N.J. Admin. Code § 8:85-1.2
The following words and terms, when used in this chapter, shall have the following meanings unless the context clearly indicates otherwise.
"Advance directive" means a written instruction relating to the provision of health care when the individual is incapacitated, such as a living will or durable power of attorney for health care.
"AIDS" means acquired immune deficiency syndrome, a condition affecting an individual who has a reliably diagnosed disease that meets the criteria for AIDS specified by the Centers for Disease Control and Prevention of the United States Public Health Service in the following volumes of the Morbidity and Mortality Weekly Review (MMWR): Volume 41 RR-17 of the MMWR published on December 18, 1992; Volume 43 No. RR-17 of the MMWR published on September 30, 1994; Volume 48 No. RR-13 of the MMWR published on December 10, 1999; Volume 57 No. RR-10 of the MMWR published on December 5, 2008; and updates found at www.cdc.gov/mmwr.
"AIDS-defining illness" means the 26 clinical conditions that affect people with advanced HIV disease listed in Categories B and C of the 1993 Revised Classification System, including, but not limited to, pneumocystis carinii pneumonia or PCP, toxoplasmosis, cytomegalovirus or CMV, oral-esophageal candidiasis, wasting, bacterial pneumonia, lymphoma, cryptococcal meningitis, mycobacterium avium complex or MAC, and Kaposi's sarcoma.
"Air fluidized therapy bed" means a device employing the circulation of filtered air through ceramic spherules (small, round ceramic objects).
"Allowable costs" means those costs of a nursing facility that are allowable for reimbursement pursuant to the Medicare Provider Reimbursement Manual unless modified by specific provisions of N.J.A.C. 8:85-3.
"Bed" or "licensed bed" means "bed" or "licensed bed" as those terms are defined at 8:39-1.2.
"Beneficiary" means a qualified applicant receiving benefits under the Medical Assistance and Health Services Act, 30:4D-1 et seq.
"Care management" means a process by which professional staff designated by the Department monitor the provision of NF care to:
1. Assure that services are rendered as recommended by the HSDP and in accordance with the NF's evaluation of the individual's health service needs;
2. Assure the delivery of timely and appropriate provider responses to changes in care needs;
3. Provide, direct or secure needed consultations with Medicaid professional or NF staff so that services are delivered in a coordinated, effective, and cost-prudent manner; and
4. Facilitate discharge planning and promote appropriate placement to alternate care settings.
"Case mix" means a system of staffing and reimbursement for nursing services based on variation in patient acuity and care needs that influences the type and amount of service needed.
"Case mix index (CMI)" means a numeric score that identifies the relative resource needs for the average resident classified under the resource utilization group (RUG) based on the assessed needs of the resident, whose values, incorporated herein by reference, as amended and supplemented, are set forth as CMI Set B01 located at https://www.cms.gov/MDS20SWSpecs/13_CMIVersion5.asp.
"CD4+ T cell" means a type of white blood cell that plays a major role in the functioning of the immune system and which carries the surface protein CD4.
"CDC" means the Centers for Disease Control and Prevention of the United States Department of Health and Human Services.
"Clinical audits" means a method of utilization control under the enforcement authority of Section 1902(a)(30)(A) of the Social Security Act, in accordance with 42 CFR 456.1(b)(1), to monitor the utilization of and payment for nursing facility care and services reimbursable under the Medicaid State Plan.
"CMS" means the Centers for Medicare and Medicaid Services, formerly known as the Health Care Financing Administration or HCFA, a Federal agency within the United States Department of Health and Human Services.
"Comprehensive assessment" means a process conducted by each member of the interdisciplinary team which, for each resident, identifies problems; determines care needs; and in conjunction with the resident and his or her significant other or legal representative, results in an interdisciplinary plan of care.
"Construction bed value" means the implied cost of construction of a nursing facility bed using a year 2010 base value of $ 89,000 and adjusting to prior years utilizing the index of All Urban Consumers CPI-U U.S. City Average as compiled by the U.S. Department of Labor, Bureau of Labor Statistics and found at ftp://ftp.bls.gov/pub/special.requests/cpi/cpiai.txt.
"Consultant pharmacist" means a pharmacist licensed by the New Jersey State Board of Pharmacy who meets the qualifications in 10:51-3.3.
"Conventional nursing facility"--see nursing facility.
"Cost report period case mix index" means the simple average of the day weighted facility case mix indices from the final resident rosters for a nursing facility, carried to four decimal places, for the resident roster periods that most closely match a cost reporting period.
"County welfare agency (CWA)" means that agency of county government with the responsibility to determine income eligibility for public assistance programs including Aid to Families with Dependent Children, the Food Stamp program, and Medicaid. The CWA may be identified as the Board of Social Services, the Welfare Board, the Division of Welfare, or the Division of Social Services.
"DACS" means the Division of Aging and Community Services within the Department of Health and Senior Services.
"Department of Health and Senior Services" (Department or DHSS) means the New Jersey State Department of Health and Senior Services.
"Department of Human Services" (DHS) means the New Jersey State Department of Human Services.
"Division of Developmental Disabilities" (DDD) means the New Jersey State Department of Human Services, Division of Developmental Disabilities.
"Division of Medical Assistance and Health Services" (DMAHS) means the New Jersey State Department of Human Services, Division of Medical Assistance and Health Services.
"Division of Mental Health Services" (DMHS) means the New Jersey State Department of Human Services, Division of Mental Health Services.
"Facility average Medicaid case mix index" means the day weighted average case mix index for all identified Medicaid days from each nursing facility's final resident roster for each resident roster quarter as adjusted in accordance with 8:85-3.10(a)4 iii.
"Fair rental value (FRV) allowance" means a methodology for reimbursing NFs for the use of allowable facilities and equipment based on establishing a rental valuation on a per bed basis of such facilities and equipment and a rental rate in accordance with 8:85-3.11.
"Fair Rental Value (FRV) Data Report" means the worksheet attached as N.J.A.C. 8:85 Appendix V, incorporated herein by reference, completed and submitted by the nursing facility that is used to determine the initial effective age for the first FRV allowance for each Class I NF and Class II NF effective on or after July 1, 2010. The worksheet allows the identification of the original year of construction, the original number of licensed beds and any documented allowable capitalized nursing facility additions, deletions and renovations through the period prior to the rate year.
"Fair Rental Value (FRV) Re-age Request" means the worksheet attached as N.J.A.C. 8:85 Appendix W, incorporated herein by reference, completed and submitted by an NF to request modifications to its fair rental value allowance based on allowable capitalized costs of additions, modifications and renovations placed in service during the cost reporting year.
"Federal Medical Assistance Percentage (FMAP)" means the Federal medical assistance percentage applicable for Federal financial participation purposes for medical services pursuant to 42 U.S.C. § 1396b(a), which is incorporated by reference, as amended and supplemented.
"Health Services Delivery Plan (HSDP)" means a plan of care prepared by professional staff designated by the Department during the Pre-Admission Screening (PAS) assessment process which reflects the individual's current or potential health problems and required care needs.
"HIV" means Human Immunodeficiency Virus, the virus that causes AIDS and that meets the case definitions of HIV specified by the Centers for Disease Control and Prevention of the United States Public Health Service in the following volumes of the Morbidity and Mortality Weekly Review (MMWR): Volume 41 No. RR-17 of the MMWR published on December 18, 1992; Volume 43 No. RR-17 of the MMWR published on September 30, 1994; Volume 48 No. RR-13 of the MMWR published on December 10, 1999; Volume 57 No. RR-10 of the MMWR published on December 5, 2008; and updates found at www.cdc.gov/mmwr.
"HIV infection" means a retrovirus infection caused by HIV that destroys CD4+ T cells or interferes with their normal function by triggering other events that weaken an individual's immune function.
"HIV-related medical co-morbidities" means the presence of one or more disorders or diseases in addition to a primary diagnosis of HIV and/or AIDS including, but not limited to, diabetes, cancer, hypertension, hyperlibidemis, asthma, chronic obstructive pulmonary disease, or hepatitis B or C.
"HIV-related psychosocial co-morbidities" means the presence of one or more disorders or diseases in addition to a primary diagnosis of HIV and/or AIDS including, but not limited to, substance abuse, mental illness, or dementia.
"Index factor" means a factor calculated in accordance with 8:85-3.6 and based on the Skilled Nursing Home without Capital Market Basket Index published by Global Insight, which is available from CMS at www.cms.gov, or a comparable index available from, and used by, CMS, if this index ceases to be published.
"Interdisciplinary care plan" means the care plan developed by the interdisciplinary team which includes measurable objectives and time tables to meet the resident's medical, nursing, dietary and psychosocial needs that are identified through the comprehensive assessment process.
"Interdisciplinary team" means a team consisting of a physician and a registered professional nurse and may also include other health professions relative to the provision of needed services. The interdisciplinary team performs comprehensive assessments and develops the interdisciplinary care plan.
"Level I screen and Level II evaluation and determination" means the Level I and Level II evaluations set forth in 42 CFR 483.128, which is incorporated by reference, as amended and supplemented.
"Low airloss therapy bed" means a bed frame that is equipped with air sacs which are grouped into zones corresponding to various body areas. The air sacs are inflated by a constant flow of air, some of which is directed through the air sacs to the patient surface.
"Major renovation or replacement project" means allowable capitalized costs, which include improvements, replacements, or additions to land, building and capitalized moveable equipment, that are placed in service during the reported period on the FRV data report or the FRV re-age request during the cost report period and in total are equal to or greater than $ 1,000 per bed.
"Material fact" means any reported costs, statistics, data or supporting documentation submitted to the Medicaid program for the purpose of receiving any benefit, regardless of whether any benefit is ultimately received.
"Medicaid day weighted median" means the point in the array of per diem costs of included nursing facilities ordered from low to high when the cumulative total of all Medicaid days from those nursing facilities' cost reports, excluding bed hold days, first equals or exceeds half the number of the total Medicaid days for all NFs in the array. The per diem cost at this point is the Medicaid day weighted median cost.
"Medicaid occupancy level" means the average number of Medicaid recipients and recipients of public assistance under P.L. 1947, c. 156, as amended (C44.8-107 et seq.) residing in a NF divided by the total number of licensed beds in the facility during the billing month.
"Medical director" means a physician licensed under New Jersey State law who is responsible for the direction and coordination of medical care in a nursing facility.
"Medical staff" means one or more licensed physicians who act as the attending physician(s) to Medicaid recipients in a nursing facility.
"Medicare cost report" means the skilled nursing facility cost report required by the Centers for Medicare & Medicaid Services for Medicare reimbursement. Copies of the Medicare cost report may be obtained by the Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244, or through its website at www.cms.gov/CostReports/03_SkilledNursingFacility.asp.
"Mental illness" or "MI" means mental illness as that term is defined at 42 CFR § 483.102, incorporated herein by reference, as amended and supplemented.
"Mental retardation" or "MR" means mental retardation as that term is defined at 42 CFR § 483.102, incorporated herein by reference, as amended and supplemented.
"Minimum Data Set" or "MDS" means the MDS version 3.0, required by 42 CFR 483.20 and set forth in the Resident Assessment Instrument (RAI) published by CMS, and available at www.cms.gov, incorporated herein by reference, as amended and supplemented, a core set of screening, clinical and functional status elements, including common definitions and coding categories that forms the foundation of the assessment required to be completed on all residents in Medicare- and/or Medicaid-certified long-term care facilities. The MDS identifies an individual NF resident's nursing and care needs.
"New nursing facility" means a facility which satisfies the following criteria:
1. Does not replace a pre-existing facility which was licensed in accordance with N.J.A.C. 8:39;
2. Does not assume the per diem rate of a pre-existing facility; and
3. Does not have a specific pre-existing patient base.
"NHA-100" means the form used by the Division of Taxation in the New Jersey Department of the Treasury for collecting the quarterly provider tax assessment from certain long-term care facilities.
"Normalization ratio" means the Statewide average case mix index divided by the facility's cost report period case mix index, the result of which is used for the purpose of removing cost variations associated with different levels of resident case mix.
"Normalized direct care case mix cost" means a facility's total allowable direct care case mix cost per diem multiplied by its normalization ratio for the purpose of making the per diem cost comparable among facilities based upon a common case mix in order to determine the direct care limit.
"Nursing facility (NF)" means an institution (or distinct part of an institution) certified by the New Jersey State Department of Health and Senior Services for participation in Title XIX Medicaid and primarily engaged in providing health-related care and services on a 24-hour basis to Medicaid beneficiaries (children and adults) who, due to medical disorders, developmental disabilities and/or related cognitive impairments, exhibit the need for medical, nursing, rehabilitative, and psychosocial management above the level of room and board. However, the nursing facility is not primarily for care and treatment of mental diseases which require continuous 24-hour supervision by qualified mental health professionals or the provision of parenting needs related to growth and development.
"Occupational therapist" means a person who is registered by the American Occupational Therapy Association, 1383 Piccard Drive, P.O. Box 1725, Rockville, MD 20849-1725, or is a graduate of a program in occupational therapy approved by the Council of Medical Education of the American Medical Association, 515 N. State St., Chicago, IL 60610, and engaged in the supplemental clinical experience required before registration by the American Occupational Therapy Association.
"Office of Community Choice Options" or "OCCO" means a regional office of the Office of Community Choice Options of the Division of Aging and Community Services of the Senior Services and Health Systems Branch of the Department, which is responsible for the management of the pre-admission screening process.
"Ombudsman" means the Office of the Ombudsman for the Institutionalized Elderly.
"Physical therapist" means a person who is a graduate of a program of physical therapy approved by both the Council on Medical Education of the American Medical Association, 515 N. State St., Chicago, IL 60610, and the American Physical Therapy Association, 1111 N. Fairfax St., Alexandria, VA 22314 or its equivalent; and if practicing in the State of New Jersey, is licensed by the State of New Jersey, or if treatment and/or services are provided in a state other than New Jersey, meets the requirements of that state, including licensure, if applicable, and also meets all applicable Federal requirements.
"Physician's services" means those services provided within the scope of medical practice as defined by the laws of New Jersey and those services which are performed by or under the direct personal supervision of the physician.
1. "Physician" means a doctor of medicine or osteopathy licensed to practice medicine and surgery by the New Jersey State Board of Medical Examiners.
2. "Direct personal supervision" means services which are rendered in the physician's presence.
"Pre-admission screening (PAS)" means that process by which all Medicaid eligible beneficiaries seeking admission to a Medicaid certified NF and individuals who may become Medicaid eligible within six months following admission to a Medicaid certified NF receive a comprehensive needs assessment by professional staff designated by the Department to determine their long-term care needs and the most appropriate setting for those needs to be met, pursuant to 30:4D-17.1 0. ( P.L. 1988, c.97).
"Pre-admission screening and resident review" or "PASRR" means that process by which an individual meeting the clinical criteria for mental illness (MI) or mental retardation (MR/RC), regardless of payment source, is screened prior to admission to an NF to determine the individual's appropriateness for NF services, and whether the individual requires specialized services for that individual's condition and, therefore, is ineligible for NF services. PASRR includes two distinct processes, Level I screen and Level II evaluation and determination.
"Prior authorization" means approval granted by the Department through the appropriate Office of Community Choice Options (OCCO) for payment for NF services rendered to a Medicaid beneficiary, in accordance with this chapter.
"Professional staff designated by the Department" means a registered nurse or professional social worker who performs health needs assessments and counseling on alternative options and care management as required by this chapter. Professional social workers employed by the State or a political subdivision thereof are not required to be licensed or certified.
"Provider reimbursement manual or Medicare Provider Reimbursement Manual" means the Medicare Provider Reimbursement Manual published by CMS and commonly known as CMS Publication 15-1 and 15-2, available at www.cms.gov/manuals, incorporated herein by reference, as amended and supplemented.
"Rehabilitative and/or restorative nursing care" means nursing care provided by a registered professional nurse, or under the direction of a registered professional nurse, qualified by experience in rehabilitative or restorative nursing care.
"Rehabilitative services" means physical therapy, occupational therapy, speech-language pathology services, and the use of such supplies and equipment as are necessary in the provision of such services.
"Related Condition" or "RC" means a related condition as defined in 42 CFR 435.1010, which is incorporated herein by reference, as amended and supplemented.
"Related Parties" means those individuals or entities defined as related parties in the provider reimbursement manual.
"Replacement nursing facility" means a facility which satisfies the following criteria:
1. Replaces a pre-existing facility which was licensed in accordance with N.J.A.C. 8:39;
2. Can assume the per diem rate of the pre-existing facility; and
3. Has a specific pre-existing patient base.
"Resident" means a Medicaid eligible or potentially eligible beneficiary residing in an NF.
"Resident roster" means a list of all residents in an NF for a calendar quarter based on MDS assessments and tracking forms, which are transmitted by the NF and accepted by the applicable submission site approved by CMS, used for the calculated day weighted case mix indices for Medicaid, Medicare and other payment sources.
"Resource utilization group" or "RUG" means the version III (RUG-III), 5.12 34-Group, incorporated herein by reference, as amended and supplemented, a system developed by CMS and set forth at https://www.cms.gov/MDS20SWSpecs/12_RUG-IIIVersion5.asp for grouping nursing facility residents according to the residents' functional status and anticipated uses of services and resources as identified from data supplied by the NF's MDS.
"Respiratory care practitioner" means an individual credentialed by the State Board of Respiratory Care, to practice respiratory care under the direction or supervision of a physician pursuant to State of New Jersey P.L. 1971, c. 60; P.L. 1974, c. 46; and P.L. 1978, c. 73, amended August 1991.
"Skilled nursing facility (SNF)" means a free-standing institution or an identifiable part of an institution which meets all the State and Federal requirements for participation in the Medicare Program as a skilled nursing facility.
"Social services" means those services provided to meet the emotional and social needs of the Medicaid beneficiary and significant other or guardian at the time of admission, during treatment and care in the facility, and at the time of discharge.
"Special care nursing facility (SCNF)" means a NF or separate and distinct unit within a Medicaid certified conventional NF which has been approved by the Department to provide care to New Jersey Medicaid beneficiaries who require specialized health care services beyond the scope of conventional nursing facility services as defined in N.J.A.C. 8:85-2, Nursing Facility Services.
"Specialized services for MI" mean those services offered, in accordance with 42 CFR 483.120, that are determined to be medically indicated when an individual is experiencing an acute episode of serious MI and psychiatric hospitalization is recommended, based on a psychiatric evaluation.
1. Specialized services include implementation of a continuous, aggressive and individualized treatment plan by an interdisciplinary team of qualified and trained mental health personnel.
2. During a period of 24-hour supervision of an individual with MI, specific therapies and activities are prescribed, with the following objectives:
i. To diagnose and reduce behavioral symptoms;
ii. To improve independent functioning; and
iii. As early as possible, to permit functioning at a level where less than specialized services are appropriate.
3. Specialized services for MI exceed the range of services that an NF is authorized to provide and can only be provided in a 24-hour inpatient setting.
"Specialized services for MR/RC" mean those services offered, in accordance with 42 CFR 483.120, when an individual is determined to have skill deficits or other specialized training needs that necessitate the availability of trained MR personnel, 24 hours per day, to teach the individual functional skills.
1. Specialized services are those services needed to address such skill deficits or specialized training needs.
2. Specialized services may be provided in an intermediate care facility for the mentally retarded or ICF/MR as defined at 42 CFR 440.150 or in a community-based setting that meets ICF/MR standards.
3. Specialized services for MR go beyond the range of services that a NF is required to provide.
"Speech-language pathologist" means a person who has a certificate of clinical competence from the American Speech and Hearing Association; meets all applicable Federal regulations; has completed the equivalent educational requirements and work experience necessary for the certificate, or has completed the academic program and is acquiring supervised work experience to qualify for the certificate, and, if practicing in the State of New Jersey is licensed by the State of New Jersey; or if treatment and/or services are provided in a state other than New Jersey, meets the requirements of that state, including licensure, if applicable.
"Statewide average case mix index" means the simple average of all cost report period, day weighted case mix indices represented in the limit database established pursuant to N.J.A.C. 8:85-3.8.
"Statewide average Medicaid case mix index" means the Medicaid day weighted average of all Class I and Class II NFs' case mix indices for the Medicaid days identified on the final resident rosters for each resident roster quarter.
"Track of care" means the designation of the setting and scope of Medicaid services as determined by professional staff designated by the Department following the PAS of an applicant, for Medicaid clinical eligibility, for NF placement or services, as follows:
1. "Track I" means long-term NF care and shall be designated for individuals with respect to whom long-term placement is required because clinical prognosis is poor, and as to whom PAS results in a determination that short-term stays are neither realistic nor predictable and that the individual is eligible for NF level of nursing care in accordance with N.J.A.C. 8:85-2.1.
i. A Track I designation shall not preclude the possibility of future discharge. The professional staff designated by the Department will monitor those individuals with discharge potential, reassess the individual, and update the HSDP for a change in the track of care if appropriate.
2. "Track II" means short-term NF care and shall be designated for individuals as to whom PAS results in a determination that the individual requires comprehensive and coordinated NF services, in accordance with 8:85-2.1, provided in a therapeutic setting that assures family counseling and teaching in preparation for discharge to the community setting and to achieve at least one of the objectives listed at 2i through iii below; provided that individuals designated for Track II shall also be assigned to short-term NF stays, in spite of technically complex care needs and guarded prognosis, particularly in cases in which the individual is motivated towards NF alternatives and/or in which caregivers, through case management intervention, may obtain services that make return to the community a viable option.
i. To stabilize medical conditions;
ii. To promote rehabilitation; or
iii. To restore maximum functioning levels.
3. "Track III" means long-term care services in the community and shall be designated for individuals as to whom PAS results in a determination of Medicaid clinical eligibility for NF care in accordance with 8:85-2.1, but who can be appropriately cared for in the community with supportive health care services. These individuals may be eligible for Medicaid State Plan services or Home and Community-Based Services Waiver Programs.
"Transfer of ownership" means, for reimbursement purposes, a change in the majority ownership that does not involve related parties, related corporations or public corporations. "Majority ownership" is defined as an individual or entity who owns 50 percent or more of the facility, or where no individual or entity owns 50 percent or more, the majority owner is the owner who owns the largest percentage.
"Unclassifiable MDS assessment" means an MDS assessment for which one or more MDS items used to calculate a resource utilization group are not present on the MDS assessment.
"Unsupported MDS assessment" means an assessment where one or more MDS items that are required to classify a resident into a resource utilization group are not supported by documentation in the resident's clinical record.
"Validated cost report" means a complete cost report submission that has undergone a minimum of a desk review by the Department and reflects any adjustments made by the Department in accordance with this chapter.
"Waiting list" means the standardized listing, maintained in chronological order by the NF, of the names of all individuals seeking admission to a Medicaid participating NF who have completed a written application.
N.J. Admin. Code § 8:85-1.2
See: 32 N.J.R. 2859(a), 33 N.J.R. 54(a).
Added "Transfer of ownership" to section.
Amended by R.2001 d.120, effective 4/2/2001.
See: 32 N.J.R. 3710(a), 33 N.J.R. 1108(a).
Added "New nursing facility" and "Replacement nursing facility".
Recodified from N.J.A.C. 10:63-1.2 and amended by R.2005 d.389, effective 1/17/2006.
See: 36 N.J.R. 4700(a), 37 N.J.R. 1185(a), 38 N.J.R. 674(a).
Added definitions "Bed", "Beneficiary", "County welfare agency (CWA)", "Department of Human Services", "Division of Medical Assistance and Health Services", "Long-Term Care Field Office", "Material fact", "Mental illness", "Mental retardation", "Minimum Data Set (MDS) version 2.0 or most recent version", "Ombudsman", and "Professional staff designated by the Department"; deleted definitions "Medical evaluation team (MET)", "Medical social care specialist (MSCS)", "Minimum data set (MDS)", "Regional staff nurse (RSN)" and "Section Q"; rewrote "Case management", "Department of Health", "Division of Developmental Disabilities", "Division of Mental Health and Hospital (DMH & H)", "Health Services Delivery Plan (HSDP)", "Nursing facility (NF)", "Pre-admission screening (PAS)", "Prior authorization", "Resident", "Social services", "Special care nursing facility (SCNF)" and "Track of care".
Amended by R.2007 d.391, effective 12/17/2007.
See: 38 N.J.R. 4795(a), 39 N.J.R. 5338(a).
Added definitions "AIDS", "AIDS-defining illness", "CD4+ T cell", "CDC", "CMS", "HIV", "HIV infection", "HIV-related medical co-morbidities" and "HIV-related psychosocial co-morbidities".
Amended by R.2011 d.121, effective 4/18/2011.
See: 42 N.J.R. 1793(a), 43 N.J.R. 961(c).
Rewrote definitions "AIDS", "HIV", " 'Minimum Data Set' or 'MDS' ", "Pre-admission screening and resident review", "Prior authorization", "Specialized service for MI", "Track of care" and "Transfer of ownership"; added definitions "Allowable costs", "Case mix index (CMI)", "Construction bed value", "Cost report period case mix index", "DACS", "Facility average Medicaid case mix index", "Fair rental value (FRV) allowance", "Fair Rental Value (FRV) Data Report", "Fair rental Value (FRV) Re-age Request", "Federal Medical Assistance Percentage (FMAP)", "Index factor", "Level I screen and Level II evaluation and determination", "Major renovation or replacement project", "Medicaid day weighted median", "Medicare cost report", "NHA-100", "Normalization ratio", "Normalized direct care case mix cost", " 'Office of Community Choice Options' or 'OCCO' ", "Provider reimbursement manual or Medicare Provider Reimbursement Manual", "Related Condition", "Related Parties", "Resident roster", " 'Resource utilization group' or 'RUG' ", "Statewide average case mix index", "Statewide average Medicaid case mix index", "Unclassifiable MDS assessment", "Unsupported MDS assessment" and "Validated cost report"; deleted definitions " 'Long-Term Care Field Office' or 'LTCFO' " and "Standardized Resident Assessment (SRA)"; substituted definition "Specialized services for MR/RC" for definition "Specialized services for MR"; and rewrote definition "Specialized services for MR/RC".