(b)

1. (1) The objective of this methodology is to ensure that an adequate supply of hospice beds are available and accessible while avoiding the proliferation of unneeded hospice facilities in the service area.
2. (2) The service area is the county.

(c)

1. (1) Application requirements are based on federal guidelines including Section 1861 of the Social Security Act of 1935 that states that a hospice:

   1. (A) Must provide all levels of hospice care; and
   2. (B) Cannot choose to only operate an inpatient facility.
2. (2) It must offer all levels of care including general inpatient, routine, respite, and continuous care.
3. (3) The only eligible applicants for a hospice facility are those agencies that have operated a licensed hospice agency for at least one (1) year prior to seeking application for a hospice facility.

(d) Bed need.

1. (1) The calculations to determine the number of patients eligible for hospice services are the same as those found in 20 CAR § 255-402(b)(1).
2. (2) The formula to determine the need for hospice beds is based on the federal allowance of twenty percent (20%) inpatient days and the Arkansas average of five and six-tenths percent (5.6%) in-patient days (five and two-tenths percent (5.2%) general inpatient and five-tenths percent (0.5%) respite).
3. (3) The Arkansas average is rounded to six percent (6%).
4. (4) The mean of six percent (6%) and twenty percent (20%) is thirteen percent (13%).
5. (5) This mean, thirteen percent (13%), is multiplied times the number of projected hospice patients in the county to determine the county need for hospice beds.
6. (6) Applicants can apply for a minimum of four (4) beds and a maximum of thirty-six (36) beds.

7. (7) Applicants who have a facility and who propose to expand:

   1. (A) Cannot expand to greater than the maximum number of beds per county (see Bed Need Book Appendix A); and
   2. (B) Cannot exceed thirty-six (36) beds.
8. (8) Hospice need is projected five (5) years in the future as of July 1 of each calendar year.

9. (9) The number of projected hospice patient deaths will be computed from the most recent:

   1. (A) Crude death available from the Center for Health Statistics, Department of Health; and
   2. (B) Available population estimates obtainable from the United States Census Bureau.

(e) Requirements. Applicants are required to provide a business plan including the following:

1. (1) Documentation of financial support to provide cost efficient hospice care as measured by industry standards the National Hospice and Palliative Care Organization or the Hospice Association of America;
2. (2) A street address and city for the proposed facility in the county in which the applicant is applying for a permit; and
3. (3) Agreement to provide timely and accurate reporting data to the Health Services Permit Agency as requested.

(f) Hospice facility emergency rule.

1. (1) Hospice facilities can expand current licensed bed capacity to meet the needs of hospice patients who are displaced as a result of a declared emergency in Arkansas or in a border state.

2. (2) In this circumstance, hospice facilities may temporarily expand without a permit of approval if the following conditions are met:

   1. (A) Life safety will not be jeopardized for any individual;
   2. (B) The immediate needs of residents and other individuals sheltered at the facility can be met by the facility;
   3. (C)

(i) The facility maintains a log of the additional persons being housed in the facility.

1. (ii) The log shall include the individual's name, usual address, and the dates of arrival and departure;

   1. (D) The admissions and discharge log shall be deidentified and a monthly report provided to the Health Service Permit Agency;
   2. (E) The hospice facility complies with all reporting requirements of state and federal rules and regulations; and
   3. (F) Any hospice facility that temporarily expands its capacity pursuant to this subpart must revert to its permit of approval capacity at the end of the one hundred twenty-day period.