(a) Application forms.
All applications under sub. (2)
shall be submitted on forms prescribed by the department. A prospective applicant may obtain the forms from the department.
DHS 122.06 Note
Note: For copies of the application forms, contact the Resource Allocation Program, Division of Health Care Access and Accountability, P.O. Box 309, Madison, Wisconsin 53701.
Each application submitted under sub. (2)
shall be reviewed by the department for completeness. An application shall be deemed incomplete if the applicant:
Provides the information in a manner which is illegible or otherwise unusable by the department; or
Provides information which contradicts or is not justified by other materials in the application.
The department may request additional information from the applicant within 10 days following receipt of the application by the department.
The department shall declare the application complete on the date which the department receives all the required information.
DHS 122.06 Note
Upon written request, the department will provide technical assistance to any small business, as defined in s. 227.114 (1)
, Stats., or other small organization with fewer than 25 full-time employees or annual revenues of less than $2,500,000 regarding application materials and procedures. Requests should be sent to the Resource Allocation Program, Division of Health Care Access and Accountability, P.O. Box 309, Madison, Wisconsin 53701.
(a) Beds, centers and pilot projects.
The department shall publish in the ch. 150
newsletter of the office of management and policy and in a major daily newspaper in each affected planning area a list of all complete applications received under sub. (1)
, listing all applicants and describing their applications, within 20 days after the applications are declared complete. No person submitting an application may revise the cost or scope of the proposal after a notification of completeness has been made without the written consent of the department.
(b) Other applications.
The department shall publish in the ch. 150
newsletter of the office of management and policy and in a major daily newspaper in each affected planning area a list of all complete applications received under sub. (2)
on or before the 20th day of the month following the month in which it declares the applications complete.
(c) Beginning of review period.
The review period for applications shall begin on the publication date of the list under either par. (a)
Upon the request of any affected party, the department shall hold a public meeting within 60 days following publication of the list of complete applications submitted under sub. (1)
. This meeting shall be used to elicit testimony from affected parties about applications under review. The department shall maintain minutes or another record of the testimony. All requests for a public meeting shall be received by the department within 10 days after publication of the list of complete applications. The public meeting shall be held prior to the initial finding by the department.
The department shall review applications for their consistency with the criteria in s. DHS 122.07
and shall issue an initial finding to approve or reject an application within 75 days following publication of the complete applications list, unless an applicant asks for an extension or, in the case of competing applications, all applicants undergoing concurrent review agree to an extension or the review cycle is extended under sub. (8)
(b) Initial finding.
The department's initial finding shall be based upon a comparative analysis of all applications undergoing concurrent review using the criteria specified in s. DHS 122.07
The department may issue approvals during 1987 only to applicants who file applications by June 2, 1987.
The department may delay the effective dates of approval to permit a gradual phase-in of conversions.
The department may issue an approval authorizing the applicant to reconvert all or some of the FDD beds to non-FDD nursing home beds without subsequent review and approval under this chapter if the reconversion meets both of the following requirements:
The department receives at least 30 days notice of reconversion, if all beds to be reconverted are unoccupied, or a notice that the facility has complied with the requirements of s. 50.03 (14) (c)
, Stats., if any bed to be reconverted is occupied; and
The department may extend by 60 days the review cycle of all applications undergoing concurrent review under sub. (1)
, if it finds that completing reviews within the cycle specified in sub. (7)
is not feasible due to the volume of applications received from any planning area.
An adversely affected applicant or HSA may file a written request for a public hearing under s. DHS 122.08
within 10 days after the date of the department's initial finding under sub. (7)
. A hearing request is filed when it is received by the department. If no request for a hearing is made, or if a request is received after the 10-day limit, the department's initial finding shall be the department's final decision. Except as provided in par. (b)
, a timely request for hearing from an applicant undergoing concurrent review shall preclude issuance of an approval for a competing concurrent application until a final decision is issued by the secretary or a designee. Hearings shall be held in the manner prescribed in s. DHS 122.08
When an applicant for conversion to an FDD under s. DHS 122.02 (2) (a)
who has undergone concurrent review files a timely request for a hearing under s. DHS 122.08
on the initial finding, the department shall issue approvals for the competing concurrent applications that were initially approved but only for the number of beds that exceeds the number proposed by the applicant or applicants requesting a hearing. Approvals shall be issued in order beginning with the application which received the lowest score under s. DHS 122.07 (2) (am)
The project does not increase the bed capacity of or totally replace an existing nursing home and the project was developed pursuant to a department-approved plan of correction to remedy code-related physical plant deficiencies. Applications submitted to correct code violations shall provide evidence of the violations and approved plan of correction and shall not go beyond what is necessary to correct those deficiencies; or
The application concerns a cost overrun on a previously approved project.
(b) Timing of application.
An application under par. (a)
may be submitted at any time on forms prescribed by the department provided that at least 30 days notice has been given to the department of a person's intent to submit the application and the applicant has received written authorization from the department to submit the application.
(c) Review period.
Applications which are subject to this subsection shall be reviewed by the department within 60 days of receipt of a complete application.
The department shall have 5 working days to determine if the application is complete and, if incomplete, to issue a request for additional information to the applicant. An incomplete application is one in which:
The application contains information contradicted or unjustified by other materials in the application.
Applications that were originally declared incomplete shall be declared complete on the date of receipt of all additional information requested by the department.
No public meeting is required on any project submitted under this subsection.
(f) Department's initial finding.
The department shall issue its initial finding to approve or reject the application within 60 days following receipt of a complete application. The initial finding shall be based on the criteria specified in s. DHS 122.07
An adversely affected applicant shall have 10 days after the date of the initial finding to file a written request for a public hearing to challenge the initial finding on an application. Public hearings shall be held in the manner specified in s. DHS 122.08
. If no requests for a hearing are made or if they are received after the 10-day limit, the initial finding becomes the department's final action.
DHS 122.06 History
Cr. Register, March, 1985, No. 351
, eff. 4-1-85; emerg. cr. (1) (c), eff. 1-1-87; emerg. cr. (1) (c), am. (9), eff. 5-31-87; cr. (1) (c), (7) (c) and (9) (b), am. (7) (a), renum. (9) to be (9) (a) and am., Register, October, 1987, No. 382
, eff. 11-1-87; emerg. cr. (1) (d), eff. 10-1-88; emerg. cr. (1m) eff. 7-1-89; emerg. cr. (1r), eff. 9-21-90; am. (1) (a) 1. a. to d., (3), (4) (a), (b), (c) (intro.), (d) 1. intro., 2. and 5., (7) (a), (8), (9) (a), (10) (a) (intro.), (b) (d) 1. intro. and (10) (g), r. and recr. (2) and (10) (e), r. (6) (a) and (c), renum. (5) and (6) (b) to be (5) (a) and (6) and am., cr. (1) (c) 3. to 6., (4m), (5) (b) and (c), Register, January, 1991, No. 421
, eff. 2-1-91; emerg. cr. (1) (d), eff. 5-11-93; cr. (1) (d), Register, January, 1994, No. 457
, eff. 2-1-94; emerg. am. (2), (4) (a), (d) 1. (intro.) and 5., (5) (a), (6), cr. (3m), eff. 11-29-95; am. (2), (4) (a), (d) 1. (intro.), 5., (5) (a) and (6), cr. (3m), Register, May, 1996, No. 485
, eff. 6-1-96; corrections in (1) (d) (intro.) made under s. 13.92 (4) (b) 7.
, Stats., Register January 2009 No. 637
DHS 122.07 Review criteria and selection process. DHS 122.07(1)(1)
The department shall use the criteria set out in this subsection in its review of all applications for project approval. Cost containment shall be the first priority in applying these criteria. The department may not approve a project unless the applicant has demonstrated that:
The project is consistent with the state health plan and other long-term care support plans developed by the department.
Medical assistance funds appropriated are sufficient to reimburse the applicant for providing nursing home or FDD care.
The cost of renovating or replacing the facility or adding new beds is consistent with the cost of similar nursing home or FDD projects recently approved by the department and is reasonable based on independent analyses using industry-recognized cost-estimating techniques, and:
The proposed cost per bed for total facility replacement or for new facilities and beds does not exceed the following per bed cost expressed in the formula for nursing homes and FDDs, that C is less than or equal to 1.4 (S) (F).
“C" in this formula means maximum cost per bed using the capitalized project costs, including site improvements, buildings, fixed equipment, interest during construction and professional and financing fees, calculated to the midpoint of construction.
DHS 122.07 Note
Note: $31,000 is the statewide cost per bed for the base year 1983.
DHS 122.07 Note
Note: The department uses the inflation estimates published in Engineering News Record's Building Cost Index.
The proposed equivalent cost per bed for renovation and partial replacement projects does not exceed the per bed cost as expressed in the formulae for nursing homes and FDDs, that Ce is less than - See PDF for diagram
DHS 122.07 Note
Note: The maximum capital allowances calculated pursuant to par. (c) are not to be used by applicants as the expected cost of projects. Applicants are encouraged to seek less costly alternatives to the state maximums and all applications will have to meet all review criteria before undergoing the selection process in sub. (2).
The project represents the most cost-effective, reasonable and feasible alternative for renovation or replacement of a facility, for the addition of beds to a facility or for the construction of a new facility.
The applicant shall provide an analysis which clearly defines all other reasonable alternatives such as:
The analysis shall include an evaluation of the existing physical plant.
The analysis shall include a life-cycle cost analysis for each alternative studied, using forms provided by the department. In this subsection “life cycle" means the number of years for which alternatives are compared, and “life-cycle cost" means all relevant costs associated with a project during the project's defined life cycle.
DHS 122.07 Note
Note: Copies of the life-cycle cost analysis form are included in the application materials. They may be obtained from the Resource Allocation Program, Division of Health Care Access and Accountability, P.O. Box 309, Madison, Wisconsin 53701.
The department may independently develop its own alternatives to compare with those developed by the applicant.
A need for additional beds exists in the planning area in which the project would be located. No new beds may be approved in any planning area if their addition would exceed the planning area's adjusted allocation, calculated pursuant to s. DHS 122.05
The project is consistent with local plans for developing community-based long-term care services. These plans shall include those developed by local units of government.
Necessary health care personnel, and capital and operating funds for provision of the proposed nursing home services are available, as follows:
The project will meet minimum staffing and financial requirements developed by the department pursuant to ch. DHS 132
The facility will be located to assure reasonable access to nursing staff, emergency medical care, physician coverage, acute care services and ancillary services; and
Sufficient cash resources and cash flow exist to pay operating and initial start-up costs.
The project is financially feasible, capable of being undertaken within one year of approval and completed within a reasonable period of time beyond the one-year approval period, as evidenced by:
The applicant's demonstration of ability to secure adequate funds to finance the project. The applicant shall have adequate capacity to incur the debt associated with the project. Applicants shall have the ability to pay long-term debt through their present and future cash flow and profitability positions;
The availability of financing at average or below market rates for the class of home during the period of validity of the approval. Classes of homes are governmental, proprietary and nonprofit. Projects relying on sources of financing which historically take longer to process than the period of validity of an approval shall be rejected unless there is clear and definite proof supplied by the applicant that the funding source will be able to make adequate funds available within the period of validity of the approval; and
The reasonableness and attainability of the applicant's construction schedule.
Appropriate alternative methods for providing nursing home or FDD care are unavailable in the planning area. Alternative methods shall be deemed unavailable if the project is consistent with long-term care initiatives developed by the department.
The existing and proposed quality of care is satisfactory, as determined by:
The department's investigations. No approvals may be granted to any person who owns or operates a facility with one or more uncorrected class A or class B violations unless the project is specifically designed to remedy those violations, or to any person who owns or operates a facility against which a medical assistance or medicare decertification action is pending;
The department's review of materials submitted by the applicant, which may include an independent performance evaluation of an existing facility, an evaluation of other homes owned and operated by an applicant seeking approval for a new facility, and patient satisfaction surveys, where available;
Recommendations or comments from affected parties regarding the quality of care in facilities owned and operated by the applicant; and
For applications proposing replacement or relocation of beds, approval by the department of a plan for the placement or relocation of persons residing in those beds, based on the census of the FDD or other nursing home at the time of submission of the application.
The project is consistent with all applicable federal, state and local licensing, physical plant, zoning and environmental laws.
Applications for renovation proposals, replacement facilities and capital expenditures over $600,000 which do not affect bed capacity and which meet all criteria in sub. (1)
shall be approved unless the per diem rates proposed as a result of the project are inconsistent with those of similar FDD or other nursing home projects recently approved by the department.