N.H. Admin. Code § He-Hea 1105.04

Current through Register No. 2, January 9, 2025

Section He-Hea 1105.04 - New Adult Open Heart Surgery Services

(a) Each new adult open heart surgery program shall assure that the proposed volume of service shall not be detrimental to the existing health care system of the state.

(b) Demonstration that the proposed volume of service will not be detrimental to the state's health care system shall be made by providing a statistical report in the application which compares current project increases for the following elements:

(1) Utilization;

(2) Patient charges;

(3) Market share;

(4) Physician referral patterns; and

(5) Personnel resources.

(c) The applicant shall document the need for a new or expanded open heart surgery program.

(d) Documentation of need for a new or expanded heart surgery program shall be made in the form of a statistical report which provides a detail of the number of adult open heart surgery procedures by ICD-9-CM codes performed by each facility currently providing services to residents of the applicant's proposed service area for the last 2 consecutive years. The report shall be prepared so that each patient admission during which cardiac surgery was performed is counted only once.

(e) Applicants shall also provide a report with the application that supports the need for new or expanded adult open heart surgery service in terms of:

(1) Referrals from area health care providers as evidenced by letters of support;

(2) Historical trends in volume such as:

a. Admissions;

b. Average length of stay;

c. Patient days; and

d. Occupancy rates;

(3) Changes in market share;

(4) The addition of new services with different market patterns;

(5) The addition of specialized services with different market patterns; and

(6) Any other causes presented to support the anticipated need for adult cardiac surgery services.

(f) The applicant shall demonstrate the availability of a quality assurance plan for the proposed heart surgery program.

(g) Demonstration of the availability of a quality assurance plan shall be made in the form of a report in the application, which includes an outline of a utilization or peer review and control programs or both.

(h) The report outlined in He-Hea 1105.04(g)shall indicate how the program will be established in order to:

(1) Establish protocols governing referrals, admissions and discharges of adult open heart surgery patients;

(2) Establish and review a list of indications and contraindications to govern patient selection for adult open heart surgery;

(3) Establish and review guidelines governing the admission of open heart surgery patients to the intensive care, coronary care and progressive care units, and of discharge from these units;

(4) Review morbidity and mortality rates and other indicators of patient outcomes, compared with regional or national averages; and

(5) Establish mechanisms for follow-up surveillance of discharged patients.

N.H. Admin. Code § He-Hea 1105.04

#6931, eff 1-14-99; ss by #8375; eff 6-21-05; ss by #10448, eff 10-25-13