General Long-Term Nursing Care Category of Service

Section 1125.210  General Long-Term Nursing Care Category of Service a)         Planning Areas The 95 general long-term nursing care planning areas are located within the 11 Health Services Areas (HSAs). 1)         HSA 1:  Planning areas are Boone, Carroll, DeKalb, Jo Daviess, Lee, Ogle, Stephenson, Whiteside and Winnebago Counties. 2)         HSA 2:  Planning areas are Bureau/Putnam, Henderson/Warren, Marshall/Stark, Fulton, Knox, LaSalle, McDonough, Peoria, Tazewell and Woodford Counties. 3)         HSA 3:  Planning areas are Brown/Schuyler, Calhoun/Pike, Morgan/Scott, Adams, Cass, Christian, Greene, Hancock, Jersey, Logan, Macoupin, Mason, Menard, Montgomery and Sangamon Counties. 4)         HSA 4:  Planning areas are Coles/Cumberland, Champaign, Clark, DeWitt, Douglas, Edgar, Ford, Iroquois, Livingston, McLean, Macon, Moultrie, Piatt, Shelby and Vermilion Counties. 5)         HSA 5:  Planning areas are Alexander/Pulaski, Edwards/Wabash, Gallatin/Hamilton/Saline, Johnson/Massac, Hardin/Pope, Bond, Clay, Crawford, Effingham, Fayette, Franklin, Jackson, Jasper, Jefferson, Lawrence, Marion, Perry, Randolph, Richland, Union, Washington, Wayne, White and Williamson Counties. 6)         HSA 6:  Planning Areas A)        6A:  City of Chicago Community Areas Rogers Park, West Ridge, Uptown, Lincoln Square, Edgewater, Edison Park, Norwood Park, Jefferson Park, Forest Glen, North Park, Albany Park, Portage Park, Irving Park and Avondale. B)        6B:  City of Chicago Community Areas North Center, Lakeview, Lincoln Park, Near North Side, Loop, Logan Square, West Town, Near West Side, Lower West Side, West Garfield Park, East Garfield Park, North Lawndale, South Lawndale, O'Hare, Dunning, Montclare, Belmont Cragin, Hermosa, Humboldt Park and Austin. C)        6C:  City of Chicago Community Areas Near North Side, Armour Square, Douglas, Oakland, Fuller Park, Grand Boulevard, Kenwood, Washington Park, Hyde Park, Woodlawn, South Shore, Chatham, Avalon Park, South Chicago, Burnside, Calumet Heights, Roseland, Pullman, South Deering, East Side, West Pullman, Riverdale, Hegewisch, Garfield Ridge, Archer Heights, Brighton Park, McKinley Park, Bridgeport, New City, West Elson, Gage Park, Clearing, West Lawn, Chicago Lawn, West Englewood, Englewood, Greater Grand Crossing, Ashburn, Auburn Gresham, Beverly, Washington Heights, Mount Greenwood and Morgan Park. 7)         HSA 7:  Planning Areas A)        7A:  Cook County Townships of Barrington, Palatine, Wheeling, Hanover, Schaumburg and Elk Grove. B)        7B:  Cook County Townships of Northfield, New Trier, Evanston, Niles and Maine. C)        7C:  DuPage County. D)        7D:  Cook County Townships of Norwood Park, Leyden, Proviso, River Forest, Oak Park, Riverside, Berwyn and Cicero. E)        7E:  Cook County Townships of Lyons, Lemont, Palos, Orland, Stickney, Worth, Calumet, Bremen, Thornton, Rich and Bloom. 8)         HSA 8: Planning areas are Kane, Lake and McHenry Counties. 9)         HSA 9:  Planning areas are Grundy, Kankakee, Kendall and Will Counties. 10)         HSA 10:  Planning areas are Henry, Mercer and Rock Island Counties. 11)         HSA 11:  Planning areas are Clinton, Madison, Monroe and St. Clair Counties. b)         Age Groups For general long-term nursing care, age groups of 0-64, 65-74, and 75 and over. c)         Utilization Target Facilities providing a general long-term nursing care service should operate those beds at a minimum annual average occupancy of 90% or higher. d)         Bed Capacity General long-term nursing care bed capacity is the licensed capacity for facilities subject to the Nursing Home Care Act and the total number of LTC beds for a facility as determined in the HFSRB Inventory for facilities not subject to the Nursing Home Care Act. e)         Need Determination The following methodology is utilized to determine the projected number of nursing care beds needed in a planning area: 1)         Establish minimum and maximum planning area use rates for the 0-64, the 65-74, and the 75 and over age groups as follows: A)        Divide the HSA's base year experienced nursing care patient days for each age group by the base year population estimate for each age group to determine the HSA experienced use rate for each age group; B)        the minimum planning area use rate for each age group is 60% of the HSA experienced use rate for each age group, and the maximum planning area use rate for each age group is 160% of the HSA experienced use rate for each age group; 2)         Divide the planning area's base year experienced nursing care patient days for each age group by the base year population estimate for each group to determine the planning area experienced use rate for each age group; 3)         Determine the planning area's population projection, which is 5 years from the base year; the use rate for each age group is as follows: A)        If the experienced use rate for an age group is below the minimum use rate, the minimum use rate is the projected use rate for that age group; B)        If the experienced use rate for an age group is above the maximum use rate, the maximum use rate is the projected use rate for that age group; C)        If the experienced use rate for an age group is above the minimum use rate and below the maximum use rate, the experienced use rate for the age group is the projected use rate for that age group; 4)         Multiply each age group's projected use rate times the projected population for the age group to determine the projected patient days for each age group; 5)         Total the projected patient days for the age groups to determine the planning area's total projected patient days; 6)         Divide the planning area's total projected patient days by the number of days in the projected year to obtain the projected average daily census; 7)         Divide the projected average daily census by .90 (90% occupancy factor) to obtain the projected planning area bed need; 8)         Subtract the number of existing beds in the planning area from the projected planning area bed need to determine the projected number of excess (surplus) beds or the projected need for additional (deficit) beds in an area.