(b) Need.

1. (1) The projected number of hospice patients will be thirty percent (30%) of the average of the total deaths that occurred in the county for the four (4) most recent years available as calculated by the National Center for Health Statistics.

2. (2)

   1. (A) Numeric need for a new hospice is demonstrated if the projected number of patients eligible for hospice per calendar year is thirty-five (35) or greater in the proposed service area (or expanded area).
   2. (B) The projections for the proposed area would have to indicate a need for thirty-five (35) or more after the deaths for the existing hospices for the previous four (4) quarters have been subtracted out from the total projected hospice patients.
   3. (C) The service area is the county.

(c) Requirements. Applicants are required to provide a business plan including:

1. (1) Documentation of financial support to provide cost efficient hospice care as measured by industry standards and published by the National Hospice and Palliative Care Organization or the National Association of Home Care and Hospice;

2. (2)

   1. (A) A potential office location in the county in which the applicant is applying for a permit, or documentation that research into a location for an office has been done, with the amount of rent reflected in the budget.
   2. (B) An exception exists if an applicant has a hospice office in a contiguous county.
   3. (C) In this case, the existing hospice office can serve as the address for the new application;
3. (3) A plan to educate physicians, hospital discharge planners, and other appropriate health and social service providers about the need for timely referral of potential hospice patients; and
4. (4) Agreement to provide timely and accurate reporting data to the Health Services Permit Agency as requested.

(d)

1. (1) Regardless of numeric need, no new hospice agency will be approved unless hospice death data from the last eight (8) quarters for each hospice agency servicing the proposed service area has been available for publishing by the Health Permit Services Agency.
2. (2) This provision does not prohibit approval where a new license was granted to an agency that purchased a hospice agency that had been serving the area for more than two (2) years.

(e) Unfavorable review.

1. (1) The Health Services Permit Agency may consider an applicant’s in-state and out-of-state compliance and enforcement history in determining whether to grant a permit of approval.
2. (2) No hospice application will be approved if the applicant has had any condition level deficiencies in the previous thirty-six (36) months as determined by the applicable state survey agency unless the state survey agency has documented that the deficiency was corrected at least twelve (12) months prior to the application submission.