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Title: Section 86-11.2 - Definitions

Effective Date


86-11.2 Definitions. As used in this Subpart, the following terms shall have the following meanings:

(a) Allowable costs. Costs that are allowable under 14 NYCRR Subpart 635-6 or 14 NYCRR section 681.14(f).

(b) Base year. The consolidated fiscal report period from which the initial period rate will be calculated. Such period shall be January first, two thousand eleven through December thirty-first, two thousand eleven for providers reporting on a calendar year basis and July first, two thousand ten through June thirtieth, two thousand eleven for providers reporting on a fiscal year basis.

(c) Base operating rate. Reimbursement amount calculated by dividing annual reimbursement by applicable annual units of service, both in effect on June thirtieth, two thousand fourteen.

(d) Budget neutrality adjustment. Factor applied to adjust the proposed amount so that it is equivalent to the base amount of dollars.

(e) Capital cost. Costs that are related to the acquisition, lease, construction and/or long-term use of land, buildings and fixed equipment, leasehold improvements and vehicles.

(f) Department of Health (DOH) Regions. Regions as defined by the Department, assigned to providers based upon the geographic location of the provider’s headquarters as reported on the consolidated fiscal report. Such regions are as follows:

(1) Downstate: 5 boroughs of New York City, Nassau, Suffolk and Westchester;

(2) Hudson Valley: Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster;

(3) Upstate Metro: Albany, Erie, Fulton, Genesee, Madison, Monroe, Montgomery, Niagara, Onondaga, Orleans, Rensselaer, Saratoga, Schenectady, Warren, Washington, Wyoming;

(4) Upstate Non-Metro: Any counties not listed in subparagraphs (1), (2) or (3) of this paragraph.

(g) Depreciation. The allowable cost based on historical costs and useful life of buildings, fixed equipment, capital improvements and/or acquisition of real property. The useful life shall be based on “The Estimated Useful life of Depreciable Hospital Assets (2008 edition).”

(h) Facility. The site or physical building where ICF/DD services are provided.

(i) Financing expenditures. Interest expense and fees charged for financing of costs related to the purchase/acquisition, alteration, construction, rehabilitation and/or renovation of real property.

(j) Individual. Person receiving ICF/DD services.

(k) ICF/DD. An intermediate care facility for persons with developmental disabilities, as such term is used in 14 NYCRR Part 681.

(l) Initial period. July first, two thousand fourteen through June thirtieth, two thousand fifteen.

(m) Lease/rental and ancillary payments. A provider’s annual rental payments for real property and ancillary outlays associated with the property such as utilities and maintenance.

(n) Provider - an individual, corporation, partnership or other organization to which OPWDD has issued an operating certificate pursuant to Article 16 of the Mental Hygiene Law to operate an ICF/DD, and for which the NYS Department of Health has issued a Medicaid provider agreement.

(o) Rate sheet capacity. The certified capacity of the ICF/DDs operated by a provider.

(p) Reimbursable cost. The final allowable costs of the rate year after all audit and/or adjustments are made.

(q) Start-up costs. Those costs associated with the opening of a new facility or program. Start-up costs include pre-operational rent, utilities, staffing, staff training, advertising for staff, travel, security services, furniture, equipment and supplies.

(r) Target rate. The final rate in effect at the end of the transition period for each provider.


VOLUME A-2 (Title 10)