OAR 333-610-0070
Swing Long-Term Care Beds in Hospitals
(1)
The proposal will not be subject to county-specific nursing home bed need criteria under OAR 333-610-0000 (General) to 333-610-0030 (Need) because it will not create permanent new nursing home beds. The division, in reviewing the proposal for need under OAR 333-580-0040 (Need) and for alternative uses of resources under OAR 333-580-0050 (Availability of Resources and Alternative Uses of Those Resources), will take into consideration such factors as:(a)
Health policy of the state, as reflected in ORS 410.010 (State policy for seniors and people with disabilities), 410.020 (Implementation of state policy), 410.050 (General policy) and 410.060 (Policy for persons with disabilities served by department); ORS Chapter 442 (Health Planning) 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 (Economic Evaluation), 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.
Source:
Rule 333-610-0070 — Swing Long-Term Care Beds in Hospitals, https://secure.sos.state.or.us/oard/view.action?ruleNumber=333-610-0070.