REGULATORY ANALYSIS
For
Standards for Hospitals and Health Facilities
6 CCR 1011-1
Amendments to Chapter XIX – Hospital Units
Pertaining to License Processing and Health Oversight Fees
and
Amendments to Multiple Chapters
(Chapter IV – General Hospitals, Chapter X – Rehabilitation Centers,
Chapter XIV – Maternity Hospitals, and Chapter XVIII - Psychiatric Hospitals)
Technical Change Pertaining to Determining the Conditional License Fee
Adopted by the State Board of Health on
October 15, 2008
1.
A description of the classes of persons who will be affected by the proposed rule,
including classes that will bear the costs of the proposed rule and classes that will
benefit from the proposed rule.
The technical change to the multiple chapters regarding how conditional licenses will be
determined is for clarification purposes only and is not anticipated to have any impact on
health care facilities.
The cost of the rule changes to Chapter XIX – Hospital Units will be borne by the three
existing hospital units, which will be assessed the fees and the Department which will be
responsible for monitoring health safety standards. The rule is designed to benefit the
facilities’ patients by allowing for oversight of the quality of service delivery.
2.
To the extent practicable, a description of the probable quantitative and qualitative
impact of the proposed rule, economic or otherwise, upon affected classes of
persons.
Health safety standards are an important component of ensuring access to quality care.
These fees will allow the Department to monitor and require compliance with such
standards.
3.
The probable costs to the agency and to any other agency of the implementation and
enforcement of the proposed rule and any anticipated effect on state revenues.
The Department’s licensure program is cash funded, which means that regulatory
oversight costs must be paid for through fees.
4.
A comparison of the probable costs and benefits of the proposed rule to the
probable costs and benefits of inaction.
1
Action is being taken to comply with state law. Inaction would prevent the Department
from collecting licensure fees and conducting routine licensing activities, including initial
licensure/certification and the conducting of complaint investigations.
5.
A determination of whether there are less costly methods or less intrusive methods
for achieving the purpose of the proposed rule.
The Department was directed by House Bill 07 1221 to set fees to cover the costs of
administering the health facility licensure program. No less costly or less intrusive
methods for achieving the purpose of the proposed rule were found.
6.
A description of any alternative methods for achieving the purpose of the proposed
rule that were seriously considered by the agency and the reasons why they were
rejected in favor of the proposed rule.
No alternative methods of achieving the purpose of the proposed rule were found.
7.
To the extent practicable, a quantification of the data used in the analysis; the
analysis must take into account both short-term and long-term consequences.
The technical change to the multiple chapters regarding how conditional licenses will be
determined is not anticipated to have any short- or long-term consequences.
The fees for hospital units were developed by 1) determining the overall cost of
conducting regulatory functions, and 2) establishing a base fee to cover a proportion of
fixed costs as well as a bed fee to scale for facility size. The proposed fees are shown in
the table below. (The current license processing and health care oversight fees assessed
of hospital units is $360.)
Initial License
Fee
Base: $5,300
Per Bed: $50
Cap: $10,500
Sample Fee
Range
5 bed facility = $5,550
10 bed facility = $5,800
15 bed facility = $6,050
20 bed facility = $6,300
25 bed facility = $6,550
Renewal License
Base: $1,600
Per Bed: $12
Change of
Ownership
(CHOW)
$2,500
Provisional
License
$2,500
Conditional
License
10-25% of the
renewal fee (rate
depends on the
level of Department
monitoring
required)
Cap: $3,000
5 bed facility = $1,660
10 bed facility = $1,720
15 bed facility = $1,780
20 bed facility = $1,840
25 bed facility = $1,900
2
N/A
(flat fee)
N/A
(flat fee)
$160 to $500
The proposed fees are in line with the license processing and health oversight fees
established for general acute hospitals and focused service hospitals (i.e., psychiatric,
rehabilitation, and maternity hospitals). A comparison of the initial and renewal fees for
hospital units and the other hospital types is provided below.
Initial fees. The initial fees for general hospitals range from $8,000 for a facility of 25
beds or less to $20,000 for a 200-bed facility.1 The initial fees for focused service
hospitals range from $5,950 for a 5-bed facility to $6,590 for a 25-bed facility. As such,
the initial fees for hospital units are somewhat less than the fees for focused service
hospitals.
Renewal fees. As proposed, the renewal fee for hospital units is the same as the renewal
fees for general and focused service hospitals. This is because the renewal fees do not
incorporate the cost of renewal onsite surveys at this time. It is anticipated that when the
costs of such surveys are incorporated, the Department will adopt a more scaled fee
schedule across the facility types.
1
This range is based, in part, on the capacity and willingness of larger general hospitals to subsidize some of the
costs for smaller general hospitals, which are often rural.
3