10 Colo. Code Regs. § 2505-10-8.5001

Current through Register Vol. 47, No. 16, August 25, 2024

Section 10 CCR 2505-10-8.5001 - DEFINITIONS

"Community" means the community that a hospital has defined as the community that it serves pursuant to 26 CFR § 1.501(r)-3(b).

"Community Based Organization" means a public or private nonprofit organization of that represents a community or significant segments of a community or work towards community-focused goals beyond one particular community and provides educational or related services to individuals in the community under 20 USC § 7801(5).

"Community Benefit" means the actions that hospitals take to qualify as an organization organized and operated for the charitable purpose of promoting health pursuant to § 501(c)(3) of federal Internal Revenue Code. These actions include demonstrating that the hospital provides benefits to a class of persons that is broad enough to benefit the community, and that it operates to serve a public rather than private interest. Community Benefit may also refer to the dollar amount spent on the community in the form of Free or Discounted Health Care Services; Provider Recruitment, Education, Research and Training; and Community spending activities.

"Community Benefit Implementation Plan" means a plan that satisfies the requirements of an implementation strategy as described in 26 CFR § 1.501(r)-3(c).

"Community Benefit Priorities" means Community Benefit activities that are documented within the Reporting Hospital's Community Health Needs Assessment or otherwise established pursuant to the IRS Form 990, Schedule H and its instructions.

"Community Health Center" means a federally qualified health center as defined in 42 U.S.C. § 1395x (aa)(4) or a rural health clinic as defined in 42 U.S.C. § 1395x (aa)(2).

"Community Health Needs Assessment" means a community health needs assessment that satisfies the requirements of 26 CFR § 1.501(r)-3(b).

"Community Identified Health Need" means a health need of a Community that is identified in a Community Health Needs Assessment.

"Free or Discounted Health Care Services" means health care services provided by the hospital to persons who meet the hospital's criteria for financial assistance and are unable to pay for all or a portion of the services, or physical or behavioral health care services funded by the hospital but provided without charge to patients by other organizations in the Community. Free or Discounted Health Care Services do not include the following:

1. Services reimbursed through the Colorado Indigent Care Program (CICP);

2. Bad debt or uncollectable amounts owed that the hospital recorded as revenue but wrote off due to a patient's failure to pay, or the cost of providing care to such patients;

3. The difference between the cost of care provided under Medicaid or other means-tested government programs or under Medicare and the revenue derived therefrom;

4. Self-pay or prompt pay discounts; or

5. Contractual adjustments with any third-party payers.

"Health System" means a larger corporation or organizational structure that owns, contains, or operates more than one hospital.

"Local Public Health Agency" means a county or district public health agency established pursuant to C.R.S. § 25-1-506, or a local department of public health.

"Medicaid Shortfall" means the cost of Medicaid reflected on the IRS Form 990, Schedule H, Worksheet 3.

"Programs that Address Behavioral Health" means funding or in-kind programs or services intended to improve an individual's mental and emotional well-being and are reportable on the IRS Form 990, Schedule H and its instructions. Programs that Address Behavioral Health are designed to address, but are not limited to:

1. Mental health disorders;

2. Serious psychological distress;

3. Serious mental disturbance;

4. Unhealthy stress;

5. Tobacco use prevention; and

6. Substance use.

"Programs that Address Community Based Health Care" means funding or in-kind programs or services that improve types of person-centered care delivered in the home and community and are not billable to a third party. A variety of health and human services can be provided. Community Based Health Care addresses the needs of people with functional limitations who need assistance with everyday activities such as getting dressed or bathing.

"Programs that Address the Social Determinants of Health" means funding or in-kind programs or services that improve social, economic, and environmental conditions that impact health in the Community. Social and economic conditions that impact health include education; employment; income; family and social support; and Community safety. Environmental conditions that impact health include air and water quality, housing, and transit. Programs that Address the Social Determinants of Health include but are not limited to the following:

1. Job training programs;

2. Support for early childhood and elementary, middle, junior-high, and high school education;

3. Programs that increase access to nutritious food and safe housing;

4. Medical Legal Partnerships; and

5. Community-building activities that could be included in Part II of Schedule H of the Form 990.

"Provider Recruitment, Education, Research and Training," "Workforce development," "Health professions education," and "Research" defined within the Internal Revenue Service form 990 as:

1. "Workforce development" means the recruitment of physicians and other health professionals to medical shortage areas or other areas designated as underserved, and collaboration with educational institutions to train and recruit health professionals needed in the Community (other than the health professions education activities entered on Part I, line 7f),

2. "Health Professions Education" means educational programs that result in a degree, a certificate, or training necessary to be licensed to practice as a health professional, as required by C.R.S. 12-240-110, or continuing education necessary to retain state license or certification by a board in the individual's health profession specialty,

a. Health Professions Education does not include education or training programs available exclusively to the organization's employees and medical staff or scholarships provided to those individuals. However, it does include education programs if the primary purpose of such programs is to educate health professionals in the broader community. Costs for medical residents and interns can be included, even if they are considered employees for purposes of Form W-2, Wage and Tax Statement.

3. "Research" means any study or investigation the goal of which is to generate increased generalized knowledge made available to the public (for example, knowledge about underlying biological mechanisms of health and disease, natural processes, or principles affecting health or illness; evaluation of safety and efficacy of interventions for disease such as clinical trials and studies of therapeutic protocols; laboratory-based studies; epidemiology, health outcomes, and effectiveness; behavioral or sociological studies related to health, delivery of care, or prevention; studies related to changes in the health care delivery system; and communication of findings and observations, including publication in a medical journal). The organization can include the cost of internally funded research it conducts, as well as the cost of research it conducts funded by a tax-exempt or government entity.

"Reporting Hospital" means

1. A hospital licensed as a general hospital pursuant to Part 1 of Article 3 of Title 25 of the Colorado Revised Statutes and exempt from federal taxation pursuant to Section 501(c)(3) of the federal Internal Revenue Code, but not including a general hospital that is federally certified or undergoing federal certification as a long-term care hospital pursuant to 42 CFR § 412.23(e) or that is federally certified or undergoing federal certification as a critical access hospital pursuant to 42 CFR § 485 Subpart F,

2. A hospital established pursuant to C.R.S. § 25-29-103, or

3. A hospital established pursuant to C.R.S. § 23-21-503.

"Safety Net Clinic" means a Community clinic licensed or certified by the Department of Public Health and Environment pursuant to C.R.S. § 25-1.5-103 (1)(a)(I) or (1)(a)(II).

10 CCR 2505-10-8.5001

47 CR 14, July 25, 2024, effective 8/30/2024