DAR File No. 28301

Health, Health Systems Improvement, Licensing

R432-106

Specialty Hospital - Critical Access

NOTICE OF PROPOSED RULE

DAR File No.: 28301
Filed: 10/25/2005, 02:39
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

The Code of Federal Regulations, 42 CFR 485 Subpart F, for Critical Access Hospitals has changed. The definition of Critical Access Hospital is changed. Several criteria have been deleted from the federal rules, and others simplified. The hospitals are now allowed up to 25 swing beds at any time, from the previous limit of 10. The definition for Critical Access Hospitals has also changed. The state rule needs to be amended to follow the new requirements in the CFR.

Summary of the rule or change:

The definition of Critical Access Hospital will be changed to amend the requirements that are presently stated in the rule to update with new federal requirements. The section for swing beds will also be amended to allow 25 swing beds from the 10 beds that is presently stated.

State statutory or constitutional authorization for this rule:

Title 26, Chapter 21

Anticipated cost or savings to:

the state budget:

No anticipated costs or savings. This rule amendment only updates the state rule to reflect changes in the federal rules. This will have no budget impact on the State.

local governments:

No anticipated costs or savings. This rule amendment only updates the state rule to reflect changes in the federal rules, and does not affect local governments.

other persons:

No anticipated costs or savings. This rule amendment only updates the state rule to reflect changes in the federal rules. Providers and consumers will see no cost increases or cost savings from this change.

Compliance costs for affected persons:

There are no anticipated costs for any parties as a result of this rulemaking. The rule change only updates the rule to reflect the federal regulation changes. It does not add or take away any rules that would have a fiscal impact on providers or consumers.

Comments by the department head on the fiscal impact the rule may have on businesses:

Federal requirements have been updated to provide more flexibility for affected providers. This rule change will have a positive impact on impacted providers, by allowing for additional swing beds, and removing distance requirements. David N. Sundwall, MD

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Direct questions regarding this rule to:

Joel Hoffman at the above address, by phone at 801-538-6165, by FAX at 801-538-6163, or by Internet E-mail at jhoffman@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

12/15/2005

This rule may become effective on:

12/16/2005

Authorized by:

David N. Sundwall, Executive Director

RULE TEXT

R432. Health, Health Systems Improvement, Licensing.

R432-106. Speciality Hospital - Critical Access.

R432-106-3. Definitions.

For purposes of this rule the definitions in R432-1-3 apply. In addition the following definitions apply:

(1) "Critical [Care ]Access Hospital" means a nonprofit, profit or public hospital that [meets the criteria set forth in 42 U.S.C. 1395i-4(c)(2)(B)(1988).]is enrolled as a Medicaid provider and qualifies as a Critical Access Hospital under 42 CFR, Section 485, Subpart F.[ Each CAH must comply with the conditions of participation set forth in the Code of Federal Regulations, Title 42, Volume 3, Parts 430 to End, 1999, which is adopted and incorporated by reference. The distance from another hospital may be waived if the facility meets any of the following sub-criteria and is designated as a necessary provider by the state.

(a) An area that meets federal criteria for designation as a Health Professional Shortage Area (HPSA).

(b) A county where the percentage of population age 65 or older exceeds the current state average.

(c) A county where the percentage of families with incomes less than 200% of federal poverty level is higher than the current state average.

(d) A county whose population density meets the "rural"(between 7 and 100 people per square mile) or the "frontier" (6 or fewer people per square mile) definition.

(e) A county where the unemployment rate is higher than that of the state.

(f) An area where, throughout the course of a year, has an increase in population due to the influx of migrant workers or tourists.

(g) Combined acute inpatient days for Medicare and Medicaid beneficiaries, and unreimbursed care patients account for at least 50% of the hospital's total acute inpatient days in the last full year for which data was available.]

(2) "Referral Hospital" means a hospital that has sufficient resources to receive emergency or non-emergency patient transfers and referrals from a CAH. Sufficient resources include at least three full-time physicians on staff and licensure as a general hospital.

R432-106-6. Critical Access Hospital Swing-Bed Units.

The CAH participating in the swing-bed program may maintain up to [10]25 swing-beds for care at one time. In addition to R432-106, designated hospital swing beds shall comply with the following sections of R432-150, Nursing Care Facility Rules:

(1) R432-150-4, Definitions.

(2) R432-150-12, Resident Rights.

(3) R432-150-13, Resident Assessment.

(4) R432-150-14, Restraint Policy.

(5) R432-150-15, Quality of Care.

(6) R432-150-17, Social Services.

(7) R432-150-20, Recreation Therapy.

KEY: health facilities

[January 23, 2001]2005

26-21-5

26-21-2.1

26-21-13.6

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For questions regarding the content or application of this rule, please contact Joel Hoffman at the above address, by phone at 801-538-6165, by FAX at 801-538-6163, or by Internet E-mail at jhoffman@utah.gov

For questions about the rulemaking process, please contact the Division of Administrative Rules (801-538-3764). Please Note: The Division of Administrative Rules is NOT able to answer questions about the content or application of these administrative rules.