Missouri Revised Statutes
Chapter 197
Medical Treatment Facility Licenses
←197.317
Section 197.318.1
197.320→
August 28, 2015
Licensed and available, defined--review of letters of intent--application of law in pending court cases--expansion procedures.
197.318. 1. As used in this section, the term "licensed and
available" means beds which are actually in place and for which a license
has been issued.
2. The committee shall review all letters of intent and applications
for long-term care hospital beds meeting the requirements described in 42
CFR, Section 412.23(e) under its criteria and standards for long-term care
beds.
3. Sections 197.300 to 197.366 shall not be construed to apply to
litigation pending in state court on or before April 1, 1996, in which the
Missouri health facilities review committee is a defendant in an action
concerning the application of sections 197.300 to 197.366 to long-term care
hospital beds meeting the requirements described in 42 CFR, Section
412.23(e).
4. Notwithstanding any other provision of this chapter to the
contrary:
(1) A facility licensed pursuant to chapter 198 may increase its
licensed bed capacity by:
(a) Submitting a letter of intent to expand to the department of
health and senior services and the health facilities review committee;
(b) Certification from the department of health and senior services
that the facility:
a. Has no patient care class I deficiencies within the last eighteen
months; and
b. Has maintained a ninety-percent average occupancy rate for the
previous six quarters;
(c) Has made an effort to purchase beds for eighteen months following
the date the letter of intent to expand is submitted pursuant to paragraph
(a) of this subdivision. For purposes of this paragraph, an "effort to
purchase" means a copy certified by the offeror as an offer to purchase
beds from another licensed facility in the same licensure category; and
(d) If an agreement is reached by the selling and purchasing
entities, the health facilities review committee shall issue a certificate
of need for the expansion of the purchaser facility upon surrender of the
seller's license; or
(e) If no agreement is reached by the selling and purchasing
entities, the health facilities review committee shall permit an expansion
for:
a. A facility with more than forty beds may expand its licensed bed
capacity within the same licensure category by twenty-five percent or
thirty beds, whichever is greater, if that same licensure category in such
facility has experienced an average occupancy of ninety-three percent or
greater over the previous six quarters;
b. A facility with fewer than forty beds may expand its licensed bed
capacity within the same licensure category by twenty-five percent or ten
beds, whichever is greater, if that same licensure category in such
facility has experienced an average occupancy of ninety-two percent or
greater over the previous six quarters;
c. A facility adding beds pursuant to subparagraphs a. or b. of this
paragraph shall not expand by more than fifty percent of its then licensed
bed capacity in the qualifying licensure category;
(2) Any beds sold shall, for five years from the date of relicensure
by the purchaser, remain unlicensed and unused for any long-term care
service in the selling facility, whether they do or do not require a
license;
(3) The beds purchased shall, for two years from the date of
purchase, remain in the bed inventory attributed to the selling facility
and be considered by the department of social services as licensed and
available for purposes of this section;
(4) Any residential care facility licensed pursuant to chapter 198
may relocate any portion of such facility's current licensed beds to any
other facility to be licensed within the same licensure category if both
facilities are under the same licensure ownership or control, and are
located within six miles of each other;
(5) A facility licensed pursuant to chapter 198 may transfer or sell
individual long-term care licensed beds to facilities qualifying pursuant
to paragraphs (a) and (b) of subdivision (1) of this subsection. Any
facility which transfers or sells licensed beds shall not expand its
licensed bed capacity in that licensure category for a period of five years
from the date the licensure is relinquished.
5. Any existing licensed and operating health care facility offering
long-term care services may replace one-half of its licensed beds at the
same site or a site not more than thirty miles from its current location
if, for at least the most recent four consecutive calendar quarters, the
facility operates only fifty percent of its then licensed capacity with
every resident residing in a private room. In such case:
(1) The facility shall report to the health and senior services
vacant beds as unavailable for occupancy for at least the most recent four
consecutive calendar quarters;
(2) The replacement beds shall be built to private room
specifications and only used for single occupancy; and
(3) The existing facility and proposed facility shall have the same
owner or owners, regardless of corporate or business structure, and such
owner or owners shall stipulate in writing that the existing facility beds
to be replaced will not later be used to provide long-term care services.
If the facility is being operated under a lease, both the lessee and the
owner of the existing facility shall stipulate the same in writing.
6. Nothing in this section shall prohibit a health care facility
licensed pursuant to chapter 198 from being replaced in its entirety within
fifteen miles of its existing site so long as the existing facility and
proposed or replacement facility have the same owner or owners regardless
of corporate or business structure and the health care facility being
replaced remains unlicensed and unused for any long-term care services
whether they do or do not require a license from the date of licensure of
the replacement facility.
(L. 1986 S.B. 553 & 775 § 6, A.L. 1992 S.B. 573 & 634, A.L. 1994 H.B.
1408, A.L. 1996 S.B. 575, A.L. 1996 H.B. 1362, A.L. 1997 S.B.
373, A.L. 1999 S.B. 326, A.L. 2010 H.B. 1516 Revision merged with
H.B. 1965, A.L. 2014 H.B. 1299 Revision)
2010
1999
2010
197.318. 1. As used in this section, the term "licensed and
available" means beds which are actually in place and for which a license
has been issued.
2. The committee shall review all letters of intent and applications
for long-term care hospital beds meeting the requirements described in 42
CFR, Section 412.23(e) under its criteria and standards for long-term care
beds.
3. Sections 197.300 to 197.366 shall not be construed to apply to
litigation pending in state court on or before April 1, 1996, in which the
Missouri health facilities review committee is a defendant in an action
concerning the application of sections 197.300 to 197.366 to long-term care
hospital beds meeting the requirements described in 42 CFR, Section
412.23(e).
4. Notwithstanding any other provision of this chapter to the
contrary:
(1) A facility licensed pursuant to chapter 198 may increase its
licensed bed capacity by:
(a) Submitting a letter of intent to expand to the division of aging
and the health facilities review committee;
(b) Certification from the division of aging that the facility:
a. Has no patient care class I deficiencies within the last eighteen
months; and
b. Has maintained a ninety-percent average occupancy rate for the
previous six quarters;
(c) Has made an effort to purchase beds for eighteen months following
the date the letter of intent to expand is submitted pursuant to paragraph
(a) of this subdivision. For purposes of this paragraph, an "effort to
purchase" means a copy certified by the offeror as an offer to purchase
beds from another licensed facility in the same licensure category; and
(d) If an agreement is reached by the selling and purchasing
entities, the health facilities review committee shall issue a certificate
of need for the expansion of the purchaser facility upon surrender of the
seller's license; or
(e) If no agreement is reached by the selling and purchasing
entities, the health facilities review committee shall permit an expansion
for:
a. A facility with more than forty beds may expand its licensed bed
capacity within the same licensure category by twenty-five percent or
thirty beds, whichever is greater, if that same licensure category in such
facility has experienced an average occupancy of ninety-three percent or
greater over the previous six quarters;
b. A facility with fewer than forty beds may expand its licensed bed
capacity within the same licensure category by twenty-five percent or ten
beds, whichever is greater, if that same licensure category in such
facility has experienced an average occupancy of ninety-two percent or
greater over the previous six quarters;
c. A facility adding beds pursuant to subparagraphs a. or b. of this
paragraph shall not expand by more than fifty percent of its then licensed
bed capacity in the qualifying licensure category;
(2) Any beds sold shall, for five years from the date of relicensure
by the purchaser, remain unlicensed and unused for any long-term care
service in the selling facility, whether they do or do not require a
license;
(3) The beds purchased shall, for two years from the date of
purchase, remain in the bed inventory attributed to the selling facility
and be considered by the department of social services as licensed and
available for purposes of this section;
(4) Any residential care facility licensed pursuant to chapter 198
may relocate any portion of such facility's current licensed beds to any
other facility to be licensed within the same licensure category if both
facilities are under the same licensure ownership or control, and are
located within six miles of each other;
(5) A facility licensed pursuant to chapter 198 may transfer or sell
individual long-term care licensed beds to facilities qualifying pursuant
to paragraphs (a) and (b) of subdivision (1) of this subsection. Any
facility which transfers or sells licensed beds shall not expand its
licensed bed capacity in that licensure category for a period of five years
from the date the licensure is relinquished.
5. Any existing licensed and operating health care facility offering
long-term care services may replace one-half of its licensed beds at the
same site or a site not more than thirty miles from its current location
if, for at least the most recent four consecutive calendar quarters, the
facility operates only fifty percent of its then licensed capacity with
every resident residing in a private room. In such case:
(1) The facility shall report to the division of aging vacant beds as
unavailable for occupancy for at least the most recent four consecutive
calendar quarters;
(2) The replacement beds shall be built to private room
specifications and only used for single occupancy; and
(3) The existing facility and proposed facility shall have the same
owner or owners, regardless of corporate or business structure, and such
owner or owners shall stipulate in writing that the existing facility beds
to be replaced will not later be used to provide long-term care services.
If the facility is being operated under a lease, both the lessee and the
owner of the existing facility shall stipulate the same in writing.
6. Nothing in this section shall prohibit a health care facility
licensed pursuant to chapter 198 from being replaced in its entirety within
fifteen miles of its existing site so long as the existing facility and
proposed or replacement facility have the same owner or owners regardless
of corporate or business structure and the health care facility being
replaced remains unlicensed and unused for any long-term care services
whether they do or do not require a license from the date of licensure of
the replacement facility.
1999
197.318. 1. The provisions of section 197.317 shall not apply to a
residential care facility, assisted living facility, intermediate care
facility or skilled nursing facility only where the department of social
services has first determined that there presently exists a need for
additional beds of that classification because the average occupancy of all
licensed and available residential care facility, assisted living facility,
intermediate care facility and skilled nursing facility beds exceeds ninety
percent for at least four consecutive calendar quarters, in a particular
county, and within a fifteen-mile radius of the proposed facility, and the
facility otherwise appears to qualify for a certificate of need. The
department's certification that there is no need for additional beds shall
serve as the final determination and decision of the committee. In
determining ninety percent occupancy, residential care facility and assisted
living facility shall be one separate classification and intermediate care and
skilled nursing facilities are another separate classification.
2. The Missouri health facilities review committee may, for any facility
certified to it by the department, consider the predominant ethnic or
religious composition of the residents to be served by that facility in
considering whether to grant a certificate of need.
*3. There shall be no expenditure minimum for facilities, beds, or
services referred to in subdivisions (1), (2) and (3) of section 197.317. The
provisions of this subsection shall expire January 1, 2003.
4. As used in this section, the term "licensed and available" means beds
which are actually in place and for which a license has been issued.
5. The provisions of section 197.317 shall not apply to any facility
where at least ninety-five percent of the patients require diets meeting the
dietary standards defined by section 196.165, RSMo.
6. The committee shall review all letters of intent and applications for
long-term care hospital beds meeting the requirements described in 42 CFR,
Section 412.23(e) under its criteria and standards for long-term care beds.
7. Sections 197.300 to 197.366 shall not be construed to apply to
litigation pending in state court on or before April 1, 1996, in which the
Missouri health facilities review committee is a defendant in an action
concerning the application of sections 197.300 to 197.366 to long-term care
hospital beds meeting the requirements described in 42 CFR, Section 412.23(e).
8. Notwithstanding any other provision of this chapter to the contrary:
(1) A facility licensed pursuant to chapter 198, RSMo, may increase its
licensed bed capacity by:
(a) Submitting a letter of intent to expand to the division of aging and
the health facilities review committee;
(b) Certification from the division of aging that the facility:
a. Has no patient care class I deficiencies within the last eighteen
months; and
b. Has maintained a ninety-percent average occupancy rate for the
previous six quarters;
(c) Has made an effort to purchase beds for eighteen months following
the date the letter of intent to expand is submitted pursuant to paragraph (a)
of this subdivision. For purposes of this paragraph, an "effort to purchase"
means a copy certified by the offeror as an offer to purchase beds from
another licensed facility in the same licensure category; and
(d) If an agreement is reached by the selling and purchasing entities,
the health facilities review committee shall issue a certificate of need for
the expansion of the purchaser facility upon surrender of the seller's
license; or
(e) If no agreement is reached by the selling and purchasing entities,
the health facilities review committee shall permit an expansion for:
a. A facility with more than forty beds may expand its licensed bed
capacity within the same licensure category by twenty-five percent or thirty
beds, whichever is greater, if that same licensure category in such facility
has experienced an average occupancy of ninety-three percent or greater over
the previous six quarters;
b. A facility with fewer than forty beds may expand its licensed bed
capacity within the same licensure category by twenty-five percent or ten
beds, whichever is greater, if that same licensure category in such facility
has experienced an average occupancy of ninety-two percent or greater over the
previous six quarters;
c. A facility adding beds pursuant to subparagraphs a. or b. of this
paragraph shall not expand by more than fifty percent of its then licensed bed
capacity in the qualifying licensure category;
(2) Any beds sold shall, for five years from the date of relicensure by
the purchaser, remain unlicensed and unused for any long-term care service in
the selling facility, whether they do or do not require a license;
(3) The beds purchased shall, for two years from the date of purchase,
remain in the bed inventory attributed to the selling facility and be
considered by the department of social services as licensed and available for
purposes of this section;
(4) Any residential care facility** licensed pursuant to chapter 198,
RSMo, may relocate any portion of such facility's current licensed beds to any
other facility to be licensed within the same licensure category if both
facilities are under the same licensure ownership or control, and are located
within six miles of each other;
(5) A facility licensed pursuant to chapter 198, RSMo, may transfer or
sell individual long-term care licensed beds to facilities qualifying pursuant
to paragraphs (a) and (b) of subdivision (1) of this subsection. Any facility
which transfers or sells licensed beds shall not expand its licensed bed
capacity in that licensure category for a period of five years from the date
the licensure is relinquished.
9. Any existing licensed and operating health care facility offering
long-term care services may replace one-half of its licensed beds at the same
site or a site not more than thirty miles from its current location if, for at
least the most recent four consecutive calendar quarters, the facility
operates only fifty percent of its then licensed capacity with every resident
residing in a private room. In such case:
(1) The facility shall report to the division of aging vacant beds as
unavailable for occupancy for at least the most recent four consecutive
calendar quarters;
(2) The replacement beds shall be built to private room specifications
and only used for single occupancy; and
(3) The existing facility and proposed facility shall have the same
owner or owners, regardless of corporate or business structure, and such owner
or owners shall stipulate in writing that the existing facility beds to be
replaced will not later be used to provide long-term care services. If the
facility is being operated under a lease, both the lessee and the owner of the
existing facility shall stipulate the same in writing.
10. Nothing in this section shall prohibit a health care facility
licensed pursuant to chapter 198, RSMo, from being replaced in its entirety
within fifteen miles of its existing site so long as the existing facility and
proposed or replacement facility have the same owner or owners regardless of
corporate or business structure and the health care facility being replaced
remains unlicensed and unused for any long-term care services whether they do
or do not require a license from the date of licensure of the replacement
facility.
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