56-1503. DEFINITIONS. As used in this chapter:

(1) "CMS" means the centers for medicare and medicaid.

(2) "Department" means the department of health and welfare.

(3) "Fiscal year" means the time period from July 1 to June 30.

(4) "Fund" means the nursing facility assessment fund established pursuant to section 56-1504, Idaho Code.

(5) "Net patient service revenue" means gross revenue from services provided to nursing facility patients, less reductions from gross revenue resulting from an inability to collect payment of charges. Patient service revenue excludes nonpatient care revenue such as beauty and barber, vending income, interest and contributions, revenue from sale of meals and all outpatient revenue. Reductions from gross revenue includes: bad debts; contractual adjustments; uncompensated care; administrative, courtesy and policy discounts and adjustments; and other such revenue deductions.

(6) "Nursing facility" means a nursing facility as defined in section 39-1301, Idaho Code, and licensed pursuant to chapter 13, title 39, Idaho Code.

(7) "Resident day" means a calendar day of care provided to a nursing facility resident, including the day of admission and excluding the day of discharge, provided that one (1) resident day shall be deemed to exist when admission and discharge occur on the same day.

(8) "Medicare part A resident days" means those resident days funded by the medicare program or by a medicare advantage or special needs plan.

(9) "Upper payment limit" means the limitation established by federal regulations, 42 CFR 447.272, that disallows federal matching funds when state medicaid agencies pay certain classes of nursing facilities an aggregate amount for services that exceed the amount that is paid for the same services furnished by that class of nursing facilities under medicare payment principles.

(10) "Value-based purchasing payments" means supplemental payments effective in state fiscal year 2021 made to providers for reaching department-selected quality indicators.

History:

[56-1503, added 2009, ch. 221, sec. 1, p. 687; am. 2018, ch. 49, sec. 1, p. 125.]