South Dakota Administrative Rules › Title 67 - Department of Social Services › Article 67:16 - Covered medical services › Chapter 67:16:04 - Nursing facility rate setting › Section 67:16:04:33 - Definitions

Current through Register Vol. 51, page 10, July 15, 2024
Terms used in this chapter mean:
(1) "Administration costs," costs defined in
  the statistical and cost summary report which include the administrator's and
  assistant administrator's salaries, administrative travel, office salaries,
  office supplies and expenses, central office and home office expenses, dues,
  fees, subscriptions, professional license fees, and legal and accounting
  expense if these costs are related to patient care;
(2) "Capital costs," costs associated with
  building insurance, building depreciation, furniture and equipment
  depreciation, amortization of organization and preoperating costs, mortgage
  interest, rent on the facility and grounds, equipment rent, and return on net
  equity;
(3) "Case mix," the mixture
  of residents of different classifications within a nursing facility;
(4) "Case mix score," the average of the
  Patient Driven Payment Model nursing case mix group weights for residents in a
  facility over a particular time period;
(5) "Chain organization," a group of two or
  more health care facilities that are owned, leased, or otherwise controlled by
  one organization;
(6) "Desk audit,"
  a review of the statistical and cost reports to determine omissions, erroneous
  calculations, reasonableness of selected cost items, and compliance with other
  reporting requirements before establishing a database from which per diem rates
  are established
(7) "Field audit,"
  a comprehensive on-site review of the statistical and cost reports to determine
  omissions, erroneous calculations, reasonableness of selected cost items, and
  compliance with other reporting requirements before establishing a database
  from which per diem rates are established;
(8) "Hospital-affiliated nursing facility," a
  licensed nursing facility that is under common ownership with and is operated
  by the same administrative authority as the licensed hospital and shares on a
  daily basis common service areas and which is required to use the stepdown
  method of allocation required by Medicare if the stepdown results in part of
  the cost of the shared areas being allocated between the hospital and the
  nursing facility and if the stepdown numbers are the numbers used for Medicare
  reimbursement;
(9) "Nursing
  facility," any facility that is licensed, maintained, and operated for the
  express or implied purpose of providing care to one or more persons, whether
  for consideration or not, who are not acutely ill but require nursing care and
  related medical services of such complexity as to require professional nursing
  care under the direction of a physician twenty-four hours a day;
(10) "Over-the-counter medications,"
  medications that can be purchased by the general public without a physician or
  other licensed practitioner's prescription;
(11) "Patient Driven Payment Model nursing
  case mix group," the relative ratio of resources required to care for one class
  of residents when compared to another class of residents as measured by the
  resident assessment;
(12)
  "Related-party transaction," a business transaction between parties having a
  common ownership or control interest;
(13) "Resident assessment," a comprehensive
  assessment of a nursing facility resident completed under §
									44:73:06:10;
(14) "Routine services," services and items
  necessary for the care, treatment, and comfort of a resident;
(15) "Salvage value," the estimated value of
  a depreciable asset at the end of its useful life. The value is estimated at
  the time of acquisition or construction and is deducted from the cost of the
  depreciable property to arrive at the basis for depreciation;
(16) "Stepdown method of allocation," an
  accounting methodology in which costs flow from nonrevenue-producing cost
  centers to revenue-producing cost centers. On ledgers showing this allocation,
  the lists of numbers take on a visual tiering appearance from the left of the
  page to the right;
(17)
  "Straight-line depreciation method," a procedure followed in depreciation
  computations that assigns equal segments of the cost of an item to the benefits
  to be yielded by the item, often over a period of time; and
(18) "Swing-bed hospital," an acute care
  general hospital that has been approved by the Department of Health to provide
  short-term nursing facility services in a portion of its licensed hospital beds
  pending the availability of a nursing facility bed.
General Authority:
SDCL
		28-6-1.
Law Implemented:
SDCL
		28-6-1(1)(2)(4).