1. (1) In evaluating need in the service area, the Oregon Health Authority shall consider indicators such as:
   (a) Documented hospital discharge delays due to insufficient nursing facility placement;
   (b) Travel distance and travel‑time burdens to the nearest appropriate facility;
   (c) Limited or unavailable specialized services (such as ventilator care, bariatric care, complex behavioral health);
   (d) Local workforce constraints that limit the number of set‑up beds relative to licensed capacity; or

   1. (e) Hospital readmissions.
2. (2) Population forecasting must be evidence‑based and must distinguish short‑stay and long‑stay utilization.
   (3) Forecasts must incorporate:
   (a) Anticipated hospital discharge volumes;
   (b) Statewide clinical and demographic trends;
   (c) Patterns of Home and Community Based Service (HCBS) utilization; and
   (d) Projected growth in the population age 65 and over, while recognizing that age is no longer a primary predictor of nursing facility use.
3. (4) Need determinations must reflect Oregon’s statutory preference for supporting individuals in the least restrictive setting.
4. (5) Increased utilization of Home and Community Based Services does not, by itself, demonstrate reduced need for nursing facility beds if post‑acute or specialized nursing facility capacity remains insufficient.

5. (6) Rural areas with limited facilities, or counties with no facilities, are permitted to propose an alternate service area. The Oregon Health Authority shall consider the following exception criteria. Factors include:

   1. (a) Hospital referral patterns;
   2. (b) Travel‑time access;
   3. (c) Clinical service availability; and
   4. (d) Other factors consistent with statewide health planning.
6. (7) All analyses must rely on the best available data. Applicants and the Oregon Health Authority may use hospital discharge data, Medicaid claims, cost reports, Minimum Data Set data, set‑up bed inventories, Home and Community Based Services utilization data, and population forecasts from Portland State University or other approved sources.

Statutory/Other Authority

ORS 431.120 & 442.315

Statutes/Other Implemented

ORS 431.120 & 442.315

History

PH 27-2026, temporary amend filed 06/25/2026, effective 06/25/2026 through 12/21/2026
HD 13-1994, f. & cert. ef. 4-22-94