Agencies | Governor
Virginia Regulatory Town Hall
Agency
Virginia Department of Health
Board
State Board of Health

General Notice
Notice of No Need for Certificate of Public Need Applications for Development of Additional Nursing Home Beds
Date Posted: 3/3/2020
Expiration Date: 4/13/2020
Submitted to Registrar for publication: YES
14 Day Comment Forum Will begin on 3/30/2020 and will end at midnight on 4/13/2020

THE STATE BOARD OF HEALTH and THE VIRGINIA DEPARTMENT OF MEDICAL ASSISTANCE SERVICES

Legal Notice of Request for Certificate of Public Need Applications

Pursuant to the requirements of § 32.1-102.3:2 of the Code of Virginia of 1950, as amended, notice is hereby given of consideration of the need to issue a Request for Applications (RFA) for the development of additional nursing home beds in Virginia. This notice reviews the qualification of Virginia's twenty-two health planning districts for the authorization of additional nursing home beds pursuant to applicable law and regulation (12VAC5-230-610).

Evaluation of Need for Additional Nursing Home Beds

The "Nursing Home Services" component of the Virginia State Medical Facilities Plan (SMFP) (12VAC5-230-10 et seq.) contains a nursing home bed-need forecasting method (12VAC5-230-610). This method has been employed by the Virginia Department of Health (VDH) to compute a forecast of needed nursing home beds in 2022 in each of Virginia’s twenty-two health planning districts. For conduct of the certificate of public need program, VDH continues to recognize the former Planning District 20, Southeastern Virginia, and the former Planning District 21, Peninsula, rather than the current combined Planning District 23, Hampton Roads.

Consistent with the SMFP (12VAC5-230-610(A)), a health planning district is considered to have a need for additional nursing home beds when: (1) the median annual occupancy of all existing non-federal, Medicaid-certified nursing homes in the planning district was at least 93%; and (2) the average annual occupancy of all existing non-federal, Medicaid-certified nursing homes in the planning district was at least 90% for the most recent year for which bed utilization has been reported to VDH (through nursing home filings with Virginia Health Information, Inc.). The Veterans Care Centers are excluded by regulation from consideration in the determination of nursing home bed need. For purposes of this notice, 2017 is the most recent year of nursing home utilization data reported to Virginia Health Information.

Also, no health planning district will be considered to have a need for additional nursing home beds if there are uncompleted nursing home beds that were authorized for the health planning district within the last three years and that will be Medicaid-certified beds. The following table displays, by health planning district, the nursing home gross bed need forecast for 2022, the current licensed bed inventory plus authorized additions of nursing home beds, and the net bed need forecast for 2022.

The table also shows the average annual percent occupancy and the median annual percent occupancy of Medicaid-certified nursing homes in each health planning district for the 2017 reporting year. The final column of the table states whether the health planning district qualifies for additional nursing home beds for the 2022 planning horizon year, and it identifies any health planning district with uncompleted nursing home beds that are expected to be Medicaid-certified, when this determines the health planning district’s qualification for an RFA.

Nursing Home Bed Need Forecast and
Whether a Health Planning District Qualifies for Additional Nursing Home Beds
for the 2022 Planning Year

Planning District

Gross Bed Need Forecast for 2022 Existing plus Authorized Beds

Projected Net Bed Need in 2022

( ) = surplus

Median Occupancy of Medicaid NFs 2017

Average Occupancy of Medicaid NFs 2017 Plan. District Qualifies for Additional NH Beds
1 560 641 (81) 92.1% 90.8% No - no need
2 490 509 (19) 86.5% 84.2% No - no need
3 1,335 1,519 (184) 88.4% 89.7% No - no need
4 772 773 (1) 88.7% 85.1% No - no need
5 2,051 2,275 (224) 90.7% 87.6% No - no need
6 1,588 1,504 84 92.8% 91.5% No - low occu.
7 1,024 1,003 21* 92.6% 89.2% No - no need
8 4,799 4,515 284 87.8% 84.5% No - low occu.
9 790 766 24* 90.6% 88.6% No - no need
10 1,115 1,064 51 90.0% 89.6% No - low occu.
11 1,457 1,560 (103) 86.8% 85.1% No - no need
12 1,881 1,929 (48) 89.4% 87.4% No - no need
13 815 841 (26) 92.3% 85.1% No - no need
14 567 662 (95) 89.7% 86.1% No - no need
15 4,182 4,096 86 90.7% 87.6% No - low occu.
16 900 875 25* 86.6% 79.5% No - no need
17 252 268 (16) 83.8% 76.3% No - no need
18 529 550 (21) 91.4% 88.8% No - no need
19 943 1,055 (112) 87.0% 82.0% No - no need
20 4,210 4,330 (120) 87.5% 86.0% No - no need
21 1,838 1,828 10* 88.9% 87.5% No - no need
22 292 281 11* 73.9% 77.7% No - no need

*Per 12VAC5-230-610(C), a projected net bed need of 1-29 beds rounds to zero.

Sources: Virginia State Medical Facilities Plan (12VAC5-230-610); University of Virginia Weldon Cooper Center for Public Service (population projections, 2019 edition); 2014 Virginia Nursing Home Patient-Origin Survey, VDH Office of Licensure and Certification (for age-specific nursing home use rates); VDH Office of Licensure and Certification (for bed inventory).

Conclusion

The RFA for nursing home beds issued in 2019 is hereby issued as a notice that no need exists for additional nursing home beds. As shown in the preceding table, no health planning district is identified by the standards of the SMFP as having a forecasted need for nursing home beds by 2022. No health planning district in Virginia currently meets the four-part test for qualification by:

1) Having a positive formula-generated need projection, and;

2) Having a median annual occupancy percentage of Medicaid-certified nursing homes for the most recent reporting year of 93% or higher, and;

3) Having an average annual occupancy percentage of Medicaid-certified nursing homes for the most recent reporting year of 90% or higher, and;

4) Having no uncompleted nursing home beds authorized within the last three years that will be Medicaid-certified.

Any person objecting to this notice may notify the State Health Commissioner and the State Board of Health within fourteen days of publication of this notice in The Virginia Register of Regulations. Any objections received will be considered and replied to before a final notice is published.


Contact Information
Name / Title: Rebekah E. Allen  / Sr. Policy Analyst
Address: Virginia Department of Health
9960 Mayland Drive, Ste. 401
Richmond, 23233
Email Address: regulatorycomment@vdh.virginia.gov
Telephone: (804)367-2157    FAX: (804)527-4502    TDD: ()-