Appendix C
Glossary
Acuity - the intensity of care needed by nursing home residents based on a comprehensive physical, mental, and psychosocial assessment. Acuity levels largely determine the amount of resources (in terms of nurse and therapist staff time) a particular resident or a class of residents will need.
Allowable Costs - items or elements of a facility's costs which are reimbursable. Costs that are not allowed may include uncovered services, costs that are not deemed unreasonable, and luxury accommodations.
Case Mix - numbers and types of residents served by a facility. Residents can be classified according to diagnosis, severity of illness or other characteristics.
Chronic and Convalescent Nursing Home (CCNH) - licensed by CT Department of Public Health to provide 24-hour skilled nursing care under medical supervision and direction. Requires a higher nursing-staff-to-resident ratio than rest homes with nursing supervision.
Cost Reports - prescribed forms by CT Department of Social Services certifying nursing home provider's costs and charges.
Per Diem Costs - institutional costs for one day of care per resident. Per diem costs represent averages and do not reflect the true cost of care for each resident.
Rate Year - the time period that CT issues nursing home Medicaid per diem rates is from July 1 through June 30, the same period as the state fiscal year.
Rebasing Costs - A component of the reimbursement system that periodically assess and updates the actual costs of operating a nursing home. A cost year is selected as a base year and allowable costs are established; those costs are inflated forward from that base cost year to the applicable rate year(s).
Rest Homes with Nursing Supervision (RHNS) - licensed by CT Department of Public Health to provide health-related services to individual whose mental or physical condition required services above the level of room and board but below CCNH care. Requires a lower nursing-staff-to resident ratio than CCHN licensure.
Stop Gain/Stop Loss - caps nursing home Medicaid rate increases from year to year to a specific percent that is specified in CT statute.