(1)Clinical and epidemiological research indicates that, on the average, 30 nursing home beds per 1,000 persons age 65 and over would be sufficient to meet the need for care for those functional deficits for which nursing home care is medically necessary and cost effective. This does not include utilization which is socially convenient rather than medically necessary. The experience of some states and some Oregon counties indicates that when sufficient alternatives are available, a ratio of less than 30 nursing home beds per 1,000 persons age 65 and over may be sufficient to meet the population’s needs.
(2)Oregon data are consistent with section (1) of this rule. Because about ten percent of Oregon nursing home residents are not age 65 and over, and to allow for local variations, a goal of 40 beds (actually, a range of 35 to 45) (per 1,000 persons age 65 and older is hereby set, 33 percent greater than the research figure in section (1) of this rule. No county should exceed this bed ratio; although, as noted in section (1) of this rule, ratios well under 40 beds per 1,000 persons age 65 and over are often sufficient to meet community needs.
(3)By 1991, there shall be no more than 40 nursing home beds per 1,000 persons age 65 and over in any Oregon county:
(a)For counties which had 54 or fewer beds per 1,000 in 1980, the goal is to be reached by 1986;
(b)For counties which had more than 54 beds in 1980, or have population densities below the state median, up to five additional years are allowed (see Tables 1, 2, and 3), recognizing the greater amount of time required to organize the expansion of alternative care under such circumstances.
(4)An average county or service area minimum occupancy of 95 percent, before adding beds, is to be used except when plans of state agencies utilizing beds, anticipated population changes, plans of other service area providers, and considerations of maintaining access at reasonable cost indicate that 90 percent is appropriate.
(5)Proposed beds are evaluated in relation to the entire local long-term care system; to resources in the local service area and in the health service areas as a whole; to plans of state and local agencies; and to state policies expressed by the legislature. Additional beds will not be approved simply on the basis of “need” at a specific facility.
(6)Need should be projected on the basis of forecasted elderly population in three years. This time period will be extended for counties with population densities below the state median. It will be shortened when utilization of beds by state agencies has declined, and compensating utilization of alternative care has occurred and is projected to continue.
(7)For future years, population projections prepared and published by the Portland State University Center for Population Research and Census (CPRC) in Population Projections, Oregon and Its Counties: 1980 to 2000, June 1984, will be used unless the applicant can demonstrate invalidity. If existing projections are shown to be invalid, an alternative acceptable to both the Public Health Division and CPRC will be substituted.
(8)Separate capacity levels for ICF and SNF beds are not set because these bed categories are not separately licensed.
Rule 333-610-0020 — Principles,