C.M.R. 10, 144, ch. 101, ch. III, 144-101-III-50, subsec. 144-101-III-50-6000 - LABOR COST COMPONENT

6010 Wages: Reasonable costs incurred for personnel wages will be reimbursed at actual cost.

6011 All Facility Staff

6011.1 The reasonable allowable cost of wages for personnel employed on site at the facility shall be determined based on the lesser of actual hours worked, or hours approved by the Department.

6011.2 Direct care staff hours related to mandatory programs, as specified in Section 3005.10, above, will be considered allowable and will be reimbursed at the actual hourly wage for the relevant category of direct care staff.

6011.3 Contract labor costs for RNs, LPNs, and CNAs working on-site are an allowable labor cost. Contract labor hours must be included with the direct care worked hours for the comparison to approved hours.

6011.4 Bonuses that are part of a written policy of the provider and that require some measurable and attainable job performance expectation from the employee are allowable.

6011.5 Orientation, on the job training, in-service education, and similar work learning programs are recognized as normal operating costs for labor cost. The hours associated with orientation are not used to determine approved hours (staffing pattern) for the facility.

6020 Fringe Benefits. The Department will reimburse the facility for its actual contribution to the reasonable and customary cost of the following designated types of fringe benefits if they are provided to the facility's personnel:

6021 Designated Benefits

6021.1 health insurance - insurance premiums for employees are an allowable cost

6021.2 dental insurance

6021.3 life and disability insurance

6021.4 worker's compensation

6021.5 holiday leave

6021.6 sick leave

6021.7 unemployment compensation

6021.8 Federal Insurance Contribution Act (FICA) vacation

6021.9 qualified retirement contributions

6022 Pay In Lieu of Benefits (PIB). PIB is an allowable cost for those benefits unrelated to wage driven benefits such as FICA and Worker's Compensation. In order to receive pay in lieu of health insurance the staff member must demonstrate to the facility that he/she is covered for comprehensive medical care under an alternative program or policy. This benefit shall be reimbursable for personnel who are employed at the facility at least twenty-four (24) hours per week. PIB shall be reported as a fringe benefit on the appropriate cost reporting form.

For facilities that have hired per diem nursing staff prior to April 1, 1989, those per diem nursing staff members will be exempt from the twenty-four (24) hour per week requirement as stated in this Principle. The facility must make documentation available at the time of audit.

6023 Costs incurred for fringe benefits other than those designated in 6021 or 6022 above, if they are determined to be reasonable, may be reimbursed only as a part of the variable cost component.

Notes

C.M.R. 10, 144, ch. 101, ch. III, 144-101-III-50, subsec. 144-101-III-50-6000