When a hospital proposes to utilize a given number of its licensed hospital acute beds intermittently as skilled nursing facility swing beds under applicable federal regulations, the hospital is expected to submit a letter of intent to the Oregon Health Authority. The organized and regular provision of skilled nursing facility services within the licensed physical plant of the hospital may be subject to review as a new long-term care facility under OAR 333-550-0010(3)(a). In addition:

1. (1) The proposal will not be subject to county-specific nursing facility bed need criteria under OAR 333-610-0000 to 333-610-0030 because it will not create permanent new nursing facility beds. The Oregon Health Authority, in reviewing the proposal for need under OAR 333-580-0040 and for alternative uses of resources under OAR 333-580-0050, will take into consideration such factors as:

   1. (a) Health policy of the state, as reflected in ORS 410.010, 410.020, 410.030, 410.050 and 410.065; and ORS 442.310
   2. (b) Interpretation of that policy, as reflected in the plans and administrative rules of the Oregon Health Authority and the Oregon Department of Human Services. In considering strategies for increasing the accessibility of nursing facility beds, priority will be given to increasing the utilization of appropriate alternative care (thereby freeing up existing nursing facility beds), rather than increasing the number of nursing facility beds;
   3. (c) Comparative experience with, and quality of, long-term care provided by staff in licensed acute care hospitals and in licensed long-term care facilities.

2. (2) The Oregon Health Authority, in reviewing the proposal for financial feasibility under OAR 333-580-0060, will take into consideration such factors as:

   1. (a) Estimated projection of Medicare utilization
   2. (b) Estimated potential for diversion of public and private funds now available for alternative care into facility-based long-term care when the patient needs involved could be met, at equal or lesser cost, through provision of alternative care;
   3. (c) Balanced against section (3) of this rule, estimated potential for diversion of public and private funds now available for acute care into facility-based and alternative long-term care;
   4. (d) Comparative costs of long-term care provided in licensed hospitals and in licensed long-term care facilities, and the feasibility of the hospitals contracting for skilled care in an existing long-term care facility at equal or lesser cost; and
   5. (e) Potential that the proposal will or will not increase Medicare costs.

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
OHD 11-1998, f. & cert. ef. 10-22-98
HD 13-1994, f. & cert. ef. 4-22-94