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UNOFFICIAL 1700.1-18 (1) The individual is formally released from the hospital; (2) The individual is transferred to an out-of- state hospital; (3) The individual is transferred to a long-term care level or facility; (4) The individual dies while hospitalized; (5) The individual signs out against medical advice; (6) In the case of a delivery where the mother and baby are discharged at the same time, release of the mother and her baby shall be considered two discharges for payment purposes. In cases of multiple births, each baby will be considered a separate discharge; or (7) A transfer shall be considered a discharge for billing purposes but shall not be reimbursed as a full discharge except as specified in section 17-1739-70(f)(1). “Disproportionate share” adjustment means the largest of the following adjustments: (1) Divide indigent acute inpatient days by total acute inpatient days. Each percentage point or fraction thereof in excess of fifteen per cent shall be converted to a decimal and added to 1.00 to obtain the disproportionate share adjustment; (2) Calculate the facility's Medicaid utilization rate and subtract one standard deviation above the statewide mean Medicaid utilization rate. Each percentage point in excess of this standard deviation shall be converted to a decimal and added to 1.00 to obtain the disproportionate share adjustment. A calculation resulting in a fraction of a percentage point shall be rounded up to the next percentage point. When the Medicaid utilization rate equals the rate at one standard deviation point, it will be considered a fraction of a percentage point and rounded up; or