N.H. Admin. Code § He-Hea 2103.01

Current through Register No. 50, December 12, 2024

Section He-Hea 2103.01 - Criteria

In addition to the criteria in RSA 151-C:7 and He-Hea 303, applicants shall meet the criteria set forth in this section:

(a) Proposed LTACH services shall be financially feasible;

(b) In order to assess the current and long-range financial feasibility of the proposed project, each applicant shall demonstrate that resources:

(1) Are available to fund the proposed capital costs and operating costs; and

(2) Will be available to maintain operations in the event of interruptions to cash flow;

(c) Demonstration of financial feasibility shall be made by providing with the application:

(1) For those applicants with existing LTACH programs and filing an application for a CON, copies of the facility's financial statements for:

a. The past 3 fiscal years; or

b. Since the facility has been in existence, if less than 3 years;

(2) For all facilities, documentation in the form of projected financial statements for the next 3 fiscal years; and

(3) A copy of a letter from the applicant's lender stating the method of financing which includes:

a. Financed amount;

b. Rate of interest; and

c. Term of debt;

(d) Applicants shall provide a description of the state and patient populations which includes the following:

(1) Demographic characteristics of the state by age and sex compositions;

(2) Income levels of the state population;

(3) Anticipated payer source by population totals and percentages expressed as:

a. Medicare;

b. Medicaid;

c. Private insurance companies;

d. Self-pay; and

e. Health maintenance organizations;

(4) A description of the anticipated patient population that includes, but is not limited to, the DRGs and comorbidities of the patients for whom the applicant anticipates caring;

(e) Applicants shall document the anticipated impact on patient charges as a result of the proposed project;

(f) Documentation of the proposed project's anticipated impact on patient charges shall be made in the form of report included with the application identifying:

(1) For an existing facility, a schedule of patient charges for:

a. The past 3 fiscal years; or

b. Since the facility has been in existence, if less than 3 years;

(2) For all facilities a schedule of patient charges projected for 3 years after project completion; and

(3) The anticipated project-related changes in patient charges;

(g) LTACH services shall be available and accessible to all persons in the state, including those persons in the state who might not have the means to pay for such services;

(h) Applicants shall demonstrate the extent to which LTACH services are available and accessible to all persons within its institution by providing a report in the application that:

(1) Delineates the amount that is presently or planned to be budgeted to cover the cost of free care, reduced fee care, and bad debts; and

(2) Separately delineates the amount of free care from bad debts in the projected financial report;

(i) Personnel resources shall be available to support the proposed LTACH services project;

(j) Demonstration of sufficient personnel resources for the LTACH services shall be made in the form of a report included in the application which includes:

(1) A table listing the personnel which shall include each position and job title:

a. For an existing facility, for:

1. The past 3 fiscal years; or

2. Since the facility has been in existence, if less than 3 years;

b. For all facilities, projected for 3 years after project completion;

(2) The number of medical staff employed by or with admission privileges to the facility;

(3) An outline of the recruitment policies and procedures;

(4) A schedule of contracted services which shall list the services that are provided, including, but not limited to:

a. Emergency services;

b. Outpatient services;

c. Diagnostic evaluation services;

d. Medical services;

e. Social services;and

f. Surgical services.

(k) In order to determine the financial feasibility of the project pursuant to RSA 151-C:7, II, applicants shall submit an assessment of costs and methods of construction for the proposed project;

(l) The assessment shall be made by providing preliminary floor plans showing space allocations expressed on a per square foot basis;

(m) Applicants shall provide a comparison of the anticipated proposed construction cost per square foot to the January 2007 edition of the Marshall Valuation Service, section 15, for the proposed class and type of construction;

(n) Applicants shall include a report with the application which provides:

(1) Details of all the project costs and space of the proposed project;

(2) An analysis of the class and quality of construction pursuant to section one of the January 2007 edition of the Marshall Valuation Service;

(3) The allocation of costs within a multiple use building;

(4) The allocations of site costs and land costs where facilities are proposed to have multiple uses;

(5) The methodology used in calculating construction costs for renovations;

(6) The methodology used in calculating construction costs involving leasehold improvements; and

(7) The anticipated useful life of the building;

(o) The following construction costs shall be compared with the January 2007 edition of the Marshall Valuation Service:

(1) Labor;

(2) Materials;

(3) Fixed equipment;

(4) Building permits;

(5) Architectural and engineering fees;

(6) Site preparation for the building;

(7) Utilities from structure to lot line;

(8) Insurance costs during construction; and

(9) Interest costs during construction;

(p) The applicant shall follow the outline of the calculator method set forth in section 10 of the January 2007 edition of the Marshall Valuation Service to determine construction costs according to the Marshall Valuation Service;

(q) The costs and factors to take into account pursuant to (o) above shall include:

(1) The base cost found in the general hospital table in section 15, page 24;

(2) An adjustment to heating, ventilating, and air-conditioning costs for:

a. Extreme climate; and

b. A different type of HVAC system from that assumed in the table, if necessary;

(3) All fire protection systems costs;

(4) Elevator costs, if not included in the base cost;

(5) Number of stories multiplier;

(6) Story height multipliers;

(7) Floor area - perimeter multipliers; and

(8) Cost multipliers from section 99 of the January 2007 edition of the Marshall Valuation Service;

(r) LTACH services shall be provided in a safe and efficient manner;

(s) In the case of existing facilities, demonstration of safe services shall be made by providing with the application:

(1) Copies of inspection surveys and reports from state, federal, or accrediting agencies;

(2) Copies of corrective action plans if deficiencies have been cited by state, federal or accrediting agencies;

(3) A copy of the facility's emergency procedure and evacuation plan to be followed in case of fire or other emergencies;

(4) A report detailing how patients will be protected from hazards which might occur during the construction or renovation project; and

(5) A signed statement made by the applicant pursuant to He-Hea 303.05(c) or (d);

(t) For new facilities, demonstration of safe services shall be made by providing with the application:

(1) A copy of the facility's emergency procedure and evacuation plan to be followed in case of fire or other emergencies; and

(2) A signed statement made by the applicant pursuant to He-Hea 303.05(c) or (d);

(u) Applicants shall document the planned use of beds by patients originating from outside the State of New Hampshire and the impact of these services on the accessibility of beds by New Hampshire residents; and

(v) Demonstration of the use of beds by out-of-state patients shall be in the form of a report including:

(1) The projected utilization by non-New Hampshire residents; and

(2) Referral agreements from physicians and other medical personnel.

N.H. Admin. Code § He-Hea 2103.01

#9110, eff 3-25-08