Section 122.04. Statewide bed limit.

 

(1)   Department recommendation.

(a) Nursing homes exclusive of FDDs. The department shall biennially update and submit to the legislature statewide recommended bed limits for nursing homes exclusive of FDDs, taking into account programs the purpose of which is to reduce institutionalization of persons in long-term care facility settings. In developing the recommendation for a new statewide bed limit, the department shall add the following numbers for nursing homes exclusive of FDDs:

1. The number of beds licensed under subch. I of ch. 50 , Stats., exclusive of beds in FDDs;

2. The number of new beds approved under s. 150.29 , Stats.; and

3. An allotment for new beds which shall be derived by dividing medical assistance reimbursement funds available for new beds as proposed in the following biennial budget by an estimated medical assistance allowable skilled care per diem rate. The resulting patient days shall be divided by the most recent available 3-year average percentage ratio of medical assistance residents to total residents. The patient days shall then be divided by the number of days in the year. This figure is the new allotment. Separate allotments shall be developed for nursing homes exclusive of FDDs. The new bed allotment shall be the maximum number of new nursing home beds exclusive of FDDs which may be approved during the biennium for which the new bed limit is approved by the legislature.

(b) Facilities for the developmentally disabled.

1. The department shall biennially update and submit to the legislature statewide recommended bed limits for FDD beds, taking into account programs whose purpose is to reduce institutionalization of developmentally disabled persons. The new statewide bed limit for FDDs shall be established in the same manner as for nursing homes under par. (a) except that the new bed allotment for FDDs may not exceed the number of beds determined to be needed under s. DHS 122.05 (2) (a) and (b) .

2.

a. Except as provided in subd. 2. b. , the department shall limit approvals for conversions to FDDs under s. DHS 122.02 (2) (a) and (c) to a total of 1,600 beds statewide by December 31, 1989, no more than 1,000 of which may be approved by December 31, 1987.

b. Notwithstanding the bed limit under subd. 2. a. , the department may in addition approve the total conversion of a facility to an FDD if the conversion would be the result of relocating developmentally disabled residents from 2 or more facilities operated by one county, the new FDD will serve only residents who are developmentally disabled and the department determines that there is a compelling need for the conversion.

(2)   Interim adjustments by the department. Interim adjustments to the statewide bed limit may be made by the department for:

(a) Conversion of community-based residential facilities. The department shall adjust the total statewide bed limit, on a bed-for-bed basis, for each community-based residential facility currently certified as a medical assistance provider which obtains nursing home or FDD licensure in order to retain medical assistance certification. The effect of the adjustment may be to increase the statewide bed limit. If the number of licensed and approved nursing home beds is less than the statewide bed limit, the department shall count the CBRF beds under this paragraph toward the originally established statewide bed limit;

(b) Code violations. The department may decrease the statewide bed limit, on a bed-for-bed basis, to account for nursing home or FDD beds which are licensed but which are not set up or staffed due to life-safety or physical plant code violations. The department shall determine whether the situation is likely to be corrected within the forthcoming biennium. If the beds are not likely to be reopened within the forthcoming biennium, the department shall reduce the statewide bed limit by the number of beds currently out of circulation due to code violations;

(c) Medical assistance waivers. The department shall decrease the statewide bed limit, on a bed-for-bed basis, to account for nursing home or FDD beds closed under the medical assistance waiver specified in 42 USC 1396n (c) or under other medical assistance waivers specified in 42 USC 1396 to 1396n ; and

(d) Wisconsin center reductions. The department shall decrease, on a bed-for-bed basis, the statewide bed limit for FDDs by each bed removed at the Wisconsin centers for the developmentally disabled as a result of the department's community integration program under s. 46.275 , Stats.

(e) Other allowable bed reduction criteria.

1. The department may decrease the statewide bed limit, on a bed-for-bed basis, to account for beds made available by the reduction of licensed beds not included in pars. (b) to (d) . The department may decrease the statewide bed limit under this paragraph only if:

a. The county in which the beds were located had more than 125% of the statewide average number of nursing home beds per 1,000 persons 65 years of age or older, as determined under subd. 2. , prior to the reduction in that county; and

b. No decrease under this paragraph may result in the county in which the bed reduction occurred having fewer than the statewide average number of nursing home beds per 1,000 persons 65 years of age or older.

2. The statewide average number of nursing home beds per 1,000 persons 65 years of age or older in subd. 1. is calculated by dividing the total current number of licensed nursing home beds exclusive of FDD beds in the state, as reported by the department's bureau of quality compliance, by the total current estimated population of persons 65 years of age or older, as determined by the Wisconsin department of administration, and multiplying that result by 1,000.

(f) Conversion of nursing homes and FDDs. The department shall adjust the statewide bed limits to account for the partial or total conversion of nursing homes to facilities primarily serving the developmentally disabled or of facilities primarily serving the developmentally disabled to nursing homes that have received approval under this chapter.

(3)   Publication of adjustments. The department shall publish any adjustments to the statewide bed limit in the ch. 150 newsletter of the department's office of management and policy and in a newspaper of general circulation. This publication shall occur by the 20th day of the month following the adjustment date.

History: Cr. Register, March, 1985, No. 351 , eff. 4-1-85; emerg. cr. (1) (b) 2., eff. 1-1-87; cr. (2) (e), Register, January, 1987, No. 373 , eff. 2-1-87; emerg. cr. (1) (b) 2., eff. 5-31-87; cr. (1) (b) 2., Register, October, 1987, No. 382 , eff. 11-1-87; r. (1) (a) 2., renum. (1) (a) 3. and 4. to be 2. and 3. and am. 3., cr. (2) (f), am. (3), Register, January, 1991, No. 421 , eff. 2-1-91; emerg. renum. (2) (d) to be (2) (d) 1. and am., cr. (2) (d) 2., eff. 9-27-91.