SD36 - Study on Continuing Care Retirement Communities Pursuant to SB 1139 of 1997

Executive Summary:

Senate Bill 1139 was introduced to the 1997 General Assembly in reaction to the magnitude of a proposed continuing care retirement community (CCRC) in Northern Virginia, known as Greenspring Village. The filing requested a 240 nursing bed unit; in the previous ten years, the largest number of nursing beds under a single certificate of public need (COPN) for a CCRC had been 60. Thus, Senate Bill 1139 was introduced.

Senate Bill (SB) 1139, approved by the 1997 Session of the General Assembly, placed into statute the following action in order to prevent the potential approval of the Greenspring Village project as initially requested:

"Notwithstanding the provisions of 32.1-102.3:2.1, the Commissioner shall only approve, authorize or accept applications for the issuance of certificate of public need filled for continuing care retirement community nursing home bed projects by continuing care providers registered with the State Corporation Commission pursuant to Chapter 49 (38.2-4900 et seq.) of Title 38.2 for sixty or fewer beds."

As a matter of compromise between the primary stakeholders, the bill further directed the Joint Commission on Health Care, in conjunction with the Commissioner of Health or his designee and the Commissioner of Insurance or his designee, to study the management of applications for nursing facility projects in CCRC's under the Commonwealth's Medical Facilities COPN law and regulations.

Specifically, the bill has directed the Joint Commission on Health Care to study the following five (5) issues as they relate to nursing home beds associated with continuing care retirement communities:

• whether to include or exempt CCRC projects from the Request for Application (RFA) process established pursuant to 32.1-102.3:2;

• the different forms of CCRC contracts being offered in Virginia and the effect of such contracts on the utilization of nursing facility beds in CCRCs;

• the impact of increase in nursing facility beds in CCRCs, if any, on the occupancy rates and charges of existing nursing homes and certified nursing facilities in the Commonwealth;

• the impact, if any, of nursing facility beds in CCRCs on Virginia Medicaid expenditures; and

• the appropriateness of the present registration law, Chapter 49 (38.2-4900 et seq.) of Title 38.2, for CCRC providers and the need for any modifications to such law, particularly in view of the changing configurations in the continuing care market.

As an effort to obtain additional data upon which to base the study's findings, a mail survey was administered subsequent to the original draft of the staff study report to 178 nursing facilities in all planning districts which contain at least one CCRC and the Commonwealth's 35 CCRCs which have associated nursing facilities. A total of 47 nursing home surveys were returned in time to be included in the analysis, a response rate of 26%. Fourteen of the fifteen CCRC surveys that were returned and included in the analysis were useable, providing a response rate of 40%. The overall findings from the survey analysis further support the study Results of the analysis is located in Appendix B.