The Oregon Administrative Rules contain OARs filed through November 15, 2015
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OREGON HEALTH AUTHORITY,
PUBLIC HEALTH DIVISION
DIVISION 560
ABBREVIATED CERTIFICATE OF NEED REVIEW, DELAY OF REVIEW,
WAIVER OF REVIEW FOR FACILITIES, AND EXPEDITED REVIEW
333-560-0010
Abbreviated Certificate of Need Review for Specific Projects
The following types of projects are eligible for abbreviated review:
(1) The establishment of new health services or new facilities which, based on documentation submitted by the applicant and found acceptable by the Division, will predominantly or exclusively service medically indigent patients:
(a) Such documentation should include any admissions policies or needs tests to be used by the applicant in determining the appropriateness of admissions. Documentation should also include information on projected revenues for the facility or service, including the sources of such revenues;
(b) If the facility or service, in the future, wishes to provide services to persons who are not medically indigent, either because of a change of ownership or for other reasons, the applicant must submit a new letter of intent detailing the proposed changes in the population to be served. The Division may consider such a change to constitute the establishment of a new health service subject to review, if it concludes that the patients to be served will no longer be predominantly medically indigent, and if it concludes that there will be a substantial impact on the cost of patient care;
(c) For the purposes of this section, persons will be considered to be medically indigent if they are uninsured by either public or private insurers or payers for the types of services being proposed and if their household or family income is equal to or less than 200 percent of the poverty income established in federal regulations. Except for projects involving long-term care facilities or services, persons will also be considered to be medically indigent if they are eligible for Medicaid services.
(2) Partnerships or joint ventures between hospitals/health systems and existing non-hospital-based, long-term care facilities neither of which is owned or controlled by the same entity, when all of the following criteria are met:
(a) The project does not result in a net increase in licensed long-term care beds in the service area. In this context "service area" has the same meaning as it is given in OAR 333-610-0030(1);
(b) The partnership or joint venture is for a minimum of two years and is terminable only for cause. As used in this rule, the term "partnership" is intended to be defined broadly, so that it covers collaboration beyond just a legal partnership including, but not limited to, a jointly owned corporation or a limited liability corporation. Not withstanding OAR 333-550-0010(3)(a), if the beds operated under the partnership or joint venture are proposed to be sold or otherwise transferred, the transfer shall be subject to the full review process detailed in division 570 of this chapter and to the application and review criteria established in division 580, or if applicable, an expedited review under this chapter. If as part of the partnership or joint venture, conversion of existing space within a hospital building occurred, expedited review cannot later be sought under 333-560-0110. If the beds operated under the partnership or joint venture are to be relocated back to the non-hospital-based, long-term care facility the bed relocation is eligible for an abbreviated review;
(c) The hospital/health system and the long-term care facility can demonstrate to the satisfaction of the Division that projected per diem inpatient routine service costs in the partnership or joint venture setting (calculated in conformance with Medicare cost report parameters) will not exceed 125 percent of the per diem routine service cost limitation computed by the fiscal intermediary for freestanding skilled nursing facilities in its urban or rural location during the first two years of operation. The routine cost limitation may be adjusted, as appropriate, to allow for reasonable inflation as measured by the DRI (HCFA) McGraw Hill Nursing Facility Market Basket Index;
(d) The applicant shall submit a completed copy of Forms CN-3 and CN-11. The applicant shall also submit a summary for the first two years of operation of projected revenue, expenses, operating income, non-operating revenue and net income with and without the project;
(e) Projects approved under OAR 333-560-0010(2) are subject to the full review process detailed in division 570 of this chapter and to the application and review criteria established in division 580, or, if applicable, an expedited review under this chapter, if the cost limitation required under subsection (2)(c) of this rule is not maintained for the first two years of operation.
(3) A project involving the relicensing of long-term care beds by a facility participating in a Seniors and People with Disabilities Division approved Nursing Home Vision 2000 Project ("Vision 2000 Project"), if all of the following conditions are met:
(a) The number of long-term care beds to be added by the facility does not exceed the number of long-term care beds delicensed by the facility because of participation in the Vision 2000 project; and
(b) Relicensure of beds to be added will occur within five years of the date that the first bed or beds were delicensed at the facility because of participation in the Vision 2000 Project; and
(c) Notwithstanding OAR 333-565-0000(4), an application fee of $1,500 is paid;
(d) The following applies to Seniors and People with Disabilities Division approved Vision 2000 Projects:
(A) Notwithstanding any contrary provision in OAR chapter 333, during the five-year period referred to in subsection (3)(b) of this rule, the delicensed beds will be counted as existing long-term care beds for determining the need for additional long-term care beds in the geographical service area under division 610 of this chapter. The delicensed beds will not be considered existing long-term care beds for the purpose of 333-560-0110 and 333-560-0120;
(B) Notwithstanding paragraph (3)(d)(A) of this rule, if a Vision 2000 Project participating facility notifies the Division in writing of its intention not to seek relicensure of some or all the beds within the five-year period, these beds will not be counted as existing long-term care beds for determining the need for additional long-term care beds in the geographical service area under division 610 of this chapter, and the facility will be foreclosed from seeking the addition of these beds under section (3) of this rule;
(C) The sale of a Vision 2000 Project participating facility does not affect the ability of the facility to seek the addition of beds under section (3) of this rule as long as the other requirements of the rule are met.
(4) Development of a freestanding hospice facility, as that term is used in OAR 333-500-0010(1)(a), if all the following conditions are met:
(a) The number of freestanding hospice facilities that can be approved under this section is limited to a total of six. Facilities approved under this section will be required to report the information specified in subsection (4)(e) of this rule to the Certificate of Need Program which will allow it to monitor the effect of these facilities and to develop appropriate rules by which to judge the need for any future facilities;
(b) Projects will be considered for abbreviated review in the order in which a completed letter of intent is received for the project. The provisions of OAR 333-560-0030 shall not apply;
(c) The applicant shall submit a completed copy of Forms CN-1 and CN-3;
(d) The applicant shall submit a population-based needs assessment for the proposed facility. The needs assessment shall include, but not be limited to, the following elements:
(A) A discussion of why this facility is needed in the geographic area served by the applicant. This discussion shall take into account the actual and projected death rates by age and sex; an estimate of how many of those individuals would have been eligible for hospice services and the historical utilization of hospice services; an estimate of how many of those individuals would have benefited from inpatient hospice care and the historical utilization of inpatient care for hospice patients; the applicant's market share of hospice services and any anticipated changes in that market share; the effect of the proposed facility on the utilization of inpatient care in all settings both by the patients served by the applicant and by other hospice providers in the geographic area (if any); projected population growth by age and sex for the area; and household composition, particularly the number of people living alone by age and sex. The discussion shall also include information about the availability of inpatient care in the geographic area, an explanation of why it is preferable for patients to receive care in the proposed facility as opposed to other possible settings and an explanation of how the availability of the proposed facility will impact the continuum of care available in the geographic area; and
(B) A projected income statement for the first five years of operation of the facility accompanied by a narrative explaining the assumptions underlying the projections. Information concerning payer source, number of admissions, numbers of deaths and discharges, and length of stay shall be provided. If the facility is to provide residential care beds, such information shall also be provided for those beds. The income statement shall follow the format used by Form CN-5.
(e) The applicant agrees to provide the following information to the Certificate of Need Program on an annual basis for a period of five years after the facility begins operation:
(A) An income statement accompanied by a narrative discussion of the information provided. Information concerning payer source, number of admissions, numbers of deaths and discharges, and length of stay shall be provided. If the facility provides residential care beds, such information shall also be provided for those beds. The income statement shall follow the format used by Form CN-5;
(B) A statement with supporting data discussing the impact on the age adjusted rates of nursing home and hospital deaths in the geographic area served by the applicant; the impact on the rate of hospice admissions to nursing homes and hospitals in the area; and the impact on the rate of deaths of hospice patients in nursing homes and hospitals; and
(C) A statement discussing data collected from a satisfaction survey tool which measures whether families and other persons closely associated with the patient were satisfied with the different aspects of their loved one's end-of-life care and the environment provided by the facility.
(5) Development of a new Oregon State Hospital facility.
(a) A project for a new Oregon State Hospital is not required to meet any review criteria and notwithstanding OAR 333-565-0000(4) an application fee is not required.
(b) Notwithstanding OAR 333-560-0020(5), the granting of abbreviated review may be rescinded following an informal hearing only if the Division finds that the project is not a new Oregon State Hospital facility.
[ED. NOTE: Forms referenced are available from the agency.]
[Publications: Publications referenced are available from the agency.]
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) & 442.315
Hist.: HD 13-1994, f. & cert. ef. 4-22-94; HD 14-1994(Temp), f. & cert. ef. 4-28-94; HD 9-1995(Temp), f. & cert. ef. 11-14-95; HD 3-1997, f. & cert. ef. 2-3-97; OHD 5-1998, f. & cert. ef. 6-16-98; OHD 11-1998, f. & cert. ef. 10-22-98; OHD 10-2002, f. 7-3-02 cert. ef. 7-5-02; PH 10-2003(Temp), f. & cert. ef. 7-31-03 thru 1-15-04; PH 2-2004, f. & cert. ef. 1-16-04; PH 15-2008, f. & cert. ef. 10-7-08
333-560-0020
Procedures for Abbreviated Review
(1) Abbreviated review may be granted by the division either upon request by the applicant or on the division's own initiative. Decisions to grant or to not grant abbreviated review shall be based on a letter of intent which has been properly filed by the applicant under OAR 333-555-0000 through 333-555-0020 and on the division's findings concerning the applicable criteria for abbreviated review under OAR 333-560-0010. In addition to a letter of intent, applicants seeking abbreviated review shall submit information and narrative necessary to allow the division to make findings regarding the applicable criteria for abbreviated review.
(2) The division shall provide written notification to the applicant that abbreviated review is:
(a) Denied and state the reason; or
(b) Granted.
(3) If abbreviated review is granted, the proposal is exempt from the full review process detailed in division 570 of this chapter, with the exception of OAR 333-570-0070(4) through (10); and from the application requirements and review criteria established in Division 580. The notification to the applicant shall include a proposed order granting the certificate of need. Such an order shall contain findings sufficient to justify the granting of abbreviated review, but need contain no other findings.
(4) The proposed order on an abbreviated review is subject to an informal hearing, as provided in OAR 333-570-0070(5) through (9). Notwithstanding the provisions of OAR 333-570-0070(8), within ten days following the close of an informal hearing on an abbreviated review, the division will either issue a final order approving the application, or will rescind its granting of abbreviated review and require the project to undergo full review.
(5) The granting of abbreviated review may be rescinded following an informal hearing only if:
(a) The division finds that the project does not meet the criteria for abbreviated review; or
(b) The division finds that significant issues have been raised regarding the appropriateness of the proposed project.
(6) The final order in an abbreviated review is subject to a reconsideration hearing, as provided in OAR 333-570-0070(10) and division 670 of this chapter.
(7) Projects granted a certificate of need under the abbreviated review provisions are not exempt from the monitoring and reporting requirements of OAR 333-575-0000 and 333-575-0010.
Stat. Auth.: ORS 431.120(6) & 442.315
Stats. Implemented: ORS 431.120(6) & 442.315
Hist.: HD 13-1994, f. & cert. ef. 4-22-94
333-560-0030
Delayed or Simultaneous Review
(1) An applicant who has submitted a letter of intent may request the division to delay consideration of an application for the purpose of simultaneous review. The division may, on its own initiative, delay consideration of an application pursuant to subsection (1)(b) and section (2) of this rule:
(a) The requesting party must state reasons for the request which shall include the determination in section (2) of this rule and must show reasonable evidence supporting the request;
(b) A request and determination that an application will be subject to simultaneous review must be made prior to the first of the affected applications being declared complete by the division. Although a determination may be made at the letter of intent stage, delay of review will not begin until the application is submitted and declared complete. However, if a delay is already in effect, additional applications may be considered as part of the simultaneous review process if they are declared complete before one of the events in section (3) of this rule occurs.
(2) The division may delay the consideration of an application for the purpose of simultaneous review when the division has determined that all of the following conditions have been met:
(a) More than one letter of intent sufficient for a ruling by the division has been received;
(b) Each letter of intent proposes to provide a similar service or to meet closely related needs to substantially the same area and population;
(c) There is a reasonable expectation that the approval of two or more applications in question may not be justified; and
(d) There is a reasonable expectation that the additional application(s) to be submitted will be declared complete by the division not later than 105 days after the division commences the delay of the first application held for simultaneous review.
(3) The start of review of an application must occur the day after the first of the following events:
(a) Lapse of 105 days from written declaration by the division of completeness of the first application, without receipt of a second complete application;
(b) Actual receipt of a second complete application, unless additional applicants have been granted simultaneous review;
(c) Notice or information that additional applications will not be received within 105 days of written declaration of completeness of the first application; or
(d) Receipt, by the division, of additional applications which are not declared complete within 105 days of written declaration of completeness of the first application.
(4) In the event that a proposal is subject to simultaneous review in more than one service area, review will not start on any of the affected applications in any of the service areas until one of the events listed in section (3) of this rule has occurred in each service area.
(5) Once consideration of the application is commenced, the division shall notify the applicant that a simultaneous review is in effect.
Stat. Auth.: ORS 431.120(6) & ORS 442.315
Stats. Implemented: ORS 431.120(6) & ORS 442.315
Hist.: HD 13-1994, f. & cert. ef. 4-22-94; OHD 11-1998, f. & cert. ef. 10-22-98
333-560-0100
Facility Waiver Limitations
A certificate of need facility waiver does not authorize a hospital to develop a new inpatient hospital facility or provide new long-term care services.
Stat. Auth.: ORS 431.120(6), 442.315 & 442.342
Stats. Implemented: ORS 431.120(6), 442.315 & 442.342
Hist.: HD 13-1994, f. & cert. ef. 4-22-94
333-560-0110
Expedited Review for Relocation or Replacement of Long-Term Care Beds
Under certain circumstances, the Public Health Division may approve relocation or replacement of existing long-term care beds under the expedited review process set forth in this rule and OAR 333-560-0120 without the analysis of service area need specified in OAR 333-610-0030 when all of the following conditions are met:
(1) Relocation or replacement, under this rule, shall include:
(a) Rebuilding of all or part of a long-term care facility within its service area; or
(b) Relocation of all or part of the beds in two existing long-term care facilities within the same service area, at either one of the facilities, or at a new location in the service area; or
(c) Combinations of the above;
(d) For the purposes of this rule, relocation or replacement shall not include the conversion of existing space within a hospital building;
(e) Regardless of subsection (b) of this section, if the applicant can demonstrate to the satisfaction of the Public Health Division that a location outside of the original service area is appropriate based upon the unique nature and characteristics of the population served by the facility and can satisfactorily demonstrate the appropriateness of an alternative site for the replaced facility, the Public Health Division may waive the requirement that the beds be relocated or replaced within the original service area. To qualify under this subsection, the applicant must demonstrate to the satisfaction of the Public Health Division that the facility has a statewide or regional service area and that it specializes in serving a distinct population with unique medical needs such as children or ventilator dependent individuals with specific programmatic services. Only beds which serve this type of distinct population are eligible for relocation or replacement under this subsection.
(2) The applicant shall submit, with the letter of intent, a copy of a letter that has been sent to Seniors and People with Disabilities requesting irrevocable delicensure of the relocated or replaced beds, effective as of the date of licensure of the replacement beds.The Public Health Division will confirm that Seniors and People with Disabilities has received the letter before ruling the project eligible for expedited review. The applicant must provide a written statement to the Public Health Division stating that it will not withdraw this letter if it is granted a certificate of need for its project.
(3) In any event, the relocation or replacement process shall not result in a net increase in the number of licensed long-term care beds in the geographical service area except as provided under OAR 333-550-0010(3)(b) or 333-560-0110(1)(e) when applicable.
(4) If the project involves construction of a new facility, the design and construction of the entire relocated or replaced facility must meet all Senior and People with Disabilities criteria for new construction standards in long-term care facilities or has received a waiver from Seniors and People with Disabilities based on a showing that full compliance with new construction standards is not required. If the project involves relocating beds to an existing facility, the patient rooms that will house the relocated beds and areas of the existing facility that support the relocated beds must meet all Seniors and People with Disabilities criteria for new construction standards in long-term care facilities or a waiver must be obtained from Seniors and People with Disabilities based on a showing that full compliance with new construction standards is not required. The applicant must submit schematic plans for the project.
(5)(a) The applicant must demonstrate, to the satisfaction of the Public Health Division, that the physical environment for patients and the ability to provide patient care both at the new setting and, if it remains open, at the original setting will significantly improve as a result of the proposed project. The Public Health Division may waive this requirement if the applicant can demonstrate, to the Public Health Division's satisfaction, that failure to undertake the project will result in serious adverse economic consequences for the applicant that will jeopardize its ability to continue to provide nursing facility services. A waiver under this section will only be granted if the applicant can demonstrate to the satisfaction of the Public Health Division that the physical environment for patients and the ability to provide patient care will remain the same or improve as a result of the project. The Public Health Division may, at its discretion, perform an on-site evaluation of all existing facilities involved.
(b) Examples of the types of improvements that the Public Health Division may consider under this section include, but are not limited to: reduction of the number of residents in rooms; increased square footage per resident rooms; increased or remodeled dining, activities, social services, therapy, kitchen, laundry, and nursing station space; improved fire and life safety; improved resident toilet, hand washing and bathing areas; improved electrical systems including alarms and call systems; and improved heating and ventilation systems.
(6) The applicant shall demonstrate, to the satisfaction of the Public Health Division, that the applicant's proposal is financially viable and shall indicate the impact on patient charges. The applicant must demonstrate financial viability and the impact on charges at the new setting. If the original setting remains open, the applicant must demonstrate that reducing the number of beds at the original setting will not adversely impact the financial condition of that facility. Applicants must submit completed Forms CN-3 through CN-12 and a narrative discussion of the items identified in OAR 333-580-0060. Forms or narrative discussion which are not relevant to the proposal need not be completed, however. Applicants should contact the Public Health Division to determine which forms and narrative discussion are relevant to their proposal.
Stat. Auth.: ORS 431.120(6) & ORS 442.315
Stats. Implemented: ORS 431.120(6) & ORS 442.315
Hist.: HD 13-1994, f. & cert. ef. 4-22-94; OHD 1-1998, f. & cert. ef. 1-6-98; PH 28-2004, f. & cert. ef. 8-19-04
333-560-0120
Procedures for Expedited Review
(1) The expedited review process shall be initiated upon the written request of the applicant, payment of the fee specified in OAR 333-565-0000(4), and submission of four copies of the completed forms and narrative discussion identified in section (2) of this rule. The forms and narrative discussion must be completed to the satisfaction of the Public Health Division. As soon as possible after receiving and reviewing such forms and narrative, the Public Health Division shall notify the applicant whether or not the forms and narrative discussion are complete. Within five working days of the date that the Public Health Division notifies the applicant that the forms and narrative discussion identified in section (2) of this rule are complete, the Public Health Division shall rule the project eligible for expedited review. Notwithstanding the previous sentence, however, a project shall not be ruled to be eligible for expedited review sooner than the date of the Public Health Division ruling on the letter of intent for the project.
(2) Projects undergoing expedited review are exempt from the full review process detailed in division 570 of this chapter, with the exception of OAR 333-570-0070(3) to (10); and from the application requirements and review criteria established in division 580 of this chapter, with the exception of OAR 333-580-0060, 333-580-0090 and 333-580-0100. Applicants must complete Forms CN-1 through CN-12 and submit four copies of these forms along with four copies of the narrative discussion required by OAR 333-580-0060 at the time that expedited review is requested under section (1) of this rule. Forms which are not relevant to the proposal need not be completed, however. Applicants should contact the Public Health Division to determine which forms are relevant to their proposal.
(3) If all of the conditions specified in OAR 333-560-0110 have been met, the Public Health Division shall issue a proposed order granting the certificate of need for the project. The date of this proposed order shall be no later than 15 days from the date that the Public Health Division rules the project eligible for expedited review. Such an order shall contain findings to justify the granting of a certificate of need under this rule and OAR 333-560-0110, but need contain no other findings.
(4) Projects granted a certificate of need under the expedited review provisions are not exempt from the monitoring and reporting requirements of OAR 333-575-0000 and 333-575-0010.
[ED. NOTE: Forms referenced are available from the agency.]
Stat. Auth.: ORS 431.120(6) & ORS 442.315
Stats. Implemented: ORS 431.120(6) & ORS 442.315
Hist.: HD 13-1994, f. & cert. ef. 4-22-94; OHD 11-1998, f. & cert. ef. 10-22-98; PH 28-2004, f. & cert. ef. 8-19-04
333-560-0130
Expedited Review for Relocation of Long-Term Care Beds to Hospitals
(1) Under certain circumstances, the Public Health Division may approve relocation of existing long-term care beds to a hospital-based setting under the expedited review process set forth in this rule without the analysis of service area need specified in OAR 333-610-0030, provided that all of the following conditions are met:
(a) The long-term beds are relocated from one existing long-term care facility to not more than one location which is or will be licensed as a long-term care facility at the time of the relocation and is within the same standard metropolitan statistical area or within 15 miles of the hospital, whichever is greater.
(b) The project involves the relocation of not more than 50 percent of the licensed long-term care beds from one site to another.
(c) The applicant shall submit, with the letter of intent, a letter to the Seniors and People with Disabilities Division requesting irrevocable delicensure of the remaining long-term beds at the facility from which the beds are transferred pursuant to this rule, which request shall be effective as of the date of licensure of the beds being transferred. The Public Health Division will determine whether this letter provides substantial assurance that the remaining beds will in fact be delicensed. No application will be approved under this rule unless the Public Health Division determines that such assurance exists.
(d) The facility from which the long-term care beds are to be transferred shall be closed as a long-term care facility and shall not offer or develop a new skilled nursing or intermediate care service or facility as described in OAR 333-550-0010(3) without approval pursuant to full certificate of need review.
(e) Notwithstanding subsections (1)(c) and (1)(d) of this rule, the facility from which beds are relocated may be allowed to continue operation if it can be demonstrated to the satisfaction of the division that the continued operation of the facility is necessary to maintain adequate bed capacity in the service area and provided that it reduces its current licensed bed capacity by twice as many beds as are relocated.
(f) The design and construction of the renovated space must either meet all Seniors and People with Disabilities Division criteria for new construction standards in long-term care facilities or receive a waiver from the Seniors and People with Disabilities Division based on a showing that full compliance with the new construction standards is not appropriate. The applicant shall submit schematic plans for the proposed project.
(g) Serious structural and fire and life safety problems, or other problems significantly affecting the care and well-being of patients must be demonstrated to exist at the facility whose beds are proposed to be relocated. The procedure for demonstrating these physical problems is the same as that set out in OAR 333-560-0110(7)(a) through (d).
(h) The applicant must demonstrate to the satisfaction of the division that projected per diem inpatient routine service costs in the hospital-based setting (calculated in conformance with Medicare cost report parameters) will not exceed 125 percent of the per diem routine service cost limitation computed by the Medicare fiscal intermediary for freestanding skilled nursing facilities in its urban or rural location during the first two years of operation. The routine cost limitation may be adjusted, as appropriate, to allow for reasonable inflation as measured by the DRI (HCFA) McGraw Hill Nursing Facility Market Basket Index. Notwithstanding anything to the contrary in the two immediately preceding sentences, if the hospital has owned or controlled the long-term care facility from which it proposes to move beds for at least three years, the applicant must demonstrate to the satisfaction of the Division that projected per diem actual inpatient routine service costs in the hospital-based setting will either not exceed 125 percent of actual per diem inpatient routine service costs experienced in its current setting during the first two years of operation or will not exceed 125 percent of the per diem routine service cost limitation computed by the Medicare fiscal intermediary for freestanding skilled nursing facilities in its urban or rural location during the first two years of operation.
(i) The applicant shall submit a completed copy of Forms CN-3 and CN-11. The applicant shall also submit a summary for the first two years of operation of projected revenue, expenses, operating income, non-operating revenue and net income with and without the project.
(j) Projects approved under this rule are subject to the full review process detailed in division 570 of this chapter and to the application and review criteria established in division 580, or if applicable, an expedited review under this chapter, if the cost limitations required under subsection (1)(h) of this rule are not maintained for the first two years of operation of the relocated beds.
(2) For the purposes of this rule, relocation shall include the conversion of existing space within a hospital building to house the relocated long-term care beds.
(3) The procedure for expedited review set out in OAR 333-560-0120 is not applicable to projects proposed under this rule. For the purposes of OAR 333-560-0130 the following procedure shall be followed:
(a) The expedited review process shall be initiated upon the written request of the applicant, payment of the fee specified in OAR 333-565-0000(4) and submission of the information and materials necessary to support the request for expedited review as specified in section (1) of this rule. Within five working days of the date that the division notifies the applicant that the necessary information and materials have been provided, the division shall rule the project eligible for expedited review. Notwithstanding the previous sentence, however, a project shall not be ruled to be eligible for expedited review sooner than the date of the division's ruling on the letter of intent for the project.
(b) If all of the conditions specified in section (1) of this rule have been met, the division shall issue a proposed order granting the certificate of need for the project. The date of this proposed order shall be no later than 20 working days from the date of the division's finding under OAR 333-560-0110(7)(c) or (d), as applicable. Such an order shall contain findings to justify the granting of a certificate of need under this rule but need contain no other findings.
(c) Projects undergoing expedited review under this rule are exempt from the full review process detailed in division 570 of this chapter, with the exception of OAR 333-570-0070(4) through (10); and from the application and review criteria established in division 580.
(d) Projects undergoing expedited review under this rule are not exempt from the monitoring and reporting requirements of OAR 333-575-0000 and 333-575-0010.
Stat. Auth.: ORS 431.120(6), 442.315 & 442.342
Stats. Implemented: ORS 431.120(6) & 442.315
Hist.: HD 3-1997, f. & cert. ef. 2-3-97
333-560-0140
Accelerated Certificate of Need Review for Specific Projects
The following types of projects are eligible for accelerated review:
(1) The development of a "new hospital" as that term is defined in OAR 333-550-0010(2) when all of the following conditions are met:
(a) The new hospital is the result of a relocation of an existing general hospital under OAR 333-500-0070(1)(a) and does not involve a "substantial increase in services" or "change in the services offered" as those terms are defined in OAR 333-550-0010(2) and determined by the Authority;
(b) The existing general hospital must be delicensed and acute inpatient care must not be provided at that location without approval pursuant to certificate of need review. The applicant must provide the Public Health Division with assurances that this condition will be met. No application will be approved under this section without adequate assurances of these conditions as determined by the Authority;
(c) New hospital health services will not be offered for a period of three years after licensure of the new facility. A new hospital health service must have been offered at the applicant's existing hospital for a period of at least one year prior to the licensure of the new facility in order for such service not to be considered a new hospital health service when offered at the new facility. For purposes of this section, the term "new hospital health service" has the same meaning as is found in OAR 333-550-0010(4) and 333-550-0010(5) through (9) apply to this definition. Projects approved under this section are subject to the full review process detailed in Division 570 of this chapter and to the application and review criteria established in Division 580 if a new hospital health service is offered at the new facility within this three year period. The applicant must provide the Public Health Division with assurances that this condition will be met. No application will be approved under this section without adequate assurances of these conditions as determined by the Authority;
(d) The location of the new general hospital will not result in the loss of the critical access status of an existing federally designated critical access hospital;
(e) A general hospital, unaffiliated with the applicant, proposes to relocate its main hospital campus into the service area of applicant's existing hospital. As used in this section, the term "unaffiliated" means under independent ownership or control. The Authority must have ruled, based upon a letter of intent, that the relocation of the unaffiliated hospital is not subject to certificate of need review. As used in this section, the term "service area" will be determined in accordance with the provisions of OAR 333-550-0010(2).
(f) The applicant must demonstrate, to the Authority's satisfaction, that relocation of the unaffiliated hospital will have an adverse economic impact on the applicant's hospital operations and that this adverse impact will jeopardize the applicant's ability to continue to operate. The applicant must further demonstrate to the Authority's satisfaction that loss of applicant's services will result in a significant decrease in provider competition and consumer choice.
(g) The new hospital will be sited within the boundaries of the service area of the hospital that is proposing to relocate into the service area of the applicant's existing hospital. In addition, the applicant's new hospital must be located at a site that is no further than half the distance between the main campus of the hospital that is proposing to relocate into the applicant's service area and either the new site of the main campus of the hospital that is proposing to relocate into the applicant's service area or the site of any other existing general hospital.
Stat. Auth.: ORS 431.120(6), 442.315
Stats. Implemented: ORS 431.120(6), 442.315
Hist.: PH 29-2004, f.& cert. ef. 9-23-04
333-560-0150
Procedures for Accelerated Review
(1) The accelerated review process will be initiated upon the written request of the applicant and payment of the fee specified in OAR 333-565-0000(4). Decisions to grant or not to grant accelerated review will be based on a letter of intent which has been properly filed by the applicant under OAR 333-555-0000 through 333-555-0020 and on the Authority's findings concerning whether the conditions for accelerated review under OAR 333-560-0140 and the requirements of this rule have been met. In addition to a letter of intent, applicants seeking accelerated review must submit sufficient information and narrative to allow the Authority to make findings regarding the conditions and requirements for accelerated review set out in OAR 333-560-0140 and this rule. The applicant must provide the letter of intent and other materials submitted for review in both electronic and paper formats.
(2) The Authority will hold at least one public meeting in the geographical area affected by the proposed relocation prior to issuing a decision. The purpose of the public meeting is to discuss issues relevant to the project under review and to allow submission of documents or other evidence relevant to the application:
(a) Authority staff will chair and conduct the meeting.
(b) Any person may speak at a public meeting, and any person who speaks at the public meeting may be questioned by the Authority's staff. No questions by other than staff of the Authority will be allowed, unless permission is given by the chair. The chair may set time limits for testimony in order to assure a timely and equitable presentation of information.
(c) Notice of the public meeting will be given to the applicant; any hospitals located in the affected service areas; newspapers providing general circulation to the affected service areas; and persons who have requested and been granted designation as affected parties.
(d) The Authority will not unnecessarily delay scheduling the public meeting(s).
(3) The applicant must provide the Authority with the following documents:
(a) A copy of a city council or county board of commissioners resolution supporting the siting of the facility in its jurisdiction. A city council resolution is required if the facility is to be located within the boundaries of a city, otherwise a county board of commissioners resolution is required; and
(b) Proof that zoning approval for the facility has been applied for or obtained.
(4) The division will provide written notification to the applicant that accelerated review is:
(a) Denied and state the reason; or
(b) Granted.
(5) If accelerated review is granted, the proposal is exempt from the full review process detailed in Division 570 of this chapter, with the exception of OAR 333-570-0070(3) through (10); and from the application requirements and review criteria established in Division 580. The notification to the applicant will include a proposed order granting the certificate of need. Such an order will contain findings sufficient to justify the granting of accelerated review, but need contain no other findings.
(6) The proposed order on an accelerated review is subject to an informal hearing, as provided in OAR 333-570-0070(5) through (9). Notwithstanding the provisions of OAR 333-570-0070(8), within ten days following the close of an informal hearing on an accelerated review, the Authority will either issue a final order approving the application, or will rescind its granting of accelerated review and require the project to undergo full review.
(7) The granting of accelerated review may be rescinded following an informal hearing only if:
(a) The Authority finds that the project does not meet the criteria for accelerated review; or
(b) The Authority finds that significant issues have been raised regarding the appropriateness of the proposed project.
(8) The final order in an accelerated review is subject to a reconsideration hearing, as provided in OAR 333-570-0070(10) and Division 670 of this chapter.
(9) Projects granted a certificate of need under the accelerated review provisions are not exempt from the monitoring and reporting requirements of OAR 333-575-0000 and 333-575-0010.
Stat. Auth.: ORS 431.120(6), 442.315
Stats. Implemented: ORS 431.120(6), 442.315
Hist.: PH 29-2004, f.& cert. ef. 9-23-04
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