The applicant shall document that the number of beds to be
established or added is necessary to serve the planning area's population,
based on the following:
1) 77 Ill.
Adm. Code
1100 (formula calculation)
A) The
number of beds to be established for each category of service is in conformance
with the projected bed deficit specified in 77 Ill. Adm. Code
1100, as
reflected in the latest updates to the Inventory.
B) The number of beds proposed shall not
exceed the number of the projected deficit, to meet the health care needs of
the population served, in compliance with the occupancy standard specified in
77 Ill. Adm. Code
1100.
2) Service to Planning Area Residents
A) Applicants proposing to establish or add
beds shall document that the primary purpose of the project will be to provide
necessary health care to the residents of the area in which the proposed
project will be physically located (i.e., the planning or geographical service
area, as applicable), for each category of service included in the
project.
B) Applicants proposing to
add beds to an existing category of service shall provide patient origin
information for all admissions for the last 12-month period, verifying that at
least 50% of admissions were residents of the area. For all other projects,
applicants shall document that at least 50% of the projected patient volume
will be from residents of the area.
C) Applicants proposing to expand an existing
category of service shall submit patient origin information by zip code, based
upon the patient's legal residence (other than a health care
facility).
3) Service
Demand - Establishment of Bed Category of Service
The number of beds proposed to establish a new category of
service is necessary to accommodate the service demand experienced annually by
the existing applicant facility over the latest 2-year period, as evidenced by
historical and projected referrals, or, if the applicant proposes to establish
a new hospital, the applicant shall submit projected referrals. The applicant
shall document subsection (b)(3)(A) and either subsection (b)(3)(B) or
(C):
A) Historical Referrals
If the applicant is an existing facility, the applicant shall
document the number of referrals to other facilities, for each proposed
category of service, for each of the latest 2 years. Documentation of the
referrals shall include: patient origin by zip code; name and specialty of
referring physician; name and location of the recipient hospital.
B) Projected Referrals
An applicant proposing to establish a category of service or
establish a new hospital shall submit the following:
i) Physician referral letters that attest to
the physician's total number of patients (by zip code of residence) who have
received care at existing facilities located in the area during the 12-month
period prior to submission of the application;
ii) An estimated number of patients the
physician will refer annually to the applicant's facility within a 24-month
period after project completion. The anticipated number of referrals cannot
exceed the physician's documented historical caseload;
iii) The physician's notarized signature, the
typed or printed name of the physician, the physician's office address, and the
physician's specialty; and
iv)
Verification by the physician that the patient referrals have not been used to
support another pending or approved CON application for the subject
services.
C) Project
Service Demand - Based on Rapid Population Growth
If a projected demand for service is based upon rapid
population growth in the applicant facility's existing market area (as
experienced annually within the latest 24-month period), the projected service
demand shall be determined as follows:
i) The applicant shall define the facility's
market area based upon historical patient origin data by zip code or census
tract;
ii) Population projections
shall be produced, using, as a base, the population census or estimate for the
most recent year, for county, incorporated place, township or community area,
by the U.S. Census Bureau or IDPH;
iii) Projections shall be for a maximum
period of 10 years from the date the application is submitted;
iv) Historical data used to calculate
projections shall be for a number of years no less than the number of years
projected;
v) Projections shall
contain documentation of population changes in terms of births, deaths, and net
migration for a period of time equal to, or in excess of, the projection
horizon;
vi) Projections shall be
for total population and specified age groups for the applicant's market area,
as defined by HFSRB, for each category of service in the application;
and
vii) Documentation on
projection methodology, data sources, assumptions and special adjustments shall
be submitted to HFSRB.
4) Service Demand - Expansion of Existing
Category of Service
The number of beds to be added for each category of service
is necessary to reduce the facility's experienced high occupancy and to meet a
projected demand for service. The applicant shall document subsection (b)(4)(A)
and either subsection (b)(4)(B) or (C):
A) Historical Service Demand
i) An average annual occupancy rate that has
equaled or exceeded occupancy standards for the category of service, as
specified in 77 Ill. Adm. Code
1100, for each of the latest 2 years;
ii) If patients have been referred to other
facilities in order to receive the subject services, the applicant shall
provide documentation of the referrals, including: patient origin by zip code;
name and specialty of referring physician; and name and location of the
recipient hospital, for each of the latest 2 years.
B) Projected Referrals
The applicant shall provide the following:
i) Physician referral letters that attest to
the physician's total number of patients (by zip code of residence) who have
received care at existing facilities located in the area during the 12-month
period prior to submission of the application;
ii) An estimated number of patients the
physician will refer annually to the applicant's facility within a 24-month
period after project completion. The anticipated number of referrals cannot
exceed the physician's experienced caseload. The percentage of project
referrals used to justify the proposed expansion cannot exceed the historical
percentage of applicant market share within a 24-month period after project
completion;
iii) Each referral
letter shall contain the physician's notarized signature, the typed or printed
name of the physician, the physician's office address and the physician's
specialty; and
iv) Verification by
the physician that the patient referrals have not been used to support another
pending or approved CON application for the subject services.
C) Projected Service Demand -
Based on Rapid Population Growth:
If a projected demand for service is based upon rapid
population growth in the applicant facility's existing market area (as
experienced annually within the latest 24-month period), the projected service
demand shall be determined as follows:
i) The applicant shall define the facility's
market area based upon historical patient origin data by zip code or census
tract;
ii) Population projections
shall be produced, using, as a base, the population census or estimate for the
most recent year, for county, incorporated place, township or community area,
by the U.S. Census Bureau or IDPH;
iii) Projections shall be for a maximum
period of 10 years from the date the application is submitted;
iv) Historical data used to calculate
projections shall be for a number of years no less than the number of years
projected;
v) Projections shall
contain documentation of population changes in terms of births, deaths and net
migration for a period of time equal to or in excess of the projection
horizon;
vi) Projections shall be
for total population and specified age groups for the applicant's market area,
as defined by HFSRB, for each category of service in the application;
and
vii) Documentation on
projection methodology, data sources, assumptions and special adjustments shall
be submitted to HFSRB.
5) Service Accessibility
The number of beds being established or added for each
category of service is necessary to improve access for planning area residents.
The applicant shall document the following:
A) Service Restrictions
The applicant shall document that at least one of the
following factors exists in the planning area:
i) The absence of the proposed service within
the planning area;
ii) Access
limitations due to payor status of patients, including, but not limited to,
individuals with health care coverage through Medicare, Medicaid, managed care
or charity care;
iii) Restrictive
admission policies of existing providers;
iv) The area population and existing care
system exhibit indicators of medical care problems, such as an average family
income level below the State average poverty level, high infant mortality, or
designation by the Secretary of Health and Human Services as a Health
Professional Shortage Area, a Medically Underserved Area, or a Medically
Underserved Population;
v) For
purposes of this subsection (b)(5) only, all services within the established
radii outlined in 77 Ill. Adm. Code
1100.510(d)
meet or exceed the utilization standard specified in 77 Ill. Adm. Code
1100.
B) Supporting
Documentation
The applicant shall provide the following documentation, as
applicable, concerning existing restrictions to service access:
i) The location and utilization of other
planning area service providers;
ii) Patient location information by zip
code;
iii) Independent time-travel
studies;
iv) A certification of
waiting times;
v) Scheduling or
admission restrictions that exist in area providers;
vi) An assessment of area population
characteristics that document that access problems exist; and
vii) Most recently published IDPH Hospital
Questionnaire.
