1. (a) An application for a permit of approval under 20 CAR § 255-501 et seq., Nursing Facility Bed Methodology will be denied if it:

   1. (1)

      1. (A) Does not agree to eliminate all three (3) or more bed units in the applicant facility.
      2. (B) A facility may have three (3) or more beds units only in order to comply with specific rules for intensive care, Alzheimer’s disease, and/or subacute care units (pertinent rules to be promulgated by the Department of Human Services, Office of Long-Term Care);
   2. (2) Is for an applicant home with current life threatening compliance issues that could not be corrected by the proposed construction;

   3. (3)

      1. (A) Is for any nursing home found to have had an H level deficiency or higher by the office in the twelve (12) months preceding the date the application is placed under review or from the date the application is placed under review until the final decision of the Health Services Permit Commission.
      2. (B) This section is intended to prohibit the expansion of existing facilities with a history of serious noncompliance.
      3. (C) This section, however, shall not apply to applicants under 20 CAR § 255-504 who are replacing older facilities, or who are correcting the noted deficiency;
   4. (4) Will cause a facility to exceed one hundred forty (140) beds;
   5. (5) Will create a facility with fewer than seventy (70) beds;

   6. (6)

      1. (A) Would create an under-served area.
      2. (B) The commission will make this determination; or

   7. (7)

      1. (A) Is located in a county where the number of approved but unlicensed beds, including beds in transition, equals ten percent (10%) or more of the county’s licensed beds in the previous state fiscal year, e.g., if in 1997 County “A” had one hundred forty (140) licensed beds with a twenty-eight-bed approval then the facilities in County “A” would not be eligible for additional beds under either the population-based or utilization-based methodology.
      2. (B) The rationale is that an increase in beds would have affected occupancy.
2. (b) An application for a POA will be denied if the owner/operator, or the majority of its controlling individuals, applying for a permit of approval has abandoned one (1) or more long-term facilities either in Arkansas or in another state.

3. (c)

   1. (1) The Health Services Permit Agency may consider an applicant’s compliance and enforcement history in determining whether to grant a permit of approval.
   2. (2) Occupancy data on Medicaid-certified facilities will be based on the report supplied by the Department of Human Services, Division of Medical Services to the agency.
   3. (3) Occupancy data on facilities that did not report to the office will be based on the survey conducted by the agency.
   4. (4) Non-reporting facilities include facilities without Medicaid beds and those facilities which changed ownership during the previous calendar year.

Codification Notes: "POA" means permit of approval.