Code of Massachusetts Regulations › 114 CMR - DIVISION OF HEALTH CARE FINANCE AND POLICY › Title 114.1 CMR 40.00 - NON-ACUTE HOSPITAL PUBLICLY ASSISTED RATES OF PAYMENT AND THE FEE FOR RESIDENTIAL ALCOHOLISM TREATMENT PROGRAMS › Section 40.02 - Definitions

Current through Register 1525, July 5, 2024
As used in 114.1 CMR 40.00, unless the context requires
				otherwise, terms shall have the meanings ascribed in 114.1 CMR 40.02.
Adjusted Base Year Volume
. The actual
				base year volume adjusted to include the volume associated with recurring CBCs,
				new services and transfers on of cost and exclude volume associated with
				discontinued services and transfers off of cost.
Administrative Day.
An inpatient day
				spent in a non-acute hospital or public health care facility, other than a
				hospital operated by the Department of Mental Health (except facilities which
				are certified to provide services under Title XIX of the Social Security Act),
				by a patient who has been identified by a Professional Standards Review
				Organization (where applicable) or otherwise by the Division of Medical
				Assistance or by the Department of Public Health, or any combination of these
				organizations as a patient which does not require a hospital level of
				care.
Base Year.
For DMH and DPH hospitals
				only licensed and/or operated as non-acute hospitals during FY 1993, the base
				year is the hospital's FY1993. For hospitals that were not licensed and/or
				operated as non-acute hospitals during fiscal year 1993, the base year shall be
				determined pursuant to 114.1 CMR 40.09. For all other hospitals licensed and/or
				operated as non-acute hospitals during FY 1984, the base year is the hospital's
				FY 1984, For hospitals that were not licensed and/or operated as non acute
				hospitals during fiscal year 1984, the base year shall be determined pursuant
				to 114.1 CMR 40.09.
CBC
. Cost beyond control.
Commission.
The Rate Setting
				Commission was established under M.G.L. c. 6A, § 32. On July 1, 1996, all
				functions were transferred to the Division of Health Care Finance and Policy
				under M.G.L. c. 118G.
Department of Public Health.
The
				Department of Public Health established under M.G.L. c. 17, § 1.
DHCFP-450
. DHCFP-450, Report of
				Charges and Volume, is a report which documents a hospital's charges and
				volume, utilized for the purpose of adjusting the cost-to-charge ratio or the
				payment on account factor should the facility increase their charges beyond the
				allowable increase specified in 114.1 CMR 40.04(4)(b).
Discontinued Service.
A health
				service, supply or accommodation which conforms in scope to a cost center as
				defined in Chapter III of the Reporting Manual which:
(a) is included in the adjusted base year cost and which will
				not be offered during the budget year, or
(b) is being offered and terminated during the budget
				year.
Direct Cost.
The cost of a center as
				defined by the Reporting Manual after reclassification and recoveries of
				expense and prior to the allocation of overhead cost to patient care cost
				centers through the step-down.
Division
. The Division of Health Care
				Finance and Policy, established under M.G.L. c. 118G.
Free Care.
The amount, net of free
				care income or community fund grants, which is charged off by a hospital for
				hospital care and services, supplies and accommodations provided to indigent
				persons, pursuant to a plan adopted by the hospital's governing board and filed
				with the Division. Free care will not include accounting provisions for free
				care, free care provided to employees or courtesy allowances.
FTEs
: Full-time equivalent staff. To
				compute FTEs, divide the total annual paid hours (including vacation, sick
				leave, and overtime) for all employees in each cost center by a 40 hour
				standard work week, annualized to a norm of 2080 hours.
Governmental Unit.
The Commonwealth of
				Massachusetts and any department, agency, board, commission, or political
				subdivision of the Commonwealth.
GPSR
. Gross patient service revenue is
				the total dollar amount of a hospital's charges for services rendered during
				the reporting period, generally within a fiscal year
HURM Manual.
The Commonwealth of
				Massachusetts Hospital Uniform Reporting Manual, promulgated by the Division
				under 114.1 CMR 4.00.
Intermediate Year.
The hospital fiscal
				year just before the current rate year.
Inpatient Day
. HURM standard unit of
				measure to report care of patients admitted to a hospital including the day of
				admission, but not the day of discharge. If both admission and discharge occurs
				on the same day, the day is considered a day of admission and counts as one
				inpatient day.
Non-Acute Hospital.
A hospital which
				is defined and licensed under M.G.L. c. 111, § 51, with less than a majority of
				medical-surgical, pediatric, maternity and obstetric beds, or any psychiatric
				facility licensed under M.G.L. c. 19, § 19, or any public health care
				facility.
PAF
. Payment on account factor is a
				percentage applied to charges to calculate a purchaser's discounted
				reimbursement level.
Public Health Care Facility.
A
				facility operated by the Department of Public Health, the Department of Mental
				Health, a County of the Commonwealth, or a Soldiers' Home which provides
				inpatient medical, skilled nursing, or mental retardation care and services and
				which may provide outpatient medical, mental health, or mental retardation care
				and services.
Publicly-Aided Individual.
A person
				who receives healthcare and services for which a governmental unit is in whole
				or part liable under a statutory program of public assistance.
Rate Year
. For allnon-acute hospitals,
				as defined in 114.1 CMR 40.01, the rate year will be defined as follows:
(a) For facilities classified as a "Public Health Care
				Facility" as defined in 114.1 CMR 40.02, the rate year will be from 7/1 to
				6/30.
(b) For all other non-acute facilities, the rate year will be
				10/1 to 9/30.
Residential Alcoholism Treatment
				Program
. A residential care program for second-time driving while
				intoxicated offenders approved by the Division of Alcoholism, Massachusetts
				Department of Public Health pursuant to 105 CMR 166.00.
RFR
. Reasonable Financial
				Requirements.
Transfer of Cost.
An increase
				(transfer on) or decrease (transfer off) of hospital costs related to persons
				or entities which provide hospital care or services which changes compensation
				arrangements from non-hospital based to hospital based (transfer on) or from
				hospital based to non-hospital based (transfer off). A transfer on of physician
				compensation will only be allowed if reasonable.