ࡱ>  2bjbjO O <-a-aJ J 4h@D<:(&BV XZZZZZZ$;V~bbb~42b^XbXؐt@+%9^L^DŠ<CHCCbbbbbbb~~fHbbbbbbbCbbbbbbbbbJ j: DATE: October 10, 2013 TO: Mary C. Mayhew, Commissioner, DHHS THROUGH: Ken Albert III, Director, Division of Licensing and Regulatory Services FROM: Phyllis Powell, Assistant Director, Medical Facilities Larry Carbonneau, Senior Health Care Financial Analyst Richard S. Lawrence, Senior Health Care Financial Analyst SUBJECT: Change of Ownership Hibbards Nursing Home ISSUE ACTIVATED BY: The referenced proposal requires Certificate of Need (CON) approval as defined in "The fb88 Certificate of Need Act of 2002," 22 MRSA 326 et seq., as amended. REGISTERED AFFECTED PARTIES: None I. BACKGROUND: Hibbard Nursing Home (NPI # 1255315263-001) is a 93-bed facility licensed for SNF/NF beds located in Dover-Foxcroft, fb88. There is also a separate building containing fourteen independent living apartments. Hibbards Nursing Home is a family owned business which has served the Dover-Foxcroft area since 1955. The applicants seek to acquire the assets of the facility from Jane Hibbard-Merrill. The assets would be incorporated into a newly created LLC owned 50% by First Atlantic Corporation (FAC) and 50% by Rosscare of Bangor, Inc. (Ross). II. PROJECT DESCRIPTION: Hibbards Nursing Home, Inc. consists of land, building and equipment located on six acres next to fb88 Street West in Dover-Foxcroft fb88. The healthcare campus offers two separately licensed levels of care in attached but separate buildings: (1) 93 NF beds providing 24-hour skilled care known as Hibbards Nursing and Rehabilitation and, (2) fourteen independent living apartments at fb88 Street West. FAC and Ross will pay approximately $4,521,675 for the nursing home and the independent living apartments. The nursing home component is reviewable under the CON analysis. This consists of buildings and equipment valued at $2,606,126. This transaction is structured as an asset purchase and will be subject to depreciation capture at the time of closing. fb88Care neutrality is ensured because the applicant identified revenue sources from previous projects which will offset the projects annual expenses. Please see Economic Feasibility Section below. The Preliminary Review by CONU staff, dated September 11, 2013, concluded that the applicant had met its burden to demonstrate that the application meets the criteria for approving the project. III. HIGHLIGHTS: Letter of Intent dated: May 17, 2013 Technical Assistance meeting held: Waived CON application filed: July 22, 2013 CON application certified complete: July 22, 2013 Public Informational Meeting held: N/A Public Hearing: N/A Preliminary Analysis released: September 11, 2013 Record Closed: October 1, 2013 IV. PUBLIC COMMENTS RECEIVED IN RESPONSE TO THE PRELIMINARY ANALYSIS: Following release of the Preliminary Analysis, no public comments were received. V. CONU ANALYSIS/APPLICANTS COMMENTS: Fit, Willing and Able: FAC and Ross have provided SNF/NF level of care in the State of fb88 for more than twenty years. The services provided by the applicant are consistent with applicable licensing and certification standards. Economic Feasibility: The applicants submitted a pro-forma cost report representing post acquisition costs of operating the facility. The pro forma demonstrated that additional staffing costs and interest costs of $286,335 will be incurred; however, sufficient financial resources from the Bucksport replacement project are available to make this project fb88Care neutral. CONU is unaware of any regulatory changes which would have an adverse effect on reimbursement. Public Need: The project will have a positive impact on the health status indicators of the population to be served. There is a demonstrated need for SNF/NF beds in Piscataquis County. Individualized care and specialized rehabilitation services have been demonstrated to decrease healing time and allow patients to return home faster. This decrease in treatment time has a positive effect on health status indicators. The applicant will offer the services to all residents of the area therefore ensuring accessibility of the service. Orderly and Economic Development: The applicant is assuming control of an existing facility. Area capacity is not great enough to suggest a benefit from eliminating these services or substantial opportunities to modify services to reduce total healthcare expenditures. This is particularly true given recent delicensing and closure of SNF/NF beds at C.A. Dean hospital in Greenville. Outcomes and Community Impact: There will be no change in either services or the number of licensed beds. Existing service providers will not be negatively impacted. Service Utilization: This project will not add additional SNF/NF beds or new health services to the region. The project will not result in an inappropriate increase in service utilization. vii. Funding in fb88Care nursing Facility Funding Pool The project utilized no resources from the fb88Care Nursing Facility Funding Pool. VI. CONCLUSION: For all the reasons set forth in the Preliminary Analysis and in the record, CONU concludes that the review criteria have been satisfied. CONU recommends the approval of the CON. VII. 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