Ohio Administrative Code › Title 5160 - Ohio Department of Medicaid › Chapter 5160-2 - Hospital Services › Section 5160-2-08 - Data policies for disproportionate share and indigent care adjustments for hospital services

Current through all regulations passed and filed through July 1, 2024
This rule sets forth the data used to determine assessments and
				adjustments, and the data policies that are applicable for each program year
				for all providers of hospital services included in the definition of "hospital"
				as described under section
				5168.01 of the Revised
				Code.
(A) Definitions.
(1) "Disproportionate share hospital" means a
			 hospital that meets the requirements for disproportionate share status as
			 defined in rule
			 5160-2-09
			 of the Administrative Code.
(2)
			 "Governmental hospital" means a county hospital with more than five hundred
			 beds or a state-owned and -operated hospital with more than five hundred
			 beds.
(3) "Hospital" means a
			 hospital that is described under section
			 5168.01 of the Revised Code.
(4) "Hospital care assurance
			 program fund" means the fund described under section
			 5168.11 of the Revised
			 Code.
(5) "Hospital care assurance
			 match fund" means the fund described under section
			 5168.11 of the Revised
			 Code.
(6) "Intergovernmental
			 transfer" means any transfer of money by a governmental hospital.
(7) "Health care
			 services administration fund" means the fund described under section
			 5162.54 of the Revised
			 Code.
(8) "Program year" means the twelve-month period
			 beginning on the first day of October and ending on the thirtieth day of
			 September.
(9) "Total facility costs" for each hospital means the
			 amount from the ODM 02930, "Ohio Medicaid
			 Hospital Cost Report," for the applicable state fiscal year, schedule B, column
			 3, line 202. For non-medicaid participating hospitals, total
			 facility costs shall be determined from the medicare cost report.
(10)
			 "Total skilled nursing facility costs" for each hospital means the amount on
			 the ODM 02930, schedule B, column 3, line 44. For non-medicaid participating
			 hospitals, total skilled nursing facility costs shall be determined from the
			 medicare cost report.
(11) "Total home
			 health facility costs" for each hospital means the amount on the ODM 02930,
			 schedule B, column 3, line 98. For non-medicaid participating hospitals, total
			 home health facility costs shall be determined from the medicare cost
			 report.
(12) "Total hospice facility costs" for each hospital
			 means the amount on ODM 02930, schedule B, column 3, line 99. For non-medicaid
			 participating hospitals, total hospice facility costs shall be determined from
			 the medicare cost report.
(13) "Total ambulance
			 costs" for each hospital means the amount on ODM 02930, schedule B, column 3,
			 line 95. For non-medicaid participating hospitals, total ambulance costs shall
			 be determined from the medicare cost report.
(14) "Total Durable
			 Medical Equipment (DME) rental costs" for each hospital means the amount on ODM
			 02930, schedule B, column 3, line 96. For non-medicaid participating hospitals,
			 total DME rental costs shall be determined from the medicare cost
			 report.
(15) "Total DME sold costs" for each hospital means
			 the amount on ODM 02930, schedule B, column 3, line 97. For non-medicaid
			 participating hospitals, total DME sold costs shall be determined from the
			 medicare cost report.
(16) "Other
			 non-hospital costs" for each hospital means separately identifiable
			 non-hospital operating costs found on worksheet B, Part I of the medicare cost
			 report, as determined by the department upon the request of the hospital, that
			 are permitted to be excluded from the provider tax in compliance with section
			 1903(w) of the Social Security Act.
(17) "Adjusted total
			 facility costs" means the result of subtracting the sum of the amounts defined
			 in paragraphs (A)(10), (A)(11), (A)(12), (A)(13),
			 (A)(14)and
			 (A)(15)  of this rule from the
			 amount defined in paragraph (A)(9) of this rule.