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402.

Medical Supplies Nursing supplies such as: -Adhesives -Dressings -Gauze -Gloves -Thermometers -Syringes -Incontinence Supplies -Disposable Diapers -Underpads

403.

Other(specify) Other expenses not identified in the above accounts.

HEAD INJURY SERVICES

414.

Salaries & Wages (RN) Registered Nurse salaries, wages, and vacation/holiday/sick pay.

415.

Salaries & Wages (LPN) Licensed Practical Nurse salaries, wages, and vacation/holiday/sick pay.

416.

Salaries & Wages (A & O) Aides and orderlies salaries, wages, and vacation/holiday/sick pay.

417.

Payroll Taxes -FICA -FUTA -SUTA

418.

Employee Benefits Benefits paid by the employer such as: -Cancer Insurance -Child Day Care -Dental Insurance -Disability Insurance -Health Insurance -Life Insurance -Other Insurance -Retirement -Uniforms -Worker’s Compensation -Employee Appreciation Meals -Pre-employment screening -General and Professional Liability Insurance

35 of 38

Cost Report Line Number

Nursing Facility Chart of Accounts

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