Colorado § 25.5-6-209 - Establishment of nursing facility provider demonstration of need - criteria - rules.

§ 25.5-6-209. Establishment of nursing facility provider demonstration of need - criteria - rules.

(1) The state department, in making any medicaid certification determination, shall encourage an appropriate allocation of public health-care resources and the development of alternative or substitute methods of delivering health-care services so that adequate long-term care services are made reasonably available to every qualified member within the state at the appropriate level of care, at the lowest reasonable aggregate cost, and in the least restrictive setting. Medicaid certification determinations shall be made in accordance with Olmstead v. L.C., 527 U.S. 581 (1999).

(2) The state department shall develop, analyze, and enforce a demonstration of need to determine the viability of and required need for each new nursing facility provider seeking medicaid certification. The requirement does not apply to a nursing facility provider certified prior to June 30, 2021.

(3) In order to determine a valid demonstration of need, the state department shall, at a minimum, consider:

(a) State demography office data illustrating the present or impending need within the requesting nursing facility's geographic area;

(b) Quality and performance data of the requesting nursing facility or associated nursing facilities;

(c) Business continuity and solvency information of the requesting nursing facility or associated nursing facilities;

(d) Input from the department of public health and environment; the department of local affairs; the department of regulatory agencies; the department of labor and employment; and any local governments, including cities and counties; and

(e) Measurable innovative practices of the requesting nursing facility.

(4) No later than June 30, 2022, the state board shall promulgate rules pursuant to the "State Administrative Procedure Act", article 4 of title 24, addressing the establishment of criteria to be used in determining a nursing facility provider's medicaid certification. The state board shall publicly consider and gather input on the demonstration of need criteria prior to promulgating rules. The state department shall consider input from, at a minimum:

(a) Disability advocacy organizations;

(b) Urban nursing facility providers;

(c) Rural nursing facility providers;

(d) Aging and older adult advocacy organizations; and

(e) Nursing facility trade organizations.

Source: L. 2021: Entire section added, (HB 21-1227), ch. 192, p. 1014, § 1, effective September 7. L. 2024: (1) amended, (SB 24-176), ch. 152, p. 665, § 78, effective August 7.