reglab/statecodes huggingface dataset:
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-07.1 - Ratesetting for Basic Care Facilities › Section 75-02-07.1-13 - Related organizations

Current through Supplement No. 393, July, 2024
1. Except as
				provided in subsection 4, costs applicable to services, facilities, and
				supplies furnished to a provider by a related organization may not exceed the
				lower of the cost to the related organization or the price of comparable
				services, facilities, or supplies purchased elsewhere primarily in the local
				market. The provider shall identify the related organizations and costs in the
				cost report.
2. A provider may
				lease a facility from a related organization within the meaning of ratesetting
				principles. In such case, the rent paid to the lessor by the provider is not
				allowable as cost. The provider may include in its cost the allowable costs of
				ownership of the facility. These costs are property insurance, depreciation as
				provided for in section
				75-02-07.1-15, interest on the
				mortgage as provided for in section
				75-02-07.1-16, and real estate
				taxes as provided for in section
				75-02-07.1-17. Other operating
				expenses of the related organization, relating to the leased facility, are not
				includable by the provider as an allowable cost of ownership, but may be
				included as allowable operating expenses subject to subsection 1.
3. The relationship between a provider and a
				related organization at the time a transaction between the two parties occurs
				must govern the treatment of cost regardless of subsequent events that may
				change the relationship between the parties.
4. In the case of a facility acquired through
				purchase of shares, interest and depreciation expense are treated in the same
				manner as if the capital assets of the acquired corporation were acquired as an
				ongoing operation by the acquiring entity on the day the secretary of state
				issues a certificate of dissolution of the acquired corporation if organized in
				North Dakota, or on the day the acquired corporation is irrevocably dissolved
				if organized other than in North Dakota, provided the transaction has all of
				the following characteristics:
a. The
				facility was owned and operated by the acquired corporation;
b. The acquired corporation is irrevocably
				dissolved, and all of its capital assets become the property of the acquiring
				entity, within one year after the first day on which any ownership interest in
				the acquired corporation was acquired by the acquiring entity; and
c. Neither the acquiring entity nor any
				related organization of the acquiring entity has had any ownership interest in
				the acquired corporation, or any ownership interest in any related organization
				of the acquired corporation, for at least ten years prior to the day the
				acquiring entity, or a related organization of the acquiring entity, first
				acquired any ownership interest in the acquired corporation.
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-07.1 - Ratesetting for Basic Care Facilities › Section 75-02-07.1-14 - Compensation

Current through Supplement No. 393, July, 2024
1. Compensation on an annual basis for top
				management personnel must be limited, prior to allocation, if any, to the
				greatest of:
a. The highest market-driven
				compensation of an administrator employed by a freestanding not-for-profit
				facility during the previous report year increased by the consumer price index
				for all urban consumers, United States city average, all items;
b. If the facility is combined with a nursing
				facility or hospital, the compensation limit for top management personnel as
				determined by
				chapter
				75-02-06, except the
				allocation of the compensation to the basic care facility may not exceed
				subdivision a; or
c. For a facility
				licensed before July 1, 2016, which is located in North Dakota and shares a
				home office that is also located in North Dakota with no more than two nursing
				facilities that are located in North Dakota, but whose cost report does not
				include nursing facility costs, the compensation limit for top management
				personnel as determined by
				75-02-06, except the allocation
				of the compensation to the basic care facility may not exceed subdivision
				a.
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-07.1 - Ratesetting for Basic Care Facilities › Section 75-02-07.1-15 - Depreciation

Current through Supplement No. 393, July, 2024
1. Ratesetting principles require that
				payment for services include depreciation on all capital assets used to provide
				necessary services.
a. Capital assets that
				may have been fully or partially depreciated on the books of the provider, but
				are in use at the time the provider enters the program, may be depreciated. The
				useful lives of such assets are considered not to have ended and depreciation
				calculated on the revised extended useful life is allowable. To properly
				provide for costs or the valuation of such assets, an appraisal is required if
				the provider has no historical cost records or has incomplete records of the
				capital assets.
b. A depreciation
				allowance is permitted on assets used in a normal standby or emergency
				capacity.
c. If any depreciated
				personal property asset is sold or disposed of for an amount different than its
				undepreciated value, the difference represents an incorrect allocation of the
				cost of the asset to the facility and must be included as a gain or loss on the
				cost report. The facility shall use the sale price in computing the gain or
				loss on the disposition of assets.
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-07.1 - Ratesetting for Basic Care Facilities › Section 75-02-07.1-16 - Interest expense

Current through Supplement No. 393, July, 2024
1. To be allowable,
				interest expense must meet all of the following criteria:
a. Interest expense must be supported by
				evidence of an agreement that funds were borrowed and that payment of interest
				and repayment of the funds is required.
b. Interest expense must be identifiable in
				the facility's accounting records.
c. Interest expense must be related to the
				reporting period in which the costs are incurred.
d. Interest expense must be necessary and
				proper for the operation, maintenance, or acquisition of the facility.
e. Interest expense must not
				relate to funds borrowed to finance costs of assets in excess of the
				depreciable cost basis established at the time of purchase as recognized in
				section 75-02-07.1-15.
f. If associated with refinancing or
				refunding debt, interest expense associated with the original borrowing must
				have been allowable when the debt was initially incurred.
g. If associated with borrowing for the
				purpose of acquiring assets as an ongoing operation in a bona fide sale,
				interest expense must be limited to the amount of interest associated with
				borrowing, occurring at the time of the sale, that does not exceed ninety
				percent of the cost basis as determined in subsection 6 of section
				75-02-07.1-15.
h. In a sale not bona fide, interest expense
				may not exceed the amount that would have been allowable had the sale not
				occurred.
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-07.1 - Ratesetting for Basic Care Facilities › Section 75-02-07.1-17 - Taxes

Current through Supplement No. 393, July, 2024
1. Taxes assessed against the provider, in
				accordance with the levying enactments of the several states and lower levels
				of government and for which the provider is liable for payment, are allowable
				costs. Tax expense may not include fines, penalties, or those taxes identified
				as nonallowable costs in section
				75-02-07.1-10.
2. Whenever exemptions to taxes are legally
				available, the provider is to take advantage of them. If the provider does not
				take advantage of available exemptions, the expense incurred for the taxes is
				not an allowable cost.
3. Special
				assessments in excess of one thousand dollars paid in a lump sum must be
				capitalized and depreciated. Special assessments not paid in a lump sum may be
				expensed as they are billed by the taxing authority.
General Authority: NDCC
					 50-06-16,
					 50-24.5-02(3)
Law Implemented: NDCC
					 50-24.5-02(3)
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-07.1 - Ratesetting for Basic Care Facilities › Section 75-02-07.1-18 - Startup costs

Current through Supplement No. 393, July, 2024
In the first stages of operation, a new facility incurs
				  certain costs in developing its ability to care for residents prior to
				  admission. Staff is obtained and organized, and other operating costs are
				  incurred during this time of preparation that cannot be allocated to resident
				  care because there are no residents receiving services. These costs are
				  commonly referred to as startup costs. Actual allowable startup costs may be
				  considered as deferred charges and allocated over a number of periods that
				  benefit from the costs. Where a facility has properly capitalized startup costs
				  as a deferred charge, the startup costs must be recognized as allowable costs
				  amortized over sixty consecutive months starting with the month in which the
				  first resident is admitted.
General Authority: NDCC
					 50-06-16,
					 50-24.5-02(3)
Law Implemented: NDCC
					 50-24.5-02(3)
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-07.1 - Ratesetting for Basic Care Facilities › Section 75-02-07.1-19 - Funded depreciation

Current through Supplement No. 393, July, 2024
1. Funding
				of depreciation is the practice of placing funds, including nonborrowed bond
				reserve and sinking funds, in a segregated account for the acquisition of
				capital assets used in rendering resident care or for other capital purposes
				related to resident care. Other capital purposes include capital debt
				liquidation, such as principal payments for bonds and mortgages.
2. All provisions of this subsection must be
				met in order to qualify as funding of depreciation. If the provisions are not
				met, income earned on investments must be offset to interest expense.
a. The action to fund depreciation must be
				approved by the appropriate managing body of the facility.
b. The fund or funds must be clearly
				designated in the facility's records as funded depreciation.
c. Funded depreciation (total market value of
				fund) must be available, unless contractually committed as provided in
				subsections 8 and 9, on an as-needed basis for the acquisition of the
				facility's capital assets used to render resident care, or for other capital
				purposes related to resident care. Loans made from funded depreciation do not
				alter the requirement that funded depreciation must be available.
d. Income earned on investments in the fund
				must be deposited in and become part of the funded depreciation account.
e. Deposits to the funded
				depreciation account must remain for six months or more to be considered as
				funded depreciation. Deposits of less than six months are not eligible for the
				benefits of the funded depreciation account. Investment income earned prior to
				elapse of the six-month period may not be offset unless the deposits are
				actually withdrawn and then only if the withdrawal is not for capital purposes.
f. Funded depreciation may not be
				restricted for a specific or future purpose.
g. When a provider invests or transfers the
				assets of the fund to a home office of a chain organization or the motherhouse
				or governing body of a religious order or to other related parties, the assets
				are considered to be the facility's funds and are subject to all provisions of
				this section.
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-07.1 - Ratesetting for Basic Care Facilities › Section 75-02-07.1-20 - Rate calculation

Current through Supplement No. 393, July, 2024
1. For each cost
				category, the actual rate is calculated using allowable historical operating
				costs plus adjustment factors provided for in section
				75-02-07.1-21 for the direct care,
				indirect care, and food and plant cost categories, divided by in-house resident
				days for the direct care and indirect care cost categories and resident days
				for the food and plant and property cost categories. The actual rate as
				calculated for direct care and indirect care is compared to the limit rate for
				each category to determine the lesser of the actual rate or the limit rate. The
				lesser of the actual rates or the limit rates for the direct personal care and
				indirect personal care costs and the operating margin are added to establish
				the facility's personal care rate. The rates for property costs, food and plant
				costs, the operating margin for room and board, and the lesser of the actual
				rates or the limit rates for direct room and board and indirect room and board
				costs are added to establish the facility's room and board rate. The sum of the
				personal care rate and the room and board rate is the facility's established
				rate.
2. The established rate for
				a licensed nursing facility providing services to an eligible beneficiary is:
a. For a nursing facility that shares basic
				services with a licensed basic care facility, the rate established for the
				licensed basic care facility as provided for in subsection 1; and
b. For a nursing facility that does not share
				basic services with a licensed basic care facility, the sum of the limit rates
				for direct care and indirect care costs, the maximum three percent operating
				margin calculated in section
				75-02-07.1-21, and a rate
				calculated using allowable food and plant and property costs and census used in
				establishing the nursing facility's current rate under 75-02-06.
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-07.1 - Ratesetting for Basic Care Facilities › Section 75-02-07.1-21 - Adjustment factor for direct care, indirect care, and food and plant costs

Current through Supplement No. 393, July, 2024
The adjustment factor will be applied to adjust historical
				  costs. The adjustment factor will be used to adjust direct care, indirect care,
				  and food and plant costs, exclusive of bad debt expense.
General Authority:
NDCC 50-06-16,
					 50-24.5-02(3)
Law Implemented:
NDCC
					 50-24.5-02(3)
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-07.1 - Ratesetting for Basic Care Facilities › Section 75-02-07.1-22 - Rate limitations

Current through Supplement No. 393, July, 2024
Historical costs, as adjusted, for all facilities for which a
				  rate is established excluding specialized facilities for individuals with
				  mental disease, must be used in the establishment of a limit rate for the
				  direct care and indirect care cost categories. The actual rate for each cost
				  category for each facility must be determined in accordance with this chapter.
				  When establishing a facility's rate:
1. Except for a specialized facility for
				individuals with mental disease, a facility with an actual rate that exceeds
				the limit rate for direct care cost category shall receive the limit rate for
				that cost category;
2. A
				specialized facility for individuals with mental disease with an actual rate
				that exceeds two times the limit rate for the direct care cost category shall
				receive the limit rate times two for that cost category; and
3. A facility with an actual rate that
				exceeds the limit rate for the indirect care cost category shall receive the
				limit rate for that cost category. A facility shall receive an operating margin
				of three percent based on the lesser of the actual direct care rate, exclusive
				of the adjustment factor, or the direct care limit rate, exclusive of the
				adjustment factor, established for the rate year.
4. The July 1, 2023, direct care limit rate
				is seventy-six dollars and ninety-one cents.
5. The July 1, 2023, indirect care limit rate
				is sixty-two dollars and seventy-nine cents.
6. The department may use an adjustment
				factor to calculate the direct care and indirect care limits for future rate
				years within legislative appropriation.
General Authority:
NDCC 50-06-16,
					 50-24.5-02(3)
Law Implemented:
NDCC
					 50-24.5-02(3)
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-07.1 - Ratesetting for Basic Care Facilities › Section 75-02-07.1-23 - Rates

Current through Supplement No. 393, July, 2024
1.
Desk audit rate.
a. The cost report must be reviewed taking
				into consideration the prior year's adjustments. The facility must be notified
				by telephone or electronic mail of any adjustments based on the desk review.
				Within seven working days after notification, the facility may submit
				information to explain why the desk adjustment may not be made. The department
				shall review the information and make any appropriate adjustments.
b. The desk audit rate must be effective July
				first of each rate year unless the department specifically identifies an
				alternative effective date, and must continue in effect until a final rate is
				established.
c. The desk rate may
				be adjusted for special rates or one-time adjustments provided for in section
				75-02-07.1-25 or
				75-02-07.1-26.
d. The desk rate may be adjusted to reflect
				errors, omissions, or adjustments for the report year that results in a change
				of at least twenty-five cents per day.
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-07.1 - Ratesetting for Basic Care Facilities › Section 75-02-07.1-24 - Rate payments

Current through Supplement No. 393, July, 2024
1. The established
				rate must be considered as payment for all accommodations and includes all
				items includable as allowable under this chapter for an eligible beneficiary.
				No payment may be solicited or received from the eligible beneficiary or any
				other person to supplement the rate as established, unless otherwise provided
				for in this chapter.
2. The
				department may supplement the income of an eligible beneficiary receiving
				necessary basic care services only if the lowest rate charged to private-pay
				residents equals or exceeds the established rate. If at any time the facility
				discounts rates for private-pay residents, the discounted rate must be the
				maximum chargeable to an eligible beneficiary for the same bed type, including
				medical leave or therapeutic leave days.
3. If the established rate exceeds the rate
				charged to a private-pay resident on any given date, the facility shall
				immediately report that fact to the department and charge an eligible
				beneficiary at the lower rate. If payments were received at the higher rate,
				the facility shall, within thirty days, refund the overpayment to the
				department. The refund must be the difference between the established rate and
				the rate charged the private-pay residents times the number of resident days
				paid for eligible beneficiaries during the period in which the established rate
				exceeded the rate charged to the private-pay residents, plus interest
				calculated at two percent over the Bank of North Dakota prime rate on any
				amount not repaid within thirty days. The refund provision also applies to all
				duplicate billings involving the department. Interest charges on these refunds
				are not allowable costs.
4. The
				established rate is paid based on a prospective ratesetting procedure. No
				retroactive settlements for actual costs incurred during the rate year that
				exceed the established rate may be made unless specifically identified in other
				sections of this chapter.
5. Peer
				groupings, limitations, or adjustments based upon data received from or
				relating to more than one facility are effective for a rate period. Any change
				in the data used to establish peer groupings, limitations, or adjustments may
				not be used to change the peer groupings, limitations, or adjustments during
				the rate period, except with respect to the specific facility or facilities to
				which the data change relates.
General Authority: NDCC
					 50-06-16,
					 50-24.5-02(3)
Law Implemented: NDCC
					 50-24.5-02(3)
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-07.1 - Ratesetting for Basic Care Facilities › Section 75-02-07.1-25 - Special rates

Current through Supplement No. 393, July, 2024
1. For a new
				facility, the department shall establish an interim rate equal to the lesser of
				the limit rates for direct and indirect care for the rate year in which the
				facility begins operation, plus the maximum operating margin, plus a room and
				board rate equal to the average food and plant rate, of all facilities for
				which a rate was established for the rate year, plus a projected property rate
				calculated based on projected property costs and imputed census, or a rate
				established based on an annual budget submitted by the facility. The interim
				rate may be in effect for no more than eighteen months. No retroactive
				adjustment may be made to the rate.
a. If the
				effective date of the interim rate is on or after September first and on or
				before December thirty-first, the interim rate must be effective for the
				remainder of that rate year and must continue through December thirty-first of
				the subsequent rate year. By August thirty-first, the facility shall file an
				interim cost report for the period ending June thirtieth of the period in which
				the facility first provides services. The interim cost report is used to
				establish the actual rate to be effective January first of the subsequent rate
				year.
b. If the effective date of
				the interim rate is on or after January first and on or before June thirtieth,
				the interim rate must remain in effect through the end of the subsequent rate
				year. By March first, the facility shall file a cost report for the partial
				report year ending December thirty-first of the subsequent rate year. This cost
				report must be used to establish the rate for the next subsequent rate
				year.
c. If the effective date of
				the interim rate is on or after July first and on or before August
				thirty-first, the interim rate must remain in effect through the end of the
				rate year in which the interim rate becomes effective. By March first, the
				facility shall file a cost report for the period ending December thirty-first
				of the current rate year. This cost report must be used to establish the rate
				for the subsequent rate year.
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-07.1 - Ratesetting for Basic Care Facilities › Section 75-02-07.1-26 - One-time adjustments

Current through Supplement No. 393, July, 2024
1.
Adjustments to meet licensure standards.
a. The department may provide for an increase
				in the established rate for additional costs incurred to meet licensure
				standards. The survey conducted by the department's public health division must
				clearly require that the facility take steps to correct deficiencies dealing
				with resident care. The plan of correction must identify the salary or other
				costs increased to correct the deficiencies cited in the survey
				process.
b. The facility shall
				submit a written request to the department within thirty days of submitting the
				plan of correction to the department's public health division. The request
				must:
(1) Include a statement that costs or
				staff numbers have not been reduced for the report year immediately preceding
				the department's public health division's licensure survey;
(2) Identify the number of new staff or
				additional staff hours and the associated costs required to meet the licensure
				standards;
(3) Provide a detailed
				list of any other costs necessary to meet licensure standards;
(4) Describe how the facility shall meet
				licensure standards if the adjustment is received, including the number and
				type of staff to be added to the current staff and the projected salary and
				fringe benefit cost for the additional staff; and
(5) Document that all available resources,
				including efficiency incentives, if used to increase staffing, are not
				sufficient to meet licensure standards.
c. The department shall review the submitted
				information and may request additional documentation or conduct onsite
				visits.
d. If an increase in costs
				is approved, the adjustment must be calculated based on the costs necessary to
				meet licensure standards less any incentives included when calculating the
				established rate. The net increase must be divided by resident days and the
				amount calculated must be added to the established rate. This rate must then be
				subject to any rate limitations that may apply.
e. Any additional funds provided must be used
				in accordance with the facility's written request to the department and are
				subject to audit. If the department determines that the funds were not used for
				the intended purpose, an adjustment must be made in accordance with section
				75-02-07.1-23.
f. If the actual cost of implementation
				exceeds the amount included in the adjustment, no retroactive settlement may be
				made.
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-07.1 - Ratesetting for Basic Care Facilities › Section 75-02-07.1-27 - No rate adjustments of less than twenty-five cents per day

Current through Supplement No. 393, July, 2024
Under no circumstances, including an appeal or judicial
				  decision to the effect that a rate was erroneously established, may a rate
				  adjustment be made unless the cumulative impact of adjustments equals or
				  exceeds twenty-five cents per day.
General Authority: NDCC
					 50-06-16,
					 50-24.5-02(3)
Law Implemented: NDCC
					 50-24.5-02(3)
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-07.1 - Ratesetting for Basic Care Facilities › Section 75-02-07.1-28 - Notification of rates

Current through Supplement No. 393, July, 2024
The department shall notify each facility of the desk audit
				  rate on or before May twenty-first of the year in which the rate year begins.
General Authority: NDCC
					 50-06-16,
					 50-24.5-02(3)
Law Implemented: NDCC
					 50-24.5-02(3)
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-07.1 - Ratesetting for Basic Care Facilities › Section 75-02-07.1-29 - Reconsiderations and appeals

Current through Supplement No. 393, July, 2024
1.
Reconsiderations.
a. Any
				requests for reconsideration of the final rate must be filed with the
				department within thirty days of the date of the rate notification.
b. A request for reconsideration must
				include:
(1) A statement of each disputed
				item and the reason or basis for the dispute;
(2) The dollar amount of each adjustment that
				is disputed; and
(3) The authority
				in statute or rule upon which the facility is relying for each disputed item.
c. The department may
				request additional documentation or information relating to the disputed item.
				If additional documentation is not provided within fourteen days of the
				department's request, the department shall make its determination based on the
				information and documentation available as of the fourteenth day following the
				date the department requested additional documentation.
d. The department shall make a determination
				regarding the reconsideration within forty-five days of receiving the
				reconsideration filing and any requested documentation.
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-07.1 - Ratesetting for Basic Care Facilities › Section 75-02-07.1-30 - Resident personal funds

Current through Supplement No. 393, July, 2024
1. A
				facility may not require a resident to deposit personal funds with the
				facility.
2. Upon written
				authorization of a resident or the resident's legal representative, a facility
				shall hold, safeguard, manage, and account for the resident's personal funds
				deposited with the facility.
3. A
				facility may not charge the resident for holding, safeguarding, managing, or
				accounting for the resident's personal funds. Any related administrative costs,
				including bank charges, must be included in the daily rate. A facility may not
				impose a charge against a resident's personal funds for any item or service
				included in the daily rate.
4. A
				facility may maintain a resident's personal funds not exceeding one hundred
				dollars in a noninterest-bearing account. A facility shall deposit any
				resident's personal funds in excess of one hundred dollars in an
				interest-bearing account separate from any of the facility's accounts. The
				facility shall credit interest earned to the resident's account.
5. A facility shall maintain a system that
				ensures a full, complete, and separate accounting, according to generally
				accepted accounting principles, of each resident's personal funds. An
				individual financial record must be available on request and a written
				accounting of transactions must be provided quarterly to the resident or the
				resident's legal representative.
6. A resident's personal funds may not be
				commingled with any facility funds or with funds of any person other than
				another resident.
7. Upon death of
				a resident, a facility shall promptly convey the resident's personal funds, and
				a final accounting of those funds, to the individual administering the
				resident's estate. For purposes of this section, an "individual administering
				the resident's estate" includes a person lawfully empowered to facilitate the
				transfer of small estates without the use of a personal representative.
General Authority: NDCC
					 50-06-16,
					 50-24.5-02(3)
Law Implemented: NDCC
					 50-24.5-02(3)
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-08 - Homes for the Aged and Infirm [Repealed]

Current through Supplement No. 393, July, 2024
Determined repealed by the
				office of the Legislative Council pursuant to subsection 3 of North Dakota
				Century Code section
				28-32-03 because the authority for
				the adoption of the rules was repealed by S.L. 1989, ch. 317 and replacement
				rules, chapter 33-03-24, were adopted by the
				Department of Health and Consolidated Laboratories effective December 1,
				1990.
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-09 - Ratesetting for Psychiatric Residential Treatment Facilities › Section 75-02-09-02 - Financial reporting requirements

Current through Supplement No. 393, July, 2024
1.
				Records.
a. The facility shall maintain on
				the premises census records and financial information sufficient to provide for
				a proper audit or review. For any cost being claimed on the cost report,
				sufficient data must be available as of the audit date to fully support the
				report item.
b. If several
				facilities are associated with a group and their accounting and reports are
				centrally prepared, added information must be submitted for those items known
				to be lacking support at the reporting facility prior to the audit or review of
				the facility. Accounting or financial information regarding a related
				organization must be readily available to substantiate cost.
c. Each facility shall maintain, until any
				rate based upon a cost report is final and not subject to any appeal, but in
				any event, for a period of not less than three years following the date of
				submission of the cost report to the state agency, accurate financial and
				statistical records of the period covered by the cost report in sufficient
				detail to substantiate the cost data reported. Each facility shall make the
				records available upon reasonable demand to representatives of the department.
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-09 - Ratesetting for Psychiatric Residential Treatment Facilities › Section 75-02-09-03 - General cost principles

Current through Supplement No. 393, July, 2024
1. For
				ratesetting purposes, a cost must:
a. Be
				ordinary, necessary, and related to resident care;
b. Be no more than an amount a prudent and
				cost-conscious business person would pay for the specific good or service in
				the open market in an arm's-length transaction; and
c. Be for goods or services actually provided
				by the facility.
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-09 - Ratesetting for Psychiatric Residential Treatment Facilities › Section 75-02-09-04 - Ratesetting

Current through Supplement No. 393, July, 2024
1. The established rate is based on
				prospective ratesetting procedures. The establishment of a rate begins with
				historical costs. Adjustments are then made for claimed costs not includable in
				allowable costs. Adjustment factors are then applied to allowable costs.
				Retroactive settlements for actual costs incurred during the rate year
				exceeding the final rate will not be made unless specifically provided in this
				chapter.
2. The department shall
				establish a desk rate, based on the cost report, which will be effective the
				first day of the seventh month following the facility's fiscal yearend or on an
				alternate effective date determined by the department.
a. The desk rate will continue in effect
				until a final rate is established.
b. The cost report will be reviewed taking
				into consideration the prior year's adjustments. A facility will be notified by
				telephone or mail of any desk adjustments based on the desk review. Within
				seven working days after notification, the facility may submit information to
				explain why a desk adjustment should not be made. The department shall review
				the submitted information, make appropriate adjustments, including adjustment
				factors, and issue the desk rate.
c. Reconsideration will not be given by the
				department for the desk rate unless the facility has been notified that the
				desk rate is the final rate.
d. A
				desk rate may be adjusted at any time if subsection 4 applies to the facility.
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-09 - Ratesetting for Psychiatric Residential Treatment Facilities › Section 75-02-09-05 - Resident census

Current through Supplement No. 393, July, 2024
1. A daily census
				record must be maintained by the facility. Any day services are provided or for
				which payment is ordinarily sought for an available bed must be counted as a
				resident day. The day of admission and day of death are resident days. The day
				of discharge will be counted if payment is sought for that day. For a medical
				assistance resident, payment may not be sought for any day on which the
				resident was not in the facility or for the day of discharge.
2. The daily census records must include:
a. Identification of the resident;
b. Entries for all days, and not just by
				exception; and
c. Identification
				of type of day, i.e., in-house or leave day.
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-09 - Ratesetting for Psychiatric Residential Treatment Facilities › Section 75-02-09-06 - Allowable costs by cost category

Current through Supplement No. 393, July, 2024
1.
				Administration costs are those allowable costs of activities performed by the
				staff in which the direct recipient of the activity is the organization itself,
				including fiscal activities, statistical reporting, recruiting, and general
				office management indirectly related to reimbursable services provided.
				Administration personnel includes administrators, regional directors, program
				directors, accounting personnel, clerical personnel, secretaries,
				receptionists, data processing personnel, purchasing personnel, and security
				personnel. Administration costs directly assignable to the facility must be
				reported as facility administration. Administration costs not directly
				assignable to the facility must be reported as other administration. Costs for
				administration include:
a. Salary and fringe
				benefits for individuals who provide services administrative in nature or who
				are not included specifically in any other cost category;
b. Office supplies;
c. Insurance, except property insurance and
				insurance included as a fringe benefit;
d. Postage and freight;
e. Professional fees for services such as
				legal, accounting, and data processing;
f. Central or home office costs;
g. Personnel recruitment costs;
h. Management consultants and fees;
i. Dues, license fees, and
				subscriptions;
j. Travel and
				training for employees;
k.
				Interest on funds borrowed for working capital;
I. Startup costs;
m. Telephone service not included in other
				cost categories; and
n. All costs
				not specifically identified in other cost categories.
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-09 - Ratesetting for Psychiatric Residential Treatment Facilities › Section 75-02-09-07 - Cost allocation

Current through Supplement No. 393, July, 2024
1. Direct costing
				of allowable facility costs must be used whenever possible. If direct costing
				is not possible, the allocation methods for facility and nonfacility operations
				described in this subsection must be used.
a.
				Salaries for direct care employees, which cannot be reported based on direct
				costing, must be allocated using time studies. Time studies must be conducted
				at least semiannually for a two-week period or quarterly for a one-week period.
				The time study must represent a typical period of time when employees are
				performing normal work activities in each of their assigned areas of
				responsibility. Allocation percentages based on the time studies must be used
				starting with the next pay period following completion of the time study or
				averaged for the report year.
b.
				Salaries of supervisory personnel must be allocated based on full-time
				equivalents of the employees supervised or on a ratio of salaries.
c. Fringe benefits must be allocated based on
				the ratio of salaries to total salaries.
d. Plant and housekeeping expenses must be
				allocated based on square footage.
e. Property costs must be allocated based on
				square footage.
f. Administration
				costs must be allocated on the basis of the percentage of total costs,
				excluding the allocable administration costs.
g. Dietary costs must be allocated based on
				meals served.
h. Laundry costs
				must be allocated on the basis of pounds of laundry.
i. Vehicle expenses must be allocated based
				on mileage logs. Mileage logs must include documentation for all miles driven
				and purpose of travel. If sufficient documentation is not available to
				determine which cost category vehicle expenses are to be allocated, vehicle
				expenses must be allocated in total to administration.
j. Costs not direct costed or allocable using
				methods identified in subdivisions a through i must be included as
				administration costs.
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-09 - Ratesetting for Psychiatric Residential Treatment Facilities › Section 75-02-09-09 - Depreciation

Current through Supplement No. 393, July, 2024
1. Ratesetting principles require that
				payment for services should include depreciation on all depreciable type assets
				used to provide necessary services. This includes assets that may have been
				fully or partially depreciated on the books of the facility, but are in use at
				the time the facility enters the program. The useful lives of such assets are
				considered not to have ended and depreciation calculated on the revised
				extended useful life is allowable. Likewise, a depreciation allowance is
				permitted on assets used in a normal standby or emergency capacity. If any
				depreciated personal property asset is sold or disposed of for an amount
				different than its undepreciated value, the difference represents an incorrect
				allocation of the cost of the asset to the facility and must be included as a
				gain or loss on the cost report.
2. Depreciation methods.
a. The straight-line method of depreciation
				must be used. All accelerated methods of depreciation including depreciation
				options made available for income tax purposes, such as those offered under the
				asset depreciation range system, are unacceptable. The method and procedure for
				computing depreciation must be applied on a basis consistent from year to year,
				and detailed schedules of individual assets must be maintained. If the books of
				account reflect depreciation different than that submitted on the cost report,
				a reconciliation must be prepared by the facility.
b. A facility must use a minimum composite
				useful life of ten years for all equipment and land improvements, and four
				years for vehicles. Buildings and improvements to buildings are to be
				depreciated over the length of the mortgage or a minimum of twenty-five years,
				whichever is greater.
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-09 - Ratesetting for Psychiatric Residential Treatment Facilities › Section 75-02-09-10 - Interest expense

Current through Supplement No. 393, July, 2024
1. To be allowable
				under the program, interest must be:
a.
				Supported by evidence of an agreement that funds were borrowed and that payment
				of interest and repayment of the funds are required. Repayment of operating
				loans must be made within two years of the borrowing;
b. Identifiable in the facility's accounting
				records;
c. Related to the
				reporting period in which the costs are incurred;
d. Necessary and proper for the operation,
				maintenance, or acquisition of the facility. Necessary means that the interest
				be incurred on a loan made to satisfy a financial need of the facility and for
				a purpose reasonably related to resident care. Proper means that the interest
				be incurred at a rate not in excess of what a prudent borrower would have had
				to pay in an arm's-length transaction. In addition, the interest must be paid
				to a lender not related to the facility through common ownership or control;
e. Unrelated to funds borrowed to
				finance costs of assets in excess of the depreciable cost of the asset as
				recognized in section
				75-02-09-09; and
f. If associated with refinancing or
				refunding debt, interest expense associated with the original borrowing must
				have been allocable when the debt was initially incurred.
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-09 - Ratesetting for Psychiatric Residential Treatment Facilities › Section 75-02-09-11 - Taxes

Current through Supplement No. 393, July, 2024
1. Taxes assessed against the facility in
				accordance with the levying enactments of the several states and lower levels
				of government and for which the facility is liable for payment are allowable
				costs except for those taxes identified as nonallowable in section
				75-02-09-08.
2. Whenever exemptions to taxes are legally
				available, the facility is to take advantage of them. If the facility does not
				take advantage of available exemptions, the expense incurred for such taxes is
				not an allowable cost.
3. Special
				assessments in excess of one thousand dollars paid in a lump sum must be
				capitalized and depreciated. Special assessments not paid in a lump sum may be
				expensed as they are billed by the taxing authority.
General Authority: NDCC
					 50-24.1-04
Law Implemented:
					 42 USC
					 1396
					 a(a)(30)(A)
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-09 - Ratesetting for Psychiatric Residential Treatment Facilities › Section 75-02-09-12 - Home office costs

Current through Supplement No. 393, July, 2024
1. Home
				offices of chain organizations vary greatly in size, number of locations,
				staff, mode of operations, and services furnished to their member facilities.
				Although the home office of a chain is normally not a facility in itself, it
				may furnish to the individual facility central administration or other services
				such as centralized accounting, purchasing, personnel, or management services.
				Only the home office's actual costs of providing services is includable in the
				facility's allowable costs under the program.
2. Costs not allowed in the facility are not
				allowed as home office costs allocated to the facility.
3. Any service provided by the home office
				included in costs as payments by the facility to an outside vendor or which
				duplicates costs for services provided by the facility is a duplication of
				costs and is not allowed.
4. Where
				the home office makes a loan to or borrows money from one of the components of
				a chain organization, the interest paid is not an allowable cost and interest
				income is not used to offset interest expense.
General Authority: NDCC
					 50-24.1-04
Law Implemented:
					 42 USC
					 1396
					 a(a)(30)(A)
North Dakota Administrative Code › Title 75 - Department of Human Services › Article 75-02 - Economic Assistance › Chapter 75-02-09 - Ratesetting for Psychiatric Residential Treatment Facilities › Section 75-02-09-13 - Related organizations

Current through Supplement No. 393, July, 2024
1. Costs
				applicable to services, buildings, equipment, and supplies furnished to a
				facility by a related organization may not exceed the lower of the costs to the
				related organization or the price of comparable services, buildings, equipment,
				or supplies purchased elsewhere primarily in the local market. A facility must
				identify such related organizations and costs. If any such costs are allocated,
				the allocation methods and statistics supporting the allocations must be
				submitted with the cost report.
2.
				A facility may lease buildings or equipment from a related organization within
				the meaning of ratesetting principles. In such a case, the rent paid to the
				lessor by the facility is not allowable as cost unless the rent paid is less
				than the allowable costs of ownership. If rent paid exceeds the allowable costs
				of ownership, the facility may include only the allowable costs of ownership.
				These costs are property insurance, depreciation, interest on the mortgage,
				real estate taxes, and plant operation expenses incurred by the lessor.
General Authority: NDCC
					 50-24.1-04
Law Implemented:
					 42 USC
					 1396
					 a(a)(30)(A)