Minnesota Administrative Rules

9549.0040 REPORTING BY COST CATEGORY.

Subpart 1.

Dietary services.

The costs listed in items A to D are to be reported in the dietary services cost category:

A.

direct costs of normal and special diet food including raw food, dietary supplies, food preparation and serving, and special dietary supplements used for tube feeding or oral feeding, such as elemental high nitrogen diet, even if written as a prescription item by a physician;

B.

the salaries and wages of the supervisor, dietitians, chefs, cooks, dishwashers, and other employees assigned to the kitchen and dining room including the salaries or fees of dietary consultants;

C.

the costs of training including the cost of lodging and meals to meet the requirements of laws, rules, or regulations for keeping an employee's salary, status, or position or to maintain or update skills needed in performing the employee's present duties; and

D.

the costs of travel necessary for training programs for dietitians required to maintain licensure, certification, or professional standards.

Subp. 2.

Laundry and linen services.

The costs listed in items A and B are to be reported in the laundry and linen services cost category:

A.

direct costs of linen and bedding, the laundering of resident clothing, other laundering, and laundry supplies; and

B.

the salaries and wages of the supervisor, menders, ironers, and other laundry employees.

Subp. 3.

Housekeeping services.

The costs listed in items A and B are to be reported in the housekeeping services cost category:

A.

direct costs of housekeeping supplies, including cleaning and lavatory supplies; and

B.

the salaries and wages of the supervisor, housekeepers, and other cleaning personnel.

Subp. 4.

Plant operation and maintenance services.

The costs listed in items A to C are to be reported in the plant operations and maintenance cost category:

A.

direct costs for maintenance and operation of the building and grounds, including fuel, electricity, water, sewer, supplies, tools, and repairs which are not capitalized;

B.

the salaries and wages of the supervisor, engineers, heating-plant employees, independent contractors, and other maintenance personnel; and

C.

the cost of required licenses and permits required for operation of the nursing facility.

Subp. 5.

Nursing services.

Direct costs associated with nursing services identified in items A to Y, are to be included in the nursing services cost category:

A.

nursing assessment of the health status of the resident and planning of appropriate interventions to overcome identified problems and maximize resident strengths;

B.

bedside care and services;

C.

care and services according to the order of the attending physicians;

D.

monitoring procedures such as vital signs, urine testing, weight, intake and output, and observation of the body system;

E.

administration of oral, sublingual, rectal, and local medications topically applied, and appropriate recording of the resident's responses;

F.

drawing blood and collecting specimens for submission to laboratories;

G.

prevention of skin irritation and decubitus ulcers;

H.

routine changing of dressings;

I.

training, assistance, and encouragement for self-care as required for feeding, grooming, ambulation, toilet, and other activities of daily living including movement within the nursing facility;

J.

supportive assistance and training in resident transfer techniques including transfer from bed to wheelchair or wheelchair to commode;

K.

care of residents with casts, braces, splints, and other appliances requiring nursing care or supervision;

L.

care of residents with behavior problems and severe emotional problems requiring nursing care or supervision;

M.

administration of oxygen;

N.

use of nebulizers;

O.

maintenance care of resident's colostomy, ileostomy, and urostomy;

P.

administration of parenteral medications, including intravenous solutions;

Q.

administration of tube feedings;

R.

nasopharyngeal aspiration required for maintenance of a clean airway;

S.

care of suprapubic catheters and urethral catheters;

T.

care of tracheostomy, gastrostomy, and other tubes in a body;

U.

costs of equipment and supplies that are used to complement the services in the nursing services cost category, including items stocked at nursing stations or on the floor and distributed or used individually, including: alcohol, applicators, cotton balls, incontinence pads, disposable ice bags, dressings, bandages, water pitchers, tongue depressors, disposable gloves, enemas, enema equipment, soap and water, medication cups, diapers, plastic waste bags, sanitary products, thermometers, hypodermic needles and syringes, and clinical reagents or similar diagnostic agents, and drugs which are not paid on a separate fee schedule by the medical assistance program or any other payer;

V.

costs for education or training including the cost of lodging and meals of nursing service personnel. Educational costs are limited to either meeting the requirements of laws or rules or keeping an employee's salary, status, or position or for maintaining or updating skills needed in performing the employee's present duties, except that training to become a nurses aid is an allowable cost;

W.

the salaries and wages of persons performing nursing services including salaries of the director, and assistant director of nursing, supervising nurses, medical records personnel, registered professional nurses, licensed practical nurses, nurses aides, orderlies, and attendants;

X.

the salaries or fees of medical director, physicians, or other professionals performing consulting services on medical care which are not reimbursed separately on a fee for service basis; and

Y.

the costs of travel necessary for training programs for nursing personnel required to maintain licensure, certification, or professional standards.

Subp. 6.

Other care-related services.

The costs listed in items A to D are to be reported in the other care-related services cost category:

A.

direct costs of other care-related services, such as recreational or religious activities, arts and crafts, pets, and social services which are not reimbursed separately on a fee for service basis;

B.

the salaries and wages of recreational therapists and aides, rehabilitation therapists and aides, chaplains, arts and crafts instructors and aides, social workers and aides, and other care-related personnel including salaries or fees of professionals performing consultation services in these areas which are not reimbursed separately on a fee for service basis;

C.

the costs of training including the cost of lodging and meals to meet the requirements of laws or rules for keeping an employee's salary, status, or position, or to maintain or update skills needed in performing the employee's present duties; and

D.

telephone, television, and radio services provided in areas designated for use by the general resident population, such as lounges and recreation rooms and the charge of transferring a resident's phone from one room to another within the same nursing facility.

Subp. 7.

General and administrative services.

Direct costs for administering the overall activities of the nursing facility are included in the general and administrative cost category. These direct costs include:

A.

business office functions;

B.

travel expenses other than travel expenses reported under subparts 1, item D, and 5, item Y;

C.

all motor vehicle operating expenses;

D.

telephone and telegraph charges;

E.

office supplies;

F.

insurance, except as included as a fringe benefit;

G.

personnel recruitment costs including help wanted advertising;

H.

the salaries, wages, or fees of administrators, assistant administrators, accounting and clerical personnel, data processing personnel, and receptionists;

I.

professional fees for services such as legal, accounting, and data processing services;

J.

management fees, and the cost of management and administrative consultants;

K.

central, affiliated, or corporate office costs excluding the cost of depreciable equipment used by individual nursing facilities which are included in the computation of the property-related payment rate under part 9549.0060 and those costs specified in part 9549.0030, subpart 4, items A and B;

L.

business meetings and seminars;

M.

postage;

N.

training including the cost of lodging and meals for management personnel and personnel not related to direct resident care if the training either meets the requirements of laws, rules, or regulations to keep an employee's salary, status, or position or maintains or updates skills needed to perform the employee's present duties;

O.

membership fees for associations and professional organizations which are directly related to resident care;

P.

subscriptions to periodicals which are directly related to the operation of the nursing facility;

Q.

security services or security personnel;

R.

joint commission on accreditation of hospitals survey;

S.

advertising;

T.

board of director's fees;

U.

interest on working capital debt;

V.

bad debts and fees paid for collection of bad debts provided that the conditions in subitems (1) to (4) are met:

(1)

the bad debt results from nonpayment of the payment rate or part of the payment rate;

(2)

the nursing facility documents that reasonable collection efforts have been made, the debt was uncollectible, and there is no likelihood of future recovery;

(3)

the collection fee does not exceed the amount of the bad debt; and

(4)

the debt does not result from the nursing facility's failure to comply with federal and state laws, state rules, and federal regulations;

W.

the portion of preopening costs capitalized as a deferred charge and amortized over a period of 120 consecutive months beginning with the month in which a resident first resides in a newly constructed nursing facility;

X.

the cost of meals incurred as a result of required overnight business related travel; and

Y.

any costs which cannot be specifically classified to another cost category.

Subp. 8.

Payroll taxes, fringe benefits, and clerical training.

Only the costs identified in items A to I are to be reported in the payroll taxes, fringe benefits, and clerical training cost category:

A.

the employer's share of the social security withholding tax;

B.

state and federal unemployment compensation taxes or costs;

C.

group life insurance;

D.

group health and dental insurance;

E.

workers' compensation insurance;

F.

either a pension plan or profit-sharing plan, approved by the United States Internal Revenue Service, but not both for the same employee;

G.

governmentally required retirement contributions;

H.

uniform allowance; and

I.

costs of training clerical personnel including the cost of meals and lodging.

Subp. 9.

Real estate taxes and special assessments.

Real estate taxes and special assessments for each nursing facility are to be reported in the real estate taxes and special assessments cost category. In addition, payments permitted under part 9549.0036, item CC must be reported in this cost category.

Statutory Authority:

MS s 256B.41 to 256B.502

History:

9 SR 2659; L 1992 c 513 art 7 s 136

Published Electronically:

October 11, 2007