Code of Massachusetts Regulations › 114 CMR - DIVISION OF HEALTH CARE FINANCE AND POLICY › Title 114.1 CMR 39.00 - CHRONIC AND REHABILITATION PUBLICLY ASSISTED RATES OF PAYMENT AND THE FEE FOR RESIDENTIAL ALCOHOLISM TREATMENT PROGRAMS › Section 39.02 - Definitions

Current through Register 1525, July 5, 2024
As used in 114.1 CMR 39.00, unless the context requires
				otherwise, terms shall have the meanings ascribed in 114.1 CMR 39.02.
Administrative Day
. An inpatient day
				spent in a chronic/rehabilitation hospital by a patient who has been identified
				by a Peer Review Organization (where applicable) or otherwise by the Division
				of MedicalAssistance or by the Department of Public Health, or any combination
				of these organizations as a patient not requiring a Hospital Level of
				Care.
Base Year
.
(a) For hospitals licensed and/or operated as
				chronic/rehabilitation hospitals in Fiscal Year 1993 (FY 1993), the base year
				is the hospital's FY 1993.
(b) For hospitals licensed and/or operated as
				chronic/rehabilitation hospitals in FY 1993 but which converted a majority of
				beds to long term care beds during FY 1993, the base year shall be FY 1994
				deflated to FY 1993.
(c) For hospitals licensed and/or operated as
				chronic/rehabilitation hospitals in FY 1993 but which eliminated a majority of
				beds and closed the facility and which in subsequent years continued to provide
				some services in a new location and under a new management, the base year is
				the first cost reporting period of at least 12 months after the hospital
				started to provide the service at the new location.
(d) For hospitals which were not licensed and/or operated as
				chronic/rehabilitation hospitals in FY 1993, the base year is the first cost
				reporting period of at least 12 months after the hospitalis licensed and/or
				operated as a chronic/rehabilitation hospital.
Commission
. The Rate Setting
				Commission established under M.G.L. c. 6A, and currently referred to as the
				Division of Health Care Finance and Policy.
Direct Cost
. The cost of a center as
				defined by the Hospital Uniform Reporting Manual (HURM) after reclassification
				and recoveries of expense and prior to the allocation of overhead cost to
				patient care cost centers through the stepdown.
DHCFP-450 Form
. The Division of Health
				Care Finance and Policy's DHCFP-450 Form is a report which documents a
				facilities 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.
Division
. The Division of Health Care
				Finance and Policy established under M.G.L. c. 118G, formerly the Rate Setting
				Commission.
FTEs
. FTE is an acronym for full-time
				equivalent staff. To compute full-time equivalents (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 Common wealth
				of Massachusetts and any department, agency, board, commission, division, or
				political subdivision of the Commonwealth.
HURM Manual.
The Common wealth of
				Massachusetts Hospital Uniform Reporting Manual, promulgated by the Division
				under 114.1 CMR 4.00.
New Hospital.
A hospital which was not
				licensed and/or operated as a chronic/rehabilitation hospital in FY 1993, or
				which did not report a full year of actual costs in FY 1993.
Non-Acute Hospital.
A hospital which
				is defined and licensed under M.G.L. c. 111, § 51, with less than majority of
				medical-surgical, pediatrics, maternity and obstetric beds, or any psychiatric
				facility licensed under M.G.L. c. 19, § 29, or any public health care
				facility.
Overhead
. Overhead includes expenses
				for depreciation, long term interest, fringe benefits, administration, plant
				maintenance and repairs, plant operations, laundry, housekeeping, cafeteria,
				dietary, maintenance personnel, nursing administration and in service
				education, RN & LPN education, medical staff teaching and administration,
				post graduate medical education, medical records, medical care review, and
				social services.
Payment on Account Factor
. The
				percentage of charge which was most recently approved by the Commission
				pursuant to 114.1 CMR 28.00 or 114.1 CMR 37.00 for eligible services rendered
				to publicly-assisted patients.
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 Patient
. A person who
				receives health care and services for which a governmental unit is in whole or
				part liable under a statutory program of public assistance.
Rate Year
. The rate year is the 12
				month period, October 1, through September 30.