Postsurgical Recovery Care Center Alternative Health Care Model

Section 1100 Section 1100.750  Postsurgical Recovery Care Center Alternative Health Care Model a)         Planning Areas: 1)         The City of Chicago; 2)         Cook County outside the City of Chicago; 3)         Kane, Lake, and McHenry Counties; 4)         Municipalities with a population greater than 50,000 not located in the areas described in subsections (a)(1), (2), and (3) of this Section. Municipalities means geographic areas designated as Metropolitan Statistical Area by the Bureau of the Census; and 5)         Rural areas, i.e., all areas exclusive of subsections (a)(1), (2), (3), and (4) of this Section. b)         Age Groups: All ages c)         Development Restrictions: 1) No proposed postsurgical recovery care center alternative health care model shall be located in counties with populations greater than 600,000 but less than 1,000,000. (Section 30(a) of the Alternative Health Care Delivery Act [210 ILCS 3/30(a)]) 2) A proposed postsurgical recovery care center alternative health care model must be owned or operated by a hospital if it is to be located within, or will primarily serve the residents of, a health service area (see Section 1100.220 for definition of Health Service Area) in which more than 60% of the gross patient revenue of the hospitals within that health service area are derived from Medicare and Medicaid, according to the most recently available calendar year data from the Illinois Health Care Cost Containment Council. (Section 30(a) of the Alternative Health Care Delivery Act [210 ILCS 3/30(a)]) Health Service Areas which exceed this standard are Health Service Areas 5 and 11. 3)         Restrictions delineated above shall not preclude a hospital and an ambulatory surgical treatment center from forming a joint venture or developing a collaborative agreement to own or operate a postsurgical recovery care center. (Section 30(a) of the Alternative Health Care Delivery Act [210 ILCS 3/30a]) 4) No facility, or portion of a facility, may participate in a demonstration program as a postsurgical recovery care center unless the facility has been licensed as an ambulatory surgical treatment center or hospital for at least two years before August 20, 1993.  (Section 35 of the Alternative Health Care Delivery Act [210 ILCS 3/35]) d)         Bed Capacity: A postsurgical recovery care center shall be no larger than 20 beds. (Section 35 of the Alternative Health Care Delivery Act [210 ILCS 3/35]) Bed capacity within a postsurgical recovery care center shall be inventoried as a separate category of service. e)         Occupancy Targets: Beds should have an occupancy of 80% or higher. f)         Need Determination: There shall be no more than a total of twelve postsurgical recovery care center alternative health care models in the demonstration program, located as follows: 1) Two in the City of Chicago. 2) Two in Cook County outside the City of Chicago. At least one of these shall be owned or operated by a hospital devoted exclusively to caring for children. 3) Two in Kane, Lake and McHenry Counties . 4) Four in municipalities (as defined in subsection (a)(4)), three of which shall be owned or operated by hospitals, at least two of which shall be located in counties with a population of less than 175,000, according to the most recent decennial census for which data are available, and one of which shall be owned or operated by an ambulatory surgical treatment center. 5) Two in rural areas (as defined in subsection (a)(5)), both of which shall be owned or operated by hospitals. (Section 30(a-5) of the Alternative Health Care Delivery Act [210 ILCS 3/30(a-5)])