Current through Register Vol. 60, No. 12, December 1, 2021
The following definitions apply to OAR 410-050-0700 to
(1) "Authority" means
the Oregon Health Authority.
"Bad Debt" means the current period charge for actual or expected uncollectible
accounts resulting from the extension of credit on inpatient and outpatient
hospital services. Bad debt charges shall be offset by any recoveries received
on accounts receivable during that current period, subject to final assessment
reporting and reconciliation processes required in these rules.
"Charges for Inpatient Care" means gross
inpatient charges generated from room, board, general nursing, and ancillary
services provided to patients who are expected to remain in the hospital at
least overnight and occupy a bed (as distinguished from categories of health
care items or services identified in
not charges for inpatient hospital services). Charges for inpatient care
include all payers, and are not limited to Medicaid patients.
"Charges for Outpatient Care" means gross
outpatient charges generated from services provided by the hospital to a
patient who is not confined overnight. These services include all ancillary and
clinic facility charges (as distinguished from categories of health care items
or services identified in
433.56(a)(1) and (3)-(19)
that are not charges for outpatient hospital services). Charges of outpatient
care include all payers and are not limited to Medicaid charges.
(5) "Charity Care" means costs for providing
inpatient or outpatient care services free of charge or at a reduced charge
because of the indigence or lack of health insurance of the patient receiving
the care services. Charity care results from a hospital's policy as reflected
in its official financial statements to provide inpatient or outpatient
hospital care services free of charge or at a reduced charge to individuals who
meet financial criteria. Charity care does not include any amounts above the
payments by the Authority that constitute payment in full under ORS
or above the payment rate established by contract with a prepaid managed care
health services organization or health insurance entity for inpatient or
outpatient care provided pursuant to such contract, or above the payment rate
established under ORS
for inpatient or outpatient care reimbursed under that statute.
(6) "Contractual Adjustments" means the
difference between the amounts charged based on the hospital's full,
established charges and the amount received or due from the payer.
(7) "Declared Fiscal Year" means the fiscal
year declared to the Internal Revenue Service (IRS).
(8) "Deficiency" means the amount by which
the assessment, as correctly computed, exceeds the assessment, if any, reported
and paid by the hospital. If, after the original deficiency is assessed,
subsequent information shows the correct amount of assessment to be greater
than previously determined, an additional deficiency arises.
(9) "Delinquency" means the hospital fails to
file a report when due as required under these rules or fails to pay the
assessment as correctly computed when the assessment was due.
(10) "Director" means the Director of the
(11) "Hospital" means a
hospital licensed under ORS chapter 441. Hospital, as used in this section,
does not include special inpatient care facilities as that term is defined in
hospitals that provide only psychiatric care, pediatric specialty hospitals
providing care to children at no charge, and public hospitals other than
hospitals created by health districts under ORS
purposes of these rules, the hospital shall be identified by using the federal
payer identification number for the hospital.
(12) "Net Revenue" means the total amount of
charges for inpatient or outpatient care provided by the hospital to patients,
less charity care, bad debts, and contractual adjustments. Net revenue does not
include revenue derived from sources other than inpatient or outpatient
operations including but not limited to interest and guest meals and any
revenue that is taken into account in computing a long-term care assessment
under the long-term facility assessment.
(13) "Type A Hospital" means a small remote
hospital that has 50 or fewer beds and is more than 30 miles from another acute
inpatient care facility.
B Hospital" means a small and rural hospital that has 50 or fewer beds and is
30 miles or less from another acute inpatient care facility.