DHS 122.04 History
History: Cr.
Register, March, 1985, No. 351, eff. 4-1-85; emerg. cr. (1) (b) 2., eff. 1-1-87; cr. (2) (e),
Register, January, 1987, No. 373, eff. 2-1-87; emerg. cr. (1) (b) 2., eff. 5-31-87; cr. (1) (b) 2.,
Register, October, 1987, No. 382, eff. 11-1-87; r. (1) (a) 2., renum. (1) (a) 3. and 4. to be 2. and 3. and am. 3., cr. (2) (f), am. (3),
Register, January, 1991, No. 421, eff. 2-1-91; emerg. renum. (2) (d) to be (2) (d) 1. and am., cr. (2) (d) 2., eff. 9-27-91.
DHS 122.05(1)(a)
(a) Distribution of the statewide allotment of new beds. In distributing among planning areas new nursing home beds exclusive of FDD beds from the allotment under s.
DHS 122.04 (1) (a) 3., the department shall proceed as follows:
DHS 122.05(1)(a)1.
1. Calculate for each planning area the population growth for the age cohorts under 65, 65 to 74, 75 to 84 and over 84 years of age for a 3-year period beginning in the calendar year for which the most current data on utilization of nursing homes are available;
DHS 122.05(1)(a)2.
2. Divide each planning area's population growth for each age cohort by the state growth in population for each cohort for those years to obtain the percentage that a planning area's growth represents of the total state growth by cohort;
DHS 122.05(1)(a)3.
3. Ascertain the statewide nursing home utilization percentage for each of the age cohorts in subd.
1. and multiply these by the new bed allotment for nursing homes exclusive of FDDs calculated pursuant to s.
DHS 122.04 (1) (a) 3. to get the statewide allotment for each age cohort;
DHS 122.05(1)(a)4.
4. Multiply the statewide allotment for each age cohort by each planning area's percentage of state growth for its respective cohort calculated under subd.
2.;
DHS 122.05(1)(a)5.
5. Add the 4 age cohort allotments for each planning area to determine the unadjusted new bed allotment for each planning area for nursing homes exclusive of FDDs;
DHS 122.05(1)(a)6.
6. Adjust downward the allotment for each planning area that has more beds per 1,000 residents age 65 and over than there are beds per 1,000 residents age 65 and over statewide by multiplying the unadjusted allotment for the planning area by the ratio of the number of existing and approved beds per 1,000 residents age 65 and over statewide to the number of existing and approved beds per 1,000 residents age 65 and over in the planning area as calculated from county level data, and subtracting the result from the unadjusted allotment. The result shall be the maximum new bed allotment for that planning area; and
DHS 122.05(1)(a)7.
7. Increase the unadjusted allotment for the remaining planning areas proportionately so that the total new bed allotments for all planning areas equal the total statewide new bed allotment calculated pursuant to s.
DHS 122.04 (1) (a) 3. The result shall be the maximum new bed allotments for these planning areas.
DHS 122.05(1)(b)1.1. The department shall distribute new nursing home beds exclusive of FDD beds within a planning area by:
DHS 122.05(1)(b)1.a.
a. Calculating the age-specific statewide use rates for long-term care services by adding the total statewide number of persons being served under a medical assistance waiver, exclusive of persons relocated from a state center for the developmentally disabled under s.
46.275, Stats., and the total statewide number of persons utilizing nursing homes, exclusive of FDDs, for each of the age groups under 21, 21 to 54, 55 to 64, 65 to 74, 75 to 84 and 85+, and dividing the resulting sum for each age group by the current total statewide population for that age group. Utilization data shall be for December 31 of the most recent year for which data is available;
DHS 122.05(1)(b)1.b.
b. Determining the age-specific expected county use of long-term care services by multiplying each age-specific statewide use rate by the actual current population for each age group in each county as estimated by the Wisconsin department of administration;
DHS 122.05(1)(b)1.c.
c. Determining each county's total expected use of long-term care services by summing the age-specific calculations in subd.
1. b. for each county;
DHS 122.05(1)(b)1.d.
d. Determining the actual countywide use of long-term care services by adding the total number of residents of the county reported in the department's annual survey of nursing homes as residing in nursing homes, exclusive of FDD's, on December 31 of the recent survey year, and the number of persons being served under a medical assistance waiver, exclusive of persons relocated from a state center for the developmentally disabled under s.
46.275, Stats., in the same year in that county; and
DHS 122.05(1)(b)1.e.
e. Determining the ratio of actual use to expected use by dividing the result of the calculation in subd.
1. d. by the result of the calculation in subd.
1. c. DHS 122.05(1)(b)2.
2. Only applicants whose projects would be located in counties which meet both of the following conditions are eligible to compete for new beds:
DHS 122.05(1)(b)2.b.
b. The countywide occupancy rate as reported in the most recently available annual survey of nursing homes is greater than 94%. The countywide occupancy rate is calculated by dividing the sum of all patient days for all nursing homes exclusive of FDDs in a county, as reported in the annual survey of nursing homes, by the number of days in the calendar year and then dividing that result by the total current number of licensed nursing home beds in that county, exclusive of FDDs, as reported by the department's bureau of quality compliance.
DHS 122.05(1)(b)3.a.a. The department shall review the methodology under subds.
1. and
2. every 3 years in consultation with the area agencies on aging, the county social service or human service departments and representatives of the nursing home industry.
DHS 122.05(1)(b)3.b.
b. The department shall annually update data necessary to establish a priority list of counties for the purpose of allocating beds. The department may revise the priority list between annual updates to reflect changes in bed capacity resulting from approvals under this chapter, reductions in the capacity of existing nursing homes, facility closures, or relocations of beds or facilities within a planning area.
DHS 122.05(1)(c)1.1. The department may distribute nursing home beds, exclusive of FDD beds, made available in the state as a result of facility closure or bed capacity reductions which were not closed under a medical assistance waiver, as specified in
42 CFR 1396n, and which were not replaced by CBRF beds converting to nursing home licensure. Except as provided in s.
150.40, Stats., applications to replace or redistribute closed beds may be submitted only from counties which are eligible to compete for new beds under par.
(b).
DHS 122.05(1)(c)2.
2. Except as provided in s.
150.40, Stats., the department shall redistribute beds under this paragraph to the planning area in which they were originally located.
DHS 122.05(1)(c)3.
3. The statewide average of nursing home beds for each 1,000 persons 65 years of age or over referred to in s.
150.40, Stats., is calculated by dividing the total current number of licensed nursing home beds, exclusive of FDD beds, in the state, as reported by the department's bureau of quality compliance, by the total current estimated population of persons 65 years of age and older, as determined by the Wisconsin department of administration, and multiplying that result by 1,000.
DHS 122.05(1)(c)4.
4. The department may not approve more beds for redistribution within a planning area, or within a county if s.
150.40, Stats., is applicable, than were made available as a result of facility closure or bed reduction in that planning area or county.
DHS 122.05(2)(a)
(a) The department shall not approve the addition of new beds to a state center for the developmentally disabled or other FDD licensed under subch.
I of ch. 50, Stats., unless the beds are needed to serve persons who cannot adequately be served in an existing FDD, another nursing home or in a less costly or less restrictive setting. Need for the beds shall be determined by the department through an objective analysis of the developmentally disabled population in the planning area.
DHS 122.05(2)(b)
(b) The number of new beds allocated to the centers and other FDDs in an FDD planning area shall not exceed the number of persons requiring FDD care as determined under par.
(a) for that planning area.
DHS 122.05 History
History: Cr.
Register, March, 1985, No. 351, eff. 4-1-85; emerg. cr. (2) (c), eff. 1-1-87; r. and recr. (1) (b) and (c),
Register, January, 1987, No. 373, eff. 2-1-87; emerg. cr. (2) (c), eff. 5-31-87; cr. (2) (c),
Register, October, 1987, No. 382, eff. 11-1-87; am. (1) (a) (intro.), 3. and 7., (b) 2. intro. and (2) (a), r. (1) (b) 3., renum. (1) (b) 4. to be 3. and am.,
Register, January, 1991, No. 421, eff. 2-1-91.
DHS 122.06(1)(a)1.1. After amendment of the statewide bed limit by the legislature, the department shall accept applications to fill the allotments for new beds, if any, for each planning area. Allotments shall be determined in the manner described in s.
DHS 122.05. Application shall be made according to the following schedule:
DHS 122.06(1)(a)2.
2. The department shall request applications for new beds once from each planning area during the first half of each biennium. If the number of new beds approved for an area is less than the planning area's adjusted allotment, a second request for applications may be made during the second half of the biennium according to the schedule in par.
(a).
DHS 122.06(1)(b)
(b) Replacement beds. The department shall annually accept applications to replace beds in a planning area which have been de-licensed but which were not closed under a medical assistance waiver or which were not replaced by CBRF beds which converted to nursing home licensure in order to retain medical assistance certification. Application shall be made according to the schedule in par.
(a).
DHS 122.06(1)(c)1.
1. Applications that meet all applicable review criteria but do not receive approval due to bed limits imposed under s.
DHS 122.04 (1) (b) 2. a. shall be automatically accepted for review under any subsequent request for applications without additional application fee unless the application has been substantially modified.
DHS 122.06(1)(c)2.
2. The department shall request applications at least once between January 1, 1988 and December 31, 1989.
DHS 122.06(1)(c)3.
3. Upon application to the department, the department may approve the operation of a distinct part of a nursing home as an FDD for a period of time not to exceed 4 years. Renewal of an approval initially granted under this subsection may be granted for a period of time not to exceed 4 years and only if all of the following conditions are met by the applicant:
DHS 122.06(1)(c)3.b.
b. There is continued need, as determined by the department, for the FDD in the health planning area in which the facility is located; and
DHS 122.06(1)(c)3.c.
c. Community-based services, including services developed under s.
46.278, Stats., are inappropriate for the individuals served in the FDD.
DHS 122.06(1)(c)4.
4. The department may require that a nursing home seeking approval or an FDD seeking renewal under subd.
3. agree to reduce the size of the FDD under a plan submitted by the facility and approved by the department, during the approval or renewal period, in order to reflect reduced service need or increased availability of community-based long-term care services.
DHS 122.06(1)(c)6.
6. Notwithstanding s.
150.29, Stats., if initial approval of an FDD is not renewed under subd.
3. or if approval or renewal is conditioned upon the requirement of subd.
4., reconversion of these beds to nursing home beds does not require approval under s.
DHS 122.04.
DHS 122.06(1)(d)1.
1. An application may be submitted only in response to a request by the department for applications.
DHS 122.06(1)(d)2.
2. The department may accept an application only if the proposed converted facility is presently located or will be located in a county designated in accordance with s.
DHS 122.05 (1) (b) 2. or s.
150.40, Stats., and that county is located within the same health planning area in which the facility is presently located.
DHS 122.06(2)
(2) Other applications. Any person intending to engage in activities subject to this subchapter that are not specified under sub.
(1),
(3) or
(3m) shall notify the department in writing of this intent at least 30 days prior to submitting an application for review. An application expires unless the department declares the application complete within 365 days after the date the department receives notice of the applicant's intent to engage in the activity.
DHS 122.06(3)
(3) Centers. After a change in the statewide bed limit, the department shall solicit applications from the state centers for the developmentally disabled to increase bed capacity. The schedule for submitting applications shall be determined by the department.
DHS 122.06(3m)
(3m) Pilot projects. The department may at any time solicit applications from nursing homes which seek to demonstrate new nursing home designs. The schedule for submitting applications shall be determined by the department.
DHS 122.06(4)
(4) Process for applications for beds, applications from centers and applications for pilot projects. DHS 122.06(4)(a)
(a) Notice requesting applications. A notice requesting applications for beds under sub.
(1), applications from centers under sub.
(3) and applications for pilot projects under sub.
(3m) shall be published in a major daily newspaper in each affected planning area on the first and second working days of the month during which requests are to be made. The notice shall state the deadline by which all applications are to be received.
DHS 122.06(4)(b)
(b) Application forms. All applications shall be submitted on forms prescribed by the department. A prospective applicant may obtain the forms from the department.
DHS 122.06 Note
Note: For copies of application forms, contact: Resource Allocation Program, Division of Health Care Access and Accountability, P.O. Box 309, Madison, Wisconsin 53701.
DHS 122.06(4)(c)
(c) Period for accepting applications. The department shall accept applications submitted within 60 days following publication of the request for applications. The department shall return any application which:
DHS 122.06(4)(c)1.
1. Proposes to add new beds in a planning area, county or service area for which a request for applications was not made;
DHS 122.06(4)(c)3.
3. Was submitted more than 60 days after the request for applications was published; or
DHS 122.06(4)(d)1.1. Each application submitted under sub.
(1),
(3) or
(3m) shall be reviewed by the department for completeness. An application shall be deemed incomplete if the applicant:
DHS 122.06(4)(d)1.b.
b. Provides the information in a manner which is illegible or otherwise unusable by the department; or
DHS 122.06(4)(d)1.c.
c. Provides information which contradicts or is not justified by other materials in the application.
DHS 122.06(4)(d)2.
2. The department may request additional information from the applicant within 10 working days following receipt of the application by the department.
DHS 122.06(4)(d)3.
3. The applicant shall provide the required additional information within 30 days following the closing date for accepting applications.
DHS 122.06(4)(d)4.
4. The department shall return all applications for which additional information has not been received by the deadline established in subd.
3. DHS 122.06(4)(d)5.
5. Except as provided in subd.
4., the department shall declare all applications under subs.
(1),
(3) and
(3m) complete 60 days after the date of publication of the request for applications, or 90 days from that date if an application under sub.
(1),
(3) or
(3m), including any application under sub.
(1) or
(3m) undergoing concurrent review, was originally declared incomplete and the additional information requested by the department was received within 30 days following the closing date for accepting applications.
DHS 122.06 Note
Note: Upon written request, the department will provide technical assistance to any small business, as defined in s.
227.114 (1), Stats., or other small organization with fewer than 25 full-time employees or annual revenues of less than $2,500,000 regarding application materials and procedures. Requests should be sent to the Resource Allocation Program, Division of Health Care Access and Accountability, P.O. Box 309, Madison, Wisconsin 53701.
DHS 122.06(4m)(a)(a) Application forms. All applications under sub.
(2) shall be submitted on forms prescribed by the department. A prospective applicant may obtain the forms from the department.
DHS 122.06 Note
Note: For copies of the application forms, contact the Resource Allocation Program, Division of Health Care Access and Accountability, P.O. Box 309, Madison, Wisconsin 53701.
DHS 122.06(4m)(b)1.1. Each application submitted under sub.
(2) shall be reviewed by the department for completeness. An application shall be deemed incomplete if the applicant:
DHS 122.06(4m)(b)1.b.
b. Provides the information in a manner which is illegible or otherwise unusable by the department; or
DHS 122.06(4m)(b)1.c.
c. Provides information which contradicts or is not justified by other materials in the application.
DHS 122.06(4m)(b)2.
2. The department may request additional information from the applicant within 10 days following receipt of the application by the department.
DHS 122.06(4m)(b)3.
3. The department shall declare the application complete on the date which the department receives all the required information.
