North Dakota Administrative Code

Other direct care costs include only those costs identified in this section. 1. The cost of consumable food products. 2. Dietary supplements, including supplements used for tube feedings such as elemental high nitrogen diet. 3. Laundry costs: a. Salary and employment benefits for…

Indirect care costs include all costs specifically identified in this section. Indirect care costs must be included in total, without direct or indirect allocation to other cost categories unless specifically provided for elsewhere. 1. Administration. Direct costs for administeri…

Property-related costs and other passthrough costs include only those costs identified in this section: 1. Depreciation. 13 2. Interest expense on capital debt. 3. Property taxes including special assessments as provided for in section 75-02-06-09. 4. Lease and rental costs. 5. S…

1. Direct costing of allowable costs must be used whenever possible. For a facility that cannot direct cost, the following allocation methods must be used: a. If a facility is combined with a hospital or has more than one license (including basic care), the following allocation m…

1. Ratesetting principles require that payment for services includes depreciation on all capital assets used to provide necessary services. a. Capital assets that may have been fully or partially depreciated on the books of the provider, but are in use at the time the provider en…

1. To be allowable, interest expense must meet all of the following criteria: a. Interest expense must be supported by evidence of an agreement that funds were borrowed and that payment of interest and repayment of the funds are required. b. Interest expense must be identifiable …

1. Funding of depreciation is the practice of placing funds, including nonborrowed bond reserve and sinking funds, in a segregated account for the acquisition of capital assets used in rendering resident care or for other capital purposes related to resident care. Other capital p…

1. Compensation on an annual basis for top management personnel must be limited, prior to allocation, if any, to the highest market-driven compensation of an administrator employed by a freestanding facility, with licensed capacity, during the previous report year, at least equal…

No return on investment shall be allowed. History: Effective September 1, 1980; amended effective December 1, 1983; October 1, 1984; September 1, 1987. General Authority: NDCC 50-24.1-04, 50-24.4-02 Law Implemented: NDCC 50-24.4; 42 USC 1396a(a)(13)

1. Home offices of chain organizations vary greatly in size, number of locations, staff, mode of operations, and services furnished to member facilities. Although the home office of a chain is normally not a provider in itself, it may furnish central administration or other servi…

1. Except as provided in subsection 3, costs applicable to services, facilities, and supplies furnished to a provider by a related organization may not exceed the lower of the cost to the related organization or the price of comparable services, facilities, or supplies purchased …

A provider may lease a facility from a related organization within the meaning of ratesetting principles. In such case, the rent paid to the lessor by the provider is not allowable as cost unless the rent paid is less than the allowable costs of ownership. If rent paid exceeds th…

1. Taxes assessed against the provider, in accordance with the levying enactments of the several states and lower levels of government and for which the provider is liable for payment, are allowable costs. Tax expense may not include fines, penalties, or those taxes identified as…

1. Bad debts for charges incurred on or after January 1, 1990, and fees paid for the collection of those bad debts, are allowable, provided all the requirements of this subsection are met. a. The bad debt must result from nonpayment of the payment rate or part of the payment rate…

In the first stages of operation, a new facility incurs certain costs in developing its ability to care for residents prior to admission. Staff is obtained and organized, and other operating costs are incurred during this time of preparation which cannot be allocated to resident …

1. Several items of income must be considered as offsets against various costs as recorded in the books of the facility. Income in any form received by the facility must be offset up to the total of the appropriate actual allowable costs, with the following exceptions: a. An esta…

Costs not related to resident care are costs not appropriate or necessary and proper in developing and maintaining the operation of resident care facilities and activities. These costs are not allowed in computing the rates. Nonallowable costs include: 1. Political contributions;…

Repealed effective January 1, 1990.

1. A resident day is any day for which service is provided or for which payment is ordinarily sought for use of a bed. The amount of remuneration has no bearing on whether a day should be counted. 2. Adequate census records must be prepared and maintained on a daily basis by the …

Repealed effective January 1, 1990.

1. This section is applicable for establishing a cost rate for direct care, other direct care, and indirect care for the June 30, 2021, report year. 2. Rate determination. a. For the direct cost category, the actual rate is calculated using allowable historical operating costs an…

Repealed effective July 2, 2003.

1. The department shall increase rates otherwise established by this chapter for supplemental payments or one-time adjustments to historical costs approved by the legislative assembly. 2. Any additional funds made available by the supplemental payments or one-time adjustments mus…

1. Rate determination. a. For the direct cost category, the actual rate is calculated using allowable historical operating costs and adjustment factors provided for in subsection 4 divided by standardized resident days. The actual rate must include the margin cap. The actual rate…

1. A facility shall complete a resident assessment for any resident occupying a licensed facility bed, except a respite care resident. 2. A resident must be classified based on the resident assessment. If a resident assessment is not performed in accordance with subsection 3, exc…

Repealed effective January 1, 1999.

Repealed effective February 1, 1995.

1. A facility may not require a resident to deposit personal funds with the facility. 2. Upon written authorization of a resident or the resident's legal representative, a facility shall hold, safeguard, manage, and account for the resident's personal funds deposited with the fac…

1. A specialized rate for an individual with extraordinary medical needs may be established if the criteria in both subdivisions a and b are met. a. (1) The individual requires specialized therapies that are: (a) Restorative in nature (restorative means the individual has the abi…

A facility must comply with the following provisions in order to be eligible to receive medical assistance payments. 1. A facility may not charge private-pay residents rates that exceed those rates approved by the department for medical assistance recipients, except that: a. A fa…

A facility that charges a private-pay resident a rate in violation of this chapter is subject to action for civil damages. The damages awarded may include three times the payments that result from the violation, together with costs and disbursements, including reasonable attorney…

1. A facility that exclusively provides residential services for nongeriatric individuals with physical disabilities or a unit within a facility which exclusively provides geropsychiatric services shall not be included in the calculation of the rate limitations. 2. The rate for a…

1. The department shall notify each facility of the desk audit rate on or before November twenty- fourth of the year preceding the rate year, except a facility that has requested and received a cost reporting deadline extension of fifteen days or less shall be notified on or befo…

made by the department unless, after the facility has been notified that the desk rate is the final rate, the facility requests, in writing within thirty days of the rate notification, the department to issue a decision on that request for reconsideration. (5) The desk rate may b…

1. "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 calc…

1. Records. a. The facility shall maintain on the premises the required census records and financial information in a manner sufficient to provide for a proper audit or review. For any cost being claimed on the cost report, sufficient data must be available as of the audit date t…

1. For ratesetting purposes, a cost must: a. Be ordinary, necessary, and related to resident care; b. Be what a prudent and cost-conscious business person would pay for the specific good or service in the open market in an arm's-length transaction; and c. Be for goods or services…

A facility may not receive aid to vulnerable aged, blind, and disabled individuals assistance payments unless it complies with all provisions of this section. 1. A facility shall have an effective provider agreement with the department. 2. A facility may charge to hold a bed for …

1. Adequate census records must be prepared and maintained on a daily basis by the facility to allow for proper audit of the census data. The daily census records must include: a. Identification of the resident; b. Entries for all days, and not just by exception; c. Identificatio…

Direct care costs include only those costs identified in this section. 1. Resident care. a. Salary and employment benefits for the director or supervisor of resident care staff, inservice trainers for resident care staff, quality assurance personnel, resident care aides, medicati…

Indirect care costs include all costs specifically identified in this section. Indirect care costs must be included in total, without direct or indirect allocation to other cost categories unless specifically provided for elsewhere. 1. Administration. Costs for administering the …

Property-related costs and pass-through costs include only those costs identified in this section. 1. Depreciation. 2. Interest expense on capital debt. 3. Property taxes including special assessments as provided for in section 75-02-07.1-17. 4. Lease and rental costs. 5. Startup…

Food and plant costs include only those costs identified in this section. 1. The cost of consumable food products and dietary supplements. 2. The cost of heating and cooling, electricity, water, sewer and garbage, and cable television. 3. Repairs and maintenance contracts and pur…

1. Direct costing of allowable costs must be used whenever possible. For a facility that cannot direct cost, the following allocation methods must be used: a. If a facility is combined with other residential or health care facilities, except for a nursing facility, the following …

Costs not related to resident care are costs not appropriate or necessary and proper in developing and maintaining the operation of the facility and its activities. These costs are not allowed in computing the rates. Nonallowable costs include: 1. Political contributions; 2. Sala…

1. Several items of income must be considered as offsets against various costs as recorded in the books of the facility. Income received by the facility in any form must be offset up to the total of the appropriate allowable costs, with the following exceptions: a. The establishe…

1. Home offices of chain organizations vary greatly in size, number of locations, staff, mode of operations, and services furnished to member facilities. Although the home office of a chain is normally not a provider in itself, it may furnish central administration or other servi…

1. Except as provided in subsection 4, costs applicable to services, facilities, and supplies furnished to a provider by a related organization may not exceed the lower of the cost to the related organization or the price of comparable services, facilities, or supplies purchased …

1. Compensation on an annual basis for top management personnel must be limited, prior to allocation, if any, to the greatest of: a. The highest market-driven compensation of an administrator employed by a freestanding not-for-profit facility during the previous report year incre…

1. Ratesetting principles require that payment for services include depreciation on all capital assets used to provide necessary services. a. Capital assets that may have been fully or partially depreciated on the books of the provider, but are in use at the time the provider ent…