Part 441 - Definitions

Effective Date: 
Tuesday, December 23, 1980
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Statutory Authority: 
Public Health Law, Section 2803-b

Section 441.1 - General

Section 441.1 General. For the purposes of this Article, the following terms shall have the following meanings.
 

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Section 441.2 - Abandonment

441.2 Abandonment. The complete retirement of a fixed asset from service, following salvage or other reclaiming of removable parts.

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Section 441.3 - Accelerated payments

441.3 Accelerated payments. Amounts received where delays in payments by an intermediary for covered services rendered to beneficiaries have caused financial difficulties for the hospital, or where a hospital has incurred a temporary delay in its bill processing beyond the provider's normal billing cycle.
 

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Section 441.4 - Account

441.4 Account. A formal record of a particular type of transaction expressed in money and kept in a ledger.
 

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Section 441.5 - Accountability

441.5 Accountability. The obligation of an employee, agent or other person to supply a satisfactory report, often periodic, of action or of failure to act following delegated authority/responsibility.
 

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Section 441.6 - Accounting control

441.6 Accounting control. The administrative procedures employed in maintaining the accuracy and propriety of transactions and the bookkeeping record thereof.
 

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Section 441.7 - Accounting policy

441.7 Accounting policy. The general principles and procedures under which the accounts of an organization are maintained and reported; any one such principle or procedure.
 

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Section 441.8 - Accrual

441.8 Accrual. (a) The recognition of events and conditions as they occur, rather than in the period of their receipt, or payment.

(b) The partial recognition of an item of revenue or expense and its related assets or liability resulting from the lack of coincidence of the reporting period and the contractual or benefit period.

(c) An amount accrued.
 

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Section 441.9 - Accrual reporting

441.9 Accrual reporting. The recognizing and reporting of the effects of transactions and other events on the assets and liabilities of the hospital entity in the time period to which they relate, rather than only when cash is received or paid.
 

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Section 441.10 - Accrue

441.10 Accrue. To give effect to an accrual; to record revenue or expense in the reporting period to which it relates, notwithstanding that the required receipt or outlay may take place, in whole or in part, in a preceding or following accounting period.
 

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Section 441.11 - Accrued depreciation

441.11 Accrued depreciation. The total depreciation incurred by an asset or asset group, based on customary or fairly determined rates or estimates of useful life, now generally referred to as accumulated depreciation.
 

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Section 441.12 - Accrued expense

441.12 Accrued expense. See accrued liability.
 

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Section 441.13 - Accrued liability

441.13 Accrued liability. An amount of interest, wages, or other expense recognized or incurred on and before a given date but not paid; sometimes referred to as accrued expense.
 

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Section 441.14 - Accrued revenue

441.14 Accrued revenue. Revenue earned, but neither received nor past due.
 

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Section 441.15 - Accumulated depreciation

441.15 Accumulated depreciation. The fixed-asset valuation account resulting from depreciation provisions; also known as reserve for depreciation, accrued depreciation, and allowance(s) for depreciation.

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Section 441.16 - Active medical staff

441.16 Active medical staff. Hospital-based and nonhospital-based physicians, other than interns and residents who are voting members of and can hold office in the medical staff organization of the hospital.

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Section 441.17 - Actuarial basis

441.17 Actuarial basis. A basis compatible with principles followed by actuaries: said of computations involving compound interest, retirement and mortality estimates, and the like.
 

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Section 441.18 - Acute care

441.18 Acute care. Inpatient general routine care 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 an institution.

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Section 441.19 - Addition

441.19 Addition. An addition is something which does not merely replace a thing previously owned. This includes enlargements and extensions of existing facilities.
 

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Section 441.20 - Additional (paid-in) capital

441.20 Additional (paid-in) capital. Contributions of corporate stockholders credited to accounts other than capital stock; sources: an excess over par or stated value received from the sale or exchange of capital stock, an excess of par or stated value of capital stock reacquired over the amount paid therefor, or an excess from recapitalization; often displayed on the balance sheet as a separate item or in combination with par or stated value and designated paid-in capital; known also as paid-in surplus.
 

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Section 441.21 - Admission

441.21 Admission. The formal acceptance by an institution of a patient who is to be provided with room, board, continuous nursing service, and other institutional services while lodged in the institution.
 

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Section 441.22 - Adult beds

441.22 Adult beds. Those beds assigned for regular use by inpatients who are 14 years of age or over, and which are maintained in areas allotted for adult or adolescent lodging, even though in some instances utilized by children.
 

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Section 441.23 - Advance

441.23 Advance. (a) Payment of cash or the transfer of goods for which an accounting must be rendered by the recipient at some later date.

(b) A payment of a contract before its completion.

(c) The payment of wages, salaries, or commissions before they have been earned.

(d) Deferred income or expense.
 

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Section 441.24 - Affiliate

441.24 Affiliate. A corporation or other organization related to another by owning or being owned, by common management or by a long-term lease of its properties or other control device.
 

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Section 441.25 - Age

441.25 Age. The number of years or other time periods an asset or asset group has remained in service at a given date.
 

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Section 441.26 - AICPA

441.26 AICPA. American Institute of Certified Public Accountants.
 

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Section 441.27 - Alcohol and drug unit

441.27 Alcohol and drug unit. A unit for the care of alcohol and/or drug rehabilitation inpatients. The hospital must also employ specially trained personnel to staff this unit, and at least one psychiatrist must be on the medical staff.

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Section 441.28 - Ambulance calls

441.28 Ambulance calls. The number of trips made in response to a request for assistance.
 

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Section 441.29 - Ambulatory care

441.29 Ambulatory care. Health services rendered to persons who are not confined overnight in a health care institution. Ambulatory care services are often referred to as outpatient services.
 

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Section 441.30 - Ambulatory services

441.30 Ambulatory services. The essential characteristic of ambulatory services is that the patients come to or are brought to a facility of the hospital for a purpose other than admission as an inpatient. Ambulatory services include emergency services, clinical services, ambulance services and home health services, but exclude ancillary services.
 

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Section 441.31 - Amortization

441.31 Amortization. (a) The gradual extinguishment of any amount over a period of time: as, the retirement of a debt by serial payments to the creditor or into a sinking fund; the periodic writedown of an insurance premium or a bond premium.

(b) A reduction of the book value of a fixed asset: a generic term for the depreciation, depletion, writedown or writeoff of a limited-life asset.
 

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Section 441.32 - Ancillary services

441.32 Ancillary services. Diagnostic or therapeutic services performed by specific facility departments as distinguished from general or routine patient care such as room and board. Ancillary services generally are those special services for which charges are customarily made in addition to routine charges and include such services as laboratory, radiology, surgical services, etc.
 

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Section 441.33 - Asset

441.33 Asset. Any owned physical object (tangible) or right (intangible) having economic value to its owner: an item or source of wealth expressed, for accounting purposes, in terms of its cost, depreciated cost, or fair market value at date of donation.
 

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Section 441.34 - Audit

441.34 Audit. (a) The examination of contracts, orders and other original documents for the purpose of substantiating individual transactions before their settlement.

(b) Any systematic investigation or appraisal of procedures or operations for the purpose of determining conformity with prescribed criteria; the work performed by an internal auditor.

(c) Auditing. An exploratory, critical review by a public accountant of the underlying internal controls and accounting records of a business enterprise or other economic unit, precedent to the expression by him of an opinion of the propriety ("fairness") of its financial statements.
 

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Section 441.35 - Available beds

441.35 Available beds. Health facility beds which are maintained and staffed for the provision of patient care.
 

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Section 441.36 - Average daily inpatient census

441.36 Average daily inpatient census. Average number of inpatients (based on the daily inpatient census) present each day for a given period of time.
 

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Section 441.37 - Average length of stay

441.37 Average length of stay. The average number of days of service rendered to each inpatient discharged during a given period.
 

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Section 441.38 - Average life

441.38 Average life. The arithmetic mean of the estimated useful-life expectancies of a group of assets subject to depreciation.
 

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Section 441.39 - Bad debt

441.39 Bad debt. An uncollectible receivable.
 

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Section 441.40 - Balance

441.40 Balance. (a) The difference between the total debits and the total credits of an account, or the total of an account containing only debits or credits.

(b) The equality of the total debit balances and the total credit balances of the accounts in a ledger.

(c) Agreement of the total of the account balances in a subsidiary ledger with its general-ledger control.
 

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Section 441.41 - Balance sheet

441.41 Balance sheet. A statement of financial position of any economic unit, or component thereof, reporting as at a given moment of time its assets (at cost, depreciated cost, or other indicated value), its liabilities, and its ownership equities recorded under an accounting system.
 

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Section 441.42 - Bassinets

441.42 Bassinets. Those beds assigned for regular use by infants newly born in the hospital and which are maintained in areas allotted for newborn infant lodging.
 

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Section 441.43 - Bed complement (beds available)

441.43 Bed complement (beds available). The total number of accommodations which are available (those set up and staffed for use). This figure should exclude the newborn nursery bassinets, beds in rooms intended for induction, recovery, labor, emergency, diagnostic and treatment purposes, and beds in such nonadaptable areas as corridors.
 

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Section 441.44 - Betterment

441.44 Betterment. An expenditure having the effect of extending the useful life of an existing fixed asset, increasing its normal rate of output, lowering its operating cost, increasing rather than merely maintaining efficiency or otherwise adding to the worth of benefits it can yield.
 

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Section 441.45 - Blood bank transfusions

441.45 Blood bank transfusions. The number of whole blood and packed red cell units prepared for transfusion. A unit is considered to be 500 cc.
 

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Section 441.46 - Board-designated assets

441.46 Board-designated assets. Unrestricted assets set aside by the governing board for specific purposes or projects.
 

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Section 441.47 - Boarder baby

441.47 Boarder baby. (a) A baby receiving lodging in the institution and who is not an institution patient.

(b) A newborn infant whose mother is discharged but the newborn does not occupy a patient bed but is retained in the nursery.
 

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Section 441.48 - Bond

441.48 Bond. (a) A certificate of indebtedness, in writing and often under seal.

(b) An obligation in writing, binding one or more parties as surety for another.
 

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Section 441.49 - Bond discount

441.49 Bond discount. The excess of the face amount of a bond or class of bonds over the net amount yielded from its sale. On the books and balance sheet of the issuer it appears as a deferred charge.
 

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Section 441.50 - Bond premium

441.50 Bond premium. The net amount yielded by the sale of a bond or class of bonds in excess of its face value. On the books and balance sheet of the issuer it appears as a deferred credit.
 

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Section 441.51 - Book inventory

441.51 Book inventory. (a) An inventory which is not the result of actual stocktaking but of adding the units and the cost of incoming goods to previous inventory figures and deducting the units and cost of outgoing goods.

(b) The balances of materials or products on hand in quantities, dollars, or both, appearing in perpetual inventory accounts.
 

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Section 441.52 - Book of original entry

441.52 Book of original entry. A record book, recognized by law or custom, in which transactions are successively recorded, and which is the source of postings to ledgers; a journal. Books of original entry include general and special journals, such as cashbooks and registers of sales and purchases.
 

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Section 441.53 - Book value

441.53 Book value. (a) The net amount at which an asset or asset group appears on the books of account, as distinguished from its market value or some intrinsic value.

(b) The face amount of a liability less any unamortized discount and expense.

(c) As applied to capital stock:

(1) the book value of the net assets;

(2) in a corporation, the book value of the net assets, divided by the number of outstanding shares of capital stock.
 

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Section 441.54 - Burn center

441.54 Burn center. A burn unit (see section 444.18(b)(5) of this Article for the definition of a burn care unit) with an emphasis on research and teaching, where the intensive care environment serves as a classroom for teaching the complexities of burn care and a laboratory for research.
 

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Section 441.55 - Capital asset

441.55 Capital asset. (a) An asset intended for continued use or possession.

(b) Common subclassifications are:

(1) land, buildings and equipment, leaseholds (fixed assets);

(2) goodwill, patents, trademarks, franchises (intangibles);

(3) investments in affiliated companies.
 

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Section 441.56 - Capital expenditure

441.56 Capital expenditure. An expenditure intended to benefit future periods, in contrast to a revenue expenditure, which benefits a current period; an addition to a capital asset. The term is generally restricted to expenditures that add fixed-asset units or that have the effect of increasing the capacity, efficiency, life span, or economy of operation of an existing fixed asset.
 

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Section 441.57 - Capital lease

441.57 Capital lease. (a) A lease which meets one of the following four criteria:

(1) The present value of the minimum lease payments is 90 percent or more of the fair value of the property to the lessor.

(2) The lease term is 75 percent or more of the leased property's estimated economic life.

(3) The lease contains a bargain (less than fair value) purchase option.

(4) Ownership is transferred to the lessee by the end of the lease term.

(b) See FASB Statement No. 13 for further details.
 

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Section 441.58 - Capitalize

441.58 Capitalize. (a) To record and carry forward into one or more future periods any expenditure, the benefits or proceeds from which will then be realized.

(b) To add to a fixed asset account the cost of plant additions, improvements and expenditures having the effect of increasing the efficiency or yield of a capital asset or making possible future savings in cost from its use.

(c) To transfer surplus to a capital-stock account, as the result of the issue of a stock dividend, a recapitalization, or, under the laws of some states, resolution of the board of directors.

(d) To discount or calculate the present worth of the projected future earnings of an asset or business.
 

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Section 441.59 - Certificate of deposit

441.59 Certificate of deposit. (a) A formal instrument, frequently negotiable or transferable, issued by a bank as evidence of indebtedness and arising from a deposit of cash subject to withdrawal under the specific terms of the instrument: (1) demand certificates, payable upon presentation, seldom bearing interest; (2) time certificates, payable at a fixed or determinable future date, usually bearing interest at a specific rate.

(b) A formal certificate, usually printed or engraved, ordinarily negotiable or transferable, and issued by a depository or agent against the deposit of bonds or stock of a corporation under the terms of a reorganization plan or other agreement.
 

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Section 441.60 - Certified bed capacity

441.60 Certified bed capacity. The total number of beds for which the facility has approval from the Commissioner of Health to operate. This is the number of beds that appears on the operating certificate.
 

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Section 441.61 - Certified bed days available

441.61 Certified bed days available. Bed days are computed by multiplying the number of certified beds (excluding newborn) available throughout the period by the number of days in the period. If there is an increase or decrease in the number of certified beds available during the period, the number of certified beds available for each part of the cost reporting period should be multiplied by the number of days for which that number was available.
 

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Section 441.62 - Chain organization

441.62 Chain organization. A health care, or other organization consisting of a group of two or more facilities which are owned, leased or, through any other device, controlled by one business entity.
 

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Section 441.63 - Chart of accounts

441.63 Chart of accounts. A systematically arranged list of accounts applicable to a specific concern, giving account names and numbers. A chart of accounts, accompanied by descriptions of their use and of the general operation of the books of account, becomes a classification or manual of accounts.
 

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Section 441.64 - Clearing account

441.64 Clearing account. A primary account containing costs that are to be transferred to other accounts; an intermediate account to which is transferred a group of costs or revenues or a group of accounts containing costs or revenues and from which a distribution of the total is made to other accounts.
 

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Section 441.65 - Clinic outpatient

441.65 Clinic outpatient. A clinic outpatient is one who is registered with a formally organized hospital service unit known as a clinic. The clinic constitutes an organizational entity to provide diagnosis and/or treatment under the direction of a specialty or subspecialty department of the hospital pursuant to section 405.1032 of this Subchapter.
 

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Section 441.66 - Comprehensive inpatient rehabilitation service

441.66 Comprehensive inpatient rehabilitation service. A program of care providing multidisciplinary physician and restorative services; including skilled rehabilitation nursing, physical therapy, occupational therapy, activities of daily living, speech therapy, and prosthetic-orthotic services; and having a physician director whose primary activity is supervision and coordination of the various rehabilitation modalities.
 

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Section 441.67 - Consistency

441.67 Consistency. Continued uniformity, during a period or from one period to another, in methods of accounting, mainly in valuation bases and methods of accrual, as reflected in the financial statements of an accounting entity.
 

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Section 441.68 - Contract service

441.68 Contract service. Services performed in whole or in part by an outside organization on a contractual basis.
 

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Section 441.69 - Contractual adjustment

441.69 Contractual adjustment. The difference between billings at established charges and amounts received or due from third-party payors under contract agreements.
 

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Section 441.70 - Contributed capital

441.70 Contributed capital. The payments in cash or property made to a corporation by its stockholders in exchange for capital stock, in response to an assessment or the capital stock, or as a gift; paid-in capital.
 

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Section 441.71 - Contributed services

441.71 Contributed services. See donated services.
 

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Section 441.72 - Control

441.72 Control. The process by which the activities of an organization are conformed to a desired plan of action and the plan is conformed to the organization's activities.
 

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Section 441.73 - Cost

441.73 Cost. An expenditure or outlay of cash, other property, capital stock, or services, or the incurring of a liability therefor, identified with goods or services acquired or with any loss incurred, and measured by the amount of cash paid or payable or the market value of other property, capital stock, or services given in exchange or, in other situations, any commonly accepted basis of valuation. Implicit in the concept of cost is the accrual basis of accounting.
 

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Section 441.74 - Cost center

441.74 Cost center. A cost center is an accounting device for accumulating items of cost that have common characteristics. A cost center may or may not be a department within the institution. A cost center such as Depreciation and Amortization, is an example where the cost center would not be a department of the institution. A cost center may be a function within the health facility, as opposed to a department.
 

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Section 441.75 - Critical care units

441.75 Critical care units. A discrete inpatient unit within the hospital providing maximum surveillance/support of vital functions; definitive therapy for patients with acute but reversible life-threatening impairments; patient monitoring; cardiopulmonary resuscitation; other life support techniques; and a staff of health professionals who have received specialized training in the provision of these services.
 

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Section 441.76 - Critical care units (type I)

441.76 Critical care units (type I). (a) Intensive medical care.

(b) Medical director who has completed residency training in one of the major clinical specialties and has acquired advanced skills and knowledge in life support and patient monitoring techniques.

(c) The medical director devotes the majority of his time to the unit.

(d) An MD (attending or senior resident) physically present within the unit 24 hours a day.
 

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Section 441.77 - Critical care units (type II)

441.77 Critical care units (type II). (a) Intensive nursing care.

(b) Intensive nursing care 24 hours a day.

(c) Medical director who has completed residency training in one of the major clinical specialties and has acquired advanced skills and knowledge in life support and patient monitoring techniques.

(d) MD rounds within the unit at least every 24 hours, and available in-house or on call 24 hours a day.
 

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Section 441.78 - Current assets

441.78 Current assets. Unrestricted cash, or other assets held for conversion within one year into cash or other readily convertible asset, or currently useful goods or services. The five customary subdivisions of current assets are cash, temporary investments, receivables, inventory, and prepaid expenses.
 

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Section 441.79 - Current liability

441.79 Current liability. A short-term debt, regardless of its source, including any liability accrued and deferred and unearned revenue that is to be paid out of current assets or is to be transferred to income within one year. The currently maturing portion of long-term debt is thus classified unless it is to be paid from a sinking fund or other noncurrent asset source.
 

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Section 441.80 - Daily hospital services

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

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Section 441.81 - Daily inpatient census

441.81 Daily inpatient census. The number of inpatients present at the census-taking time each day, plus any inpatients who were both admitted and discharged after the census-taking time the previous day. Generally the inpatient census is taken each midnight. However, a facility may designate and consistently use any other specified hour for census-taking.
 

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Section 441.82 - Date of acquisition

441.82 Date of acquisition. The effective purchase date of an asset. Usually, this is the date title is acquired, or the burdens of ownership are assumed and the asset is in possession.
 

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Section 441.83 - Date of change in certified bed capacity--decrease

441.83 Date of change in certified bed capacity--decrease. (a) Partial decertification of beds in a unit. The date proposed in the hospital's letter of intent to decertify filed with the Department of Health and subsequently approved.

(b) Retroactive decertification of part or all of a unit. The date promulgated by the Department of Health.

(c) Full decertification of beds in a unit. The date the last patient was discharged from the unit.
 

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Section 441.84 - Date of change in certified bed capacity--increase

441.84 Date of change in certified bed capacity--increase. The date the hospital receives approval from the Department of Health to utilize a unit or portion thereof.
 

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Section 441.85 - Deductible

441.85 Deductible. Under the Medicare program, that portion of covered hospital and medical charges which an insured person must pay before his policy benefits begin. Proposed as a mechanism to discourage over-utilization or to avoid processing small claims.
 

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Section 441.86 - Deductions from revenue

441.86 Deductions from revenue. Reductions in gross revenue arising from bad debts, contractual adjustments, uncompensated/charity care, administrative, courtesy, policy discounts, adjustments and others.
 

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Section 441.87 - Deferral (or deferment)

441.87 Deferral (or deferment). The accounting treatment accorded the receipt or accrual of revenue before it is earned, or the incurrence of an expenditure before the benefits therefrom are received. Such items are balance-sheet liabilities or assets and are carried forward to the income account of succeeding periods as the revenue is earned or as the benefits are received from the expenditure.
 

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Section 441.88 - Deferred charge

441.88 Deferred charge. An expenditure not recognized as a cost of operations of the period in which incurred but carried forward to be written off in one or more future periods.
 

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Section 441.89 - Deferred credit

441.89 Deferred credit. Revenue received or recorded before it is earned, i.e., before the consideration is given, in whole or in part, for which the revenue is or is to be received.
 

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Section 441.90 - Depreciable cost

441.90 Depreciable cost. That part of the cost of a fixed asset that is to be spread over useful life; i.e., cost less the estimated recovery from resale or salvage.
 

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Section 441.91 - Depreciation

441.91 Depreciation. Lost usefulness; expired utility; the diminution of service yield from a fixed asset or fixed-asset group that cannot or will not be restored by repairs or by replacement of parts.
 

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Section 441.92 - Depreciation fund

441.92 Depreciation fund. Money or marketable securities set aside for the purpose of replacing or providing assistance in replacing depreciable fixed assets.
 

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Section 441.93 - Direct expense

441.93 Direct expense. The cost of any good or service that contributes to, and is readily ascribable to, product or service output. Direct expense includes salaries and wages, employee benefits, professional fees, supplies, purchased services, other direct expenses and transfers.
 

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Section 441.94 - Direct assignment of cost

441.94 Direct assignment of cost. The process of identifying and assigning costs directly to the functional cost center generating those costs.
 

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Section 441.95 - Discharge

441.95 Discharge. The termination of lodging and the formal release of an inpatient by the institution. Since deaths are a termination of lodging, they are also inpatient discharges.
 

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Section 441.96 - Discount earned

441.96 Discount earned. A reduction in the purchase price of a good or service because of early payment.
 

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Section 441.97 - Discrete unit

441.97 Discrete unit. A separately organized, staffed and equipped unit of the institution.
 

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Section 441.98 - Distribution

441.98 Distribution. (a) Any payment to stockholders or owners of cash, property or shares, including any of the various forms of dividends in noncorporate enterprise; a withdrawal.

(b) A spread of revenue or expenditure or of capital additions to various accounts; an allocation.

(c) Disposal of a product by sale.
 

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Section 441.99 - Donated commodities

441.99 Donated commodities. Gifts of supplies and other materials, such as medicines, blood, linen and office supplies, which are normally purchased by the institution, and are recorded on the books at their fair market value at the time of donation, regardless of when actual receipt takes place.
 

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Section 441.100 - Donated services

441.100 Donated services. The services performed by personnel who receive no compensation or partial compensation for their services. The equivalent of an employer-employee relationship must exist between the institution and the individual donating the services. The term is usually applied to services rendered, by members of religious orders, societies or similar groups, to institutions operated by or affiliated with such institutions.
 

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Section 441.101 - Due from other funds

441.101 Due from other funds. A receivable for money loaned, stores issued, work performed, or services rendered to or for the benefit of another fund.
 

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Section 441.102 - Due to other funds

441.102 Due to other funds. A payable for money borrowed, stores received, work performed, or services from another fund.
 

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Section 441.103 - Earned

441.103 Earned. Realized or accrued as revenue through sales of goods, services performed, or the lapse of time.
 

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Section 441.104 - Emergency outpatient

441.104 Emergency outpatient. An emergency outpatient is one who is admitted to the emergency, accident or equivalent service of the hospital for the diagnosis and/or treatment of a condition. The service is one operated pursuant to section 405.1033 of this subchapter.
 

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Section 441.105 - Emergency service category 4--basic emergency services

441.105 Emergency service category 4--basic emergency services. A physician beyond the first postdoctoral year and a registered nurse anesthetist or anesthesiologist must be available within 15 minutes of being called. Physicians with expertise in anesthesiology, surgery, internal medicine, pediatrics and obstetrics must be available within two minutes. The facility should have an ICU with 24-hour staffing by at least one registered nurse trained in emergency lifesaving techniques.
 

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Section 441.106 - Emergency services category 3--general emergency services

441.106 Emergency services category 3--general emergency services. In addition to the requirements for category 4 facility, a category 3 facility should have 24-hour in-house physician coverage and in-house storage of whole blood or packed red cells.
 

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Section 441.107 - Emergency services category 2--major emergency hospital

441.107 Emergency services category 2--major emergency hospital. In addition to meeting the qualifications for category 3 facility, a category 2 facility must also render resuscitation and extended critical care to patients. Also, intensive nursing care and basic intensive medical care, including 24-hour blood gas determinations and inhalation therapy services should be available.
 

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Section 441.108 - Emergency services category 1--comprehensive emergency medical services

441.108 Emergency services category 1--comprehensive emergency medical services. Comprehensive emergency medical services provide immediate, complete and advanced care for all patients, including those requiring the most complex and specialized techniques. In addition to meeting the qualifications of a category 2 facility, a category 1 facility should have an anesthesiologist, internist, surgeon and, if applicable, an obstetrician or pediatrician, all of whom are specially trained in resuscitation and are available 24 hours a day to the emergency department. Continuous 24-hour laboratory support should be available, including such services as the determination of blood gases, blood pH, cardiac output, oxygen consumption, oxygen content, plasma protein, serum electrolytes, blood volume. hematologic determination and blood sugar. Capability for hemodialysis and extracorporeal oxygenation must also be present.
 

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Section 441.109 - Empirical

441.109 Empirical. Derived from experience; sometimes contrasted with rational (i.e., derived from some plan or principle).
 

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Section 441.110 - Employee

441.110 Employee. As distinguished from an independent contractor, a person subject to the will and control of an employer with respect to what the employee does and how he does it, and who is on the payroll of the institution.
 

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Section 441.111 - Employee benefit

441.111 Employee benefit. A pension provision, retirement allowance, insurance coverage, paid vacation, sick leave, and holiday time off or other cost representing a present or future return to an employee, which is neither deducted on a payroll nor paid for by the employee.
 

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Section 441.112 - Encounter

441.112 Encounter. A face-to-face contact between a patient and a provider who has primary responsibility for assessing and treating the condition of the patient at a given contact and exercises independent judgment in the care of the patient.
 

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Section 441.113 - Endowment funds

441.113 Endowment funds. Funds in which a donor has stipulated, as a condition of his gift, that the principal of the fund is to be maintained inviolate and in perpetuity, and that only income from investments of the fund be expended (see also term endowment funds).
 

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Section 441.114 - Equity

441.114 Equity. (a) Any right or claim to assets.

(b) An interest in property or in a business, subject to claims of creditors.

(c) The difference between assets and liabilities.

(d) Net worth.
 

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Section 441.115 - Equity ownership

441.115 Equity ownership. (a) The interest of an owner in property or in a business or other organization, subject, in case of liquidation, to prior claim of creditors.

(b) The interest (paid-in capital and retained earnings) of a stockholder or of stockholders collectively in a corporation; proprietorship.
 

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Section 441.116 - Error

441.116 Error. Deviation, inaccuracy or incompleteness in the measurement or representation of fact.
 

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Section 441.117 - Estimated useful life

441.117 Estimated useful life. Expected operating or service life of an asset or asset group in terms of utility to the institution.
 

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Section 441.118 - Expenditure

441.118 Expenditure. (a) The incurring of a liability, the payment of cash, or the transfer of property for the purpose of acquiring an asset or service or settling a loss.

(b) The amount of cash or property paid or to be paid for a service rendered, or an asset purchased.

(c) Any cost, the benefits of which may extend beyond the current accounting period.
 

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Section 441.119 - Expense

441.119 Expense. Expired cost; any item or class of cost of (or loss from) carrying on an activity; a present or past experience defraying a present operating cost or representing an irrecoverable cost or loss.
 

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Section 441.120 - Expense center

441.120 Expense center. See cost center.
 

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Section 441.121 - Expired cost

441.121 Expired cost. An expenditure from which no further benefit is anticipated; an expense; a cost absorbed over the period during which benefits were enjoyed or a loss incurred.
 

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Section 441.122 - Extraordinary expense

441.122 Extraordinary expense. A material expense (see materiality) so unusual in nature or in frequency of occurrence as to be accorded special treatment in the accounts or separate disclosure in financial statements.
 

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Section 441.123 - Facility

441.123 Facility. A coordinated group of fixed assets--land, buildings, machinery and equipment constituting a plant.
 

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Section 441.124 - Fair market value

441.124 Fair market value. (a) Value determined by bona fide bargaining between well-informed buyers and sellers, usually over a period of time.

(b) An estimate of market value, in the absence of sales or quotations.
 

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Section 441.125 - FASB

441.125 FASB. Financial Accounting Standards Board.
 

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Section 441.126 - Fellow

441.126 Fellow. A graduate of a medical/osteopathic/dental school who has had an advanced period of graduate training and is in a fellowship program in a subspecialty or in a clinical research program.
 

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Section 441.127 - Fidelity bond

441.127 Fidelity bond. Insurance against losses arising from dishonest acts of employees involving money, merchandise or other property.
 

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Section 441.128 - Fiduciary

441.128 Fiduciary. Any person responsible for the custody or administration, or both, of property belonging to another; as, a trustee.
 

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Section 441.129 - Financial Accounting Standards Board (FASB)

441.129 Financial Accounting Standards Board (FASB). A quasi-independent organization established in 1973 by the AICPA-sponsored Financial Accounting Foundation for the purpose of developing principles for financial reporting by business enterprises.
 

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Section 441.130 - Financial statements

441.130 Financial statements. A balance sheet, income statement, funds statement, statement of changes in financial position, or any supporting statement or other presentation of financial data derived from accounting records.
 

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Section 441.131 - Financially indigent patient

441.131 Financially indigent patient. A patient lacking the financial ability to reasonably be expected to pay for medical services received.
 

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Section 441.132 - Fixed assets

441.132 Fixed assets. (a) Assets of a relatively permanent nature held for continuous use in hospital operations and not intended to be converted into cash through sales.

(b) A balance sheet classification denoting capital assets other than intangibles and investments in affiliated companies or other long-term investments.

(c) Included in the usual fixed-asset categories are land (from which the flow of services is seemingly permanent), land improvements, buildings, fixed equipment, tools, leasehold improvements, major movable and minor movable equipment; generally excluded are goodwill, patents, and other intangibles. The characteristic fixed asset has a limited life (land is the one important exception), and, in organizations where expenses are accounted for, its cost, less estimated salvage at the end of its useful life, is distributed over the periods it benefits by means of provisions for depreciation.
 

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Section 441.133 - Fixed capital

441.133 Fixed capital. The investment in capital assets.
 

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Section 441.134 - Fixed cost (or expense)

441.134 Fixed cost (or expense). An operating expense, or operating expense as a class, that does not vary with business volume. Examples: interest on bonds; rent; property tax; depreciation (sometimes in part); minimal amounts of general overhead. Fixed costs are not fixed in the sense that they do not fluctuate or vary; they vary, but from causes independent of volume.
 

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Section 441.135 - Fringe benefit

441.135 Fringe benefit. See employee benefit.
 

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Section 441.136 - Full-time equivalent employees (FTE)

441.136 Full-time equivalent employees (FTE). An objective measurement of the personnel employment of an institution in terms of full-time labor capability. To calculate the number of full-time equivalent employees, sum all hours for which employees were paid (whether worked or not) during the year and divide by 2080.
 

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Section 441.137 - Function

441.137 Function. A collection of activities having related purposes.
 

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Section 441.138 - Functional reporting

441.138 Functional reporting. Reporting of the revenues and expenses according to type of activity performed.
 

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Section 441.139 - Fund

441.139 Fund. A self-contained accounting entity set up to account for a specific activity or project.
 

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Section 441.140 - Fund accounting

441.140 Fund accounting. Maintenance of separate and/or group accounts for health facility resources according to spending objectives set by donors, other outside sources or the governing body.
 

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Section 441.141 - Fund asset

441.141 Fund asset. An asset belonging to a particular fund or a group of funds.
 

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Section 441.142 - Fund balance

441.142 Fund balance. The excess of assets over liabilities (net equity). An excess of liabilities over assets is known as a deficit in fund balance.
 

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Section 441.143 - Fund balance sheet

441.143 Fund balance sheet. A balance sheet divided into self-balancing sections, each of which shows the assets and liabilities of a single fund or group of related funds.
 

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Section 441.144 - Fund liability

441.144 Fund liability. A liability of a fund which is to be met out of its existing resources.
 

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Section 441.145 - Funded debt

441.145 Funded debt. Debt evidenced by outstanding bonds or long-term notes.
 

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Section 441.146 - Funded depreciation

441.146 Funded depreciation. See depreciation fund.
 

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Section 441.147 - Funded reserve

441.147 Funded reserve. A pension reserve, a reserve for bonuses or for the retirement of preferred stock, or other prospective future liability against which certain assets have been accumulated and set aside or earmarked.
 

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Section 441.148 - Funds held in trust by others

441.148 Funds held in trust by others. Funds held and administered, at the direction of the donor, by an outside trustee for the benefit of an institution or institutions.
 

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Section 441.149 - GAAP

441.149 GAAP. Generally accepted accounting principles.
 

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Section 441.150 - Gain or loss

441.150 Gain or loss. The net result of a concluded transaction or of an operating period following the application of generally accepted accounting principles.
 

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Section 441.151 - General fund

441.151 General fund. See operating fund.
 

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Section 441.152 - General journal

441.152 General journal. The journal in which are recorded transactions not provided for in specialized journals.
 

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Section 441.153 - General ledger

441.153 General ledger. A ledger containing accounts in which all the transactions of a business enterprise or other accounting unit are classified either in detail or in summary form.
 

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Section 441.154 - Generally accepted

441.154 Generally accepted. Given authoritative recognition; said of accounting principles or audit standards, and the pronouncements concerning them, particularly, in recent years, those of the American Institute of Certified Public Accountants and the Financial Accounting Standards Board.
 

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Section 441.155 - Gift

441.155 Gift. Any voluntary conveyance of assets gratuitously made and not in consideration of any kind of exchange.
 

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Section 441.156 - Goodwill

441.156 Goodwill. The excess of the price paid for a business as a whole over the book value or over the computed or agreed value of all tangible net assets purchased. Normally, goodwill thus acquired is the only type appearing on books of account and in financial statements.
 

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Section 441.157 - Governing board

441.157 Governing board. The policy-making board of the hospital. Some of the responsibilities usually attributed to the governing board may be assumed by appropriate committees.
 

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Section 441.158 - Gross

441.158 Gross. Undiminished by related deductions, except corrections; applied to sales, revenues, income, expense, and the like.
 

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Section 441.159 - Gross charges (gross revenue)

441.159 Gross charges (gross revenue). The total charges at the hospital's full established rates for services rendered and goods sold (including patient-related and non-patient-related).
 

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Section 441.160 - Gross square feet

441.160 Gross square feet. The total floor areas of the plant, including common areas (hallways, stairways, elevators, lobbies, closets, etc.).
 

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Section 441.161 - Health facility

441.161 Health facility. Any licensed facility, place or building which is organized, maintained and operated for the diagnosis, care and treatment of human illness, physical or mental, including convalescence and rehabilitation and including care during and after pregnancy, or for any one or more of these purposes, for one or more persons, to which such persons are admitted for a 24-hour stay or longer.
 

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Section 441.162 - Health-related beds

441.162 Health-related beds. Beds in facilities providing institutional care and services with nursing services available, but not continuous. Refer to the definition of residential care in section 444.18(d)(7) of this Article.

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Section 441.163 - Health-related care

441.163 Health-related care. Care, other than medical, that is performed by qualified personnel and pertains to protective, preventive, personal and social services.

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Section 441.164 - Historical cost

441.164 Historical cost. The amount of cash or cash equivalent given in exchange for properties or services at the time of acquisition (see basis of valuation in section 442.10 of this Article).

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Section 441.165 - Holding account

441.165 Holding account. See clearing account.

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Section 441.166 - Home office

441.166 Home office. The office of the controlling organization. This office generally incurs costs and provides services to or on behalf of the individual health facility.

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Section 441.167 - Hospital

441.167 Hospital. An establishment that provides, through an organized medical or professional staff, permanent facilities that include inpatient beds, medical services and continuous nursing services, diagnosis and treatment for patients.
 

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Section 441.168 - Hospital-based physician

441.168 Hospital-based physician. A physician who spends the predominant part of his practice time within one or more hospitals instead of in an office setting, or providing services to one or more hospitals or their patients. Such physicians have either a special financial arrangement with the hospital (salary or percentage of fees collected), or bill patients separately for their services. Such physicians include directors of medical education, pathologists, anesthesiologists and radiologists, as well as physicians who staff emergency rooms and outpatient departments.
 

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Section 441.169 - Hospital boarder

441.169 Hospital boarder. An individual who receives lodging in the hospital but who is not an inpatient. In most hospitals, a small number of persons who are not patients and who are not hospital personnel or physicians may, nevertheless, be occasionally provided with room and board, often in "areas of the hospital where patients generally stay at least overnight". Most often this is arranged so that they can be near children or other members of the family who are ill.
 

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Section 441.170 - Hospital patient

441.170 Hospital patient. An individual receiving, in person or otherwise (telemetry), hospital-based or coordinated medical services for which the hospital is responsible.
 

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Section 441.171 - Imprest fund

441.171 Imprest fund. A fixed cash fund or petty cash fund in the form of currency, a bank checking account, or both, maintained for expenditures that must be made in cash, and, from time to time, restored to its original amount by a transfer from general cash of a sum equal to the aggregate of disbursements; a form of working fund.
 

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Section 441.172 - Improvement

441.172 Improvement. (a) Betterment.

(b) The clearing, draining, grading, or other addition to the worth of a tract of land; any cost of developing real estate, whether paid for directly or through special assessment taxes.

(c) A betterment of leased property or plant.
 

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Section 441.173 - Income realization

441.173 Income realization. The recognition of income, the usual test being the passage of title to or delivery of goods, or the performance of services.
 

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Section 441.174 - Income statement

441.174 Income statement. An accounting statement which reflects the financial results of a hospital during an accounting period. The data for this statement are accumulated in the revenue and expense accounts.
 

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Section 441.175 - Indirect liability

441.175 Indirect liability. (a) An obligation not yet incurred but for which responsibility may have to be assumed in the future; as, the possible liability from the premature settlement of a long-term contract.

(b) A debt of another, as the result of which an obligation to pay may develop; a contingent liability.
 

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Section 441.176 - Inpatient

441.176 Inpatient. A patient who is provided with room, board, and continuous general nursing service in an area of the hospital where patients stay overnight.
 

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Section 441.177 - Inpatient admission

441.177 Inpatient admission. The formal acceptance by a health facility of a patient who is to be provided with room, board, and continuous nursing service in an area of the health facility where patients generally stay at least overnight.
 

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Section 441.178 - Intangible asset

441.178 Intangible asset. A capital asset having no physical existence, its value being limited by the rights and anticipative benefits that possession confers upon the owner.
 

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Section 441.179 - Intensive care

441.179 Intensive care. Services provided in a routine patient care unit to patients which require extraordinary observation and care on a concentrated exhaustive and continuous basis.
 

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Section 441.180 - Interfund transfer

441.180 Interfund transfer. The transfer of money or other asset or of a liability from one fund to another.
 

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Section 441.181 - Intern

441.181 Intern. A graduate of a medical/osteopathic/dental school serving a first-year period of graduate clinical training.
 

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Section 441.182 - Internal control

441.182 Internal control. (a) The general methodology by which management is carried on within an organization; also, any of the numerous devices for supervising and directing an operation or operations generally.

(b) Internal control, a management function, is a basic factor operating in one form or another in the administration of every organization, business or otherwise. Although sometimes identified with the administrative organism itself, it is often characterized as the nervous system that activates overall operating policies and keeps them within practicable performance ranges. The principles contributing to internal control are usually these:

(1) recognition that within every organizational unit there are one or more functional or action components known as activities, costs, or responsibility centers, or management units;

(2) delegated operating authority in each organizational unit permitting freedom of action within defined limits;

(3) the linking of expenditures--their incurrence and disposition--with specified individual authority;

(4) end product planning by means of (i) a budget fitted to the organizational structure and to its functional components, thus maintaining dual forward operating disciplines; and (ii) the adoption of standards of comparison and other performance measurements such as standard costs, quality controls and timing goals;

(5) an accounting process that provides organizational and functional administrators with prompt, complete, and accurate information on operating performance, and comparisons with predetermined performance standards;

(6) periodic reports, consonant with accounting and related records, by activity heads to supervisory management; reports serving as feedbacks of informative pictures of operations, and as displays of favorable and unfavorable factors that have influenced performance;

(7) internal check, built into operating procedures, and providing maximum protection against fraud and error;

(8) frequent professional appraisals, through internal audit, of management and its policies and operations generally, as a protective and constructive management service, its emphasis varying with the quality of operating policies and their administration; and

(9) the construction of the above controls in such a manner as to stimulate and take full advantage of those natural attributes of individual employees the recognition and exercise of which may obviate the need for some internal controls and determine the extent and rigidity of others.
 

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Section 441.183 - Inventory control

441.183 Inventory control. The control of merchandise, materials, goods in process, finished goods, and supplies on hand by accounting and physical methods. An accounting control is effected by means of a stock or stores ledger, mechanical storage records, or a ledger account in which the quantities or amounts (or both) of goods received during an accounting period are added to corresponding balances at the beginning of the period and amounts of goods sold or otherwise disposed of are deducted at a calculated cost based on individual identification or any of various methods of averaging. Physical controls consist of various plans of buying, storing, handling, issuing, supervising and stock-taking. Stock-ledger control is made more effective by physical control in the nature of continuous check of the goods on hand.
 

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Section 441.184 - Inventory valuation

441.184 Inventory valuation. The determination of the cost or the portion of cost assignable to on-hand raw materials, merchandise, merchandise held for resale, and supplies based on any generally accepted method consistently applied.
 

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Section 441.185 - Invested capital

441.185 Invested capital. (a) The amount of capital contributed to a business by its owners; capital.

(b) The amount so contributed, plus retained earnings (or less accumulated losses) and appropriated surplus.
 

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Section 441.186 - Investor-owned (proprietary) hospital

441.186 Investor-owned (proprietary) hospital. A hospital owned by a person, an unincorporated group of people, or a corporation. Operation of this type of hospital is usually intended to return a monetary gain to the investors; but may include instances where individuals own and operate hospitals primarily for community benefit.
 

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Section 441.187 - Invoice

441.187 Invoice. A document showing the character, quantity, price, terms, nature of delivery, and other particulars of goods sold or of services rendered.
 

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Section 441.188 - Invoice cost

441.188 Invoice cost. Cost incurred by a buyer and reflected on an invoice which, unless otherwise specified, is net after deducting trade discounts.
 

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Section 441.189 - Irrevocable trust

441.189 Irrevocable trust. A trust that cannot be set aside by its creator.
 

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Section 441.190 - Lease

441.190 Lease. A conveyance of land or of the use of a building or a part of a building or equipment from one person (lessor) to another (lessee) for a specified period of time, in return for rent or other compensation.
 

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Section 441.191 - Leasehold

441.191 Leasehold. An interest in land, buildings and equipment under the terms of a lease, normally classified as a (tangible) fixed asset.
 

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Section 441.192 - Liability

441.192 Liability. (a) An amount owing by one person (a debtor) to another (a creditor), payable in money, or in goods or services: the consequence of an asset or service received or a loss incurred or accrued; particularly, any debt (1) due or past due (current liability), (2) due at a specified time in the future (e.g., funded debt, accrued liability), or (3) due only on failure to perform a future act (deferred income, contingent liability).

(b) The title of the credit half of a balance sheet, often including net worth as well as obligations to outsiders; when thus used, the inference is that the organization reflected in the balance sheet has a status independent of both its creditors and its owners--to whom it must account in the amounts shown.
 

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Section 441.193 - License

441.193 License. A permission granted by competent authority to engage in a business or corporation or any activity otherwise unlawful.
 

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Section 441.194 - Listing of accounts

441.194 Listing of accounts. A systematically arranged list of accounts applicable to a specific concern, giving names and numbers. See also chart of accounts.
 

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Section 441.195 - Live births

441.195 Live births. A live birth is the complete expulsion or extraction from its mother in a hospital facility, of a product of conception, irrespective of the duration of pregnancy, which after such separation breathes or shows any evidence of life such as beating of the heart, pulsation of the umbilical cord or definite movement of voluntary muscles, whether or not the umbilical cord has been cut or the placenta is attached.
 

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Section 441.196 - Living trust funds

441.196 Living trust funds. Funds acquired by an institution subject to agreement whereby resources are made available to the institution on condition that the institution pay periodically to a designated person, or persons, the income earned on the resources acquired for the lifetime of the designated person or persons, or for a specified period.
 

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Section 441.197 - Maintenance

441.197 Maintenance. Effort expended to maintain assets in fit condition to do their work--such items are ordinary and recurring and do not improve the asset or add to its life. A useful distinction can be made between maintenance as preventive and repairs as curative.
 

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Section 441.198 - Materiality

441.198 Materiality. The relative importance, when measured against a standard of comparison, of all items (cumulative by cost center or account) included in or omitted from books of account or financial statements, or any procedure or change in procedure that conceivably might affect such statements. An amount is material if its exclusion from or inclusion in an accounting statement would make it misleading.
 

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Section 441.199 - Medicaid (Title XIX)

441.199 Medicaid (Title XIX). A federally aided, State-operated and administered program which provides medical benefits for certain low-income persons in need of health and medical care. The program, authorized by title XIX of the Social Security Act, is basically for the poor. It does not cover all of the poor, however, but only persons who are members of one of the categories of people who can be covered under the welfare cash payment programs--the aged, the blind, the disabled, and members of families with dependent children where one parent is absent, incapacitated or unemployed. Subject to broad Federal guidelines, states determine the benefits covered, program eligibility, rates of payment for providers, and methods of administering the program.
 

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Section 441.200 - Medical record

441.200 Medical record. A record kept on patients which properly contains sufficient information to identify the patient clearly, to justify his/her diagnosis and treatment, and to document the results accurately. The purposes of the record are to serve as the basis for planning and continuity of patient care; provide a means of communication among physicians and any professional contributing to the patient's care; furnish documentary evidence of the patient's course of illness and treatment; serve as a basis for review, study and evaluation; serve in protecting the legal interests of the patient, hospital and responsible practitioner; and provide data for use in research and education. Medical records and their contents are not usually available to the patient himself. The content of the record is usually confidential. Each different provider in a community caring for a given patient usually keeps an independent record of that care.
 

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Section 441.201 - Medical services

441.201 Medical services. The services pertaining to medical care that are performed at the direction of a physician on behalf of patients by physicians, dentists, nurses, and other professional and technical personnel.
 

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Section 441.202 - Medical staff classification--associate

441.202 Medical staff classification--associate. New applicants are generally appointed as associate staff members for a period of two to four years, after which they become members of the attending staff.
 

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Section 441.203 - Medical staff classification--attending

441.203 Medical staff classification--attending. Have full admitting privileges in accordance with their abilities and qualifications, and also participate as members of the medical staff committees, serve as officers of the medical staff and serve as directors or chiefs of departments. They are required to attend meetings of the general staff and departmental staff, and may be required to devote time to the education programs and supervise residents in outpatient clinics or emergency departments.
 

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Section 441.204 - Medical staff classification--consulting

441.204 Medical staff classification--consulting. Physicians of recognized professional ability in their specialty, but who are not members of the attending staff.
 

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Section 441.205 - Medical staff classification--courtesy

441.205 Medical staff classification--courtesy. Certain doctors are designated as courtesy members when they have retired. They have privileges consistent with their abilities and qualifications.
 

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Section 441.206 - Medical staff classification--house staff (paid staff)

441.206 Medical staff classification--house staff (paid staff). Licensed physicians who are employed by the hospital to provide service to all patients, according to need, and are subject to the approval of the patients' own physicians.
 

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Section 441.207 - Medicare

441.207 Medicare. A third-party reimbursement program administered by the Health Care Financing Administration that underwrites the medical costs of persons 65 and over, and some qualified persons under 65. "Part A" covers hospital services and "Part B" covers physicians' services.
 

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Section 441.208 - Mentally disordered patient

441.208 Mentally disordered patient. A person with a chronic psychiatric impairment and whose adaptive functioning is moderately impaired. This patient requires continuous supervision and can be expected to benefit from an active rehabilitation program effort designed to improve his adaptive functioning and develop a potential for replacement in a less protected living environment.
 

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Section 441.209 - Modernization

441.209 Modernization. Includes the alteration, expansion, major repair (to the extent permitted by regulations), remodeling, replacement and renovation of existing buildings (including initial equipment thereof and the replacement of obsolete equipment of existing buildings).
 

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Section 441.210 - Neonatal intensive care unit

441.210 Neonatal intensive care unit. A special unit, approved by the State, set up for the treatment of infants from hour of birth through first 28 days; also of infants up to three months of age with medical and surgical problems which are best managed in a neonatal intensive care unit.
 

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Section 441.211 - Net

441.211 Net. Diminished by all relevant and commonly associated deductions.
 

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Section 441.212 - Net square feet

441.212 Net square feet. Gross square feet of a building less common areas. To determine net square feet, the number of square feet in each cost center of the hospital may be determined either by a physical measurement of the hospital or by a measurement from blueprints. Floor area measurements should be taken from the center of walls to the center of adjoining corridors if a hallway services more than one cost center. Exclude stairwells, elevators, and other shafts, commonly used (lobbies, etc.) and idle areas. Idle areas are those areas that are closed off or unused for a period of time. Hallways, waiting rooms, storage areas, etc., serving only one cost center should be included in that cost center. The effect of using only usable space in the allocable floor area is to allocate the nonproductive space (commonly used and idle area) among the cost centers in the ratio of space used.
 

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Section 441.213 - Net worth

441.213 Net worth. The aggregate presentation on the accounting records of the equities representing proprietary interests; the excess of the going concern's value of assets over liabilities to outsiders; of a corporation, the total of paid-in capital, retained earnings, and appropriated surplus; of a sole proprietorship, the proprietor's account; of a partnership, the sum of the partners' accounts.
 

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Section 441.214 - Newborn

441.214 Newborn. (a) An inpatient newly born in the hospital and accepted for routine care and lodging in a newborn bed facility. Stillbirths are not to be considered newborn.

(b) The following should not be included as newborn patient days:

(1) boarder babies for nonmedical reasons;

(2) premature infants;

(3) infants born outside of hospital;

(4) newborn who, for medical reasons, remain in the hospital after the mother's discharge; and

(5) newborn who become sick and require general hospital care.
 

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Section 441.215 - Nine-C (IX-C) corporation

441.215 Nine-C (IX-C) corporation. As defined in article IX-C of the Insurance Law.
 

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Section 441.216 - Nonoperating expense

441.216 Nonoperating expense. The expenses of a hospital which are not directly related to patient care, related patient services, or the sale of related goods. For example, nonoperating expenses includes losses on sale of hospital property and retail operations expenses.
 

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Section 441.217 - Nonoperating revenue

441.217 Nonoperating revenue. The revenue of a hospital which is not directly related to patient care, related patient services, or the sale of related goods. For example, nonoperating revenue includes unrestricted gifts, unrestricted income from endowment funds, gain on sale of hospital properties, and retail operation revenue.
 

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Section 441.218 - Nonprofit corporation

441.218 Nonprofit corporation. An incorporated charity, or any corporation operated under a policy by which no stockholder or trustee shares in the profits or losses, if any, of the enterprise.
 

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Section 441.219 - Non-revenue-producing cost centers

441.219 Non-revenue-producing cost centers. These are overhead units, such as dietary and plant operations and maintenance, that provide necessary support services to revenue-producing centers.
 

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Section 441.220 - Nonroutine maintenance and repairs

441.220 Nonroutine maintenance and repairs. Maintenance and repair work which is not repetitive and not performed regularly.
 

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Section 441.221 - Not-for-profit

441.221 Not-for-profit. A corporation as defined in section 102 of the Not-for-Profit Corporation Law.
 

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Section 441.222 - Nursing services

441.222 Nursing services. Services pertaining to the curative, rehabilitative and preventive aspects of nursing care that are planned, performed, supervised and/or directed by a registered professional nurse.
 

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Section 441.223 - Obsolescence

441.223 Obsolescence. The loss in usefulness of an asset, occasioned by the approach to the stage of economic uselessness through programs of the arts; economic inutility arising from external causes; disappearing usefulness resulting from invention, change of style, legislation, or other causes having no physical relation to the object affected. It is distinguished from exhaustion, wear and tear, and deterioration, in that these terms refer to a functional loss arising out of a change in physical condition.
 

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Section 441.224 - Occasion of service

441.224 Occasion of service. (a) A specific identifiable act of service involved in the medical care of the patient which does not require the assessment of the patient's condition nor the exercising of independent judgment as to the patient's care. An example of an occasion of service is a technician administering an injection.

(b) An examination, a consultation or a treatment in any of the services or facilities of the hospital.
 

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Section 441.225 - On-call pay (standby)

441.225 On-call pay (standby). Standby pay is compensation to an employee for being available to work.
 

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Section 441.226 - Operating expenses

441.226 Operating expenses. Operating expenses include all necessary and proper costs which are appropriate in developing and maintaining the operation of the patient care facilities and activities. Necessary and proper costs related to patient care are those costs which are common and accepted occurrences in the hospital operation.
 

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Section 441.227 - Operating fund

441.227 Operating fund. The funds within the unrestricted fund which have not been designated by the governing board of the hospital for special uses.
 

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Section 441.228 - Operating income (or profit)

441.228 Operating income (or profit). The excess of the revenues of a business enterprise over the expenses pertaining thereto, excluding income and expense derived from sources other than its regular activities.
 

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Section 441.229 - Operating lease

441.229 Operating lease. A lease which fails to meet all of the following four criteria:

(a) The present value of the minimum lease payments is 90 percent of the fair value of the property to the lessor.

(b) The lease term is 75 percent or more of the leased property's estimated economic life.

(c) The lease contains a bargain (less than fair value) purchase option.

(d) Ownership is transferred to the lessee by the end of the lease term. (See FASB Statement No. 13 for further details.)
 

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Section 441.230 - Operating revenue

441.230 Operating revenue. Operating revenue includes revenue directly related to the rendering of patient care services and revenue from nonpatient care services to patients and sales and activities to persons other than patients.
 

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Section 441.231 - Organization cost (or expense)

441.231 Organization cost (or expense). Any cost incurred in establishing a corporation or other form of organization; as, incorporation, legal and accounting fees, promotional costs incident to the sale of securities, security qualification expense, and printing of stock certificates. These and similar costs constitute, theoretically, an intangible asset of value which continues throughout the life of the corporation and hence, strictly, do not constitute a deferred charge. The organization costs must be amortized over a period of time not less than 60 months.
 

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Section 441.232 - Original cost

441.232 Original cost. Outlay for an asset by its owner, not including any adjustments of cost arising from post-acquisition alterations, improvements or depreciation.
 

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Section 441.233 - Other operating revenue

441.233 Other operating revenue. Other operating revenue includes revenue from nonpatient care services to patients and sales and activities to persons other than patients, and the value of donated commodities.
 

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Section 441.234 - Outpatient

441.234 Outpatient. A hospital patient who receives services in one or more of the facilities of the hospital when he or she is not currently an inpatient or a home care patient.
 

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Section 441.235 - Outstanding

441.235 Outstanding. (a) Uncollected or unpaid: said of an account or note receivable or payable, or of a check sent to the payee but not yet cleared against the drawee bank.

(b) In the hands of others: said of the units of funded debt of a corporation or of the certificates representing issued shares of capital stock in the hands of the public; treasury stock is defined in terms of shares issued but not outstanding.
 

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Section 441.236 - Overhead

441.236 Overhead. (a) Any cost of doing business other than a direct cost of an output of product or service.

(b) A general name for costs of materials and services not directly adding to or readily identifiable with the product or service constituting the main object of an operation.
 

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Section 441.237 - Owner's equity

441.237 Owner's equity. Net worth.
 

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Section 441.238 - Ownership

441.238 Ownership. The right to and enjoyment of services or benefits flowing from an asset, usually evidenced by the possession of legal title or by a beneficial interest in the title.
 

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Section 441.239 - Oxygen therapy minutes

441.239 Oxygen therapy minutes. The number of minutes oxygen has been administered to a patient. Consideration should be given to volume of oxygen used.
 

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Section 441.240 - Paid-in capital

441.240 Paid-in capital. The total amount of cash, property and services contributed to a corporation by its stockholders and constituting a major balance sheet item. It may be reflected in a single account or divided between capital stock and additional paid-in capital accounts.
 

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Section 441.241 - Paid staff

441.241 Paid staff. See medical staff classification.
 

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Section 441.242 - Parent company

441.242 Parent company. A controlling company having subsidiaries. Without a trade or business of its own, a parent company may also be termed a holding company.
 

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Section 441.243 - Part A and Part B services

441.243 Part A and Part B services. Medicare benefits are payable from two trust funds. Part A services, which, in general, are those rendered by institutions, are reimbursed from funds derived from payroll tax. Part B services, generally medical and surgical physicians' services, and outpatient treatment and diagnosis are reimbursed from the fund created by voluntary premium payments and general Federal revenues.
 

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Section 441.244 - Patient care services revenue

441.244 Patient care services revenue. The hospital's full established charges for services rendered to patients regardless of amounts actually paid to the hospital by or in behalf of patients.
 

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Section 441.245 - Patient day

441.245 Patient day. A unit of measure denoting lodging facilities provided and services rendered to one inpatient between the census-taking hour on two successive days. The day of admission but not the day of discharge or death is counted as a patient day. If both admission and discharge or death occur on the same day, the day is considered a day of admission and counts as one patient day.
 

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Section 441.246 - Payor

441.246 Payor. A person or organization which pays the hospital for services rendered to patients. This can be the patient and/or third party, such as Medicare, Medicaid, Blue Cross or other private insurance plan.
 

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Section 441.247 - Payroll

441.247 Payroll. (a) A record showing the wage or salary earned by employees for a certain period and the various deductions for withholding tax, health benefits, and so on.

(b) Total wages and salaries accrued or payable for a given period.
 

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Section 441.248 - Payroll distribution

441.248 Payroll distribution. (a) An analysis of the total amount of salaries and wages paid or accrued for a period, showing the component amounts to be charged to the various cost centers.

(b) The entry by which the amount of salaries and wages paid or accrued for a period is charged in the required detail to the accounts or records.
 

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Section 441.249 - Payroll records

441.249 Payroll records. The records relating to the authorization, computation, distribution and payment of wages and salaries. They include payrolls, time slips, time-clock cards, withholding authorizations, cancelled payroll checks or receipts for wages paid, wage and salary authorizations and individual earnings records.
 

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Section 441.250 - Pediatric patient

441.250 Pediatric patient. A patient less than 14 years old.
 

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Section 441.251 - Periodic interim payment (PIP)

441.251 Periodic interim payment (PIP). A plan under which the hospital receives cash payments from third-party payors (usually Medicare) in constant amounts each period. The total of these payments received over a year is the estimated cost of providing services to patients covered by the plan.
 

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Section 441.252 - Perpetual inventory

441.252 Perpetual inventory. A book inventory kept in continuous agreement with stock on hand by means of a detailed record that may also serve as a subsidiary ledger where dollar amounts as well as physical quantities are maintained. Sections of the stockroom are inventoried at short intervals and the quantities or amounts or both are adjusted, where necessary, to the physical count.
 

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Section 441.253 - Personal property

441.253 Personal property. Property or assets of a temporary and movable character as contrasted with real property.
 

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Section 441.254 - Physical inventory

441.254 Physical inventory. An inventory determined by observation and evidenced by a listing of the actual count, weight or measure.
 

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Section 441.255 - Physical life

441.255 Physical life. Total potential operating life, as of a machine, as contrasted with useful or economic life, which may be much less because of the presence of obsolescence or inadequacy, or both.
 

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Section 441.256 - Physician

441.256 Physician. A doctor of medicine or of osteopathy who is fully licensed to practice medicine.
 

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Section 441.257 - Physician, attending

441.257 Physician, attending. The physician who has legal responsibility for the care of a patient in a hospital.
 

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Section 441.258 - Physician, teaching

441.258 Physician, teaching. Physicians who have primary responsibility for teaching activities related to graduate physicians in training or medical/osteopathic/dental undergraduate students in an identified clinical service.
 

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Section 441.259 - Plant

441.259 Plant. Physical properties used for institutional purposes; i.e., land, building, improvements, equipment, and so forth. The term does not include real estate or properties of restricted or unrestricted funds not used for health facility operations.
 

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Section 441.260 - Plant replacement and expansion funds

441.260 Plant replacement and expansion funds. Resources restricted by donor and other third parties for the acquisition or construction of plant assets or the reduction of related debt.
 

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Section 441.261 - Pooled investments

441.261 Pooled investments. Assets of two or more funds consolidated for investment purposes.
 

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Section 441.262 - Premature infant

441.262 Premature infant. An infant born at any time through the 37th week of gestation (259 days).
 

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Section 441.263 - Premature nursery

441.263 Premature nursery. A separate facility, approved by the State, used exclusively for the care of infants whose birth weight is 2,500 grams or less.
 

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Section 441.264 - Prepaid expense

441.264 Prepaid expense. An expenditure, often recurrent, for future benefits; a type of deferred charge. Examples: prepaid operating expenses, prepaid rent, taxes, royalties, commissions; unexpired insurance premiums; stationery and office supplies. Such items are classifiable as current assets and constitute a part of working capital; they are charged to future operations on the basis of measurable benefits or on a time or period-charge basis.
 

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Section 441.265 - Prepay

441.265 Prepay. To pay for a service before its receipt or enjoyment; such prepayment, as for insurance or rent, reflecting long-established commercial practices, contrasts with accrue (or the recognition of the receipt or enjoyment of other types of services paid for after their receipt or enjoyment).
 

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Section 441.266 - Present value

441.266 Present value. The price a buyer is willing to pay for one or a series of future benefits, the term generally being associated with a formal computation of the estimated worth in the future of such benefits from which a discount or compensation for waiting is deducted.
 

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Section 441.267 - Prior-period adjustment

441.267 Prior-period adjustment. A correction of an error in earlier financial statements or an adjustment that results from realization of income tax benefits of pre-acquisition loss carry-forwards of purchased subsidiaries; all other items of profit or loss recognized in a fiscal year are required to be included in the determination of net income in the year recognized (see FASB Statement No. 16).
 

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Section 441.268 - Procedure

441.268 Procedure. A unit of activity in an ancillary cost center. For example, a procedure in a radiology cost center may be a series of pictures which constitute an exam.
 

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Section 441.269 - Professional component

441.269 Professional component. The professional services provided to patients by hospital-based physicians, as opposed to the education, research and administrative duties performed by the hospital-based physicians.
 

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Section 441.270 - Program

441.270 Program. Daily hospital or ambulatory service category of the patient.
 

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Section 441.271 - Provider

441.271 Provider. An individual or institution which gives medical care. Institutional providers include a hospital, skilled nursing facility and intermediate care facility. Individual providers include individuals (physicians, dentists, etc.) who practice independently of institutional providers and whose primary activity is the provision of health care to individuals.
 

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Section 441.272 - Psychiatric day care

441.272 Psychiatric day care. A program offering treatment including a planned program of recreational, social and vocational activities in a therapeutic environment under the direction of a psychiatrist or a physician with specialized knowledge in the field. Treatment services may be provided by a staff which may include psychiatrists, psychologists, social workers, nurses, educators, occupational and recreational therapists, psychiatric aides and volunteers. Treatment may include individual or group therapy, patient-staff meetings, drug therapy, occupational therapy, recreational therapy and other activity.
 

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Section 441.273 - Psychiatric inpatient service

441.273 Psychiatric inpatient service. The care of psychiatric inpatients; the hospital must also employ specially trained personnel to staff this service, and at least one psychiatrist must be on the medical staff.
 

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Section 441.274 - Psychiatric night care

441.274 Psychiatric night care. A program of inpatient care, similar to that described under psychiatric day care, and must include overnight stay in the facility.
 

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Section 441.275 - Radiology diagnostic films

441.275 Radiology diagnostic films. The total number of films used, including cardiac angiography exposures, mammography and xerography. Consideration should be given to the size of film used.
 

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Section 441.276 - Real estate (or property)

441.276 Real estate (or property). Land and land improvements, including buildings and appurtenances.
 

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Section 441.277 - Reclassification

441.277 Reclassification. The process of recasting a hospital's revenue and expense accounts into a new structure, e.g., moving from a responsibility to a functional arrangement. For purposes of this manual, the process of converting the hospital's accounts so as to comply with the prescribed reporting principles, definitions, listing of accounts and formats found in this manual. An audit trial of the conversion process must be maintained.
 

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Section 441.278 - Record

441.278 Record. A book or document containing or evidencing some or all of the activities of a hospital or containing or supporting a transaction, entry or account. Examples: a book of account; subsidiary ledger; invoice; voucher; contract; correspondence; internal report; minute book.
 

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Section 441.279 - Referred ambulatory

441.279 Referred ambulatory. A referred ambulatory patient is one who is treated and/or diagnosed in an ancillary service area of a hospital upon referral and who does not meet the definition criteria for an emergency outpatient or the clinical outpatient. A referral of an emergency or clinical outpatient to an ancillary service area does not change the classification of the patient to referred outpatient status.
 

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Section 441.280 - Rehabilitation beds

441.280 Rehabilitation beds. Beds assigned to a service for the primary purpose of assisting in the rehabilitation of disabled persons through a medical program integrated with psychiatric, social and vocational evaluation and services, under competent professional supervision.
 

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Section 441.281 - Religious corporation

441.281 Religious corporation. A corporation organized under the Religious Corporations Law, and other religious agencies and organizations, and charities, agencies and organizations operated, supervised or controlled by or in connection with a religious organization.
 

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Section 441.282 - Reporting manual

441.282 Reporting manual. A handbook of accounting policies, principles and concepts, including a chart of accounts with definitions and standard units of measure, which establishes a foundation for uniform reporting for health services institutions.
 

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Section 441.283 - Reporting period

441.283 Reporting period. The period of time for which an operating statement is prepared. This period shall consist of the 12 consecutive calendar months or 13 four-week periods that begin on the first day of a month with an additional day (two in a leap year) added to the last period to make it coincide with the end of the month.
 

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Section 441.284 - Reporting principles

441.284 Reporting principles. The body of doctrine associated with accounting, serving as an explanation of current practices and as a guide in the selection of conventions and procedures.
 

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Section 441.285 - Referred outpatient

441.285 Referred outpatient. An outpatient who is referred by his private physician to the institution for diagnosis or treatment on a ambulatory basis. The responsibility for medical care remains with the referring physician.
 

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Section 441.286 - Refund

441.286 Refund. An amount paid back or a credit allowed on account of an overcollection; rebate.
 

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Section 441.287 - Registration

441.287 Registration. The process of formally entering a patient's name on the institution's records for service in a routine outpatient care service area.
 

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Section 441.288 - Relative value unit

441.288 Relative value unit. Index number assigned to various procedures based upon the relative amount of labor, supplies and capital needed to perform the procedure. The unit value represents the cost of performing a service relative to some other service which is used as a base, i.e., has a unit value of one.
 

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Section 441.289 - Remuneration

441.289 Remuneration. Compensation for value of service rendered or expense incurred.
 

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Section 441.290 - Repair

441.290 Repair. (a) The restoration of a capital asset to its full productive capacity, or a contribution thereto, after damage, accident or prolonged use, without increase in its previously estimated service life or productive capacity.

(b) The charge to operations representing the cost of such restoration.
 

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Section 441.291 - Replacement

441.291 Replacement. The substitution of one fixed asset for another, particularly of a new asset for an old, or of a new part for an old part. On the books of account, the recognition of the cost of the new asset requires the elimination of the cost of the asset it replaces.
 

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Section 441.292 - Replacement cost

441.292 Replacement cost. (a) The cost of an acquired asset or asset part, capitalizable if the cost of its retired counterpart is removed from the asset account.

(b) The cost at current prices, in a particular locality or market area, of replacing an item or property or a group of assets.
 

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Section 441.293 - Reserve

441.293 Reserve. A segregation of retained earnings evidenced by the creation of a subordinate account. The segregation may be temporary or permanent, the purpose being to indicate to stockholders and creditors that a portion of retained earnings is recognized as unavailable for dividends. Examples: reserve for contingencies; reserve for improvements; sinking fund reserve.
 

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Section 441.294 - Resident

441.294 Resident. A graduate of a medical/osteopathic/dental school serving an advanced period of graduate training. This may represent the first year of graduate training or any year thereafter.
 

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Section 441.295 - Responsibility

441.295 Responsibility. The obligation prudently to exercise assigned or imputed authority attaching to the assigned or imputed role of an individual or group participating in organizational activities or decisions.
 

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Section 441.296 - Responsibility accounting

441.296 Responsibility accounting. An accounting system which accumulates and communicates historical and projected monetary and statistical data relating to revenues and controllable expenses, classified according to organizational units producing the revenues and responsible for incurring the expenses.
 

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Section 441.297 - Restricted funds

441.297 Restricted funds. Funds restricted by donors or grantors for specific purposes. Restricted funds generally fall into three categories: plant replacement and expansion fund, specific purpose fund, and endowment fund. The accounts within each restricted fund are self-balancing, as each fund constitutes a separate accounting entity.
 

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Section 441.298 - Retained earnings (or income)

441.298 Retained earnings (or income). Accumulated net income, less distributions to stockholders and transfers to paid-in capital accounts.
 

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Section 441.299 - Retirement

441.299 Retirement. The removal of a fixed asset from service, following its sale or the end of its productive life, accompanied by the necessary adjustment of fixed asset and depreciation-reserve accounts.
 

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Section 441.300 - Retirement of indebtedness funds

441.300 Retirement of indebtedness funds. Funds required by external sources to be used to meet debt service charges and the retirement of indebtedness on plant assets. The term sinking funds is sometimes used to describe these funds.
 

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Section 441.301 - Revenue

441.301 Revenue. Sales of products, merchandise and services, and earnings from interest, dividends and wages.
 

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Section 441.302 - Revenue center

441.302 Revenue center. An account for accumulating revenue consistent with the functional definition of the matching cost center.
 

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Section 441.303 - Revenue-producing cost centers

441.303 Revenue-producing cost centers. Health facility activities providing direct services to patients (such as nursing, physical therapy and laboratory) and thereby generating revenue.
 

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Section 441.304 - Routine

441.304 Routine. Regular; customary; ordinary; repetitive; everyday.
 

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Section 441.305 - Salvage value

441.305 Salvage value. The price at which an asset of any kind can be sold less whatever cost is yet to be incurred.
 

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Section 441.306 - Self-responsible (self-pay) patient

441.306 Self-responsible (self-pay) patient. A patient who pays either all or part of his hospital bill from his own funds as opposed to third-party funds.
 

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Section 441.307 - Self-insurance

441.307 Self-insurance. The assumption by a hospital of a risk arising out of the ownership of property or from other cause.
 

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Section 441.308 - Share of pooled investments

441.308 Share of pooled investments. The proportion of pooled investments, including accumulated gains or losses owned by a particular fund, usually expressed by a number (units) indicating the fractional ownership of total shares in the pool or by a percentage expressing the portion of the total pool owned by the particular fund.
 

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Section 441.309 - Sinking fund

441.309 Sinking fund. See retirement of indebtedness funds.
 

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Section 441.310 - Services

441.310 Services. (a) Sold services refers to ancillary services a hospital sells to other providers of health care services, rather than directly to the other provider's patients.

(b) It may also refer to other operating expenses, (i.e., laundry, data processing, etc.) which you sell to another organization (health care provider or commercial enterprise).
 

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Section 441.311 - Specific purpose funds

441.311 Specific purpose funds. Funds restricted by the donor for a specific purpose or project. Board-designated assets do not constitute specific purpose funds.
 

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Section 441.312 - Specimen

441.312 Specimen. Refers to the nature or source of material on which one or more laboratory tests may be carried out.
 

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Section 441.313 - Standard unit of measure

441.313 Standard unit of measure. The standard unit of measure is used to provide a uniform statistic for measuring and comparing hospital costs and productivity output, not activity.
 

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Section 441.314 - Standby pay (on-call)

441.314 Standby pay (on-call). Compensation paid to an employee for being available to work.
 

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Section 441.315 - Stepdown method

441.315 Stepdown method. The allocation of the accumulated costs of the nonrevenue producing centers to those other nonrevenue producing centers which utilize their services, as well as to the revenue producing centers to which they render service. Once the costs of a nonrevenue producing center have been allocated, that center is considered closed.
 

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Section 441.316 - Straight-line method of depreciation

441.316 Straight-line method of depreciation. This method of allocating depreciation is a function of the passage of time and recognizes equal periodic charges over the useful life of the asset. The depreciation charge calculated by the straight-line method is not affected by asset productivity, efficiency, or degree of use. The periodic charge is computed by relating the cost of the asset, less any salvage, to the useful life of the asset.
 

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Section 441.317 - Sub-acute care services.

441.317 Sub-acute care services. Services provided to patients who require a level of nursing care less than acute, including residential care.
 

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Section 441.318 - Subsidiary ledger

441.318 Subsidiary ledger. A supporting ledger consisting of a group of accounts the total of which is in agreement with a control account.
 

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Section 441.319 - Tangible assets

441.319 Tangible assets. A capital asset having physical existence.
 

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Section 441.320 - Teaching program (approved)

441.320 Teaching program (approved). A medical internship or residency training approved by the Council of Medical Education of the American Medical Association or, in the case of an osteopathic hospital, approved by the Committee on Hospitals of the Bureau of Professional Education of the American Osteopathic Association. Intern or residency programs in the field of dentistry must have the approval of the Council on Dental Education of the American Dental Association.
 

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Section 441.321 - Teaching program (nonapproved)

441.321 Teaching program (nonapproved). To be a nonapproved teaching program means that, a medical internship or residency training program is not approved by the Council of Medical Education of the American Medical Association or, in the case of an osteopathic hospital, is not approved by the Committee on Hospitals of the Bureau of Professional Education of the American Osteopathic Association. An intern or residency program in the field of dentistry is not approved unless approval has been received by the Council on Dental Education of the American Dental Association.
 

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Section 441.322 - Term endowment funds

441.322 Term endowment funds. Donated funds which by the terms of the agreement become available either for any legitimate purpose designated by the board or for a specific purpose designated by the donor upon the happening of an event or upon the passage of a stated period of time.
 

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Section 441.323 - Tests

441.323 Tests. Refers to each determination for which a specimen is analyzed. For example, a specimen for the SMA-12/60 is a single-patient serum on which 12 different tests are performed.
 

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Section 441.324 - Third-party payor

441.324 Third-party payor. An agency such as Blue Cross or the Medicare program which contracts with hospitals and patients to pay for the care of covered patients.
 

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Section 441.325 - Trade discount

441.325 Trade discount. The discount allowed to a class of customers on a list price before consideration of credit terms; as a rule, invoice prices are recorded in the books of account net after the deduction of trade discounts. Trade discounts are not to be confused with cash or purchase discounts which are other operating revenues.
 

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Section 441.326 - Transaction

441.326 Transaction. An event or condition the recognition of which gives rise to an entry in accounting records.
 

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Section 441.327 - Treasury stock

441.327 Treasury stock. Full-paid capital reacquired by the issuing company through gift, purchase or otherwise and available for resale or cancellation. Treasury stock is not a part of capital stock outstanding; and the term does not apply to unissued capital stock or to shares forfeited for nonpayment of subscriptions.
 

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Section 441.328 - Treatment

441.328 Treatment. A procedure performed on a hospital patient.
 

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Section 441.329 - Triage

441.329 Triage. The process of screening patients to determine the severity of the medical emergency and type of care necessary.
 

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Section 441.330 - Trial balance

441.330 Trial balance. A list or abstract of the balances or of total debits and total credits of the accounts in a ledger, the purpose being to determine the quality of posted debits and credits and to establish a basic summary for financial statements. The term is also applied to a list of account balances (and their total) abstracted from a customer's ledger or other subsidiary ledger for the purpose of testing their totals with the related control account.
 

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Section 441.331 - Trust

441.331 Trust. A right, enforceable in courts of equity, to the beneficial enjoyment of property, the legal title to which is in another.
 

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Section 441.332 - Trust fund

441.332 Trust fund. A fund held by one person (trustee) for the benefit of another pursuant to the provisions of a formal trust agreement.
 

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Section 441.333 - Tuberculosis beds

441.333 Tuberculosis beds. Beds assigned for the care and treatment of patients suffering from tuberculosis.
 

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Section 441.334 - Unit of service

441.334 Unit of service. (a) A unit of measure, often commonly accepted for determining average cost, time or efficiency, thus making possible: (1) comparisons of one operation with another or with the same operation in a preceding period; and (2) estimates of future operations.

(b) Synonymous with standard unit of measure.
 

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Section 441.335 - Unrealized revenue

441.335 Unrealized revenue. Revenue attributable to a completed business transaction but accompanied by the receipt of an asset other than cash or other form of current asset; as, an installment sale (gross revenue) or the prospective profit from such a sale (net revenue).
 

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Section 441.336 - Unrestricted funds

441.336 Unrestricted funds. Funds which bear no external restrictions as to use or purpose; i.e., funds which can be used for any legitimate purpose designated by the governing board, as distinguished from funds restricted externally for specific operating purposes, for plant replacement and expansion and for endowment.
 

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Section 441.337 - Useful life

441.337 Useful life. Normal operating life in terms of utility to the hospital.
 

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Section 441.338 - Vested interest

441.338 Vested interest. An interest (as a title to an estate) carrying a legal right to present or future enjoyment and of present alienation.
 

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Section 441.339 - Visit

441.339 Visit. The physical appearance of an outpatient at a hospital complex is recognized as contributing one visit regardless of the number of diagnostic and/or therapeutic services the patient receives or the number of sections (clinics), operating rooms, laboratories and treatment areas in which he/she receives them. The classification of the visit (i.e., emergency, clinic, etc.) will be determined by the first location where service is rendered. A patient referred from a physician's office exclusively for a specific ancillary service or services is classified as one referred ambulatory visit. A laboratory examination of a specimen sent in by a physician for his/her patient shall be included as one referred ambulatory visit.
 

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Section 441.340 - Wing

441.340 Wing. A distinct part of a building consisting of an architecturally subordinate extension of a building with a corridor connecting the main building and the extension. A wing could also be represented by the addition of one or more floors to an existing building.
 

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Section 441.341 - Zero level accounts

441.341 Zero level accounts. Accounts which have an account number with a fourth digit of zero.
 

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