1.The provider shall maintain billing records in accordance with recognized fiscal and accounting procedures. Individual records shall be maintained for each client. These records shall meet the following criteria.
a.Records shall clearly detail each charge and each payment made on behalf of the client.
b.Records shall be current and shall clearly reveal to whom charges were made and for whom payments were received.
c.Records shall itemize each billing entry.
d.Records shall show the amount of each payment received and the date received.
2.The provider shall maintain supporting fiscal documents and other records necessary to ensure that claims are made in accordance with federal and state requirements.
K.Non-acceptable Descriptions. "Miscellaneous", "other" and "various", without further detailed explanation, are not acceptable descriptions for cost reporting purposes. If any of these are used as descriptions in the cost report, a request for information will not be made and the related line item expense will be automatically disallowed. The provider will not be allowed to submit the proper detail of the expense at a later date, and an appeal of the disallowance of the costs may not be made.
L.Exceptions. Limited exceptions to the cost report filing requirements will be considered on an individual provider basis upon written request from the provider to the Bureau of Health Services Financing, Rate and Audit Review Section. If an exception is allowed, the provider must attach a statement describing fully the nature of the exception for which prior written permission was requested and granted. Exceptions which may be allowed with written approval are as follows.
1.If the center has been purchased or established during the reporting period, a partial year cost report may be filed in lieu of the required 12-month report.
2.If the center experiences unavoidable difficulties in preparing the cost report by the prescribed due date, an extension may be requested prior to the due date. Requests for exception must contain a full statement of the cause of the difficulties that rendered timely preparation of the cost report impossible.
AUTHORITY NOTE:Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.
HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Office of Aging and Adult Services, LR 34:2164 (October 2008).
§2905.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 resident 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 well being of the residents.
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 residents.
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 Legend―cost of over-the-counter and legend drugs provided by the center to its residents. This is for drugs not covered by Medicaid.
15.Medical Supplies―cost of patient-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.Other Supplies, DC—cost of items used in the direct care of residents which are not patient-specific such as recreational/activity supplies, prep supplies, alcohol pads, betadine solution in bulk, tongue depressors, cotton balls, thermometers, and blood pressure cuffs.
18.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.
19.Total Direct Care Costs—sum of the above line items.
B.Care Related 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.
Louisiana Register Vol. 34, No. 10 October 20, 2008