 11-20-15.
Document
#10977 supersedes all prior filings for the rules in the former Chapter He-Hea
900. The filings affecting the former
Chapter He-Hea 900 include the following documents:
#4096, effective 7-22-86
#4325, effective 10-21-87
#5270, effective 11-6-91, EXPIRED 11-6-97
#6654,
INTERIM, effective 12-18-97, EXPIRED 4-17-98
#6801,
effective 7-15-98, EXPIRED 7-15-06
#7442,
effective 2-2-01
#8690,
effective 7-25-06, EXPIRED 1-21-07
#8917,
effective 6-22-07
PART He-Hea 901
PURPOSE AND DEFINITION
He-Hea 901.01 Purpose. This chapter implements an institutional
health service standard for providers of long-term care services per RSA
151-C:5, II, (f) that is intended to promote reasonable distribution of these
services and stimulate competition among qualified providers.
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
He-Hea 901.02 Definitions.
(a)
“Applicant” means “applicant” as defined in RSA 151-C:2, II.
(b) “Application”
means a proposal prepared by a person and filed with the board for a
certificate of need.
(c) “Board” means
“board” as defined in RSA 151-C:2, IV.
(d)
“Certificate of need (CON)” means “certificate of need” as defined in
RSA 151-C:2, VIII.
(e)
“Construction” means “construction” as defined in RSA 151-C:2, XII.
(f) “Continuing care
contract” means a contractual arrangement between the operator and resident of
a CCRC that is in force for not less than one year, which details the rights
and obligations of each party to the contract and which guarantees the resident
nursing home care and other services for the duration of residence in the CCRC
in exchange for an entrance or other fee.
(g)
“Continuing care retirement community (CCRC)” means a residential
complex which:
(1) Operates a residential unit and a nursing
home under a single independent corporate structure;
(2) Operates a residential unit and nursing home
on a single campus or, if not on the same campus, operates the nursing home
within one mile of the residential complex; and
(3) Documents the existence of one of the
following:
a. A continuing care contract with the residents
of the CCRC in exchange for an entrance or other fee offering health care and
support services including but not limited to:
1. Independent living;
2. Dietary services;
3. Medical services;
4. Housekeeping; and
5. Nursing home services; or
b. In lieu of a continuing care contract, a
prominently and publicly displayed posted continuing care policy.
(h) “Continuum of
care” means a comprehensive system of services having diagnostic, preventative,
therapeutic, rehabilitative, supportive and maintenance services in
institutional and non-institutional settings, including but not limited to:
(1) Medical care;
(2) Mental health services;
(3) Primary health care;
(4) Nursing care;
(5) Therapy;
(6) Nutrition services;
(7) Home health care;
(8) Pharmaceutical services;
(9) Personal care services;
(10) Domestic services;
(11) Full range of living arrangements;
(12) Transportation;
(13) Information and referral services; and
(14) Respite care.
(i) “Detrimental”
means a significant adverse impact on the ability to maintain the
accessibility, quality and cost of health care services in the area.
(j) “Entrance fee”
means an initial or deferred payment of a sum of money made as full or partial
payment to ensure the resident a place in the CCRC. The term also includes
“accommodation fee” or “admission fee”.
(k) “Long-term care (LTC)” means medical and
support services provided to individuals who are frail and dependent due to
chronic physical or mental impairments in order to assist them in attaining an
optimal level of physical, social and psychological functioning.
(l) “Marshall
Valuation Service (MVS)” means an appraisal guide for the development and reporting
of replacement building and equipment costs used to determine
construction/renovation costs of commercial buildings.
(m) “Nursing home” means “nursing home” as defined in RSA
151-C:2, XXVI. The term also includes
“long-term-care facility.”
(n)
“Person” means “person” as defined in RSA 151-C:2, XXVIII.
(o) “Posted continuing care policy” means a written
description, provided by the CCRC, of the obligations, rights and privileges
of, and the services available to, all residents of the CCRC.
(p)
"Priority" means the right described in He-Hea 903 given to a
long-term care facility that has surrendered beds to add the same number of
beds or portion thereof to its facility in advance of a request for
applications for additional long-term care beds in the state.
(q)
“Provider” means a person holding a certificate of need and licensed to
do business in the state providing long-term care services in an institutional
setting.
(r) “Quality
assurance plan” means a continuous plan of collection, screening, and
evaluation of information concerning patient care, placement, and clinical
performance leading to the methods of resolving and/or eliminating problems as
identified by professional and administrative staffs, patients and their
families, and other professionals in the delivery of health care services.
(s) “Region” means
the counties as set forth in table 900.1 of He-Hea 902.02.
(t) “Renovation”
means a capital expenditure allotted to any combination of repairs, remodeling,
or reconfiguration of existing space.
(u) “Replacement”
means a capital expenditure allotted to the rebuilding, in whole or in part, of
a long-term care facility on a new or the original site.
(v)
“Resident” means:
(1) The purchaser of a continuing care contract
who physically resides in the residential unit of a CCRC; or
(2) A person who physically resides in the
residential unit of the CCRC which has a posted continuing care policy.
(w) “Residential complex”
means an amalgamation of housing arrangements that includes one or more of the
following on one physical site:
(1) Buildings;
(2) Apartments;
(3) Flats;
(4) Homes;
(5) Cottages; or
(6) Rooms.
(x) “Residential
unit” means an apartment, sheltered care facility, or other independent living
arrangement that does not require licensure as a nursing home under He-P 803.
(y)
“Story height multiplier” means the number by which the base cost of a building
is multiplied to adjust for any variation in average story height from the base
of 12 feet.
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
PART
He-Hea 902 METHODOLOGY FOR DETERMINING
NEED
He-Hea 902.01 Determination of Need for Long-Term Care
Facility Beds.
(a) “Region
population aged 65+” means the total number of persons aged 65 and over
residing in the regions designated in Table 900.1, based upon county population
statistics provided by the NH office of energy and planning.
(b) To calculate
additional bed need of long-term care facility beds, applicants shall multiply
the region population aged 65+ by 40, then divide this product by 1000, as in the
formula below:
Bed
Need = Region Population Aged 65+ x 40
1000
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
He-Hea 902.02 Regional Bed Need Formula. Service areas for long-term care shall be as
identified in Table 900.1 “Long-Term Care Service Area”, below:
Table
900.1
LONG-TERM
CARE SERVICE AREA
REGION
(1) |
|
REGION
(2) |
|
REGION
(3) |
|
REGION
(4) |
|
REGION
(5) |
|
REGION
(6) |
|
REGION
(7) |
|
REGION
(8) |
|
REGION
(9) |
|
REGION
(10) |
|
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
He-Hea 902.03 Determination Of Unmet Need.
(a)
The board shall make a determination of unmet need for long-term care
beds on January 1 of each year.
(b) Unmet need shall
be determined by subtracting the number of licensed or approved long-term care
beds and those refilled under a priority pursuant to He-Hea 903.01(d),
exclusive of those long-term care beds licensed or approved under He-Hea 907,
from that number calculated to be needed under He-Hea 902.01 for each region.
(c) The unmet need shall be the difference
between the calculated need and the existing bed inventory, not to exceed the
standard pursuant to RSA 151-C:4, III(b).
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
He-Hea 902.04 Ranking of Areas With Demonstrated Unmet
Need.
(a) The board shall
rank areas with unmet need after a determination of unmet need has occurred per
He-Hea 902.03.
(b) The degree of
unmet bed need for each region shall be determined by calculating the ratio of
unmet need to total need.
(c) The region with
the largest unmet need to total need ratio shall be ranked as the highest
priority.
(d)
Each region shall be assigned a priority ranking in order of ratio of unmet
need arranged from highest unmet need to lowest unmet need.
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
He-Hea
902.05 Requests for Applications
(RFA) to Fulfill Unmet Need.
(a)
Once the board has created a priority ranking of unmet need pursuant to
He-Hea 903.01(d), the board shall issue requests for applications every 45 days
for one region at a time until no region has an unmet need.
(b)
Requests shall be issued in accordance with RSA 151-C:8, I, based on the
ranking order specified in He-Hea 902.04.
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
PART
He-Hea 903 SURRENDER AND TRANSFER OF
BEDS
He-Hea
903.01 Surrender of Beds.
(a) Prior to surrendering beds, a nursing
facility shall notify the board of its intent to surrender any number of
licensed beds issued under a certificate of need.
(b)
Any nursing facility surrendering beds shall submit a letter of intent
to the board that documents the following:
(1) The name of the facility;
(2) The address and location of the facility;
(3) The total number of licensed beds;
(4) The CON docket number, if applicable;
(5) The proposed number of surrendered beds;
(6) The reason for surrendering the beds; and
(7) The anticipated benefits or cost savings, or
both, as a result of the surrender.
(c)
Letters of intent shall be filed in accordance with He-Hea 206. The board shall approve any letter of intent
that is complete.
(d)
Any facility that has surrendered beds shall be granted a priority to
fulfill bed need prior to the issuance of an RFA pursuant to He-Hea
902.05. The facility may refill all
previously surrendered beds or only a portion thereof. A facility that has surrendered beds shall
not add a greater number of beds than specified in its surrender notification.
(e)
Any facility proposing to refill a priority for nursing beds shall be
subject to RSA 151-C:5, II(f)(1), RSA 151-C:8 and He-Hea 301.
(f) Any beds filled under a priority status shall
be subtracted from the unmet need determined by He-Hea 902.03, prior to the
issuance of an RFA pursuant to He-Hea 902.05.
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
He-Hea
903.02 Transfer of Priority Status.
(a) Any nursing facility that has surrendered its
beds under He-Hea 903.01 may transfer its priority status to any other facility
provided notice is made to the board.
Upon transfer, the facility holding the transfer shall be the owner of
the priority status of beds.
(b)
Notice of transfer shall be made jointly, in writing, by the facility
intending to transfer the priority and the facility receiving the transfer.
(c) The notice shall:
(1) Identify the name, address, and location of
the transferring facility;
(2) Identify the name, address, and location of
the receiving facility; and
(3) Be signed by both parties authorized to make
and accept the transfer.
(d) Any facility owning the priority status of
beds due to a transfer shall be subject to the requirements of He-Hea 903.01(d)
and He-Hea 903.01(e).
(e) Any purchase price paid by the transferee for
the transfer of priority status shall not be considered in the total project
cost that is compared to the threshold amount set by RSA 151-C:5, II(f).
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
PART He-Hea 904
STANDARDS FOR LONG-TERM CARE FACILITY CONSTRUCTION, EXPANSIONS,
RENOVATIONS OR REPLACEMENT
He-Hea 904.01 Requests for Long-Term Care Facility
Construction, Renovation or Replacement.
(a) Pursuant to RSA
151-C:4, III(a), requests for submission of an application for long term care
facility construction, expansion, renovation, or replacement shall be accepted
for:
(1) Replacement or renovation of
existing beds as necessary to:
a. Meet life safety code requirements; or
b. Remedy deficiencies noted in:
i. A licensing inspection pursuant to RSA 151;
or
ii. State survey and certification process pursuant
to titles XVIII and XIX of the Social Security Act; or
(2)
Construction or renovation necessary in order to:
a. Repair or refurbish an existing facility; or
b. Accommodate beds obtained by transfer to an
existing facility.
(b) Requests shall
be made by filing a letter of intent with the board at any time.
(c) The letter of intent shall:
(1) Meet the requirements of He-Hea 206.01 and
He-Hea 207.01; and
(2) Contain the following information:
a. The name of the requestor that intends to
file an application, including the names of all affiliates of such requestor;
b. The location of the facility to be
constructed, expanded, renovated, or replaced;
c. A description of the issues that have prompted
the proposed construction, expansion, renovation, or replacement, including but
not limited to:
1. Life safety code review results;
2. Licensing inspection results;
3. State survey or federal certification review
results;
4. Repair or refurbishment needs, such as:
i. Floors and surfaces;
ii. Paint and finishes; and
iii. Air handling or plumbing;
5. Space constraints of the physical plant; or
6.
Other issues affecting the facility’s current or future operation;
d. A report indicating how the project is
projected to affect the service area in terms of:
1. Utilization;
2. Patient charges;
3. Market share; and
4. Personnel services;
e. The impact of the proposed project on other area
long-term care facilities; and
f. A report of the end results of the project in
terms of:
1. Quality;
2. Affordability;
3. Staffing; and
4. Operating costs.
(d)
The board shall review the letter of intent at its next regularly scheduled
meeting and determine if the requestor has met the requirements of He-Hea
904.01(c) in order to allow submission of an application for CON review.
(e)
All applications filed in response to a request for a long term care
facility construction, expansion, renovation, or replacement shall
be submitted to the board within 6 months of approval of the letter of intent.
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
He-Hea 904.02 Quality Assurance Plan.
(a) All applicants
shall demonstrate the availability of a quality assurance plan to objectively
and systematically monitor patient placement and care on a continuous
basis. The plan shall conform to the requirements
of He-P 803.24.
(b) Demonstration
shall be in the form of:
(1) A copy of the quality assurance plan for
those facilities with existing long-term care services; or
(2) A copy of the proposed quality assurance plan
for new facilities.
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
He-Hea
904.03 Financial Accessibility.
(a)
In order to assess the level of financial accessibility to services by
all persons served or to be served by the proposed project, all applicants
shall demonstrate that resources are available to provide services to all
patients of the proposed services, and in particular the financially underserved
and Medicaid recipients.
(b)
Demonstration shall be made by providing documentation with the
application identifying the projected number of patients indicated as:
(1) Private-paying;
(2) Medicaid;
(3) Medicare; and
(4) Total patient days for each of these patient
groups above.
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
He-Hea 904.04 Staffing Requirements. All applicants shall ensure that staffing
meets the requirements of He-P 803.17 and He-P 803.18.
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
He-Hea 904.05 Impact on Existing Facilities.
(a)
All applicants shall demonstrate that increases in market share as a
result of the construction, expansion, renovation or replacement of long-term
beds or facilities will not be detrimental to the occupancy rates in other
long-term care facilities in the region.
(b)
Demonstration that increases in market share will not be detrimental
shall be made by providing a report in the application addressing how the
construction, expansion, renovation or replacement of long-term care beds or facilities
will not have a detrimental impact on other facilities in the immediate area
and region.
Source. # 7442, eff 2-2-01; ss by #8917, eff 6-22-07; ss by #10977, eff
11-20-15 (from He-Hea 907.04)
PART
He-Hea 905 CRITERIA FOR EVALUATING
LONG-TERM CARE BEDS AND FACILITIES
He-Hea 905.01 Criteria. In addition to all other requirements in RSA
151-C:7 and He-Hea 303.02 through He-Hea 303.09, all applicants shall meet the following
criteria for consideration of a CON for construction,
expansion, renovation, or replacement of long-term care beds or facilities:
(a)
Applicants shall demonstrate that the anticipated proposed construction
cost per bed, cost per square foot, and square foot per bed shall be comparable
in cost and size within a 10% margin to the 2015 edition of Marshall Valuation
Service, section 15;
(b)
Demonstration of project costs shall be made in the form of a report
included with the application which provides:
(1) A detail of the costs and space by department
or area affected by the proposed project;
(2) A comparison of these costs, which shall be
within 10% of the 2015 edition of Marshall Valuation Service, section 15, for
the proposed class and type of construction; and
(3) An identification of the square footage
for each department or area before and after the project;
(c)
Applicants shall include a report in the application which provides:
(1) An analysis
of the class and quality of construction pursuant to section one of the 2015
(2) The
allocation of costs within a multiple use building;
(3) The
allocations of site costs and land costs where facilities are proposed to have multiple
uses;
(4) The
methodology used in calculating construction costs for renovations;
(5) The
methodology used in calculating construction costs involving leasehold
improvements; and
(6) The
anticipated useful life of the building for depreciation purposes;
(d)
The following construction costs shall be compared with the 2015
(1) Total costs
associated with:
a. Labor;
b. Materials; and
c. Fixed equipment;
(2) Building permits;
(3) Architectural
and engineering fees;
(4) Site
preparation for the building;
(5) Utilities
from structure to lot line;
(6) Insurance
costs during construction; and
(7) Interest
costs during construction;
(e) Applicants shall follow the outline of the
calculator method set forth in section 10 of the 2015
(f)
The costs and factors to take into account pursuant to (e) above shall
include:
(1) The base
cost found in the “nursing homes (convalescent hospitals)” table in section 15,
page 26 of the 2015
(2) An
adjustment to heating, ventilation, and air-conditioning costs for extreme
climate and the system used per the refinements table in section 15, page 36 of
the 2015 Marshall Valuation Service;
(3) Sprinkler
system costs;
(4) Story
height multipliers;
(5) Perimeter
multipliers; and
(6) Cost
multipliers from section 99 of the 2015
(g) For construction projects, applicants shall
provide a comparison of the proposed construction cost per bed to the 2015
edition of the Marshall Valuation Service, section 15, page 39;
(h)
For construction projects, applicants shall provide a comparison of the
proposed area per bed to the 2015 edition of the Marshall Valuation Service,
section 15, page 39;
(i)
Applicants shall describe anticipated operational cost savings that may
occur as a result of the project due to:
(1) Consolidation of services;
(2) Improved heating and maintenance costs;
(3) Environmental design of the constructed or renovated
space;
(4) Space for future expansion; or
(5) Other factors not listed above;
(j)
In order to assess the current and long-range financial feasibility of
the proposed project, applicants shall demonstrate that resources:
(1) Are available to fund the proposed capital
costs and operating costs;
(2) Will be available to maintain operations in
the event of interruptions to cash flow; and
(3) Will be available to ensure the continued
operation of the proposed project;
(k)
Demonstration of financial feasibility shall be made by providing with
the application:
(1) Copies of the facility’s 3–year historical and
3-year projected financial statements;
(2) The assumptions used to prepare the projected
financial statements;
(3) A statement of the sources of funds to
finance the proposed project; and
(4) Documentation from the applicant’s lender, underwriter,
or other anticipated source of capital, which includes:
a. Financed amount;
b. Rate of interest; and
c. Term of debt;
(l)
Applicants shall demonstrate that resources will be available to support
the personnel needs of the proposed construction, expansion, renovation, or
replacement of long-term care beds or facilities;
(m)
Demonstration of resources shall be made in the form of a report that
provides a 3-year historical and 3-year projected schedule of all personnel;
(n) Applicants
filing an application pursuant to RSA 151-C:4, III(a) shall provide with the application documentation
identifying the issues that have led to the need for construction, renovation,
or replacement, including but not limited to:
(1) Life safety code review results;
(2) Licensing inspection results;
(3) State survey or federal certification review
results;
(4) Repair or refurbishment needs, such as:
a. Floors and surfaces;
b. Paint and finishes; and
c. Air handling or plumbing;
(5) Space constraints of the
physical plant; or
(6) Other issues affecting the facility’s current
or future operation
(o)
Applicants may document the existence of additional expenses in
operations at the facility as a result of needed construction, renovation, or
replacement including:
(1) Housekeeping;
(2) Maintenance;
(3) Fire safety operations; or
(4) Other, which shall be specified;
(p) Demonstration of
additional expenses shall be made by providing with the application a report
specifying the type of expenses incurred, expressed as any combination of:
(1) Dollar amount;
(2) Man hours;
(3) Supplies; and
(4) Equipment;
(q) For facilities where
structural safety deficiencies, life safety, or inspection violations have been
cited, applications shall demonstrate the level of such deficiencies cited by
providing copies of reports as produced by a:
(1) State or local licensing agency; or
(2) National accrediting agency;
(r) Applicants shall identify the source of any
data or information provided pursuant paragraphs (c) through (q) above.
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
He-Hea 905.02 Submission of Applications. Applications filed in response to an RFA
shall be:
(a) Prepared using the board’s application form
pursuant to He-Hea 304; and
(b) Submitted to the board within 90 days of the
publication of the RFA.
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
PART
He-Hea 906 GRANTING CERTIFICATES OF NEED
He-Hea 906.01 Approval of Application.
(a) For applications
submitted in response to an RFA, the board shall grant a certificate of need to
the applicant(s) who, pursuant to RSA 151-C:9, II, demonstrates superiority on
cost effectiveness, quality and affordability, and best meets the standards and
criteria of He-Hea 904 and He-Hea 905, or He-Hea 907.
(b)
The total number of beds approved shall not exceed the unmet need.
(c)
Applications filed in response to a request for construction, expansion,
renovation or replacement transfer shall be granted a certificate of need if it
is demonstrated that they meet the standards and criteria of He-Hea 904 and
He-Hea 905.
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
He-Hea 906.02 Certificate of Need Denial. No person who has had a health facilities
license revoked, Medicare or Medicaid certification involuntarily terminated,
or who has been convicted of civil or criminal Medicare or Medicaid fraud or
patient abuse shall be granted a CON.
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
PART
He-Hea 907 STANDARDS FOR NURSING HOMES
WITHIN CCRCS
He-Hea 907.01 Limitation on Nursing Home Beds. Any facility that meets the definition of a
CCRC and which seeks approval for additional beds under this chapter, shall be
approved at no more than one nursing home bed for every 4 residential units in
the CCRC.
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
He-Hea 907.02 Limitation on Admissions and Certification. Any CCRC that seeks certificate of need
approval for long-term care beds shall, as a condition of approval, agree to
the following:
(a) Admissions to
the nursing home component of a CCRC shall be limited to persons who have been
residents of the CCRC for a period of not less than 180 consecutive days
immediately preceding admission into the nursing home;
(b)
The restriction in He-Hea 907.02 (a) above shall not apply to:
(1) Any medically indicated admission to the nursing
home resulting from an illness or accident which occurred subsequent to
residence in the CCRC; or
(2) An admission by a non-resident spouse of a
resident of the CCRC;
(c) A CCRC may
obtain medical assistance certification for no more than one bed for every 4
persons residing in federally or state subsidized housing for low-income
persons residing in the CCRC, except for those CCRCs which can demonstrate to
the board a past and continuing policy of subsidizing through endowments
residents of the CCRC who are in need;
(d) Demonstration of
medical assistance certification per He-Hea 907.02(c), above, shall be made by
providing the following documentation:
(1) The number of patients annually subsidized by
endowments by the CCRC; and
(2) A financial statement of the CCRC’s current
endowment fund with a statement of the number of patients for whom the CCRC
will provide subsidized care in the future; and
(e) No CCRC shall admit to its nursing home any
person who qualifies for medical assistance unless that person was a resident
of the CCRC’s subsidized low-income housing prior to admission to the nursing
home.
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
He-Hea 907.03 Special Review Criteria. Any CCRC that seeks a certificate of need to
add nursing home beds shall comply with RSA 151-C:7, He-Hea 303.02 through
He-Hea 303.09, and the following:
(a) The applicant shall
provide with the application an itemized and detailed description of how the
facility meets the definition of a CCRC;
(b) The CCRC shall
have the resources to cover the full cost of any resident’s required care in the
nursing home unit of the CCRC by demonstrating it has adequate financial
resources to do so without resorting to medical assistance funding, except as
allowed under He-Hea 909.07(b);
(c) Proof of
adequate resources shall be made by providing with the application an
independent financial analysis of the CCRC’s ability to cover the cost of care
for its residents;
(d) The CCRC shall
cover all costs of nursing home care in facilities not owned or operated by the
CCRC in the event that nursing home beds are not available in the CCRC and the
resident requires nursing home services;
(e) The applicant
shall submit a financial analysis with the application which documents that it
has adequate resources to cover the costs of nursing care outside of the CCRC;
(f) In addition to
(e) above, the applicant shall submit with the application a plan for the
coverage of nursing home care when beds are not available at the CCRC. This plan shall include signed written
statements from the administrators of nursing homes within a 15 mile radius of
the CCRC with whom the applicant intends to enter into an agreement stating
that they agree to admit CCRC residents who need nursing home care until a bed
becomes available in the CCRC;
(g) The CCRC shall
agree to readmit to the CCRC’s nursing home any persons admitted to an acute
care hospital or other healthcare facility for treatment as soon as a bed
becomes available;
(h) Proof of a
readmission policy shall be made by providing with the application a signed statement
attesting to this policy. This
requirement shall not apply to any patient whose medical, personal and
psychosocial needs cannot be met by the facility or to any person who is known
to have or suspected of having a communicable disease;
(i) Written policies
shall exist or be established upon implementation of the project, guaranteeing
that a bed in a CCRC’s nursing home is available to a nursing home patient for
at least 45 consecutive days following admission of that nursing home patient
to an acute care hospital for inpatient treatment or care;
(j) Proof of
guarantee shall be made by providing with the application copies of the
established or proposed policies;
(k)
In the case of a new CCRC, demand for the residential component of the
CCRC in the service area shall be demonstrated;
(l)
Demand for a CCRC shall be demonstrated by providing with the
application:
(1) A definition of the service area for the
CCRC, including demographic data and any available market studies justifying the
location of the CCRC, and the nursing home in that service area; and
(2) Evidence of prepaid deposits for placement in
the CCRC; and
(m) The nursing home
service areas described in He-Hea 902.02 shall not apply to the applications by
or on behalf of the CCRCs.
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
He-Hea 907.04 Application Process.
(a) Applications to
construct or add nursing home beds in a CCRC shall not be subject to the
requirements of RSA 151-C:8, I if the proposal:
(1) Pertains specifically to the facility for
which a CON is sought; and
(2) Does not indicate a need for additional
services beyond the limitation per He-Hea 907.01;
(b) Applications
shall be prepared and submitted using the board’s application form pursuant to
He-Hea 304.
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
He-Hea 907.05 Board Action.
(a) Applications
shall be processed in accordance with the requirements of RSA 151-C:8, II –
XIII.
(b) If an
application demonstrates that it meets the standards and criteria of sections
He-Hea 904, He-Hea 905 and He-Hea 907, a certificate of need shall be issued to
the applicant.
Source. (See Revision Note at chapter heading for
He-Hea 900) #10977, eff 11-20-15
Appendix
I
Rule |
|
He-Hea 901.01 |
RSA 151-C:1 |
He-Hea
901.02 |
RSA 151-C:2 |
He-Hea
902 |
RSA
151-C:4, III(b) |
He-Hea
903.01 |
RSA 151-C:6, III |
He-Hea
903.02 |
RSA
151-C:6, III |
He-Hea
904.01 |
RSA
151-C:4, III(b) |
He-Hea
904.02 |
RSA
151-C:7, IV |
He-Hea
904.03 |
RSA
151-C:7, III and V |
He-Hea
904.04 |
RSA
151-C:7, II |
He-Hea
904.05 |
RSA 151-C:5, II(f)(1), RSA
151-C:7, I |
He-Hea
905.01 |
RSA 151-C:7, I-V, RSA 151-C:11, I |
He-Hea
905.02 |
RSA 151-C:8 |
He-Hea
906.01 |
RSA
151-C:9 |
He-Hea
906.02 |
RSA
151-C:7, IV |
He-Hea
907.01 |
RSA
151-C:5, II(f)(1) |
He-Hea
907.02 |
RSA
151-C:5, II(f)(1) |
He-Hea
907.03 |
RSA 151-C:7, I-V, RSA 151-C:11, I |
He-Hea
907.04 |
RSA
151-C:8 |
He-Hea
907.05 |
RSA
151-C:8 |
Appendix II: Incorporation by Reference Information
Rule |
Title |
Obtain at: |
He-Hea 905.01(a) MVS,
2015, section 15. He-Hea-905.01(b)(2)
MVS, 2015, section 15. He-Hea 905.01(c)(1)
MVS, 2015, section 1. He-Hea 905.01(d) MVS,
2015, section 15. He-Hea 905.01(e) MVS,
2015, section 10. He-Hea 905.01(f)(1)
MVS, 2014, section 15, page 26. He-Hea 905.01(f)(2)
MVS, 2014, section 15, page 36. He-Hea 905.01 (f)(6)
MVS, 2015, section 99. He-Hea 905.01(g) MVS,
2015, section 15, page 39. He-Hea 905.01(h) MVS,
2014, section 15, page 39. |
Marshall Valuation
Service, 2015 edition |
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544-2678. Cost for the 2015
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