TITLE 12. HEALTH
REGISTRAR’S NOTICE: The State Board of Health is claiming an exemption from Article 2 of the Administrative Process Act in accordance with § 2.2-4006 A 3, which excludes regulations that consist only of changes in style or form or corrections of technical errors. The State Board of Health will receive, consider and respond to petitions by any interested person at any time with respect to reconsideration or revision.
Title of Regulation: 12VAC5-230. State Medical Facilities Plan (amending 12VAC5-230-540, 12VAC5-230-550, 12VAC5-230-560).
Statutory Authority: § 32.1-102.2 of the Code of Virginia.
Effective Date: April 1, 2009.
Agency Contact: Carrie Eddy, Senior Policy Analyst, Department of Health, 9960 Mayland Drive, Suite 401, Henrico, VA 23233, telephone (804) 367-2157, or email carrie.eddy@vdh.virginia.gov.
Summary:
The amendments correct an error to the formula contained in 12VAC5-230-540, 12VAC5-230-550 and 12VAC5-230-560. The formula that became effective February 15, 2009, distorts the results of the inpatient beds needed in a planning district on a magnitude of 1,000 times. To illustrate the formula, the board used a planning district with a projected population of 160,000 and 120 inpatient beds. Using this formula, the planning district is calculated to need 126,449 beds, i.e., one bed for every 1.2 residents or 126,329 more beds than the 120 beds they currently have. However, using the corrected formula, a more realistic projection is achieved of one inpatient bed for every 1,270 residents or an additional six beds over the current 120-bed allocation. Therefore, the amendments correct the formula by striking the "x 1,000" contained in the formula.
12VAC5-230-540. Need for medical/surgical beds.
The number of medical/surgical beds projected to be needed in a health planning district shall be computed as follows:
1. Determine the use rate for the medical/surgical beds for the health planning district using the formula:
BUR = (IPD/PoP) x 1,000
Where:
BUR = the bed use rate for the health planning district.
IPD = the sum of total inpatient days in the health planning district for the most recent five years for which inpatient day data has been reported by VHI; and
PoP = the sum of total population 18 years of age and older in the health planning district for the same five years used to determine IPD as reported by a demographic program as determined by the commissioner.
2. Determine the total number of medical/surgical beds needed for the health planning district in five years from the current year using the formula:
ProBed = ((BUR x ProPop)/365)/0.80
Where:
ProBed = The projected number of medical/surgical beds needed in the health planning district for five years from the current year.
BUR = the bed use rate for the health planning district determined in subdivision 1 of this section.
ProPop = the projected population 18 years of age and older of the health planning district five years from the current year as reported by a demographic program as determined by the commissioner.
3. Determine the number of medical/surgical beds that are needed in the health planning district for the five planning horizon years as follows:
NewBed = ProBed – CurrentBed
Where:
NewBed = the number of new medical/surgical beds that can be established in a health planning district, if the number is positive. If NewBed is a negative number, no additional medical/surgical beds should be authorized for the health planning district.
ProBed = the projected number of medical/surgical beds needed in the health planning district for five years from the current year determined in subdivision 2 of this section.
CurrentBed = the current inventory of licensed and authorized medical/surgical beds in the health planning district.
12VAC5-230-550. Need for pediatric beds.
The number of pediatric beds projected to be needed in a health planning district shall be computed as follows:
1. Determine the use rate for pediatric beds for the health planning district using the formula:
PBUR = (PIPD/PedPop) x 1,000
Where:
PBUR = The pediatric bed use rate for the health planning district.
PIPD = The sum of total pediatric inpatient days in the health planning district for the most recent five years for which inpatient days data has been reported by VHI; and
PedPop = The sum of population under 18 years of age in the health planning district for the same five years used to determine PIPD as reported by a demographic program as determined by the commissioner.
2. Determine the total number of pediatric beds needed to the health planning district in five years from the current year using the formula:
ProPedBed = ((PBUR x ProPedPop)/365)/0.80
Where:
ProPedBed = The projected number of pediatric beds needed in the health planning district for five years from the current year.
PBUR = The pediatric bed use rate for the health planning district determined in subdivision 1 of this section.
ProPedPop = The projected population under 18 years of age of the health planning district five years from the current year as reported by a demographic program as determined by the commissioner.
3. Determine the number of pediatric beds needed within the health planning district for the fifth planning horizon year as follows:
NewPedBed – ProPedBed – CurrentPedBed
Where:
NewPedBed = the number of new pediatric beds that can be established in a health planning district, if the number is positive. If NewPedBed is a negative number, no additional pediatric beds should be authorized for the health planning district.
ProPedBed = the projected number of pediatric beds needed in the health planning district for five years from the current year determined in subdivision 2 of this section.
CurrentPedBed = the current inventory of licensed and authorized pediatric beds in the health planning district.
12VAC5-230-560. Need for intensive care beds.
The projected need for intensive care beds in a health planning district shall be computed as follows:
1. Determine the use rate for ICU beds for the health planning district using the formula:
ICUBUR = (ICUPD/Pop) x 1,000
Where:
ICUBUR = The ICU bed use rate for the health planning district.
ICUPD = The sum of total ICU inpatient days in the health planning district for the most recent five years for which inpatient day data has been reported by VHI; and
Pop = The sum of population 18 years of age or older for adults or under 18 for pediatric patients in the health planning district for the same five years used to determine ICUPD as reported by a demographic program as determined by the commissioner.
2. Determine the total number of ICU beds needed for the health planning district, including bed availability for unscheduled admissions, five years from the current year using the formula:
ProICUBed = ((ICUBUR x ProPop)/365)/0.65
Where:
ProICUBed = The projected number of ICU beds needed in the health planning district for five years from the current year;
ICUBUR = The ICU bed use rate for the health planning district as determine in subdivision 1 of this section;
ProPop = The projected population 18 years of age or older for adults or under 18 for pediatric patients of the health planning district five years from the current year as reported by a demographic program as determined by the commissioner.
3. Determine the number of ICU beds that may be established or relocated within the health planning district for the fifth planning horizon planning year as follows:
NewICUB = ProICUBed – CurrentICUBed
Where:
NewICUBed = The number of new ICU beds that can be established in a health planning district, if the number is positive. If NewICUBed is a negative number, no additional ICU beds should be authorized for the health planning district.
ProICUBed = The projected number of ICU beds needed in the health planning district for five years from the current year as determined in subdivision 2 of this section.
CurrentICUBed = The current inventory of licensed and authorized ICU beds in the health planning district.
VA.R. Doc. No. R09-1769; Filed February 10, 2009, 11:31 a.m.