Code of Massachusetts Regulations
114 CMR - DIVISION OF HEALTH CARE FINANCE AND POLICY
Title 114.1 CMR 40.00 - NON-ACUTE HOSPITAL PUBLICLY ASSISTED RATES OF PAYMENT AND THE FEE FOR RESIDENTIAL ALCOHOLISM TREATMENT PROGRAMS
Section 40.02 - Definitions

As used in 114.1 CMR 40.00, unless the context requires otherwise, terms shall have the meanings ascribed in 114.1 CMR 40.02.

Adjusted Base Year Volume. The actual base year volume adjusted to include the volume associated with recurring CBCs, new services and transfers on of cost and exclude volume associated with discontinued services and transfers off of cost.

Administrative Day. An inpatient day spent in a non-acute hospital or public health care facility, other than a hospital operated by the Department of Mental Health (except facilities which are certified to provide services under Title XIX of the Social Security Act), by a patient who has been identified by a Professional Standards Review Organization (where applicable) or otherwise by the Division of Medical Assistance or by the Department of Public Health, or any combination of these organizations as a patient which does not require a hospital level of care.

Base Year. For DMH and DPH hospitals only licensed and/or operated as non-acute hospitals during FY 1993, the base year is the hospital's FY1993. For hospitals that were not licensed and/or operated as non-acute hospitals during fiscal year 1993, the base year shall be determined pursuant to 114.1 CMR 40.09. For all other hospitals licensed and/or operated as non-acute hospitals during FY 1984, the base year is the hospital's FY 1984, For hospitals that were not licensed and/or operated as non acute hospitals during fiscal year 1984, the base year shall be determined pursuant to 114.1 CMR 40.09.

CBC. Cost beyond control.

Commission. The Rate Setting Commission was established under M.G.L. c. 6A, § 32. On July 1, 1996, all functions were transferred to the Division of Health Care Finance and Policy under M.G.L. c. 118G.

Department of Public Health. The Department of Public Health established under M.G.L. c. 17, § 1.

DHCFP-450. DHCFP-450, Report of Charges and Volume, is a report which documents a hospital's charges and volume, utilized for the purpose of adjusting the cost-to-charge ratio or the payment on account factor should the facility increase their charges beyond the allowable increase specified in 114.1 CMR 40.04(4)(b).

Discontinued Service. A health service, supply or accommodation which conforms in scope to a cost center as defined in Chapter III of the Reporting Manual which:

(a) is included in the adjusted base year cost and which will not be offered during the budget year, or

(b) is being offered and terminated during the budget year.

Direct Cost. The cost of a center as defined by the Reporting Manual after reclassification and recoveries of expense and prior to the allocation of overhead cost to patient care cost centers through the step-down.

Division. The Division of Health Care Finance and Policy, established under M.G.L. c. 118G.

Free Care. The amount, net of free care income or community fund grants, which is charged off by a hospital for hospital care and services, supplies and accommodations provided to indigent persons, pursuant to a plan adopted by the hospital's governing board and filed with the Division. Free care will not include accounting provisions for free care, free care provided to employees or courtesy allowances.

FTEs: Full-time equivalent staff. To compute FTEs, divide the total annual paid hours (including vacation, sick leave, and overtime) for all employees in each cost center by a 40 hour standard work week, annualized to a norm of 2080 hours.

Governmental Unit. The Commonwealth of Massachusetts and any department, agency, board, commission, or political subdivision of the Commonwealth.

GPSR. Gross patient service revenue is the total dollar amount of a hospital's charges for services rendered during the reporting period, generally within a fiscal year

HURM Manual. The Commonwealth of Massachusetts Hospital Uniform Reporting Manual, promulgated by the Division under 114.1 CMR 4.00.

Intermediate Year. The hospital fiscal year just before the current rate year.

Inpatient Day. HURM standard unit of measure to report care of patients admitted to a hospital including the day of admission, but not the day of discharge. If both admission and discharge occurs on the same day, the day is considered a day of admission and counts as one inpatient day.

Non-Acute Hospital. A hospital which is defined and licensed under M.G.L. c. 111, § 51, with less than a majority of medical-surgical, pediatric, maternity and obstetric beds, or any psychiatric facility licensed under M.G.L. c. 19, § 19, or any public health care facility.

PAF. Payment on account factor is a percentage applied to charges to calculate a purchaser's discounted reimbursement level.

Public Health Care Facility. A facility operated by the Department of Public Health, the Department of Mental Health, a County of the Commonwealth, or a Soldiers' Home which provides inpatient medical, skilled nursing, or mental retardation care and services and which may provide outpatient medical, mental health, or mental retardation care and services.

Publicly-Aided Individual. A person who receives healthcare and services for which a governmental unit is in whole or part liable under a statutory program of public assistance.

Rate Year. For allnon-acute hospitals, as defined in 114.1 CMR 40.01, the rate year will be defined as follows:

(a) For facilities classified as a "Public Health Care Facility" as defined in 114.1 CMR 40.02, the rate year will be from 7/1 to 6/30.

(b) For all other non-acute facilities, the rate year will be 10/1 to 9/30.

Residential Alcoholism Treatment Program. A residential care program for second-time driving while intoxicated offenders approved by the Division of Alcoholism, Massachusetts Department of Public Health pursuant to 105 CMR 166.00.

RFR. Reasonable Financial Requirements.

Transfer of Cost. An increase (transfer on) or decrease (transfer off) of hospital costs related to persons or entities which provide hospital care or services which changes compensation arrangements from non-hospital based to hospital based (transfer on) or from hospital based to non-hospital based (transfer off). A transfer on of physician compensation will only be allowed if reasonable.