Pennsylvania Code › Title 55 - HUMAN SERVICES › Part III - MEDICAL ASSISTANCE MANUAL › Chapter 1187 - NURSING FACILITY SERVICES › Subchapter A - GENERAL PROVISIONS › Section 1187.2 - Definitions

Current through Register Vol. 54, No. 28, July 13, 2024
The following words and terms, when used in this chapter,
					 have the following meanings, unless the context clearly indicates
					 otherwise:
Accrual basis
-An accounting method by
					 which revenue is recorded in the period when it is earned, regardless of when
					 it is collected, and expenses are recorded in the period when they are
					 incurred, regardless of when they are paid.
Allowable bed
-A nursing facility bed that
					 is not subject to the limitation in §
										1187.113 (relating to capital
					 component payment limitation).
Allowable costs
-Costs as identified in
					 this chapter which are necessary and reasonable for an efficiently and
					 economically operated nursing facility to provide services to MA
					 residents.
Amortization-administrative costs
-Costs
					 not directly related to capital formation which are expended over a period
					 greater than 1 year.
Amortization-capital costs
-Preopening and
					 ongoing costs directly related to capital formation and development which are
					 expended over a period greater than 1 year. These costs include loan
					 acquisition expenses as well as interest paid during the construction or
					 preopening purchase period on a debt to acquire, build or carry real
					 property.
Audited MA-11 cost reports
-MA-11 cost
					 reports that have been subjected to desk or field audit procedures by the
					 Commonwealth and issued to providers.
Benefits, fringe
-Nondiscriminatory
					 employee benefits which are normally provided to nursing facility employees in
					 conjunction with their employment status.
Benefits, nonstandard
or
nonuniform
-Employe benefits provided to selected individuals,
					 which are not provided to all nursing facility employes in conjunction with
					 their employment status, or benefits which are not normally provided to
					 employes.
CMI-Case-Mix Index
-A number value score
					 that describes the relative resource use for the average resident in each of
					 the groups under the RUG-III classification system based on the assessed needs
					 of the resident.
CMI Report
-A report generated by the
					 Department from submitted resident assessment records and tracking forms and
					 verified by a nursing facility each calendar quarter that identifies the total
					 facility and MA CMI average for the picture date, the residents of the nursing
					 facility on the picture date and the following for each identified
					 resident:
(i) The resident's payor
				  status.
(ii) The resident's RUG
				  category and CMI.
(iii) The
				  resident assessment used to determine the resident's RUG category and CMI and
				  the date and type of the assessment.
Classifiable data element
-A data element
					 on the Federally Approved Pennsylvania Specific Minimum Data Set (PA specific
					 MDS) which is used for the classification of a resident into one of the RUG-III
					 categories.
Cost centers
-The four general categories
					 of costs:
(i) Resident care
				  costs.
(ii) Other resident related
				  costs.
(iii) Administrative
				  costs.
(iv) Capital
				  costs.
County nursing facility
-
(i) A long-term care nursing facility that
				  is:
(A) Licensed by the Department of
				  Health.
(B) Enrolled in the MA
				  program as a provider of nursing facility services.
(C) Controlled by the county institution
				  district or by county government if no county institution district
				  exists.