Oklahoma Administrative Code › Title 317 - Oklahoma Health Care Authority › Chapter 30 - Medical Providers-Fee for Service › Subchapter 5 - Individual Providers and Specialties › Part 9 - LONG-TERM CARE FACILITIES › Section 317:30-5-131.2 - Quality of care fund requirements and report

Current through Vol. 41, No. 20, July 1, 2024
(a)
Definitions.
The following
				  words and terms, when used in this Section, have the following meaning, unless
				  the context clearly indicates otherwise:
(1)
"Annualize"
means that the calculations, including, for example,
				  total patient days, gross revenue, or contractual allowances and discounts, is
				  divided by the total number of applicable days in the relevant time period.
(2)
"Direct-Care
				  Staff"
means any nursing or therapy staff who provides direct, hands-on
				  care to residents in a nursing facility and intermediate care facility for
				  individuals with intellectual disabilities pursuant to Section
				  1-1925.2
				  of Title 63 of the Oklahoma Statutes, pursuant to OAC 310:675-1 et seq., and as
				  defined in subsection (c) of this Section.
(3)
"Major Fraction Thereof"
means an additional threshold for direct-care-staff-to-resident ratios at which
				  another direct-care staff person(s) is required due to the peak in-house
				  resident count exceeding one-half of the minimum direct-care-staff-to-resident
				  ratio pursuant to Section
				  1-1925.2
				  of Title 63 of the Oklahoma Statutes.
(4)
"Nursing Facility and Intermediate
				  Care Facility for Individuals with Intellectual Disabilities"
means any
				  home, establishment, or institution or any portion thereof, licensed by the
				  Oklahoma State Department of Health (OSDH) as defined in Section
				  1-1902 of
				  Title 63 of the Oklahoma Statutes.
(5)
"Peak In-House Resident
				  Count"
means the maximum number of in-house residents at any point in
				  time during the applicable shift.
(6)
"Quality of Care Fee"
means
				  the fee assessment created for the purpose of quality care enhancements
				  pursuant to Section
				  2002
				  of Title 56 of the Oklahoma Statutes upon each nursing facility and
				  intermediate care facility for individuals with intellectual disabilities
				  licensed in this state.
(7)
"Quality of Care Fund"
means a revolving fund established in the
				  State Treasury pursuant to Section
				  2002
				  of Title 56 of the Oklahoma Statutes.
(8)
"Quality of Care Report"
means the monthly report developed by the Oklahoma Health Care Authority (OHCA)
				  to document the staffing ratios, total patient gross receipts, total patient
				  days, and minimum wage compliance for specified staff for each nursing facility
				  and intermediate care facility for individuals with intellectual disabilities
				  licensed in the state.
(9)
"Service Rate"
means the minimum direct-care-staff-to-resident
				  rate pursuant to Section
				  1-1925.2
				  of Title 63 of Oklahoma Statutes and pursuant to OAC 310:675-1 et seq.
(10)
"Staff Hours Worked by
				  Shift"
means the number of hours worked during the applicable shift by
				  direct-care staff.
(11)
"Staffing Ratios"
means the minimum direct-care-staff-to-resident
				  ratios pursuant to Section
				  1-1925.2
				  of Title 63 of the Oklahoma Statutes and pursuant to OAC 310:675-1 et seq.
(12)
"Total Gross
				  Receipts"
means all cash received in the current Quality of Care Report
				  month for services rendered to all residents in the facility. Receipts should
				  include all Medicaid, Medicare, private pay, and insurance including receipts
				  for items not in the normal per diem rate. Charitable contributions received by
				  the nursing facility are not included.
(13)
"Total Patient Days"
means
				  the monthly patient days that are compensable for the current monthly Quality
				  of Care Report.