House Bill 3437

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    Florida House of Representatives - 1998                HB 3437

        By Representative Mackey






  1                      A bill to be entitled

  2         An act relating to certificates of need;

  3         amending s. 395.003, F.S.; requiring the Agency

  4         for Health Care Administration to adopt a rule

  5         methodology for separate evaluation of

  6         certificate-of-need applications for skilled

  7         nursing beds in facilities licensed under ch.

  8         395, F.S.; limiting certain comparative review

  9         and standing to challenge applications;

10         providing standards and criteria for evaluating

11         need; amending s. 408.036, F.S.; providing an

12         exemption from certificate-of-need review for

13         certain conversions of licensed acute care

14         hospital beds to skilled nursing beds;

15         providing for expiration of the exemption;

16         requiring the agency to adopt a rule

17         methodology for separate evaluation of

18         applications for skilled nursing beds in

19         facilities licensed under ch. 395, F.S.;

20         limiting certain comparative review and

21         standing to challenge applications; providing

22         standards and criteria for evaluating need;

23         providing an exemption from review under

24         certain circumstances; amending s. 408.039,

25         F.S.; restricting who may challenge or

26         intervene in an administrative proceeding

27         relating to issuance or denial of a certificate

28         of need; providing an effective date.

29

30  Be It Enacted by the Legislature of the State of Florida:

31

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    Florida House of Representatives - 1998                HB 3437

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  1         Section 1.  Subsections (5), (6), (7), and (8) of

  2  section 395.003, Florida Statutes, are renumbered as

  3  subsections (6), (7), (8), and (9), respectively, and a new

  4  subsection (5) is added to said section to read:

  5         395.003  Licensure; issuance, renewal, denial, and

  6  revocation.--

  7         (5)  By October 1, 1998, the agency shall adopt a rule

  8  methodology which provides for the separate evaluation of

  9  applications for skilled nursing beds in facilities licensed

10  pursuant to chapter 395 and which encourages continuity of

11  care.  Such applications shall not be subject to comparative

12  review with facilities licensed pursuant to chapter 400, and

13  facilities licensed pursuant to chapter 400 shall not have

14  standing to challenge any application filed pursuant to this

15  agency rule.  The methodology shall include as criteria a

16  minimum volume threshold of the 10 diagnostic-related groups

17  identified as the principal diagnoses for admission to a

18  hospital-based skilled nursing unit in the final report of the

19  panel created pursuant to s. 142 of chapter 95-418, Laws of

20  Florida.  The methodology may also utilize other standards and

21  criteria which are reasonable and appropriate for evaluating

22  the need for skilled nursing home beds in a hospital-based

23  setting, including demonstrating a minimum volume of cases

24  sufficient to attain an average annual occupancy of 75 percent

25  within the skilled nursing unit within 24 months after

26  initiating the service.

27         Section 2.  Paragraph (o) is added to subsection (3) of

28  section 408.036, Florida Statutes, and subsection (4) is added

29  to said section, to read:

30         408.036  Projects subject to review.--

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    Florida House of Representatives - 1998                HB 3437

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  1         (3)  EXEMPTIONS.--Upon request, supported by such

  2  documentation as the agency requires, the agency shall grant

  3  an exemption from the provisions of subsection (1):

  4         (o)  For the conversion of licensed acute care hospital

  5  beds to skilled nursing beds, provided the conversion of beds

  6  does not require the construction of new facilities. The total

  7  number of acute care beds converted to skilled nursing beds

  8  pursuant to this paragraph shall not exceed 16 in a hospital

  9  with 200 or fewer licensed beds, nor 24 in a hospital with

10  more than 200 licensed beds. This exemption shall expire on

11  December 31, 1999, or the date on which a rule methodology is

12  adopted pursuant to subsection (4), whichever is later.

13

14  A request for exemption under this subsection may be made at

15  any time and is not subject to the batching requirements of

16  this section.

17         (4)  By October 1, 1998, the Agency for Health Care

18  Administration shall adopt a rule methodology which provides

19  for the separate evaluation of applications for skilled

20  nursing beds in facilities licensed pursuant to chapter 395

21  and which encourages continuity of care. Such applications

22  shall not be subject to comparative review with facilities

23  licensed pursuant to chapter 400, and facilities licensed

24  pursuant to chapter 400 shall not have standing to challenge

25  applications filed by facilities licensed pursuant to chapter

26  395, nor shall facilities licensed pursuant to chapter 395

27  have standing to challenge applications for skilled nursing

28  beds in facilities licensed pursuant to chapter 400. The

29  methodology shall include as criteria a minimum volume

30  threshold of the 10 diagnostic-related groups identified as

31  the principal diagnoses for admission to a hospital-based

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    Florida House of Representatives - 1998                HB 3437

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  1  skilled nursing unit in the final report of the panel created

  2  pursuant to s. 142 of chapter 95-418, Laws of Florida. The

  3  methodology may also utilize other standards and criteria

  4  which are reasonable and appropriate for evaluating the need

  5  for skilled nursing beds in a hospital-based setting. The need

  6  for a hospital-based skilled nursing unit shall be presumed to

  7  be met when 10 percent of the cases presenting for inpatient

  8  acute admissions, excluding labor and delivery, fall within

  9  these 10 diagnostic-related groups. When this minimum level is

10  met or exceeded, a hospital may convert up to 12 acute care

11  beds to skilled nursing beds if the hospital has 200 or fewer

12  licensed beds, and may convert up to 16 acute care beds if the

13  hospital has more than 200 licensed beds. The need shall be

14  presumed to be met for hospitals with existing skilled nursing

15  units if occupancy of the existing unit is in excess of 80

16  percent. If such occupancy is met, the hospital may convert a

17  minimum of 8 beds. If the agency fails to adopt the

18  methodology by rule by October 1, 1998, or if the rule is

19  declared invalid in a proceeding pursuant to s. 120.56,

20  hospitals with 200 or fewer licensed beds are exempt from

21  review for the conversion of 12 acute care beds to skilled

22  nursing beds and hospitals with more than 200 licensed beds

23  are exempt from review for the conversion of 16 acute care

24  beds to skilled nursing beds.

25         Section 3.  Paragraph (c) of subsection (5) of section

26  408.039, Florida Statutes, is amended to read:

27         408.039  Review process.--The review process for

28  certificates of need shall be as follows:

29         (5)  ADMINISTRATIVE HEARINGS.--

30         (c)  In administrative proceedings challenging the

31  issuance or denial of a certificate of need, only applicants

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    Florida House of Representatives - 1998                HB 3437

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  1  considered by the agency in the same batching cycle are

  2  entitled to a comparative hearing on their applications.

  3  Existing health care facilities may initiate or intervene in

  4  an administrative hearing upon a showing that an established

  5  program will be substantially affected by the issuance of any

  6  certificate of need to a competing proposed facility or

  7  program within the same district. A facility does not have

  8  standing to challenge or intervene in an administrative

  9  proceeding involving another facility unless both facilities

10  are licensed under the same licensing chapter.

11         Section 4.  This act shall take effect on July 1 of the

12  year in which enacted.

13

14            *****************************************

15                          HOUSE SUMMARY

16
      Requires the Agency for Health Care Administration to
17    adopt, by October 1, 1998, a rule methodology for the
      separate evaluation of certificate-of-need applications
18    for skilled nursing beds in facilities licensed under ch.
      395, F.S. (Hospital Licensing and Regulation). Prohibits
19    comparative review of the applications of those
      facilities and facilities licensed under ch. 400, F.S.
20    (Nursing Homes and Related Health Care Facilities), and
      denies standing for applications challenges between such
21    types of facilities. Provides standards and criteria for
      evaluating need under the rule methodology.
22

23    Exempts from certificate-of-need review conversions of up
      to specified numbers of acute care hospital beds to
24    skilled nursing beds when no new facility construction is
      required. Provides for expiration of the exemption on
25    December 31, 1999, or the date the agency adopts the
      above rule methodology, whichever is later. Exempts from
26    review certain conversions if the rule is not adopted by
      the date required or is declared invalid in an
27    administrative proceeding.

28
      Provides that a health care facility does not have
29    standing to challenge or intervene in an administrative
      proceeding relating to the issuance or denial of a
30    certificate of need which involves another facility
      unless both facilities are licensed under the same
31    licensing chapter.

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