RULE 049.00.09-004 - HSC Regulation 300M: Home Health Methodology - Home Health Criteria Rural Hospitals

RULE 049.00.09-004. HSC Regulation 300M: Home Health Methodology - Home Health Criteria Rural Hospitals

HSC REGULATION 300M. Home Health Criteria

C. Rural Hospitals

Small rural hospitals that do not have a home health agency may be approved for a home health agency to serve either the county in which the hospital is located or the townships within a twenty-mile radius of the hospital. Small hospitals are defined as short-term acute care hospitals of 50 or fewer licensed beds. Rural counties are defined as counties with a population of 25,000 or less in the last decennial census. Hospitals approved under this rule must have their home health agency licensed no later than twenty-four (24) months from the date of approval.

If the hospital voluntarily or otherwise loses, surrenders, or transfers its home health license, the hospital is not eligible for five years for a Home Health POA using the rural hospital designation.

This five-year prohibition would not be applicable if the hospital proves it did not have any financial gain or receive any benefit from the loss, surrender, or transfer of its home health license.

HSC REGULATION 300M. Home Health Criteria (12/06)

A. Methodology

1. Standards.

The following is the standard to be used in the review of additional or expanded home health agencies. The methodology is based on the following assumptions:

1) More populated areas tend to have a higher population density,

2) Areas with higher population density can be served with fewer staff due to reduced travel time. Thus, it will take fewer staff to serve the same number of patients in a metropolitan area than it would to serve patients in a rural area.

a. An area* with up to 30,000 population may be approved for a maximum of two agencies.

b. An county with 30,000 to 50,000 population may be approved for a maximum of three agencies.

c. A county with 50,000 to 75,000 population may be approved for a maximum of four agencies.

d. A county with 75,000 to 110,000 population may be approved for a maximum of five agencies.

e. A county with 110,000 to 150,000 population may be approved for a maximum of six agencies.

f. A county with 150,000 to 250,000 population may be approved for a maximum of seven agencies.

g. A county with 250,000 to 400,000 population may be approved for a maximum of eight agencies.

h. A county with 400,000 and over population would be approved for a maximum of one agency per every 50,000 population.

2. Exception.

Approvals may be granted when the methodology does not show a need if the applicant offers documentation to prove that existing agencies are not meeting the needs of the service area population.

3. Application for a change in licensure category.

An agency with a "B" license that applies for a Permit of Approval to proceed with obtaining an "A" license will have to meet published criteria including the standard of need. Such approval may not exceed the standard of need unless the applicant has provided evidence to support an exception as noted in 2.

B. Unfavorable Review.

1. No application will be approved for a new home health agency or an expanded service area or change in license category if the applicant has had any condition level deficiencies in the previous 36 months as determined by the applicable state survey agency.

C. Rural Hospitals

Small rural hospitals that do not have a home health agency may be approved for a home health agency to serve either the county in which the hospital is located or the townships within a twenty-mile radius of the hospital. Small hospitals are defined as short-term acute care hospitals of 50 or fewer licensed beds. Rural counties are defined as counties with a population of 25,000 or less in the last decennial census. Hospitals approved under this rule must have their home health agency licensed no later than twenty-four (24) months from the date of approval.

If the hospital voluntarily or otherwise loses, surrenders, or transfers its home health license, the hospital is not eligible for five years for a Home Health POA using the rural hospital designation.

This five-year prohibition would not be applicable if the hospital proves it did not have any financial gain or receive any benefit from the loss, surrender, or transfer of its home health license.

(1/16/2009)

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