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“Long-Term (Acute) Care Hospitals” Follow-up Meeting

James R.Thompson Center Conference Room 039, 9 th Floor 160 West Randolph Street Chicago, Illinois Teleconference: Illinois Department of Public Health 2nd Floor Conference Room 525 West. Jefferson Street Springfield, Illinois . Open Meeting on Rules Redevelopment

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“Long-Term (Acute) Care Hospitals” Follow-up Meeting

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  1. James R.Thompson Center Conference Room 039, 9th Floor 160 West Randolph Street Chicago, Illinois Teleconference: Illinois Department of Public Health 2nd Floor Conference Room 525 West. Jefferson StreetSpringfield, Illinois Open Meeting on Rules Redevelopment Illinois Health Facilities Planning Board April 23, 2007 “Long-Term (Acute) Care Hospitals” Follow-up Meeting Illinois Health Facilities Planning Board

  2. Rules Process • Open Meetings/Public Participation-Input • Draft Rules Reviewed and Approved by Board • Submission to JCAR • Publication in the Illinois Register • Formal Public Hearings and Comment Period • Reconsideration by the Board • Consideration and approval by JCAR Illinois Health Facilities Planning Board

  3. Meeting Protocols • Comments/Discussion Limited to Current Topic • All Interested Parties Invited to Participate • Written Comments Requested • Time Limitations - As Required • Check with website http://www.idph.state.il.us/about/hfpb/hfpbrules.htm Illinois Health Facilities Planning Board

  4. Statutory Authority • Health Facilities Planning Act - 2004: • Purpose of the Act • Establish a procedure designed to reverse the trends of increasing costs of health care resulting from unnecessary construction or modification of health care facilities. • Improve the financial ability of the public to obtain necessary health services. • Establish an orderly and comprehensive health care delivery system which will guarantee the availability of quality health care to the general public. • The Procedure • Requires a person establishing, constructing or modifying a health care facility to have the qualifications, background, character and financial resources to adequately provide a proper service for the community, • Promotes orderly and economic development of health care facilities that avoids unnecessary duplication of such services. • Promotes planning for and the development of health care facilities needed for comprehensive health care, especially in areas where the health planning process has identified needs. • Carries out these purposes in coordination with the Agency and the comprehensive State health plan developed by that Agency. Illinois Health Facilities Planning Board

  5. Meeting Objectives • Review characteristics and utilization statistics of Long-Term (Acute) Care Hospitals in Illinois. • Discuss working draft of proposed LTCH rules. • Definition • Planning Policies • Category of Service Review • The discussion will be limited to the topic identified. Illinois Health Facilities Planning Board

  6. LTCHs in Illinois (Beds by Category of Service) Illinois Health Facilities Planning Board • Regency Hospital Rockford received permit September 12, 2006. • Kindred Hospital Springfield received permit August 4, 2005. • Holy Family received permit to discontinue OB November 1, 2005. • (4) Advocate Bethany received permit to discontinue OB and AMI September 12, 2006.

  7. Hospital Discharges (by DRG) to LTCH Illinois Health Facilities Planning Board

  8. Hospital Discharges (by DRG) to LTCH Illinois Health Facilities Planning Board

  9. Hospital Discharges (by DRG) to LTCH Notes: Kindred North has 48 AMI beds; therefore, a high volume of cases ( DRG 430 Pyschoses) are discharged to this LTCH . Total Illinois Cases – all hospitals in Illinois with the exclusion of LTCH facilities. Utilization statistics for Kindred-Lakeshore were not included. This facility is a sub-acute care facility and is considered a remote facility of Kindred-Central. Source: Illinois Discharge Dataset Illinois Health Facilities Planning Board

  10. LTCH 2005 Utilization Illinois Health Facilities Planning Board Note: Kindred Lakeshore is considered a subacute facility; therefore, utilization information is not available. Source: Illinois Discharge Dataset (Calendar Year 2005)

  11. CMS Proposed Rule for LTCHs 2008 • Extension of the threshold to freestanding LTCHs proposed. • LTCHs cannot accept more than 25% of its patients from a single hospital. • 50% threshold for rural hospitals. • Propose LTCH PPS Federal rate be updated by 0.71 percent to $38,356 for Medicare discharges. • Changes to short-stay outliers and high-cost outlier threshold. Illinois Health Facilities Planning Board

  12. LTCH Definition - Draft • “Long-Term (Acute) Care Hospital” means a category of service provided in a Medicare-certified acute care hospital with an average Medicare length of inpatient stay greater than 25 days that is primarily engaged in providing long-term medical care to patients who are clinically complex and may suffer multiple acute or chronic conditions. Services typically include respiratory therapy, head trauma treatment, and pain management. Illinois Health Facilities Planning Board

  13. LTCH Planning Policies - Draft • Planning Areas • HSA 1 • HSAs 2 and 10 • HSAs 3 and 4 • HSAs 5 and 11 • HSAs 6, 7, 8 and 9  Illinois Health Facilities Planning Board

  14. LTCH Planning Policies - Draft Illinois Health Facilities Planning Board

  15. LTCH Planning Policies - Draft • Accessibility • One hour travel time • Occupancy Target • 85% • Need Determination • Minimum Use Rate – 60% of State • Experienced Use Rate – Base Year • Apply Minimum or Experienced, whichever is higher • Population projections Illinois Health Facilities Planning Board

  16. LTCH Planning Policies - Draft • Authorized Bed Capacity No Long-Term (Acute) Care Hospital category of service shall be established without approval by the HFPB. Beds in long-term (acute) care hospitals certified by CMS, shall be reclassified by the HFPB in its inventory. Illinois Health Facilities Planning Board

  17. LTCH Category of Service Review - Draft • Facility Size • An applicant must document that the project will result in a facility capacity of at least 50 Long-Term (Acute) Care beds. • Continuity of Care • An applicant proposing to establish a Long-Term (Acute) Care Hospital category of service shall provide a signed, written transfer agreement with an acute care hospital. Documentation shall consist of copies of all such agreements. • Conversion of Existing Acute Care Beds • Address Section 1110.130 for discontinuation of categories of service. • Identify modifications in scope of services or elimination of clinical service areas, not covered in Section 1110.130 (e.g. Emergency Department classification, Surgical Services, Outpatient Services, etc.). • Document that changes in clinical service areas will not have an adverse impact upon the health care delivery system. Illinois Health Facilities Planning Board

  18. LTCH Category of Service Review - Draft • Assurances • Achieve occupancy target by second year of operation; • Certify intent to be Medicare-classified as a long-term (acute) care hospital within twelve (12) months from the date of project completion; and • Certify that the proposed facility will meet all requirements of the Illinois Hospital Licensing Act. Illinois Health Facilities Planning Board

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