016.06.04 Ark. Code R. § 075 - Clarification on Cost Reporting Categories
The cost of ownership component of the property payment will consist of interest, property taxes, and insurance (including professional liability and property) as identified on the facilities cost report. The limitation on allowable interest expense is addressed in the return on equity calculation described above.
The cost of purchases of minor equipment is not covered in the Fair Market Rental Payment. Minor equipment for the purposes of reimbursement is any equipment that has a unit cost of $300.00 or less that would not have been included in the initial construction and furnishing of the facility. Minor equipment purchases are to be expensed in the cost area in which the equipment is normally used. Group purchases of minor equipment either in a single purchase or through periodic purchases throughout the reporting year costing over $1,000.00 are no longer considered minor and reimbursement is considered to have been included in the providers Fair Market Rental Payment.
The current asset value of a facility will be adjusted as a result of major renovations made to an existing facility. A major renovation is defined as renovations made to a facility where the total per bed cost of the renovation equals or exceeds ten percent (10 %) of the facility's current per bed value for the beds renovated or five (5%) for renovations to common areas. The actual cost of all additions or fundamental alterations to a facility that are required by state or federal laws or rules that take effect during the cost reporting period will be treated as an adjustment to the provider's aging index regardless of the percentage of current per bed value. The cost of renovation will be treated as an adjustment to the provider's aging index. A facility's aging index will be reduced by one percent (1%) for each percent of the current per bed value expended for renovations on a per bed basis. For facilities that have beds that have been placed in operation at different times or when renovations include only a portion of the beds in a facility, the determination that the renovation meets the criteria of major renovation and the reduction of the aging index will relate to only those beds that were included in the renovation. For renovations to common areas, the determination that the renovation meets the criteria of major renovation and the reduction of the aging index will be applied proportionally to all beds.
provisional rate will be retroactively adjusted to the per diem calculated in the following manner.
If either the provisional rate or the actual rate calculated from the six month cost report extend from one rate period to another, appropriate adjustments will be made to the vendor payment. The inflation index will be applied to the direct care per diem. The administrative and operating per diem will be changed to the class rate for the latest rate period. The fair market rental per diem will be adjusted to reflect any change in the PBV for the latest rate period.
Facilities that withdraw from the Medicaid program either voluntarily or involuntarily will not be required to submit a final cost report. All payments made to a facility as interim or provisional will be considered as final. This provision does not apply to any fines or penalties that have been imposed on a facility.
For all inflation adjustments (unless stated otherwise in the specific area of the plan) the Department will use the Skilled Nursing Facility Market Basket - Without Capital index published by Standard & Poor's DRI published for the quarter ending June 30th of the cost reporting period. The Department will use the %MOVAVG figure identified for the final quarter of the rate period.
recipient care. In addition, the facility will make available immediately upon request adequate documentation to demonstrate that the costs satisfy the following criteria:
If at the time of the request, records are in active use or are located in a place which makes immediate access impossible or impractical, the facility must certify that fact in writing and deliver the records within 72 hours of the request.
Depreciation expense for the year of acquisition and the year of disposal can be computed by using:
Line 1-27, Over-the-Counter Drugs
Cost of over-the-counter drugs provided by the facility to its residents.
Line 1-28, Oxygen
Cost of oxygen and related supplies.
Line 1-29, Medical Supplies - Direct Care
Cost of providing direct medical care. Includes by illustration:
* Single use disposable items and consumable supplies that are used in the course of providing direct medical care to a resident, such as catheters, syringes, sterile dressings, prep supplies, alcohol pads, Betadine solution in bulk, tongue depressors, and cotton balls.
* Pressure relieving devices that cannot be used by more than a single resident or that would be classified as minor equipment.
* Minor medical equipment used in providing direct medical care such as thermometers, sphygmomanometers, stethoscopes, etc.
* Costs of supplies for which Medicare Part B revenue is received must be reclassified to Line 5-11 in Column 2 or removed in Column 5 per Form 5 revenue adjustments.
Line 1-30, Therapy Supplies
The cost of supplies used directly by the therapy staff for rendering therapeutic service to the residents of the facility. Costs of therapy supplies for which other third party income is received (Medicare Part A, Medicare Part B, etc.) must be reclassified to Line 5-11 in Column 2 or removed in Column 5 per Form 5 revenue adjustments.
Line 1-31, Raw Food
Cost of food products used to provide meals and snacks to residents.
Line 1-32, Food - Supplements
Cost of food products given in addition to normal meals and snacks under doctor's orders.
Line 1-33, Incontinence Supplies
Cost of incontinence supplies to include both disposable and linen diapers, and disposable underpads.
Line 1-34, Dental (Schedule)
Cost of dentist advisory services (not individual resident specific). All other dental expenses must be reclassified to Line 5-11 in Column 2. A schedule must be attached that details the amount on this line.
For Arkansas Health Center Nursing Facility (AHC), all dental services are allowable.
Line 1-35, Drugs Legend
Cost of prescription drugs are allowable only for AHC. Other nursing facilities must reclassify these costs to Line 5-11 in Column 2.
Line 1-36, Lab and X-Ray
Cost of lab and x-ray services are allowable only for AHC. Other nursing facilities must reclassify these costs to Line 5-11 in Column 2.
This line should also include cost of providing residents medical transportation to local "community" providers when the facility obtains this service from an outside source.
Line 2-33, Resident Activities
Cost of resident activities should include pastoral services, recreational activities and supplies.
Line 2-34, Care Related Supplies
Personal hygiene items such as soaps, deodorants, shampoos, toothbrush, toothpaste, razor, razor blades etc. Includes minor equipment provided by the facility that is not used in providing direct medical care such as water pitchers, wash basin, emesis basin, bedpan, urinal. hot water bottles, heating pads, crutches, walkers, etc. Includes nurse charting forms, admission forms, medication and treatment records, physician order forms.
Line 2-35, Accounting Fees
Fees incurred for the preparation of the cost report, audits of the financial records, bookkeeping services, tax return preparation of the nursing facility and other related services, excluding personal tax planning and personal tax return preparation.
Line 2-36, Advertising for Labor/Supplies Allowable advertising expense.
Line 2-37, Amortization Expense - Non-Capital (Schedule)
Costs incurred for legal and other expenses when organizing a corporation should be amortized over a period of 60 months. Attach a detail amortization schedule for these costs. These costs are not to be included on the For 7 depreciation schedule.
Line 2-38, Bank Service Charges
Fees paid to banks for service charges, excluding penalties and insufficient funds charges.
Line 2-39, Criminal Records Checks
Cost of Criminal Records Checks for employees and job applicants.
Line 2-40, Data Processing Fees
Cost of purchased services for data processing systems and services.
Line 2-41, Dietary Supplies
Costs of consumable items such as soap, detergent, napkins, paper cups, straws, etc. used in the dietary department.
Line 2-42, Dues (Schedule)
A detailed schedule of dues must be included. The schedule should include the dates and purpose covered by the charge.
Line 2-43, Educational Seminars and Training
The cost of registration for attending non-direct care related educational seminars and training by employees of the facility and costs incurred in the provision of non-direct care related in-house training for facility staff. The cost of any travel incurred to attend an educational seminar will be included on Line 2-56, Travel.
Line 2-44, Governing Body (Schedule)
Costs incurred by members of the facility governing body to attend meetings. Attach a detail schedule of the members' names and costs incurred.
Line 2-45, Housekeeping Supplies
Cost of consumable housekeeping items including waxes, cleaners, soap, brooms and lavatory supplies.
Line 2-46, Laundry Supplies
Cost of consumable goods used in the laundry including soap, detergent, starch and bleach.
Line 2-47, Legal Fees (Schedule)
Fees paid to attorneys in accordance with other provisions of the State Plan. A schedule must be attached that details the amount on this line.
Line 2-48, Linen and Laundry Alternatives
Cost of mattress covers, sheets, blankets, pillows, and gowns.
Line 2-49, Miscellaneous (Schedule)
Costs incurred in providing nursing facility services that cannot be assigned to any other line item on Form 6. A schedule must be attached that details the amount on this line.
Line 2-50, Management Fees and Home Office Costs
The cost of purchased management services or home office costs incurred that are allocable to the provider. See Form 15 for calculation of allowable home office costs.
Line 2-51, Office Supplies and Subscriptions
Cost of consumable goods used in the business office such as pencils, paper, and computer supplies. Cost of printing forms and stationary including accounting and census forms, charge tickets, facility letterhead and billing forms. Cost of subscribing to newspapers, magazines and periodicals.
Line 2-52, Postage
Cost of postage, including stamps, metered postage, freight charges and courier services.
Line 2-53, Repairs and Maintenance
Supplies and services, including electricians, plumbers, extended service agreements, etc., used to repair the facility building, furniture, equipment, vehicles and vehicle insurance.
Line 2-54, Taxes - Other (Schedule)
The cost of property taxes on automobiles and other taxes paid that are not included on any other line on Form 6. A schedule must be attached to the cost report in order for the costs to be considered in the determination of allowable costs.
Line 2-55, Telephone and Communications
Cost of telephone services, WATS lines and FAX services.
Line 2-56, Travel (Schedule)
Cost of travel (airfare, lodging, meals, etc.) by Administrator and other authorized personnel to attend professional and continuing educational seminars and meetings related to their position within the facility. A detailed schedule must be submitted that agrees with the amount on this line. The schedule will include for each expenditure the date, destination, person traveling, purpose of the trip, expense description, and the cost.
Line 2-57, Utilities
Cost of water, sewer, gas, electric, and garbage collection services. Cost of television and cable services for common use areas in the facility.
Line 2-58, Depreciation - Vehicles and Software
Depreciation on the facility's vehicles and software. Column 6 of Line 2-58 must agree with Form 7, Page 3, Vehicle Depreciation line, Column 5 and Form 7, Page 3, Software Depreciation line, Column 5.
Line 2-59, Interest - Working Capital, Vehicles and Software
Interest paid on short term borrowing for facility operations. Also, interest paid or accrued on loans, the proceeds of which were used to purchase vehicles or software. The total of Line 2-59, Column 6, must agree with the Form 10, Page 3, Totals Column, Line 12.
Line 2-60, Total Indirect, Administrative and Operating Costs Line 2-60 is the sum of Line 2-01 through Line 2-59.
Line 3-10, Rent - Furniture and Equipment
Cost of leasing or renting the facility's furniture, equipment and vehicles.
Line 3-11, Total Property
Line 3-11 is the sum of Line 3-01 through Line 3-10.
Line 5-01, Advertising
Costs of unallowable advertising.
Line 5-02, Bad Debts
Accounts receivable written off as uncollectable.
Line 5-03, Barber and Beauty Expense
The cost of barber and beauty services provided by non-facility personnel.
Line 5-04, Contributions
Amounts donated to charitable or other organizations.
Line 5-05, Depreciation Over Straight Line
Depreciation charged above straight line. Amounts posted to this line should result from reclassifications (Column 2) from Line 3-02. Column 1 should equal zero.
Line 5-06, Income Taxes - State and Federal
Taxes on net income levied or expected to be levied by the Federal or State government.
Line 5-07, Insurance - Officers
Cost of unallowable life insurance on officers and key employees of the facility per Section 3-3.T.
Line 5-08, Non-Working Officer's Salaries
Salaries and other compensation paid to non-working officers.
Line 5-09 and 5-10, Nurse Aide Testing and Training
Costs incurred in having nurse aides tested or trained in order to meet OBRA 1987 provisions. This includes both the Medicaid and non-Medicaid portion of the expenses. Example - A nursing facility incurs
|
617.00 |
Other Fringe Benefits -Direct Care |
Cost of other fringe benefits offered to direct care staff not specifically listed in the categories above. These must be included in the facility's benefits policy. |
|
618.00 |
Contract - Aides |
Cost of Certified Nurse Aides hired through contract that are not on the facility payroll. |
|
619.00 |
Contract - LPN's |
Cost of LPN's and graduate practical nurses hired through contract that are not on facility payroll. |
|
620.00 |
Contract - RN's |
Cost of RN's and graduate nurses hired through contract that are not on facility payroll. |
|
621.00 |
Contract - Occupational Therapists |
Cost of occupational therapists hired through contract that are not on the facility payroll. |
|
622.00 |
Contract - Physical Therapists |
Cost of physical therapists hired through contract that are not on facility payroll. |
|
623.00 |
Contract - Speech Therapists |
Cost of speech therapists hired through contract that are not on facility payroll. |
|
624.00 |
Contract - Other Therapists |
Cost of therapists other than occupational, physical, and speech therapists hired through contract that are not facility employees. |
|
625.00 |
Consultant Fees - Nursing |
Fees paid to nursing personnel, not on the facility payroll, for providing advisory and educational services to the facility. |
|
626.00 |
Training - Direct Care |
Cost of training related to resident care for RN's, LPN's and Certified Nurse Aides. Also includes travel costs associated with this training. Does not include training cost for Nurse Aide certification. |
|
627.00 |
Over the Counter Drugs |
Cost of over the counter drugs provided to its residents such as pain relievers, cough and cold medications, Rubbing Alcohol, aspirin. |
|
628.00 |
Oxygen |
Cost of oxygen and related supplies. |
|
629.00 |
Medical Supplies - Direct Care |
Cost of providing direct medical care, including single use disposable items and consumable supplies that are used in the course of providing direct medical care to a resident, such as catheters, syringes, sterile dressings, prep supplies, alcohol pads, Betadine solution in bulk, tongue depressors, and cotton balls. Includes minor medical equipment used in providing direct medical care such as thermometers, sphygmomanometers, stethoscopes, etc. |
|
630.00 |
Therapy Supplies |
Cost of supplies used directly by the therapy staff for rendering therapeutic services to the residents of the facility. |
|
631.00 |
Raw Food |
Cost of food products used to provide meals and snacks to residents. |
|
632.00 |
Food Supplements |
Cost of food products given in addition to normal meals and snacks under doctor's orders (Ensure, etc.). |
|
633.00 |
Incontinence Supplies |
Cost of incontinence supplies to include diapers and underpads. |
|
634.00 |
Dental |
Cost of dental services. |
|
727.00 |
Consultant Fees - Medical Director |
Fees paid to a medical doctor, not on the facility payroll, for providing advisory and educational services to the facility. |
|
728.00 |
Consultant Fees - Pharmacy |
Fees paid to a registered pharmacist, not on the facility payroll, for providing advisory and educational services to the facility. |
|
729.00 |
Consultant Fees - Social Worker |
Fees paid to a social worker, not on the facility payroll, for providing advisory and educational services to the facility. |
|
730.00 |
Consultant Fees - Therapists |
Fees paid to licensed therapists, not on the facility payroll, for providing advisory and educational services to the facility. |
|
731.00 |
Barber & Beauty Expense - Allowable |
The cost of barber and beauty services provided to residents by facility staff. |
|
732.00 |
Medical Transportation |
Cost of providing residents medical transportation to local community providers when the facility does not use facility vehicles. |
|
732.10 |
Business Related Mileage |
Amounts claimed (rate per mile) for facility owned or other vehicles used in providing residents medical transportation to local "community" providers or used for business related mileage. |
|
733.00 |
Resident Activities |
Cost of resident activities should include pastoral services, recreational activities and supplies (games, puzzles, art supplies). |
|
733.10 |
Supplies - Care Related |
Personal hygiene items. Soaps, deodorants, shampoos, toothbrush, toothpaste, razor, razor blades etc. Includes minor equipment provided by the facility that is not used in providing direct medical care such as water pitchers, wash basin, emesis basin, bedpan, urinal, hot water bottles, heating pads, crutches, walkers, etc. Includes nurse charting forms, admission forms, medication and treatment records, physician order forms. |
|
735.00 |
Accounting Fees |
Fees paid for the preparation of the cost report, audits of the financial records, bookkeeping services, tax return preparation of the nursing facility and other related services, excluding personal tax planning and personal tax return preparation. |
|
735.10 |
Payroll Processing |
Fees paid to banks, data processing companies, or |
|
736.00 |
Advertising for Labor/Supplies |
Advertising expense limited to classified advertisements for the purpose of procurement of resident care related labor or supplies. Advertisements, including yellow page listings, designed to promote the facility or to solicit residents are not allowable. |
|
737.00 |
Amortization Exp. - Non-Capital |
Costs incurred for legal and other expenses when organizing a corporation should be amortized over a period of 60 months. |
|
738.00 |
Bank Service Charges |
Fees paid to banks for service charges, excluding |
|
755.00 |
Repairs & Maintenance |
Cost of supplies and services used to repair the facility building, furniture and equipment (include light bulbs, nails, lumber, glass). |
|
755.10 |
Vehicle Maintenance |
Costs of maintaining facility vehicles including gas, oil, tires and auto insurance. |
|
755.20 |
Painting |
Supplies and services. |
|
755.30 |
Gardening |
Supplies and services for lawn care. |
|
756.00 |
Taxes, Other |
The cost of taxes paid that are not included in any other account. |
|
757.00 |
Telephone & Communications |
Cost the telephone services, WATTS lines and FAX services. |
|
758.00 |
Travel |
Cost of travel (airfare, mileage, lodging, meals, etc.) by Administrator and other authorized personnel to attend professional and continuing educational seminars and meetings related to their position within the facility. |
|
759.00 |
Utilities |
Cost of utility services not specified in other accounts such as cable TV for common areas. . |
|
759.10 |
Utilities - Heating |
Cost of gas, or other heating fuel services. |
|
759.20 |
Utilities - Electricity |
Cost of electric services. |
|
759.30 |
Utilities - Water, Sewer & Garbage |
Cost of water, sewer and garbage collection. |
|
760.00 |
Depreciation - Vehicles |
Depreciation on vehicles. |
|
760.10 |
Depreciation - Software |
Depreciation on software. |
|
761.00 |
Interest - Vehicles |
Interest paid or accrued on notes, mortgages, and other loans, the proceeds of which were used to purchase facility vehicles. |
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PROPERTY |
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|
801.00 |
Amortization Expense - Capital |
Legal and other costs incurred when financing the facility which are amortized over the life of the mortgage. |
|
802.10 |
Depreciation - Land Improvements |
Depreciation on improvements having a limited life made to the land of the facility (paving, landscaping). |
|
802.20 |
Depreciation - Building |
Depreciation on the facility's building and attached assets. |
|
802.30 |
Depreciation - Building Improvements |
Depreciation on major additions or improvements to the facility. For example a new laundry or dining room. |
|
802.40 |
Depreciation - Equipment |
Depreciation on items of movable equipment costing $300 or more such as beds, floor polishers, stoves, washing machines, computers, etc. |
|
802.50 |
Depreciation - Leasehold |
Depreciation on major additions or improvements |
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Notes
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