“Waiver” Beds or “Bed Creep”
Health care facilities that are not acute general hospitals, may add a limited number of beds without Certificate of Need authorization.
In order to qualify for such additional beds, at least two (2) years must have passed since the initial licensure of the health care facility or two (2) years must have passed since any change in the facilities licensed bed capacity.
For comprehensive care facilities, the allowable increase is limited to ten (10) beds or ten (10) percent of the facility’s licensed bed capacity, whichever is less. For special rehabilitation hospitals, special care units, as defined in COMAR 10.07.14-1 and 14-2, intermediate care facilities, and residential treatment centers, as defined in Health-General Article, §19-301(p), Annotated Code of Maryland, the allowable increase is limited to ten (10) beds or forty (40) percent of the facility’s licensed bed capacity, whichever is less.
Rules governing the use of these waiver bed provisions by comprehensive care facilities (or nursing homes) have been established in the State Health Plan, COMAR 10.24.08, and should be consulted prior to notifying the Maryland Health Care Commission seeking confirmation that a nursing home may add bed capacity under these provisions of the CON law.