§ 16-29-7-12 — Time frame for determining state comprehensive care bed need rate and county comprehensive care bed need; publication; application requirements; criteria; sufficient information

Indiana § 16-29-7-12

• Jurisdiction: Indiana
• Title 16: HEALTH
• Art. 29: LIMITATIONS ON VARIOUS HEALTH SERVICE
• Ch. 7: Certificate of Need for Comprehensive Care Health

Text

(a) Before July 1, 2019, and before July 1 of
each year thereafter, the commissioner or the commissioner's designee
shall complete the following:
(1) Determine the state comprehensive care bed need rate as set
forth in section 8 of this chapter.
(2) For each county, determine the county's comprehensive care
bed need as set forth in section 9 of this chapter.
(b) The state department shall publish each county's comprehensive
care bed need determined under subsection (a)(2) on the state
department's Internet web site not later than one (1) month after the
determination is made under subsection (a).
(c) In considering whether to approve a certificate of need
application under this chapter, the commissioner or the commissioner's
designee shall ensure that an application is in accordance with all of the
following:
(1) The number of comprehensive care beds approved for a
county must include only comprehensive care beds available for
relocation from counties with an excess comprehensive care bed
supply.
(2) The number of comprehensive care beds approved for a
county shall not exceed the receiving county's comprehensive care
bed need as determined under subsection (a)(2).
(3) A certificate of need may not be granted if in the receiving
county:
(A) the existing occupancy rate for all comprehensive care beds
is less than eighty-five percent (85%); or
(B) the addition of a proposed comprehensive care bed would
reduce the existing occupancy rate for all comprehensive care
beds below eighty-five percent (85%).
(4) The relocation of a comprehensive care bed to a different
county may occur only if, after the relocation, the number of
comprehensive care beds in the county from which the
comprehensive care bed is relocated will still exceed the county's
comprehensive care bed need determined under subsection (a)(2)
by at least fifty (50) comprehensive care beds.
(d) In determining need, the commissioner or the commissioner's
designee shall consider the following criteria when reviewing a
certificate of need application:
(1) The need that the population served or proposed to be served
has for the services to be provided upon implementation of a
project detailed in the certificate of need application.
(2) The quality of care provided in previous or existing
comprehensive care health facilities owned or operated by the
applicant, including responses to resident and family satisfaction
surveys.
(3) The applicant's plan to meet staffing requirements for the
project as required by 410 IAC 16.2-3.1-2(c)(6).
(4) The short term and long term financial feasibility, the cost
effectiveness of the project, and the financial impact upon the
applicant, other providers, health care consumers, and the state's
Medicaid program. The applicant shall include the following with
the certificate of need application:
(A) The availability and proof of financing for the project.
(B) The operating costs specific to the project and the effect of
the costs on the operating budget of the facility based on review
of available balance sheets, cash flow statements, and audited
financial statements.
(C) The anticipated costs for the project that would be filed in
Medicaid cost reports compared to the median Medicaid costs
associated with other comprehensive care health facilities in the
county.
(D) The applicant's historical ability to meet the working capital
requirement under 410 IAC 16.2-3.1-2(c)(11).
(5) The historical, current, and projected use of the facility if the
application is for a project that involves an existing
comprehensive care health facility.
(6) The relationship of the project to the applicant's long range
plan and the planning process employed.
(7) The effectiveness of the project in meeting the health care
needs of medically underserved groups, including:
(A) low income individuals;
(B) individuals with disabilities; and
(C) minorities;
and, if applicable, the applicant's historical experience in meeting
the needs of underserved groups.
(8) The availability of and impact on ancillary and support
services that relate to the project, including the following
services:
(A) Dental care.
(B) Diagnostics.
(C) Laboratory.
(D) Pharmaceutical.
(E) Therapy.
(F) Transportation.
(G) Vision.
(H) X-ray.
(9) The extent to which the project, the facility, and the applicant
comply with applicable standards for licensure, certification, and
other approvals.
(10) The historical performance of the applicant and affiliated
parties in complying with previously granted certificate of need
applications.
(11) The public comments submitted to the state department
under section 13 of this chapter.
(12) The applicant's legal right or demonstration of a future legal
right to the beds proposed to be transferred under the application.
(13) Any other information concerning the need for the
comprehensive care beds or the comprehensive care health
facility requested on the application.
Except for public comments under subdivision (11), the applicant has
the burden of including with the application sufficient information for
each of the criteria for the commissioner or the commissioner's
designee to review.
(e) The certificate of need applicant has the burden of providing
sufficient information under this section to enable the commissioner or
the commissioner's designee to review the application under this
section.
(f) The commissioner or the commissioner's designee shall approve
a certificate of need application for:
(1) the transfer of comprehensive care beds; or
(2) the construction of a comprehensive care health facility
consisting of transferred beds;
only after finding the transfer or construction is necessary as provided
in this section.

Legislative History

As added by P.L.202-2018, SEC.8.