Updates To Need Determinations Show A General Decrease In Need For Health Care Facilities And Services In Illinois

by Polsinelli

On August 15, 2013, the Illinois Health Facilities and Services Review Board ("the Board") released updated inventories and need determinations for health service areas across the State. The new need determinations reveal a general overall decrease in calculated need for health facilities and services compared to the June 27, 2013 facility updates. This decrease is due to a combination of factors. The 2011 need determinations, upon which the monthly updates are based, utilized projected 2008 census data that overstated the State's population by 1.2 million. Such an overstatement in population combined with relatively flat utilization rates contributed to the significant decrease in need. Further, due to a 2012 amendment to the Illinois Health Facilities Planning Act, the 2013 need projections are based on five-year population projections, instead of ten-year projections as was the case for calculating the 2011 base need determinations.

The Board determines inventory numbers and calculates base need determinations for hospital, long-term care, and other health service categories utilizing State population projections and use rates for each service category. The Board adjusts the inventory monthly to reflect changes for approved projects and increases and decreases to facility capacity not requiring Board approval.

Highlights of the changes to the need determinations include:

  • Long-Term Care Facilities experienced the most dramatic decrease in need. For general long-term nursing care, the need decreased overall from 7,866 beds to 970 beds. For ICF/DD facilities, the need decreased from 2,394 beds to 2,055 beds.
  • Hospitals experienced decreasing need across most service lines. Beds needed decreased from 318 to 53 for medical-surgical and pediatrics, from 239 to 126 for intensive care, and from 163 to 79 for obstetrics/gynecology. (Hospital bed need essentially remained the same for acute mental illness, rehabilitation, and long-term acute care beds.)
  • In-Center Hemodialysis is the only service category with an increase in projected need. Due to an increase in utilization, the need for end stage renal disease dialysis stations increased from 62 to 188. However, all of the State's need is in the City of Chicago, DuPage County, and Suburban Cook County.

What Providers Should Know

  • For providers looking to open facilities and/or increase capacity in existing facilities beyond the amount permitted under the 10% rule, decreases in need determinations will inevitably affect their ability to gain Board approval and obtain a certificate of need.
  • As a result, health care providers submitting CON applications should carefully analyze utilization in their proposed service area to establish the need for additional services.
  • While the August 15, 2013 updates reflect an overall decrease in need, the need determination is one factor the Board considers—utilization of existing providers within the project's geographic service area as well as impact to existing providers in the area are the other criteria. Thus, depending on the provider's location, need for a particular service may exist despite an overall decrease across the State. Consult the recently released inventory and need determination data to review the need determinations for specific locations.

Additional Resources

  • Inventory of Hospital Services is available here.
  • Inventory of Long-Term Care Services is available here.
  • Inventory of Other Health Services is available here.


DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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