1. RHCF Bed Need Methodology 10 NYCRR Section 709.3 September 24, 2015

2. 2  Overestimates Bed Need 121,243 estimated for 2016 111,195 certified or in pipeline Occupancy 93.0% statewide Disadvantages of Current Formula

3. 3 Source: HFIS Occupancy Rates for Residential Health Care Facilities (RHCF) By Region, 2009 ‐ 2014 Region200920102011201220132014 % Change 2009‐2014 1. Western New York (WNY)94.8%93.5%92.7%91.7%92.9%92.4%‐2.5% 2. Finger Lakes (FL)94.0%93.3%91.7%96.2%92.9%93.9%‐0.1% 3. Central New York (CNY)94.8%93.8%94.4%92.9%92.3%92.4%‐2.6% 4. New York‐Penn (NY‐PENN)93.4%94.0%91.0%92.2%91.3%93.3%‐0.1% 5. Northeastern New York (NENY)94.9%93.6%94.5%94.0%92.9%92.3%‐2.8% 6. Hudson Valley (HV)91.7%93.3%92.9%92.1%91.2%91.7%0.0% 7. New York City (NYC)94.9%95.4%94.8% 93.5%93.9%‐1.1% 8. Nassau/Suffolk (N/S)94.5%94.0%92.4%92.8%92.1%91.5%‐3.2% New York State94.3% 93.6%93.7%92.6%92.9%‐1.5%

4. 4 Source: HFIS Patients in Residential Health Care Facilities (RHCF) 2009 and 2014 Age Cohorts, by Region Region20092014% Change (2009‐2014) <6565‐7475‐8485+<6565‐7475‐8485+<6565‐7475‐8485+ 1. Western New York (WNY)9.1%11.7%29.1%50.1%9.7%13.0%26.3%50.9%6.6%11.1%‐9.6%1.6% 2. Finger Lakes (FL)9.3%10.6%28.9%51.1%10.2%12.5%26.8%50.9%9.7%17.9%‐7.3%‐0.4% 3. Central New York (CNY)9.4%11.4%29.9%49.6%9.3%12.8%26.7%51.2%‐1.1%12.3%‐10.7%3.2% 4. New York‐Penn (NY‐PENN)7.1%10.4%28.9%53.6%7.0%13.4%27.4%52.5%‐1.4%28.8%‐5.2%‐2.1% 5. Northeastern New York (NENY)6.9%10.2%30.1%52.8%7.2%12.6%24.8%55.0%4.3%23.5%‐17.6%4.2% 6. Hudson Valley (HV)11.3%12.9%28.5%47.3%10.7%15.5%26.7%47.0%‐5.3%20.2%‐6.3%‐0.6% 7. New York City (NYC)17.7%17.6%28.1%36.6%17.9%19.6%26.7%35.4%1.1%11.4%‐5.0%‐3.3% 8. Nassau/Suffolk (N/S)12.7%12.0%28.6%46.7%13.3%14.7%25.8%47.2%4.7%22.5%‐9.8%1.1% All New York State12.9%13.9%28.7%44.5%13.2%16.0%26.4%44.3%2.5%15.5%‐8.0%‐0.4% Total Patient Population* (NYS)106,01499,245‐6.4%

5. 5  Statewide Decline in the Number of Nursing Home Residents 2014 99,245 Reduction 6,759 2009 106,014

6. 6  Suitability of the 97% occupancy threshold  Planning areas: County Multi-County NYC five boroughs Long Island (Nassau-Suffolk) Allow DSRIP arrangements – PPS service areas, etc. Possible factors for consideration in the revision of Section 709.3 Nursing Home bed need methodology

7. 7  Short stays of <100 days Percentage of admissions Impact on occupancy rates. Possible factors for consideration in the revision of Section 709.3 Nursing Home bed need methodology (continued)