Health, Health Systems Improvement, Licensing

Section R432-2-6

Application

Notice of Proposed Rule

(Amendment)

DAR File No.: 33221
Filed: 11/30/2009 09:38:04 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

This amendment would discontinue the requirement for a health care facility to submit a feasibility study prior to being licensed. This proposed amendment was presented to the Health Facility Committee and approved on 11/18/2009. A subcommittee of different provider types was assigned to review this proposal, and all agreed to remove this requirement. The feasibility study rule was originally developed in an attempt to have providers determine the feasibility of a proposed health facility prior to being licensed. The feasibility study requirement has not shown value to the licensing process for health providers. It cannot be used to deny a license and has become an extra unnecessary step to obtaining a license. This amendment will save staff time which will increase efficiency, and will also save provider time and expense.

Summary of the rule or change:

The amendment will remove the rule requirement for a proposed health care facility to submit a feasibility study prior to being licensed.

State statutory or constitutional authorization for this rule:

• Title 26, Chapter 23
• Title 26, Chapter 21

Anticipated cost or savings to:

the state budget:

During the 2009 fiscal year, the Bureau received 66 feasibility studies which the staff reviewed and submitted to the newspaper for posting. The staff also billed and collected the fees for the newspaper postings. With each feasibility study requiring 1.5 hours of staff time, the savings to the state budget would be approximately $1,683/year.

local governments:

Some licensed facilities that are a part of local governments may possibly be affected by the decrease in cost of not being required to post the feasibility study in the newspaper. The average cost for posting in the 2009 fiscal year was $85.

small businesses:

Some licensed facilities that are a small business may possibly be affected by the decrease in cost of not being required to post the feasibility study in the newspaper. The average cost for posting in the 2009 fiscal year was $85.

persons other than small businesses, businesses, or local governmental entities:

New health care providers will not have to submit a feasibility study to the Bureau for posting in a local newspaper. The average cost for the newspaper posting in the 2009 fiscal year was $85. The total cost to health providers for publishing all of the feasibility studies in FY 09 was $5,579.63. The cost savings to all affected persons will be approximately $5,500 per year.

Compliance costs for affected persons:

There will be no compliance costs for this rule amendment. The rule requirement will be removed, creating cost savings for affected persons.

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

The feasibility study process has not been an effective tool and its removal will have a positive fiscal impact on regulated business.

David N. Sundwall, MD, Executive Director

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

Health
Health Systems Improvement, Licensing
288 N 1460 W
SALT LAKE CITY, UT 84116-3231

Direct questions regarding this rule to:

• Joel Hoffman at the above address, by phone at 801-538-6279, by FAX at 801-538-6024, or by Internet E-mail at jhoffman@utah.gov
• Carmen Richins at the above address, by phone at 801-538-9087, by FAX at 801-538-6024, or by Internet E-mail at carmenrichins@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:

01/14/2010

This rule may become effective on:

01/21/2010

Authorized by:

David Sundwall, Executive Director

R432. Health, Health Systems Improvement, Licensing.

R432-2. General Licensing Provisions.

R432-2-6. Application.

(1) An applicant for a license shall file a Request for Agency Action/License Application with the Utah Department of Health on a form furnished by the Department.

(2) Each applicant shall comply with all zoning, fire, safety, sanitation, building and licensing laws, regulations, ordinances, and codes of the city and county in which the facility or agency is located. The applicant shall obtain the following clearances and submit them as part of the completed application to the licensing agency:

(a) A certificate of fire clearance from the State Fire Marshal or designated local fire authority certifying compliance with local and state fire codes is required with initial and renewal application, change of ownership, and at any time new construction or substantial remodeling has occurred.

(b) A satisfactory Food Services Sanitation Clearance report by a local or state sanitarian is required for facilities providing food service at initial application and upon a change of ownership.

(c) Certificate of Occupancy from the local building official at initial application, change of location and at the time of any new construction or substantial remodeling.

(3) The applicant shall submit the following:

(a) a list of all officers, members of the boards of directors, trustees, stockholders, partners, or other persons who have a greater than 25 percent interest in the facility;

(b) the name, address, percentage of stock, shares, partnership, or other equity interest of each person; and

(c) a list, of all persons, of all health care facilities in the state or other states in which they are officers, directors, trustees, stockholders, partners, or in which they hold any interest;

(4) The applicant shall provide the following written assurances on all individuals listed in R432-2-6(3):

(a) None of the persons has been convicted of a felony;

(b) None of the persons has been found in violation of any local, state, or federal law which arises from or is otherwise related to the individual's relationship to a health care facility; and

(c) None of the persons who has currently or within the five years prior to the date of application had previous interest in a licensed health care facility that has been any of the following:

(i) subject of a patient care receivership action;

(ii) closed as a result of a settlement agreement resulting from a decertification action or a license revocation;

(iii) involuntarily terminated from participation in either Medicaid or Medicare programs; or

(iv) convicted of patient abuse, neglect or exploitation where the facts of the case prove that the licensee failed to provide adequate protection or services for the person to prevent such abuse.

[(5) An applicant or licensee shall submit a feasibility study as part of its application for a license for a new facility or agency or for a new license for an increase in capacity at a health care facility or expansion of the areas served by an agency.

(a) The feasibility study shall be a written narrative and provide at a minimum:

(i) the purpose and proposed license category for the proposed newly licensed capacity;

(ii) a detailed description of the services to be offered;

(iii) identification of the operating entity or management company;

(iv) a listing of affiliated health care facilities and agencies in Utah and any other state;

(v) identification of funding source(s) and an estimate of the total project capital cost;

(vi) an estimate of total operating costs, revenues and utilization statistics for the twelve month period immediately following the licensing of the new capacity;

(vii) identification of all components of the proposed newly licensed capacity which ensures that residents of the surrounding area will have access to the proposed facility or service;

(viii) identification of the impact of the newly licensed capacity on existing health care providers; and

(ix) a list of the type of personnel required to staff the newly licensed capacity and identification of the sources from which the facility or agency intends to recruit the required personnel.

(b) The applicant or licensee shall submit the feasibility study no later than the time construction plans are submitted. If new construction is not anticipated, the applicant or licensee shall submit the study at least 60-days prior to beginning the new service. The applicant shall provide a statement with the feasibility study indicating whether it claims business confidentiality on any portion of the information submitted and, if it does claim business confidentiality, provide a statement meeting the requirements of Utah Code section 63-2-308.

(c) The Department shall publish public notice, at the applicant's expense, in a newspaper in general circulation for the location where the newly licensed capacity will be located that the feasibility study has been completed. The Department shall accept public comment for 30 days from initial publication. The Department shall retain the feasibility study and make it available to the public.

(d) The Department shall review the feasibility study, summarize the public comment, review demographics of the geographic area involved and prepare a written evaluation to the applicant regarding the viability of the proposed program.

](6) The licensee may apply to designate any number of beds within the facility's licensed capacity as banked beds on a form provided by the Department.

(a) The licensee may apply to designate beds as banked no later than December 1st of each year or upon application for license renewal.

(b) The Department shall thereafter show the facility as having an operational bed capacity equal to the licensed capacity minus any beds banked by the facility.

(c) Banking beds shall not alter the licensed capacity of a facility.

(7) The licensee may apply to return any number of banked beds to operational bed capacity on a form provided by the Department.

(a) The licensee may apply to return banked beds to operational capacity no later than December 1 of each year or upon application for license renewal.

(b) The Department shall thereafter show the facility as having an operational bed capacity equal to the licensed capacity minus any beds still banked by the facility.

(c) Beds previously banked that have been returned to operational capacity must meet the construction and life safety codes that were applicable to the facility at the time the beds were last banked.

(8) The requirements contained in Utah Code Section 26-21-23(5)(a) shall be met if a nursing care facility filed a notice of intent or application with the Department and paid a fee relating to a proposed nursing care facility prior to March 1, 2007.

(9) The requirements contained in Utah Code Section 26-21-23(5)(b) shall be met if a nursing care facility complies with the requirements of R432-4-14(4) and R432-4-16 on or before July 1, 2008.

 

KEY: health care facilities

Date of Enactment or Last Substantive Amendment: [May 29, 2007]2010

Notice of Continuation: December 24, 2008

Authorizing, and Implemented or Interpreted Law: 26-21-9; 26-21-11; 26-21-12; 26-21-13