The following definitions shall apply only to Chapter 3.
Article 9.
(a) "Administrator
Compensation" means the remuneration paid to a facility administrator
regardless of the form in which it is paid. "Administrator Compensation"
includes salary, wages, fringe benefits, allowances, bonuses, debt forgiveness,
severance payments, payments for accumulated but unused leave and payments of
amounts previously deferred. "Administrator Compensation" includes fees
regardless of the label placed on them, for example, consultant fees or
director's fees.
(b)
"Administrative Costs" means
1) expenses
including the facility's portion of home office costs related to the overall
management and administration of the facility, including those of the medical
director, general and patient accounting activities, communication systems,
data processing activities, patient admissions, governing board activities,
public relations, paid liability losses, theft insurance, auto insurance,
property insurance, licenses and taxes (other than property and income taxes
and facility license fee),
2) taxes
related to liability insurance,
3)
the production of indexes, abstracts, and statistics for facility management
uses,
4) procuring supplies,
equipment and service necessary to facility operations, and
5) interest incurred on borrowing other than
interest incurred on mortgage notes, capitalized lease obligations and other
borrowing for the acquisition of land, buildings and
equipment.
(c) "Audited
Cost Report Data" means data contained in audit reports issued by the
Department.
(d) "Benchmark" means
the maximum allowable cost.
(e)
"Capital Costs" means costs of depreciation and amortization expense on land
improvements, building improvements, leasehold improvements and equipment; all
leases and rental expenses related to building, equipment and leasehold
improvements; and interest incurred on mortgage notes, capitalized lease
obligations and other borrowing for the acquisition of land, buildings and
equipment.
(f) "De-Certified" means
not currently certified to participate in the Medi-Cal Program.
(g) "Direct Care Agency Costs" means
expenditures for contractor staff for routine services and any ancillary
services included in the Medi-Cal rate including all nursing, social services
and activities.
(h) "Direct Care
Labor Costs" means salary, wages and benefits for routine nursing services and
any ancillary services included in the Medi-Cal rate including all nursing,
social services and activities provided by employees of the facility, as well
as direct care salary costs of services provided to the facility by a related
entity.
(i) "Direct and Indirect
Care Non-labor Costs" means costs related to services supporting the delivery
of resident care (including the non-labor portion of nursing, housekeeping,
laundry and linen, dietary, medical records, in-service education and plant
operations and maintenance costs), and expenses for contracted plumbers,
gardeners, equipment service contracts, contracts for facility repairs or
remodeling, security guards, alarm services, pickup and delivery laundry
services, non-administrative consultants or any other service agreement and
minor equipment.
(j) "Direct
Pass-Through Costs for Care Giver Training" means costs, for a formal program
of education that is organized to train students to enter a care giver licensed
or certified occupational specialty, which includes salaries, wages and
benefits of the instructor and expenses for related training materials or
supplies; or the cost of a contracted instructor if services are performed
within the facility.
(k) "Direct
Pass-Through Costs for Facility License Fees" means the annual fee for a
license to operate a skilled nursing facility.
(l) "Fair Rental Value System (FRVS)" means a
system where reimbursement to a facility is based on the estimated current
value of its capital assets in lieu of direct reimbursement for depreciation,
amortization, interest, rent or lease payments.
(m) "Freestanding Nursing Facility, Level-B
(FS/NF-B)" means a licensed and certified skilled nursing facility that is not
part of an acute care hospital and that meets the standards of participation in
Welfare and Institutions Code Section
14091.21
and Title 22, California Code of Regulations Sections
51121 and
51215.
(n) "Freestanding Subacute Nursing Facility,
Level-B (FSSA/NF-B)" means a licensed and certified skilled nursing facility as
defined in subsection (m) and meets additional standards of participation to
provide adult subacute care services, pursuant to Title 22, California Code of
Regulations Section
51215.5.
(o) "Indirect Care Agency Costs" means
expenditures for contractor staff for housekeeping, laundry and linen, dietary,
medical records, in service education, and plant operations and
maintenance.
(p) "Indirect Care
Labor Costs" means salary, wages and benefits for housekeeping, laundry and
linen, dietary, medical records, in service education, and plant operations and
maintenance for employees of the facility, as well as indirect care salary
costs of services provided to the facility by a related entity.
(q) "In-service Education" means a program of
instruction, or training, provided by a facility for its employees.
(r) "Labor Inflation Index" means an index
created using the linear regression method to forecast future labor costs from
historical facility-specific wage report data as specified in Health and Safety
Code Section
128730.
(s) "Liability Insurance Costs" means the
reasonable costs of insurance premiums purchased from a commercial insurance
carrier including the related brokerage fees and reasonable policy deductible
costs or reasonable self insurance costs or reasonable costs of insurance
purchased from a captive insurance company including the policy
deductibles.
(t) "Minor Equipment"
means equipment or the combined equipment items of an integrated system with a
useful life of less than 2 years or a cost of less than $5,000.
(u) "Peer Group" means a group of counties
that are categorized and clustered together by means of the following factors:
geographic urban/rural status, median/average direct care per diem costs, and
the frequency of provider facilities within each county.
(v) "Rate Year" means the fiscal period from
August 1 through July 31.
(w)
"Rental Factor" means the average 20-year US Treasury Bond yield for the
calendar year preceding the rate year plus a two percent risk premium, subject
to a floor of seven percent and a ceiling of ten percent.
(x) "Replacement Project" means construction
costs incurred from a completed project that materially altered architectural,
structural, mechanical, electrical, and Fire & Life safety details of the
existing facility or structure. Purchases of major items of equipment, such as
capital additions are a "replacement project," provided the equipment is
related and made in conjunction with a plan that when aggregated meets the $500
per-bed cost threshold. Small unrelated costs that are accumulated in order to
meet the $500 per-bed threshold are not a "replacement project."