For the purposes of this chapter:
1."Actual allowable historical operating cost per diem" means the per diem operating
costs allowed by the department for the most recent reporting year.
2."Actual resident day" means a billable, countable day as defined by the department.
3."Department" means the department of health and human services.
4."Direct care costs" means the cost category for allowable nursing and therapy costs.
5."Fair rental value" means the depreciated replacement value of the building, fixed
equipment, moveable equipment, and land based on the facility's effective age. The
calculation of the fair rental value of the building and fixed equipment must include a
location factor, annual depreciation, and an annual replacement cost inflation factor.
6."Fair rental value rate
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For the purposes of this chapter:
1. "Actual allowable historical operating cost per diem" means the per diem operating
costs allowed by the department for the most recent reporting year.
2. "Actual resident day" means a billable, countable day as defined by the department.
3. "Department" means the department of health and human services.
4. "Direct care costs" means the cost category for allowable nursing and therapy costs.
5. "Fair rental value" means the depreciated replacement value of the building, fixed
equipment, moveable equipment, and land based on the facility's effective age. The
calculation of the fair rental value of the building and fixed equipment must include a
location factor, annual depreciation, and an annual replacement cost inflation factor.
6. "Fair rental value rate" means the per diem rate calculated using the fair rental value
and rental rate.
7. "Final rate" means the rate established after any adjustment by the department,
including adjustments resulting from cost report reviews and audits.
8. "Fringe benefits" means workforce safety and insurance, group health or dental
insurance, group life insurance, retirement benefits or plans, and uniform allowances,
and medical services furnished at nursing home expense.
9. "General and administrative costs" means all allowable costs for administering the
facility, including salaries of administrators, assistant administrators, accounting
personnel, data processing personnel, security personnel, and all clerical personnel;
board of directors' fees; business office functions and supplies; travel, except as
necessary for training programs for dietitians, nursing personnel, and direct resident
care related personnel required to maintain licensure, certification, or professional
standards requirements; telephone and telegraph; advertising; membership dues and
subscriptions; postage; insurance, except as included as a fringe benefit; professional
services such as legal, accounting, and data processing services; central or home
office costs; management fees; management consultants; employee training, for any
top management personnel and for other than direct resident care related personnel;
and business meetings and seminars.
10. "Historical operating costs" means the allowable operating costs incurred by the facility
during the reporting year immediately preceding the rate year for which the payment
rate becomes effective, after the department has reviewed those costs and determined
them to be allowable costs under the medical assistance program, and after the
department has applied appropriate limitations such as the limit on administrative
costs.
11. "Indirect care costs" means the cost category for allowable administration, plant,
housekeeping, medical records, chaplain, pharmacy, and dietary, exclusive of food
costs.
12. "Managed care organization" means a Medicaid managed care organization as that
term is defined in section 1903(m) of the Social Security Act [42 U.S.C. 1396b(m)].
13. "Margin cap" means a percentage of the price limit which represents the maximum
per diem amount a nursing home may receive if the facility has historical operating
costs below the price limit.
14. "Nursing home" means a facility, not owned or administered by the state government,
defined in section 43-34-01 or a facility owned or administered by the state, which
agrees to accept a rate established under this chapter.
15. "Operating costs" means the day-to-day costs of operating the facility in compliance
with licensure and certification standards.
16. "Other direct care costs" means the cost category for allowable activities, social
services, laundry, and food costs.
17. "Payment rate" means the rate determined under section 50-24.4-06.
18. "Payroll taxes" means the employer's share of Federal Insurance Contributions Act
taxes, governmentally required retirement contributions, and state and federal
unemployment compensation taxes.
19. "Private-paying resident" means a nursing home resident on whose behalf the nursing
home is not receiving medical assistance payments and whose payment rate is not
established by any governmental entity with ratesetting authority, including the
veterans' administration or Medicare, or whose payment rate is not negotiated by any
managed care organization contracting with a facility to provide services for the
resident.
20. "Rate year" means the fiscal year for which a payment rate determined under this
chapter is effective, from January first to the next December thirty-first.
21. "Reporting year" means the period from July first to June thirtieth, immediately
preceding the rate year, for which the nursing home submits reports required under
this chapter.
22. "Top management personnel" means owners, board members, corporate officers,
general, regional, and district managers, administrators, nursing home administrators,
and other persons performing functions ordinarily performed by such personnel.