Section 444.9 - Operating revenue--daily hospital services

444.9 Operating revenue--daily hospital services. (3211) This group of accounts (3000-3990) is used to report the gross revenue, measured in terms of the hospital's full established rates, earned from daily hospital services rendered to inpatients. These revenues must be reported at the hospital's full established rates, regardless of the amounts actually collected.

(b) Daily hospital services generally are those services included by the provider in a daily service charge--sometimes referred to as the "room and board" charge. Included in daily hospital services are the regular room, dietary and nursing services, minor medical and surgical supplies, medical social services, and the use of certain equipment and facilities for which the hospital does not customarily make a separate charge.

(c) Daily hospital services are categorized into broad areas: acute care, intensive care, nursery, and sub-acute care.

(d) Acute Care. This group of accounts (3010-3290) is used to report the gross revenues, measured in terms of the hospital's full established rates earned from daily hospital services provided to patients who are in an acute phase of illness but not to the degree which requires the concentrated and continuous observation and care provided in the intensive care units of a hospital.

(e) Intensive Care. (1) This group of accounts (3310--3490) is used to report the gross revenues measured in terms of the hospital's full established rates earned from inpatients who require extraordinary observation and care on a concentrated basis.

(2) The intensive care unit must meet the following conditions:

(i) The unit must be physically and identifiably separate from other areas. There cannot be a concurrent sharing of nursing staff between an intensive care type unit and units or areas furnishing different levels or types of care. However, two or more intensive care type units that concurrently share nursing staff can be reported as one combined intensive care type unit if all other criteria are met. Float nurses (nurses who work in different units on an as-needed basis) can be utilized in the intensive care type unit.

(ii) There must be specific written policies that include criteria for admission to, and discharge from, the unit.

(iii) Registered nursing care must be furnished on a continuous 24-hour basis. At least one registered nurse must be present in the unit at all times.

(iv) A minimum nurse/patient ratio of one nurse to two patients per patient day must be maintained. Included in the calculation of this nurse/patient ratio are registered nurses, licensed vocational nurses, licensed practical nurses, and nursing assistants who provide patient care. Not included are general support personnel such as ward clerks, custodians and housekeeping personnel.

(v) The unit must be equipped with, or have available for immediate use, lifesaving equipment necessary to treat the critically ill patients for which it is designed. This equipment may include, but is not limited to, respiratory and cardiac monitoring equipment, respirators, cardiac defibrillators, and wall or canister oxygen and compressed air.

(f) Nursery. These accounts (3510 & 3520) are used to report gross revenues measured in terms of the hospital's full established rates earned from nursery services provided to newborn infants who require routine and/or premature care.

(g) Sub-Acute Care. This group of accounts (3610-3690) is used to report the gross revenues measured in terms of the hospital's full established rates earned from services provided to patients who require a level of nursing care less than acute, including residential care.
 

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