Statutes, codes, and regulations
Louisiana Administrative Code
Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCEPart XXI - Home and Community-Based Services WaiversSubpart 1 - General ProvisionsChapter 7 - Reimbursement Methodology
Subchapter B - Adult Day Health Care Providers
Section XXI-713 - Cost Categories Included in the Cost Report

La. Admin. Code tit. 50 § XXI-713

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Current through Register Vol. 50, No. 11, November 20, 2024
Section XXI-713 - Cost Categories Included in the Cost Report
A. Direct Care (DC) Costs
1. Salaries, Aides-gross salaries of certified nurse aides and nurse aides in training.
2. Salaries, LPNs-gross salaries of nonsupervisory licensed practical nurses and graduate practical nurses.
3. Salaries, RNs-gross salaries of nonsupervisory registered nurses and graduate nurses (excluding director of nursing and participant assessment instrument coordinator).
4. Salaries, Social Services-gross salaries of nonsupervisory licensed social services personnel providing medically needed social services to attain or maintain the highest practicable physical, mental, or psychosocial wellbeing of the participants.
5. Salaries, Activities-gross salaries of nonsupervisory activities/recreational personnel providing an ongoing program of activities designed to meet, in accordance with the comprehensive assessment, the interest and the physical, mental, and psychosocial well-being of the participants.
6. Payroll Taxes-cost of employer's portion of Federal Insurance Contribution Act (FICA), Federal Unemployment Tax Act (FUTA), State Unemployment Tax Act (SUTA), and Medicare tax for direct care employees.
7. Group Insurance, DC-cost of employer's contribution to employee health, life, accident and disability insurance for direct care employees.
8. Pensions, DC-cost of employer's contribution to employee pensions for direct care employees.
9. Uniform Allowance, DC-employer's cost of uniform allowance and/or uniforms for direct care employees.
10. Worker's Comp, DC-cost of worker's compensation insurance for direct care employees.
11. Contract, Aides-cost of aides through contract that are not center employees.
12. Contract, LPNs-cost of LPNs and graduate practical nurses hired through contract that are not center employees.
13. Contract, RNs-cost of RNs and graduate nurses hired through contract that are not center employees.
14. Drugs, Over-the-Counter and Non-Legend-cost of over-the-counter and non-legend drugs provided by the center to its participants. This is for drugs not covered by Medicaid.
15. Medical Supplies-cost of participant-specific items of medical supplies such as catheters, syringes and sterile dressings.
16. Medical Waste Disposal-cost of medical waste disposal including storage containers and disposal costs.
17. Recreational Supplies, DC-cost of items used in the recreational activities of the center.
18. Other Supplies, DC-cost of items used in the direct care of participants which are not participant-specific such as prep supplies, alcohol pads, betadine solution in bulk, tongue depressors, cotton balls, thermometers, blood pressure cuffs and under-pads and diapers (reusable and disposable).
19. Allocated Costs, Hospital Based-the amount of costs that have been allocated through the step-down process from a hospital or state institution as direct care costs when those costs include allocated overhead.
20. Miscellaneous, DC-costs incurred in providing direct care services that cannot be assigned to any other direct care line item on the cost report.
21. Total Direct Care Costs-sum of the above line items.
B. Care Related (CR) Costs
1. Salaries-gross salaries for care related supervisory staff including supervisors or directors over nursing, social service, and activities/recreation.
2. Salaries, Dietary-gross salaries of kitchen personnel including dietary supervisors, cooks, helpers, and dishwashers.
3. Payroll Taxes-cost of employer's portion of Federal Insurance Contribution Act (FICA), Federal Unemployment Tax Act (FUTA), State Unemployment Tax Act (SUTA), and Medicare tax for care related employees.
4. Group Insurance, CR-cost of employer's contribution to employee health, life, accident, and disability insurance for care related employees.
5. Pensions, CR-cost of employer's contribution to employee pensions for care related employees.
6. Uniform Allowance, CR-employer's cost of uniform allowance and/or uniforms for care related employees.
7. Worker's Comp, CR-cost of worker's compensation insurance for care related employees.
8. Contract, Dietary-cost of dietary services, and personnel hired through contract that are not employees of the center.
9. Consultant Fees, Activities-fees paid to activities personnel, not on the center's payroll, for providing advisory, and educational services to the center.
10. Consultant Fees, Nursing-fees paid to nursing personnel, not on the center's payroll, for providing advisory, and educational services to the center.
11. Consultant Fees, Pharmacy-fees paid to a registered pharmacist, not on the center's payroll, for providing advisory, and educational services to the center.
12. Consultant Fees, Social Worker-fees paid to a social worker, not on the center's payroll, for providing advisory, and educational services to the center.
13. Consultant Fees, Therapists-fees paid to a licensed therapist, not on the center's payroll, for providing advisory, and educational services to the center.
14. Food, Raw-cost of food products used to provide meals and snacks to participants. Hospital based facilities must allocate food based on the number of meals served.
15. Food, Supplements-cost of food products given in addition to normal meals and snacks under a doctor's orders. Hospital based facilities must allocate food-supplements based on the number of meals served.
16. Supplies, CR-the costs of supplies used for rendering care related services to the participants of the center. All personal care related items such as shampoo and soap administered by all staff must be included on this line.
17. Allocated Costs, Hospital Based-the amount of costs that have been allocated through the step-down process from a hospital or state institution as care related costs when those costs include allocated overhead.
18. Miscellaneous, CR-costs incurred in providing care related care services that cannot be assigned to any other care related line item on the cost report.
19. Total Care Related Costs-the sum of the care related cost line items.
C. Administrative and Operating Costs (AOC)
1. Salaries, Administrator-gross salary of administrators excluding owners. Hospital based centers must attach a schedule of the administrator's salary before allocation, the allocation method, and the amount allocated to the nursing center.
2. Salaries, Assistant Administrator-gross salary of assistant administrators excluding owners.
3. Salaries, Housekeeping-gross salaries of housekeeping personnel including housekeeping supervisors, maids, and janitors.
4. Salaries, Laundry-gross salaries of laundry personnel.
5. Salaries, Maintenance-gross salaries of personnel involved in operating and maintaining the physical plant, including maintenance personnel or plant engineers.
6. Salaries, Other Administrative-gross salaries of other administrative personnel including bookkeepers, receptionists, administrative assistants, and other office and clerical personnel.
7. Salaries, Owner or Owner/Administrator-gross salaries of all owners of the center that are paid through the center.
8. Payroll Taxes-cost of employer's portion of Federal Insurance Contribution Act (FICA), Federal Unemployment Tax Act (FUTA), State Unemployment Tax Act (SUTA), and Medicare tax for administrative and operating employees.
9. Group Insurance, AOC-cost of employer's contribution to employee health, life, accident, and disability insurance for administrative, and operating employees.
10. Pensions, AOC-cost of employer's contribution to employee pensions for administration, and operating employees.
11. Uniform Allowance, AOC-employer's cost of uniform allowance and/or uniforms for administration and operating employees.
12. Worker's Compensation, AOC-cost of worker's compensation insurance for administration and operating employees.
13. Contract, Housekeeping-cost of housekeeping services and personnel hired through contract that are not employees of the center.
14. Contract, Laundry-cost of laundry services and personnel hired through contract that are not employees of the center.
15. Contract, Maintenance-cost of maintenance services and persons hired through contract that are not employees of the center.
16. Consultant Fees, Dietician-fees paid to consulting registered dieticians.
17. Accounting Fees-fees incurred for the preparation of the cost report, audits of financial records, bookkeeping, tax return preparation of the adult day health care center and other related services excluding personal tax planning and personal tax return preparation.
18. Amortization Expense, Non-Capital-costs incurred for legal and other expenses when organizing a corporation must be amortized over a period of 60 months. Amortization of costs attributable to the negotiation or settlement of the sale or purchase of any capital asset on or after July 18, 1984, whether by acquisition or merger, for which any payment has previously been made are nonallowable costs. If allowable cost is reported on this line, an amortization schedule must be submitted with the cost report.
19. Bank Service Charges-fees paid to banks for service charges, excluding penalties and insufficient funds charges.
20. Dietary Supplies-costs of consumable items such as soap, detergent, napkins, paper cups, straws, etc., used in the dietary department.
21. Dues-dues to one organization are allowable.
22. Educational Seminars and Training-the registration cost for attending educational seminars and training by employees of the center and costs incurred in the provision of in-house training for center staff, excluding owners or administrative personnel.
23. Housekeeping Supplies-cost of consumable housekeeping items including waxes, cleaners, soap, brooms and lavatory supplies.
24. Insurance, Professional Liability and Other- includes the costs of insuring the center against injury and malpractice claims.
25. Interest expense, non-capital interest paid on short term borrowing for center operations.
26. Laundry Supplies-cost of consumable goods used in the laundry including soap, detergent, starch and bleach.
27. Legal Fees-only actual and reasonable attorney fees incurred for non-litigation legal services related to participant care are allowed.
28. Linen Supplies-cost of sheets, blankets, pillows, and gowns.
29. Management Fees and Home Office Costs-the cost of purchased management services or home office costs incurred that are allocable to the provider. Costs for related management/home office must also be reported on a separate cost report that includes an allocation schedule.
30. Office Supplies and Subscriptions-cost of consumable goods used in the business office such as:
a. pencils, paper and computer supplies;
b. cost of printing forms and stationery including, but not limited to, nursing and medical forms, accounting and census forms, charge tickets, center letterhead and billing forms;
c. cost of subscribing to newspapers, magazines and periodicals.
31. Postage-cost of postage, including stamps, metered postage, freight charges, and courier services.
32. Repairs and Maintenance-supplies and services, including electricians, plumbers, extended service agreements, etc., used to repair and maintain the center building, furniture and equipment except vehicles. This includes computer software maintenance.
33. Taxes and Licenses-the cost of taxes and licenses paid that are not included on any other line of the cost report. This includes tags for vehicles, licenses for center staff (including nurse aide re-certifications) and buildings.
34. Telephone and Communications-cost of telephone services, internet and fax services.
35. Travel-cost of travel (airfare, lodging, meals, etc.) by the administrator and other authorized personnel to attend professional and continuing educational seminars and meetings or to conduct center business. Commuting expenses and travel allowances are not allowable.
36. Utilities-cost of water, sewer, gas, electric, cable TV and garbage collection services.
37. Allocated Costs, Hospital Based-costs that have been allocated through the step-down process from a hospital as administrative and operating costs.
38. Advertising-costs of employment advertising and soliciting bids. Costs related to promotional advertising are not allowable.
39. Maintenance Supplies-supplies used to repair and maintain the center building, furniture and equipment except vehicles.
40. Miscellaneous-costs incurred in providing center services that cannot be assigned to any other line item on the cost report. Examples of miscellaneous expenses are small equipment purchases, all employees' physicals and shots, nominal gifts to all employees, such as a turkey or ham at Christmas, and flowers purchased for the enjoyment of the participants. Items reported on this line must be specifically identified.
41. Total administrative and operating costs.
D. Property and Equipment
1. Amortization Expense, Capital-legal and other costs incurred when financing the center must be amortized over the life of the mortgage. Amortization of goodwill is not an allowable cost. Amortization of costs attributable to the negotiation or settlement of the sale or purchase of any capital asset on or after July 18, 1984, whether by acquisition or merger, for which any payment has previously been made are non-allowable costs. If allowable cost is reported on this line, an amortization schedule must be submitted with the cost report.
2. Depreciation-depreciation on the center's buildings, furniture, equipment, leasehold improvements, and land improvements.
3. Interest Expense, Capital-interest paid or accrued on notes, mortgages, and other loans, the proceeds of which were used to purchase the center's land, buildings and/or furniture, and equipment, excluding vehicles.
4. Property Insurance-cost of fire and casualty insurance on center buildings, and equipment, excluding vehicles. HCBS providers that share owned or leased space with other programs, Medicaid or private, should allocate building costs such as property insurance, property taxes, depreciation, etc. based on documented square footage used by each program.
5. Property Taxes-taxes levied on the center's buildings and equipment. HCBS providers that share owned or leased space with other programs, Medicaid or private, should allocate building costs such as property insurance, property taxes, depreciation, etc. based on documented square footage used by each program.
6. Rent, Building-cost of leasing the center's real property.
7. Rent, Furniture and Equipment-cost of leasing the center's furniture and equipment, excluding vehicles.
8. Allocated Costs, Hospital Based-costs that have been allocated through the step-down process from a hospital or state institution as property costs when those costs include allocated overhead.
9. Miscellaneous, Property-any capital costs related to the center that cannot be assigned to any other property and equipment line item on the cost report.
10. Total property and equipment.
E. Transportation Costs
1. Salaries, Drivers-gross salaries of personnel involved in transporting participants to and from the center.
2. Payroll Taxes, Transportation-the cost of the employer's portion of Federal Insurance Contribution Act (FICA), Federal Unemployment Tax Act (FUTA), State Unemployment Tax Act (SUTA), and Medicare tax for drivers.
3. Employee Benefits, Transportation-the cost of group insurance, pensions, uniform allowances, and other employee benefits related to drivers.
4. Workers' Compensation, Transportation-the cost of workers' compensation insurance for drivers.
5. Non-Emergency Medical Transportation-the cost of purchased non-emergency medical transportation services including, but not limited to:
a. payments to employees for use of their personal vehicle(s);
b. ambulance companies; and
c. other transportation companies for transporting participants of the center.
6. Interest Expenses, Vehicles-interest paid or accrued on loans used to purchase vehicles.
7. Property Insurance, Vehicles-the cost of vehicle insurance.
8. Vehicle Expenses-vehicle maintenance and supplies, including gas and oil.
9. Lease, Automotive-the cost of leasing vehicles used for participant care. A mileage log must be maintained. If a leased vehicle is used for both participant care and personal purposes, cost must be allocated based on the mileage log.
10. Total Transportation Costs.

La. Admin. Code tit. 50, § XXI-713

Promulgated by the Department of Health, Bureau of Health Services Financing, the Office for Citizens with Developmental Disabilities and the Office of Aging and Adult Services, LR 471116 (8/1/2021).
AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.