42 C.F.R. § 412.503 Definitions.
Title 42 - Public Health
As used in this subpart— CMS stands for the Centers for Medicare & Medicaid Services. Discharge. A Medicare patient in a long-term care hospital is considered discharged when— (1) For purposes of the long-term care hospital qualification calculation, as described in §412.23(e)(3), the patient is formally released; (2) For purposes of payment, as described in §412.521(b), the patient stops receiving Medicare-covered long-term care services; or (3) The patient dies in the long-term care facility. Long-term care hospital prospective payment system rate year means the 12-month period of July 1 through June 30. LTC-DRG stands for the diagnosis-related group used to classify patient discharges from a long-term care hospital based on clinical characteristics and average resource use, for prospective payment purposes. Outlier payment means an additional payment beyond the standard Federal prospective payment for cases with unusually high costs. QIO (formerly PRO or Peer Review Organization) stands for the Quality Improvement Organization.
Title 42: Public Health
PART 412—PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES
Subpart O—Prospective Payment System for Long-Term Care Hospitals
§ 412.503 Definitions.
