(a) General requirements. Costs shall be allocated among the following cost categories as specified in this section: - (4) operating costs. For purposes of this section, "labor costs" includes the cost of employee benefits and taxes. Services and supplies used in providing patient-related services include, but are not limited to, those specified in Attachment A. Reimbursement will be a combination of a cost based system and a fixed price system as described in Section 15.
(b) Health care component. The health care cost component consists of the following costs provided such costs are direct costs of patient-related services actually rendered within the nursing facility. This rate component is subject to a quarterly case mix acuity adjustment. - (iii) Direct nursing health care labor costs for the following:
- (B) Licensed practical nurses;
- (C) Nurse assistants and certified nurse assistants;
- (iv) Payroll taxes and employee benefits associated with the wages above.
(c) Capital cost component. The capital cost component consists of the following costs: - (i) Leasehold amortization;
- (iv) Interest on real estate and personal property.
(d) Exempt cost component. The exempt cost component consists of: - (i) Property taxes. The cost of property taxes on assets used in providing patient care is allowable. Tax penalties, late fees, and income taxes are not allowable;
- (ii) Property insurance. The cost of property insurance on assets used in providing patient care is allowable. Malpractice, workmen's compensation, and other employee-related insurances are not considered property insurance;
- (iii) Utilities. Heat, electricity, water, sewer, and garbage.
- (iv) Nurse aide training. Costs for testing, books, fees, and classes for completing the Nursing CNA exam. Wages and benefits of employees while they are being trained are not considered an exempt cost and will be included in health care costs with other nursing wages. Other training and refresher courses are not includable as exempt and shall be reported in health care costs. In-house trainer wages will not be included as exempt and shall be included in the health care cost center.
(e) Operating cost component. The operating cost component consists of: - (i) Administrative and general costs, including home office costs and management fees;
- (vii) Nurse administration;
- (viii) Central services, routine supplies, and non legend drugs;
- (ix) Pharmacy consultant;
- (xi) Payroll taxes and employee benefits associated with the wages above;
- (xiii) All other costs as permitted by federal and state rules and regulations not mentioned in (b), (c), and (d) in this section.