N.J. Admin. Code § 8:33H-1.13

Current through Register Vol. 56, No. 21, November 4, 2024

Section 8:33H-1.13 - Conversion or elimination of licensed or Certificate of Need approved beds or services

(a) Applicants proposing to convert any licensed beds shall submit schematic plans with a floor layout of the facility, illustrating how the proposed conversion will be accomplished. In order to assure that the bed conversion can be implemented in accordance with health facility construction standards, it is recommended that applicants consult with the Department of Community Affairs, Health Care Plan Review Program, prior to submitting a certificate of need application. Applications for bed conversions to a use subject to the review schedule in 8:33-4.1(a) shall be subject to that schedule and procedures described therein. Such applications that are submitted without schematic plans shall be deemed incomplete.

(b) Applicants for the conversion of residential health care beds to long-term care beds shall follow the schedule and procedures in 8:33-4.1(a) and shall document a commitment to enabling current residents to continue occupying their assigned beds until or unless a permanent relocation placement is requested by the resident.

1. The mixing of residential health care and long-term care beds within one or more units as a consequence of implementing a Certificate of Need to convert or eliminate beds may be permitted if necessary in order to avoid relocating or discharging residents who do not wish to move.

(c) An applicant whose project entails the discharge or permanent relocation of residents in order to effect the conversion or elimination of licensed beds shall provide compelling documentation, to the satisfaction of the Commissioner, that a greater public benefit is to be obtained from the proposed conversion or elimination of beds than would be obtained if the existing licensed bed complement were maintained. This documentation shall be submitted not only by applicants who propose to discharge or permanently relocate a specified number of residents upon receiving Certificate of Need approval, but also by any applicant who has discharged or relocated more than 25 percent of the residents of the beds in question during the 12-month period prior to submission of the Certificate of Need application for a bed conversion or elimination. Compelling documentation of public benefit may include, but shall not be limited to, the following:

1. Letters supporting the discharge or relocation of residents which are submitted by the residents themselves, their family members or significant others, and/or the residents' health care providers;

2. Evidence that residents' quality of life and/or care would either deteriorate if they were permitted to remain in the facility, or that it would improve as a result of their being discharged or relocated to other facilities;

3. Evidence that the quality of life and/or care of those residents who will remain as residents in the facility would either deteriorate unless the proposed beds are converted or eliminated, or substantially improve as a result of eliminating or converting the beds in question; and

4. Evidence that the relocation will afford residents' family members and significant others convenient access for visitation purposes; that is, the facility to which most residents are expected to be relocated shall be situated in an area that has readily available public transportation and/or easy access to major roadways.

(d) An exception to the documentation requirement in (c) above may be granted by the Commissioner in the case where an applicant proposes to completely and permanently close the facility in question and/or to cease operating as any type of health care facility. The applicant shall nonetheless comply with the requirements in (f) below, to the extent that they are applicable.

(e) Certificate of Need applications proposing the conversion of residential health care beds to long-term care beds shall be subject to the schedule and procedures in 8:33-4.1(a) and shall meet the following requirements:

1. If the project entails the relocation of residents from the facility, the applicant shall provide documentation of a transfer agreement with at least one other residential health care facility in the area that maintains admission policies, offers amenities, and charges fees which are similar to those of the applicant's residential health care facility. Furthermore, the applicant shall provide documentation that the residential health care facility which is the subject of the transfer agreement has the willingness and bed capacity to accommodate those residents who might be transferred from the applicant's facility, including Supplemental Security Income recipients and discharged psychiatric patients;

2. If the applicant's facility currently has residents occupying residential health care beds who may require or desire relocation, the applicant agrees to provide all necessary social service assistance to effect the relocation in a manner that maximizes consumer choice of placement alternatives. The applicant shall bear the cost of relocating residents as necessary and shall make arrangements for any residential health care resident at the facility who wishes to visit other residential health care facilities in the area, prior to making a relocation decision; and

3. The Certificate of Need application complies with all other applicable requirements in this chapter.

(f) The conversion of specialized care beds to general long-term care beds or to another specialized care use may be considered for approval, provided that the following conditions are met:

1. The applicant provides evidence, to the satisfaction of the Department, that good faith efforts have been made to implement the existing specialized care unit as it was originally approved, for a period of at least 18 months prior to submission of the Certificate of Need application for conversion. Evidence shall include:

i. Records of efforts to establish appropriate referral sources and transfer agreements;

ii. Records of efforts to negotiate reimbursement rates with third party payors including Medicaid; and

iii. Without disclosing names or otherwise publicly divulging individuals' identities, a verifiable listing of all patients referred for admission over the 12 month period prior to application submission. The listing shall include each patient's age, medical diagnoses, county of residence, payment source, and clinical care needs. For each patient, the applicant shall indicate whether the patient was admitted to the special care unit, and if not, the reason why admission was denied and the name of the facility where the patient was finally placed; and

iv. A description of all efforts to recruit and train staff for the unit; and

2. The application shall be subject to the schedule and procedures in 8:33-4.1(a).

(g) A Certificate of Need application proposing the conversion of acute care hospital beds to general or specialized long-term care beds may be approved provided that the following conditions are met:

1. The county in which the hospital is located has a documented nursing home bed.

2. The project entails a permanent conversion of beds located on one or more distinct nursing units (that is the creation of so-called "swing beds" shall not be approved);

3. The applicant documents plans for providing a suitable, home like living environment for long-stay patients or agrees to adopt admission policies limiting utilization of the proposed long-term care beds to patients whose stays can reasonably be expected to be less than 100 days;

4. The capital cost of converting the acute care beds is less than that of new nursing facility construction; and

5. The Certificate of Need application complies with all other applicable requirements in this chapter and the schedule and procedures in 8:33-4.1(a).

N.J. Admin. Code § 8:33H-1.13

Amended by R.1993 d.671, effective 12/20/1993.
See: 25 New Jersey Register 3719(a), 25 New Jersey Register 6031(a).
Amended by R.1998 d.430, effective 8/17/1998.
See: 30 New Jersey Register 1702(a), 30 New Jersey Register 3081(a).
In (e), added 1 and 2.
Amended by R.2004 d.354, effective 9/20/2004.
See: 36 New Jersey Register 1641(a), 36 New Jersey Register 4306(a).
Rewrote the section.