Section 75-02-07.1-01 - Definitions1. "Accrual basis" means the recording of revenue in the period when it is earned, regardless of when it is collected, and the recording of expenses in the period when incurred, regardless of when they are paid.2. "Actual rate" means the facility rate for each cost category calculated using allowable historical operating costs and adjustment factors.3. "Adjustment factor" means the legislatively approved inflation rate for basic care services.4. "Admission" means any time a resident is admitted to the facility from an outside location, including readmission resulting from a discharge.5. "Aid to vulnerable aged, blind, and disabled individuals" means a program that supplements the income of an eligible beneficiary who resides in a facility.6. "Allowable cost" means the facility's actual cost after appropriate adjustments as required by basic care regulations.7. "Alzheimer's and related dementia facility" means a licensed basic care facility which primarily provides services specifically for individuals with Alzheimer's disease or related dementia.8. "Bona fide sale" means the purchase of a facility's capital assets with cash or debt in an arm's-length transaction. It does not include: a. A purchase of shares in a corporation that owns, operates, or controls a facility except as provided under subsection 4 of section 75-02-07.1-13;b. A sale and leaseback to the same licensee;c. A transfer of an interest to a trust;d. Gifts or other transfer for nominal or no consideration;e. A change in the legal form of doing business;f. The addition or deletion of a partner, owner, or shareholder; org. A sale, merger, reorganization, or any other transfer of interest between related organizations.9. "Building" means the physical plant, including building components and building services equipment, licensed as a facility and used directly for resident care, and auxiliary buildings including sheds, garages, and storage buildings if used directly for resident care.10. "Capital assets" means a facility's buildings, land improvements, fixed equipment, movable equipment, leasehold improvements, and all additions to or replacements of those assets used directly for resident care.11. "Chain organization" means a group of two or more basic care or health care facilities owned, leased, or through any other device controlled by one business entity. This includes not only proprietary chains, but also chains operated by various religious and other charitable organizations. A chain organization may also include business organizations engaged in other activities not directly related to basic care or health care.12. "Close relative" means an individual whose relationship by blood, marriage, or adoption to an individual who is directly or indirectly affiliated with, controls, or is controlled by a facility is within the third degree of kinship.13. "Community contribution" means contributions to civic organizations and sponsorship of community activities. It does not include donations to charities.14. "Cost category" means the classification or grouping of similar or related costs for purposes of reporting, determination of cost limitations, and determination of rates.15. "Cost center" means a division, department, or subdivision thereof, group of services or employees, or both, or any unit or type of activity into which functions of a facility are decided for purposes of cost assignment and allocations.16. "Cost report" means the department-approved form for reporting costs, statistical data, and other relevant information of the facility.17. "Department" means the department of health and human services.18. "Depreciable asset" means a capital asset for which the cost must be capitalized for ratesetting purposes.19. "Depreciation" means an allocation of the cost of a depreciable asset over its estimated useful life.20. "Depreciation guidelines" means the American hospital association's depreciation guidelines as published by American hospital publishing, inc., in "Estimated Useful Lives of Depreciable Hospital Assets", revised 2018 edition.21. "Desk audit rate" means the rate established by the department based upon a review of the cost report submission prior to an audit of the cost report.22. "Direct care costs" means the cost category for allowable resident care, activities, social services, and laundry costs.23. "Direct costing" means identification of actual costs directly to a facility or cost category without use of any means of allocation.24. "Discharge" means the voluntary or involuntary release of a bed by a resident when the resident vacates the facility premises.25. "Eligible beneficiary" means a facility resident who is eligible for aid to vulnerable aged, blind, and disabled individuals.26. "Employment benefits" means fringe benefits and other employee benefits including vision insurance, disability insurance, long-term care insurance, employee assistance programs, employee child care benefits, and payroll taxes.27. "Facility" means a provider licensed as a basic care facility, not owned or administered by state government, which does not meet the definition of an Alzheimer's and related dementia facility, traumatic brain injury facility, or institution for mental disease, which is enrolled with the department as a basic care assistance program provider.28. "Fair market value" means value at which an asset could be sold in the open market in a transaction between informed, unrelated parties.29. "Final rate" means the rate established after any adjustments by the department, including adjustments resulting from cost report reviews and audits.30. "Fixed equipment" means equipment used directly for resident care affixed to a building, not easily movable, and identified as such in the depreciation guidelines.31. "Food and plant costs" means the cost category for allowable food, utilities, and maintenance and repair costs.32. "Freestanding facility" means a facility that does not share basic services with a hospital-based provider or a nursing facility.33. "Fringe benefits" means workers' compensation insurance, group health or dental insurance, group life insurance, retirement benefits, uniform allowances, and medical services furnished at facility expense.34. "Highest market-driven compensation" means the highest compensation given to an employee of a freestanding facility who is not an owner of the facility or is not a member of the governing board of the facility.35. "Historical operating costs" means the allowable operating costs incurred by the facility during the report year immediately preceding the rate year for which the established rate becomes effective.36. "Indirect care costs" means the cost category for allowable administration, plant, housekeeping, medical records, chaplain, pharmacy, and dietary, exclusive of food costs.37. "In-house resident day" for basic care, swing bed, and nursing facilities means a day that a resident was actually residing in the facility. "In-house resident day" for hospitals means an inpatient day.38. "Institution for mental disease" means a facility with a licensed capacity of seventeen or more beds which provides treatment or services primarily to individuals with a primary diagnosis of mental disease.39. "Land improvements" means any improvement to the land surrounding the facility used directly for resident care and identified as such in the depreciation guidelines.40. "Limit rate" means the rate established as the maximum allowable rate for direct care and indirect care.41. "Lobbyist" means any person who in any manner, directly or indirectly, attempts to secure the passage, amendment, defeat, approval, or veto of any legislation, attempts to influence decisions made by the legislative council, and is required to register as a lobbyist.42. "Medical care leave day" means any day that a resident is not in the facility but is in a licensed health care facility, including a hospital, swing bed, nursing facility, or transitional care unit, and is expected to return to the facility.43. "Medical records costs" means costs associated with the determination that medical record standards are met and with the maintenance of records for individuals who have been discharged from the facility. It does not include maintenance of medical records for in-house residents.44. "Movable equipment" means movable care and support services equipment generally used in a facility, including equipment identified as major movable equipment in the depreciation guidelines.45. "Payroll taxes" means the employer's share of Federal Insurance Contributions Act taxes, governmentally required retirement contributions, and state and federal unemployment compensation taxes.46. "Personal care rate" means a per diem rate that is the sum of the rates established for direct personal care costs, indirect personal care costs, and the operating margin for personal care.47. "Private-pay resident" means a resident on whose behalf the facility is not receiving any aid to vulnerable aged, blind, and disabled individuals program payments and whose payment rate is not established by any governmental entity with ratesetting authority.48. "Private room" means a room equipped for use by only one resident.49. "Property costs" means the cost category for allowable real property costs and passthrough costs.50. "Provider" means the organization or individual who has executed a provider agreement with the department.51. "Rate year" means the year from July first through June thirtieth.52. "Reasonable resident-related cost" means the cost that must be incurred by an efficiently and economically operated facility to provide services in conformity with applicable state laws, regulations, and quality and safety standards. Reasonable resident-related cost takes into account that the provider seeks to minimize its costs and that its actual costs do not exceed what a prudent and cost-conscious buyer pays for a given item or services.53. "Related organization" means a close relative or person or an organization which a provider is, to a significant extent, associated with, affiliated with, able to control, or controlled by, and which furnishes services, facilities, or supplies to the provider. Control exists when an individual or an organization has the power, directly or indirectly, significantly to influence or direct the policies of an organization or provider.54. "Report year" means the fiscal year from July first through June thirtieth of the year immediately preceding the rate year.55. "Resident" means an individual who has been admitted to the facility but not discharged.56. "Resident day" in a facility means any day for which service is provided or for which payment in any amount is ordinarily sought, including medical care leave and therapeutic leave days. The day of admission and the day of death are resident days. The day of discharge is not a resident day. "Resident day" in a hospital means all inpatient days for which payment is ordinarily sought. The amount of remuneration has no bearing on whether a day should be counted as a resident day. "Resident day" for assisted living or any other residential services provided means a day for which payment is sought by the provider regardless of remuneration.57. "Room and board rate" means a per diem rate that is the sum of the rates established for property costs, direct room and board costs, indirect room and board costs, the operating margin for room and board and food and plant costs.58. "Routine hair care" means hair hygiene which includes grooming, shampooing, cutting, and setting.59. "Significant capacity increase" means an increase of fifty percent or more in the number of licensed beds or an increase of twenty beds, whichever is greater. It does not mean an increase by a facility which reduces the number of its licensed beds and thereafter relicenses those beds. It does not mean an increase in a facility's capacity resulting from converting beds formerly licensed as nursing facility beds. 60. "Specialized facility for individuals with mental disease" means a licensed basic care facility with a licensed capacity of less than seventeen which provides treatment or services primarily to individuals with mental disease.61. "Therapeutic leave day" means any day that a resident is not in the facility or in a licensed health care facility.62. "Top management personnel" means corporate officers, general, regional, and district managers, administrators, and any other person performing functions ordinarily performed by such personnel.63. "Traumatic brain injury facility" means a licensed basic care facility which primarily provides services to individuals with traumatic brain injuries.64. "Working capital debt" means debt incurred to finance facility operating costs, but does not include debt incurred to acquire or refinance a capital asset or to refund or refinance debt associated with acquiring a capital asset.N.D. Admin Code 75-02-07.1-01
Effective July 1, 1996; amended effective July 1, 1998; January 1, 2000; July 1, 2001; February 1, 2007; October 1, 2011.Amended by Administrative Rules Supplement 2014-353, July 2014, effective July 1, 2014. .Amended by Administrative Rules Supplement 368, April 2018, effective 4/1/2018.Amended by Administrative Rules Supplement 2022-386, October 2022, effective 10/1/2022.Amended by Administrative Rules Supplement 2023-391, January 2024, effective 1/1/2024.General Authority: NDCC 50-06-16, 50-24.5-02(3)
Law Implemented: NDCC 50-24.5-02(3)