WAC 246-310-745

(1) The following definitions apply throughout this section unless the context clearly requires otherwise:

(a) "Base year" means the most recent full calendar year from the cardiac care outcomes assessment program (COAP) data from the foundation for health care quality reports or successor reports, effective at the time of the application submittal.

(b) "Current capacity" means the sum of all PCIs performed on adults by all certificate of need approved adult elective PCI programs, or department legacy programs within the PCI planning area. To determine the current capacity for those PCI planning areas where a new program has operated less than three years, the department will measure the volume of that hospital as the greater of:

(i) The actual volume; or

(ii) The minimum volume standard for an elective PCI program established in WAC 246-310-720.

(c) "Forecast year" means the fifth year after the base year.

(d) "Use rate" or "PCI use rate," means the number of elective PCIs performed on the adult residents of a PCI planning area, per 1,000 persons.

(e) "Legacy programs" means those hospitals operating a certificate of need approved PCI program or heart surgery program prior to December 19, 2008, that continue to operate a heart surgery program.

(2) The following data sources shall be used:

(a) The data source for adult elective PCI case volumes is the cardiac care outcomes assessment program (COAP) data from the foundation for health care quality, as provided by the department. If COAP data is no longer available for department use, the department will rely on the comprehensive hospital abstract reporting system (CHARS) and certificate of need utilizations survey data.

(b) The data source for population estimates and forecasts is the office of financial management medium growth series population trend reports or if not available for the planning area, other population data published by well-recognized demographic firms as approved by the department.

(c) The data used for calculating numeric need must be the most recent year end data as reported by COAP.

(3) A hospital approved to perform elective PCI must submit annual PCI volume data to COAP by June 30th of each year for the previous year.

(4) The applicant hospital shall take the following steps to produce a numeric methodology:

Step 1. Compute each planning area's PCI use rate calculated for adults, based on elective PCI case counts.

(a) Take the total planning area's base year population adult residents and divide by 1,000. This represents the base year population per 1,000.

(b) Divide the total number of elective PCIs performed on the adult residents in the planning area by the result of Step 1 (a). This number represents the base year PCI use rate per 1,000.

Step 2. Forecasting the planning area demand for elective and nonelective PCIs.

(a) Take the planning area's elective use rate calculated in Step 1 (b) and multiply by the planning area's corresponding forecast year population of adult residents per 1,000. This represents projected planning area resident demand for elective PCIs.

(b) Take the number of nonelective PCIs performed by planning area hospitals in the base year. This represents projected planning area demand for nonelective PCIs.

(c) Add the results from Step 2 (a) and Step 2 (b) together for total planning area forecast PCI demand.

Step 3. Compute the planning area's current capacity as outlined in subsection (1)(b) of this section.

(a) Identify all adult nonelective procedures performed at planning area hospitals.

(b) Identify all adult elective procedures performed on planning area residents at certificate of need approved hospitals within the planning area.

(c) Add results of (a) and (b).

(d) Calculate the product of the number of existing certificate of need approved elective PCI programs in the planning area multiplied by the minimum volume standard for an elective PCI program established in WAC 246-310-720.

(e) The planning area's current capacity is the greater of the results of (c) and (d). This capacity is assumed to remain constant over the forecast period.

Step 4. Subtract the calculated capacity in Step 3 from the forecasted demand in Step 2. This represents the net need for additional adult elective PCI procedures. If the net need for procedures is less than the minimum volume standard for an elective PCI program established in WAC 246-310-720, then there is no numeric need for an additional PCI program.

Step 5. If Step 4 is greater than the minimum volume standard for an elective PCI program established in WAC 246-310-720, calculate the numeric need for additional programs as follows:

(a) Divide the number of projected procedures from Step 4 by the minimum volume standard for an elective PCI program established in WAC 246-310-720.

(b) Round the results down to identify the number of needed programs. (For example: 375/200 = 1.875 or 1 program.)