JEFFERSON CITY, Mo. – The Certificate of Need (CON) Rules subcommittee voted on Tuesday to make two proposals to the the Missouri Health Facilities Review Committee. The subcommittee will be giving the proposals to the Committee during the CON Meeting on September 11.
The first recommendation agreed by the subcommittee was that the Missouri Health Facilities Review Committee would establish a minimum occupancy requirement of 75% for long term care beds, within a 15 mile radius, for the previous four quarters before accepting any applications for expansion. Currently, the Missouri Health Facilities Review Committee can accept applications without a minimum occupancy requirement. The proposal was made by Missouri Health Facilities Review Committee member Derek Hunter and was agreed upon unanimously.
The second recommendation, which was also proposed by Hunter, is that when the Missouri Health Facilities Review Committee would estimate their ratios of need for nursing homes, they calculate their estimate in relation to certain age cohorts. Currently, the Missouri Health Facilities Review Committee estimates that 53 persons per 1,000 over the age of 65 would need a nursing home bed. The proposal would estimate ratios of need based on people ages 0-64, 65-74, 75-84, and 85 and older.
Hunter based his proposition based on nationwide statistics that he’s seen finding that 54% of occupants in retirement community facilities and assisted living facilities are over the age of 85. He feels that if the Missouri Health Facilities Review Committee would allow these facilities to provide cost-efficient care to Missourians. “Right now our assumption is that we just use one [ratio] for 65+, which is not as accurate if we break it down by age cohort,” Hunter said following the meeting.
Throughout the meeting, Hunter was worried that health facilities are looking to expand without any need for it. Fellow Missouri Health Facilities Review Committee member Senator Mike Cunningham asked Hunter, “do you think there are too many beds out there now?”
“I do. I think that if the statewide occupancy [of licensed and available beds] are in the low 70 [percents, there isn’t a need for facilities to expand],” Hunter responded.
Before considering the proposal, Missouri Health Facilities Review Committee member Bill Krodinger was hesitant to accept the validity of some of their data. Some of the data used by the Missouri Health Facilities Review Committee is self reported and certain facilities could skew the data in their favor to mislead the Review Committee. “There’s really no checks and balance on how people send us [information],” he cautioned. It is important for the Missouri Health Facilities Review Committee to make their decisions based on accurate reliable data, so they did not consider using more volatile evaluations like star rating or waiting lists.
The committee was considering amending their radius of need in rural and urban areas, but failed to agree on what exactly constituted an urban versus a rural area. The committee also considered changing their radius based on miles as the crow flies to estimates of how long someone has to drive, but ultimately felt it was not as objective as the Rules subcommittee would have liked.
The Missouri Health Facilities Review Committee only meets 6 times a year to review applications from health facilities that would require around a $1 million. On the Review Committee are five citizens and four state congress people appointed by the governor. Representatives Kip Kendrick and Jack Bondon are on the committee joined by Senators Mike Cunningham and Shalonn Kiki Curls. The Honorable Judith Grace O’Connor and the Honorable Marsha Campbell are joined by Dr. Marty Vollmar, William Krodinger, and Derek Hunter. The Missouri Health Facilities Review Committee will meet on September 11th in Jefferson City to review more than 11 applications from health facilities around Missouri.
Michael Layer is a reporter for the Missouri Times and the Missouri Times Magazine. He joined the Missouri Times in August 2017 after graduating from Goucher College the previous May. To contact Michael, email michael@themissouritimes.com or follow him on Twitter @_MichaelLayer
