RHCF Bed Need Methodology10 NYCRR Section 709.3

September 24, 2015

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Overestimates Bed Need

• 121,243 estimated for 2016

• 111,195 certified or in pipeline

• Occupancy 93.0% statewide

Disadvantages of Current Formula

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Source: HFIS

Occupancy Rates for Residential Health Care Facilities (RHCF) By Region, 2009‐2014

Region 2009 2010 2011 2012 2013 2014 % Change 2009 2014‐

1. Western New York (WNY) 94.8% 93.5% 92.7% 91.7% 92.9% 92.4% ‐2.5%

2. Finger Lakes (FL) 94.0% 93.3% 91.7% 96.2% 92.9% 93.9% ‐0.1%

3. Central New York (CNY) 94.8% 93.8% 94.4% 92.9% 92.3% 92.4% ‐2.6%

4. New York‐Penn (NY PENN)‐ 93.4% 94.0% 91.0% 92.2% 91.3% 93.3% ‐0.1%

5. Northeastern New York (NENY) 94.9% 93.6% 94.5% 94.0% 92.9% 92.3% ‐2.8%

6. Hudson Valley (HV) 91.7% 93.3% 92.9% 92.1% 91.2% 91.7% 0.0%

7. New York City (NYC) 94.9% 95.4% 94.8% 94.8% 93.5% 93.9% ‐1.1%

8. Nassau/Suffolk (N/S) 94.5% 94.0% 92.4% 92.8% 92.1% 91.5% ‐3.2%

New York State 94.3% 94.3% 93.6% 93.7% 92.6% 92.9% ‐1.5%

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Source: HFIS

Patients in Residential Health Care Facilities (RHCF) 2009 and 2014 Age Cohorts, by Region

Region 2009 2014 % Change (2009‐2014)<65 65‐74 75‐84 85+ <65 65‐74 75‐84 85+ <65 65‐74 75‐84 85+

1. Western New York (WNY) 9.1% 11.7% 29.1% 50.1% 9.7% 13.0% 26.3% 50.9% 6.6% 11.1% ‐9.6%

1.6%

2. Finger Lakes (FL) 9.3% 10.6% 28.9% 51.1% 10.2% 12.5% 26.8% 50.9% 9.7% 17.9% ‐7.3%

‐0.4%

3. Central New York (CNY) 9.4% 11.4% 29.9% 49.6% 9.3% 12.8% 26.7% 51.2% ‐1.1% 12.3% ‐10.7%

3.2%

4. New York Pen‐ n (NY‐PENN) 7.1% 10.4% 28.9% 53.6% 7.0% 13.4% 27.4% 52.5% ‐1.4% 28.8% ‐5.2%

‐2.1%

5. Northeastern New York (NENY) 6.9% 10.2% 30.1% 52.8% 7.2% 12.6% 24.8% 55.0% 4.3% 23.5% ‐17.6%

4.2%

6. Hudson Valley (HV) 11.3% 12.9% 28.5% 47.3% 10.7% 15.5% 26.7% 47.0% ‐5.3% 20.2% ‐6.3%

‐0.6%

7. New York City (NYC) 17.7% 17.6% 28.1% 36.6% 17.9% 19.6% 26.7% 35.4% 1.1% 11.4% ‐5.0%

‐3.3%

8. Nassau/Suffolk (N/S) 12.7% 12.0% 28.6% 46.7% 13.3% 14.7% 25.8% 47.2% 4.7% 22.5% ‐9.8%

1.1%

All New York State 12.9% 13.9% 28.7% 44.5% 13.2% 16.0% 26.4% 44.3% 2.5% 15.5% ‐8.0%

‐0.4%

Total Patient Population* (NYS) 106,014 99,245 ‐6.4%

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Statewide Decline in the Number of Nursing Home Residents

201499,245

Reduction6,759

2009 106,014

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Suitability of the 97% occupancy thresholdPlanning areas:

• County• Multi-County• NYC five boroughs• Long Island (Nassau-Suffolk)• Allow DSRIP arrangements – PPS service areas, etc.

Possible factors for consideration in the revision of Section 709.3 Nursing Home bed need methodology

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Short stays of <100 days

• Percentage of admissions

• Impact on occupancy rates.

Possible factors for consideration in the revision of Section 709.3 Nursing Home bed need methodology (continued)