justicedao/ipfs_state_laws huggingface dataset:
411-070-0345 Allocation of Home Office and Regional Office Costs (1) The initial step in the allocation of home office and regional office costs is direct allocation of all allowable costs directly attributable to a particular nursing facility (such as construction interest, salary where the administrator of a nursing facility in the chain is paid directly by the home office, etc.) or non-nursing facility activity. (2) Other allowable costs must appropriately be allocated among the providers (and to any non-provider activities in which the home office or regional office may be engaged) on the basis of beds, resident days, or other bases, whichever most equitably allocates such costs. Revenues are not generally appropriate for distributing these costs. Where possible, allocation of costs are to be based on function and, consequently, the bases of allocation may appropriately be different, say for accounting costs and for personnel costs. Where the home office or regional office incurs costs for activities not related to resident care in the chain's participating providers, the allocation basis must provide for all allocation of costs such as rent, administrative salaries, other general overhead costs, organization costs, etc., that are attributable to non-resident care as well as resident care activities. Statutory/Other Authority: ORS 410.070 Statutes/Other Implemented: ORS 410.070 History: SPD 9-2006, f. 1-26-06, cert. ef. 2-1-06 SSD 6-1993, f. 6-30-93, cert. ef. 7-1-93 SSD 18-1991, f. 9-27-91, cert. ef. 10-1-91 SSD 14-1991(Temp), f. 6-28-91, cert. ef. 7-1-91 SSD 10-1989, f. 6-30-89, cert. ef. 7-1-89 SSD 6-1985, f. 5-31-85, cert. ef. 6-1-85 Renumbered from 461-017-0345 by Ch. 784, OL 1981 & AFS 69-1981, f. 9-30-81, cert. ef. 10-1-81 AFS 19-1978, f. & cert. ef. 5-1-78 PWC 866(Temp), f. 12-30-77, cert. ef. 1-1-78
411-070-0350 Management Fees Management fees are an allowable expense if they are necessary, reasonable, non-duplicative of facility personnel and functions, and documented by a binding contract with a non-related party defining the items, services, and activities provided. If the administrator or assistant administrator is supplied as part of the contract, the rules governing their compensation in these rules apply. Documentation demonstrating that the services were actually performed is required. Management fees paid to a related organization are subject to the rules governing related parties (OAR 411-070-0335), chain operations (411-070-0340), and allocation of home office costs (411-070-0345). The allowable salary paid to the administrator and assistant administrator is included in the total facility management fee calculation. Total management fees for allowable management and supervisory services may not exceed the limits established for the administrator and the assistant administrator in 411-070-0315 plus $5,000 allowable for other management fees per year. [Publications: Publications referenced are available from the agency.] Statutory/Other Authority: ORS 410.070 Statutes/Other Implemented: ORS 410.070 History: SPD 15-2009, f. 11-30-09, cert. ef. 12-1-09 SPD 9-2006, f. 1-26-06, cert. ef. 2-1-06 SSD 6-1993, f. 6-30-93, cert. ef. 7-1-93 SSD 10-1986, f. & cert. ef. 7-1-86 Renumbered from 461-017-0350 by Ch. 784, OL 1981 & AFS 69-1981, f. 9-30-81, cert. ef. 10-1-81 AFS 19-1978, f. & cert. ef. 5-1-78 PWC 866(Temp), f. 12-30-77, cert. ef. 1-1-78
411-070-0365 Capital Assets (1) The following costs must be capitalized and depreciated: Expenses for depreciable assets with historical cost in excess of $1,000 per unit, or in aggregate, and a useful life greater than one year from the date of purchase. (2) Repair costs in excess of $1,000 on equipment or buildings must be capitalized. (3) The provider must maintain schedules of capital assets and depreciation, on a straight line basis, to document amounts on the Nursing Facility Financial Statement. Statutory/Other Authority: ORS 410.070 Statutes/Other Implemented: ORS 410.070 History: SPD 9-2006, f. 1-26-06, cert. ef. 2-1-06 SSD 6-1993, f. 6-30-93, cert. ef. 7-1-93 SSD 8-1991, f. & cert. ef. 4-1-91 SSD 10-1986, f. & cert. ef. 7-1-86 Renumbered from 461-017-0360 by Ch. 784, OL 1981 & AFS 69-1981, f. 9-30-81, cert. ef. 10-1-81 AFS 19-1978, f. & cert. ef. 5-1-78 PWC 866(Temp), f. 12-30-77, cert. ef. 1-1-78
411-070-0370 Depreciable Assets (1) Tangible assets of the following types in which a provider has an economic interest through ownership are subject to depreciation: (a) Buildings — The basic structure or shell and additions thereto; (b) Building Fixed Equipment — Attachments to buildings, such as wiring, electrical fixtures, plumbing, elevators, heating system, and air conditioning system. The general characteristics of this equipment are: (A) Affixed to the building and not subject to transfer; (B) A fairly long life but shorter than the life of the building to which affixed. (c) Movable Equipment — Such items as beds, wheelchairs, desks, vehicles, and other depreciable items. The general characteristics of these equipment are: (A) Capable of being moved; (B) Subject to control and meeting the definition of a capital asset. (d) Land Improvements — Such items as paving, tunnels, underpasses, on-site sewer and water lines, parking lots, shrubbery, fences, walls, etc. where replacement is the responsibility of the provider; (e) Leasehold Improvements — Betterments and additions made by the lessee to the leased property that become the property of the lessor after the expiration of the lease. (2) Land is not Depreciable. The cost of land includes the cost of such items as off-site sewer and water lines, public utility charges necessary to service the land, governmental assessments for street paving and sewers, the cost of permanent roadways and grading of a non-depreciable nature, and the cost of curbs and side walks, replacement of which is not the responsibility of the provider. Statutory/Other Authority: ORS 410.070 Statutes/Other Implemented: ORS 410.070 History: SPD 9-2006, f. 1-26-06, cert. ef. 2-1-06 Renumbered from 461-017-0365 by Ch. 784, OL 1981 & AFS 69-1981, f. 9-30-81, cert. ef. 10-1-81 AFS 19-1978, f. & cert. ef. 5-1-78 PWC 866(Temp), f. 12-30-77, cert. ef. 1-1-78
411-070-0375 Depreciation Basis (1) Purchase of a Nursing Home: (a) New Facility — The depreciation basis of a new facility must be the historical cost of building the facility, including preparation for use, or the purchase price from an unrelated organization not to exceed the fair market value, including preparation for use, less salvage value; (b) Ongoing Facility — The depreciation basis of the purchase of an ongoing facility from an unrelated organization is limited to the lower of the following: (A) The allowable acquisition cost of such asset to the first owner of record on or after July 18, 1984; or (B) The acquisition cost of such asset to the new owner. (c) To properly provide for costs or valuations of fixed assets, an appraisal by an appraisal expert will be required if the provider has no historical cost records, or has incomplete records of depreciable fixed assets, or purchases a facility without designation of purchase price for the classification of assets acquired. The appraisal is subject to the approval of the Department. In any case, the Department may require such an appraisal to establish the fair market value of the provider assets; (d) If the purchase is from a related organization, the cost basis is the lower of the cost basis of the related organization or the cost basis as determined in subsections (b) and (c) of this section, less depreciation as determined by the provisions of these rules. (2) The depreciation basis of other assets must be the historical cost to the provider from an unrelated organization plus set-up costs, less salvage value. In the case of a trade-in, the historical cost will consist of the sum of the book value of the trade-in plus the cash paid. In a case where the asset is purchased from a related organization, the depreciation basis must not exceed the asset's book value to the related organization as determined under the provisions of this guide. (3) The depreciation basis of donated assets, defined as an asset acquired without making any payment for it in the form of cash, property, or services, must be the lessor of: (a) Fair market value at the date of donation adequately documented in the provider's records or by appraisal by an appraisal expert, less salvage value; or (b) If from a related organization, the depreciation basis must be the lesser of: (A) Fair market value; or (B) The depreciation basis the related party had or would have had for the asset under the program. Statutory/Other Authority: ORS 410.070 Statutes/Other Implemented: ORS 410.070 History: SPD 9-2006, f. 1-26-06, cert. ef. 2-1-06 SSD 2-1985, f. & cert. ef. 3-5-85 SSD 10-1984(Temp), f. 11-30-84, cert. ef. 12-1-84 Renumbered from 461-017-0370 by Ch. 784, OL 1981 & AFS 69-1981, f. 9-30-81, cert. ef. 10-1-81 AFS 19-1978, f. & cert. ef. 5-1-78 PWC 866(Temp), f. 12-30-77, cert. ef. 1-1-78
411-070-0385 Depreciation Lives (1) The provider must use the "Estimated Useful Lives of Depreciable Hospital Assets" Revised 2004 guidelines for asset lives when computing depreciation. (2) For assets not covered by the guidelines and with costs of more than $1,000 per unit, or in aggregate, the lives established by the provider are subject to approval by the Department. (3) Depreciation and amortization schedules must be maintained. (4) Depreciation expense is not allowed on land. (5) Depreciation and amortization must be calculated on a straight line basis and prorated over the estimated useful life of the asset. [Publications: Publications referenced are available from the agency.] Statutory/Other Authority: ORS 410.070 Statutes/Other Implemented: ORS 410.070 History: SPD 9-2006, f. 1-26-06, cert. ef. 2-1-06 SSD 6-1993, f. 6-30-93, cert. ef. 7-1-93 SSD 18-1991, f. 9-27-91, cert. ef. 10-1-91 SSD 14-1991(Temp), f. 6-28-91, cert. ef. 7-1-91 SSD 11-1986, f. 8-29-86, cert. ef. 9-1-86 SSD 6-1985, f. 5-31-85, cert. ef. 6-1-85 Renumbered from 461-017-0380 by Ch. 784, OL 1981 & AFS 69-1981, f. 9-30-81, cert. ef. 10-1-81 AFS 19-1978, f. & cert. ef. 5-1-78 PWC 866(Temp), f. 12-30-77, cert. ef. 1-1-78
411-070-0400 Equity Equity is not an allowable expense for reimbursement but must be reported. Equity capital is the net worth of the provider (owner's equity in the net assets as determined under these rules), adjusted for those assets and liabilities that are not related to the provision of resident care: (1) Generally accepted accounting principles are to be used unless otherwise specified in these rules for computing owner's equity. (2) Assets and liabilities not related to providing resident care are not includable in the provider's equity capital. (3) Loans from owners or related entities are considered as invested equity capital of the provider. (4) Owner's equity in assets leased from related entities is includable in the equity capital of a proprietary provider. (5) Goodwill is not includable as part of owner's equity. (6) Invested funds that are diverted to income producing activities that are not resident related for more than six months will not be included as part of owner's equity. (7) Amounts deposited in a funded depreciation account and the earnings on deposits are not included in equity capital. Interest earned on these funds is not offset against interest expense. (8) Land, buildings, and other assets acquired in anticipation of expansion are not includable in equity capital. Construction-in-process and liabilities related to such construction are not includable in equity capital. (9) Prepaid premiums on life insurance carried by a provider on officers and key employees, where the provider is designated as the beneficiary, are not included when computing equity capital. (10) The costs of noncompetitive agreements are not includable in equity capital. (11) The amount deposited and the earnings on self-insurance reserve funds are not includable in equity capital. (12) When an asset is totally or partially destroyed by a casualty, the unrecovered loss is not included in equity capital. (13) Working capital, defined as the difference between current assets and current liabilities, must be adjusted by any amount considered to be excessive for the necessary and proper operation of resident care activities. The excessive amount will not be included in equity capital. (14) The cash surrender value of insurance is not includable in equity capital. (15) Imputed salaries for proprietors will be offset in computing the equity capital. (16) Any portion of an acquisition cost, incurred on or after July 18, 1984, that exceeds the depreciable basis is not includable in the owner's equity calculation. Statutory/Other Authority: ORS 410.070 Statutes/Other Implemented: ORS 410.070 History: SPD 9-2006, f. 1-26-06, cert. ef. 2-1-06 SSD 6-1993, f. 6-30-93, cert. ef. 7-1-93 SSD 10-1986, f. & cert. ef. 7-1-86 SSD 2-1985, f. & cert. ef. 3-5-85 Renumbered from 461-017-0395 by Ch. 784, OL 1981 & AFS 69-1981, f. 9-30-81, cert. ef. 10-1-81 AFS 19-1978, f. & cert. ef. 5-1-78 PWC 866(Temp), f. 12-30-77, cert. ef. 1-1-78
411-070-0415 Offset Income (1) Income is offset against expenses unless specifically excluded in section (2) of this rule. If an adjustment is for a revenue producing activity representing a non-allowable cost, the revenue must be offset against the appropriate expense if the revenue is less than 2 percent of the total provider expense (sum of cost areas). Where the revenue is greater than 2 percent of the total provider expense (sum of cost areas), costs must be allocated to this area as described in OAR 411-070-0430, Allocation Methods. (2) Income items that may not be offset are: (a) Ancillary income and charges for routine services or supplies that are included in the bundled rate but charged to other residents (except as required in OAR 411-070-0359(3)); (b) Grants, unless designated for paying a specific operating cost; and (c) Donations, unless designated for paying a specific operating cost. (3) Revenue received for pediatric residents shall be offset against expenses. These revenues may not be subject to the 2 percent limitation established in section (1) of this rule. The revenue shall be offset against cost centers in the same ratio as reported by the facility in accordance with OAR 411-070-0452. (4) Mental health revenues received from local governments to provide extra care to Medicaid residents must be reported in SPD Account 819, directly offset against the related expense and explained on Schedule A. Statutory/Other Authority: ORS 414.070 Statutes/Other Implemented: ORS 410.070 History: SPD 15-2009, f. 11-30-09, cert. ef. 12-1-09 SPD 9-2006, f. 1-26-06, cert. ef. 2-1-06 SSD 1-1997, f. 6-30-97, cert. ef. 7-1-97 SSD 8-1994, f. & cert. ef. 12-1-94 SSD 6-1993, f. 6-30-93, cert. ef. 7-1-93 SSD 18-1991, f. 9-27-91, cert. ef. 10-1-91 SSD 14-1991(Temp), f. 6-28-91, cert. ef. 7-1-91 SSD 20-1990, f. & cert. ef. 10-4-90 SSD 5-1985, f. & cert. ef. 5-1-85 SS 2-1981, f. 12-31-81, cert. ef. 1-1-82 Renumbered from 461-017-0410 by Ch. 784, OL 1981 & AFS 69-1981, f. 9-30-81, cert. ef. 10-1-81 AFS 19-1978, f. & cert. ef. 5-1-78 PWC 866(Temp), f. 12-30-77, cert. ef. 1-1-78
411-070-0417 Treatment of Complex Medical Add-Ons (1) The complex medical add-on reflects the additional costs of providing skilled nursing services for certain residents due to their needs. (2) The complex medical add-on is added to the basic rate. (3) When calculating per resident day care compensation cost, the treatment of the complex medical add-on is as follows: (a) The allowable care compensation costs for both the basic rate and the complex medical add-on are divided by total basic rate resident days. (b) Revenue from the complex medical add-on received for eligible individuals is divided by the number of Medicaid basic rate resident days. (c) The per resident day amounts computed in section (3)(a) of this rule are reduced by the per Medicaid resident day amounts computed in section (3)(b) of this rule. The result is defined as care compensation per resident day and shall be used in determining the prospective base rate. Statutory/Other Authority: ORS 410.070 Statutes/Other Implemented: ORS 410.070 History: SPD 15-2009, f. 11-30-09, cert. ef. 12-1-09 SSD 1-1997, f. 6-30-97, cert. ef. 7-1-97 SSD 6-1993, f. 6-30-93, cert. ef. 7-1-93
411-070-0420 Base Year Cost Finding (1) The provider must report its gross costs and must make reclassifications and adjustments to costs as provided in these rules. This process will determine net allowable costs on the Nursing Facility Financial Statement that includes a uniform chart of accounts provided by the Department. The gross costs and revenues must agree with the statement of earnings and expenses or profit and loss statement of the provider. Revenues are to be reported in the same manner as costs on the Nursing Facility Financial Statement. The provider must also use the balance sheet provided to report its gross assets, gross liabilities, and gross equity, make reclassifications and adjustments as provided by these rules. (2) The per diem costs of care must be used to determine each provider's allowable per diem costs and must be effective for the same period as covered by the Nursing Facility Financial Statement. (3) The per diem costs of each facility will be used to establish the basic rate on July 1 of each odd numbered year. (4) Costs, revenues, assets, liabilities, and owner's equity attributable from a home office or regional office to a provider under OAR 411-070-0345 will be included on the Nursing Facility Financial Statement in the Home Office column. The home office financial data must be reconcilable to the home office financial statements and records. Statutory/Other Authority: ORS 410.070 Statutes/Other Implemented: ORS 410.070 & 414.065 History: SPD 9-2006, f. 1-26-06, cert. ef. 2-1-06 SSD 1-1997, f. 6-30-97, cert. ef. 7-1-97 SSD 6-1993, f. 6-30-93, cert. ef. 7-1-93 SSD 10-1992, f. 10-30-92, cert. ef. 11-1-92 SSD 18-1991, f. 9-27-91, cert. ef. 10-1-91 SSD 14-1991(Temp), f. 6-28-91, cert. ef. 7-1-91 SSD 8-1991, f. & cert. ef. 4-1-91 SSD 10-1989, f. 6-30-89, cert. ef. 7-1-89 SSD 4-1989, f. & cert. ef. 4-18-89 SSD 11-1986, f. 8-29-86, cert. ef. 9-1-86 SSD 10-1986, f. & cert. ef. 7-1-86 SSD 6-1985, f. 5-31-85, cert. ef. 6-1-85 Renumbered from 461-017-0415 by Ch. 784, OL 1981 & AFS 69-1981, f. 9-30-81, cert. ef. 10-1-81 AFS 19-1978, f. & cert. ef. 5-1-78 PWC 866(Temp), f. 12-30-77, cert. ef. 1-1-78
411-070-0425 Resident Days The provider must keep census records on all residents. Statutory/Other Authority: ORS 410.070 Statutes/Other Implemented: ORS 410.070 History: SPD 9-2006, f. 1-26-06, cert. ef. 2-1-06 SSD 1-1997, f. 6-30-97, cert. ef. 7-1-97 SSD 6-1993, f. 6-30-93, cert. ef. 7-1-93 SSD 8-1991, f. & cert. ef. 4-1-91 SSD 20-1990, f. & cert. ef. 10-4-90 SSD 5-1985, f. & cert. ef. 5-1-85 SS 2-1981, f. 12-31-81, cert. ef. 1-1-82 Renumbered from 461-017-0420 by Ch. 784, OL 1981 & AFS 69-1981, f. 9-30-81, cert. ef. 10-1-81 AFS 19-1978, f. & cert. ef. 5-1-78 PWC 866(Temp), f. 12-30-77, cert. ef. 1-1-78
411-070-0430 Allocation Methods (1) The provider must use the allocation methods designated on the NFFS: COST -- ALLOCATION METHOD: (a) Property -- Resident Days or Square Footage. (b) Administrative and General -- Resident Days. (c) Other Operating Support -- Resident Days. (d) Food -- Resident Days. (e) Direct Care Compensation -- Actual Cost or Resident Days. (f) Direct Care Supplies -- Actual Cost or Resident Days. (g) Ventilator Assisted Program Expense -- Actual Cost or Resident Days. (2) Where costs are related to non-nursing facility activities, the provider must use an appropriate allocation method to reasonably and accurately allocate these costs (see OAR 411-070-0415). For residential care facility individuals, the facility must use resident days for all areas except direct care compensation and direct care supplies and property. The direct care compensation and direct care supplies allocation must be actual costs incurred. The property allocation method may be based on either resident days or on square footage and must be designated on the NFFS. (3) Square footage must be used to allocate property costs to pediatric units as defined in OAR 411-070-0452. (4) Actual payroll for the pediatric unit must be used as the basis for allocating direct care compensation to pediatric units. (5) If APD determines that for a provider it is more reasonable and accurate to use a different allocation method than specified in sections (1) and (2) of this rule, then such allocation method must be used. Statutory/Other Authority: ORS 410.070 Statutes/Other Implemented: ORS 410.070 History: APD 9-2019, amend filed 01/31/2019, effective 02/01/2019 SPD 15-2009, f. 11-30-09, cert. ef. 12-1-09 SPD 9-2006, f. 1-26-06, cert. ef. 2-1-06 SSD 1-1997, f. 6-30-97, cert. ef. 7-1-97 SSD 8-1994, f. & cert. ef. 12-1-94 SSD 6-1993, f. 6-30-93, cert. ef. 7-1-93 SSD 8-1991, f. & cert. ef. 4-1-91 SSD 10-1986, f. & cert. ef. 7-1-86 SS 2-1981, f. 12-31-81, cert. ef. 1-1-82 Renumbered from 461-017-0425 by Ch. 784, OL 1981 & AFS 69-1981, f. 9-30-81, cert. ef. 10-1-81 AFS 29-1978, f. 7-28-78, cert. ef. 8-1-78 AFS 19-1978, f. & cert. ef. 5-1-78 PWC 866(Temp), f. 12-30-77, cert. ef. 1-1-78