Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1187 - Nursing Facility Services
Subchapter F - COST REPORTING AND AUDIT REQUIREMENTS
Section 1187.71 - Cost reporting
§ 1187.71. Cost reporting
(a) A nursing facility shall report costs to the MA Program by filing an acceptable MA-11 with the Department. Costs in the MA-11 are:
(1) Resident care costs.
(ii) Director of nursing.
(iii) Related clerical staff.
(v) Medical director.
(vi) Utilization and medical review.
(vii) Social services.
(viii) Resident activities.
(ix) Volunteer services.
(x) Pharmacy-prescription drugs.
(xi) Over-the-counter drugs.
(xii) Medical supplies.
(xiii) Laboratory and X-rays.
(xiv) Physical, occupational and speech therapy.
(xvi) Beauty and barber services.
(xvii) Minor movable property.
(xviii) Other supplies and other resident care costs.
(2) Other resident related costs.
(i) Dietary, including food, food preparation, food service, and kitchen and dining supplies.
(ii) Laundry and linens.
(iv) Plant operation and maintenance.
(v) Minor movable property.
(vi) Other supplies and other resident related costs.
(3) Administrative costs.
(ii) Office personnel.
(iii) Management fees.
(iv) Home office costs.
(v) Professional services.
(vi) Determination of eligibility.
(vii) Gift shop.
(xii) Other interest.
(xiii) Legal fees.
(xiv) Federal/State Corporate/Capital Stock Tax.
(xv) Officers' life insurance.
(xvi) Amortization-administrative costs.
(xvii) Office supplies
(xviii) Minor movable property.
(xix) Other supplies and other administrative costs.
(4) Capital costs.
(i) Real estate tax cost.
(ii) Major movable property.
(iv) Capital interest.
(v) Rent of nursing facility.
(vi) Amortization-capital costs.
(b) The MA-11 shall identify allowable direct, indirect, ancillary, labor and related party costs for the nursing facility and residential or other facility.
(c) The MA-11 shall identify costs of services, movable property and supplies furnished to the nursing facility by a related party and the rental of the nursing facility from a related party.
(d) The MA-11 shall be based on accrual basis financial and statistical records maintained by the nursing facility. The cost information contained in the cost report and in the nursing facility's records shall be current, accurate and in sufficient detail to support the reported costs.
(e) An acceptable cost report is one that meets the following requirements:
(1) Applicable items are fully completed in accordance with the instructions incorporated in the MA-11, including the necessary original signatures on the required number of copies.
(2) Computations carried out on the MA-11 are accurate and consistent with other related computations.
(3) The treatment of costs conforms to the applicable requirements of this chapter.
(4) Required documentation is included.
(5) The MA-11 is filed with the Department within the time limits in §§ 1187.73, 1187.75 and 1187.76 (relating to annual reporting; final reporting; and reporting for new nursing facilities).
(f) The nursing facility shall maintain adequate financial records and statistical data for proper determination of costs under the MA Program. The financial records shall include lease agreements, rental agreements, ledgers, books, records and original evidence of cost-purchase requisitions, purchase orders, vouchers, vendor invoices, inventories, time cards, payrolls, bases for apportioning costs and the like-which pertain to the determination of reasonable costs.
(g) Records and other information described in subsection (d) are subject to periodic verification and audit. Costs which are adequately documented are allowable.
(h) The nursing facility shall maintain the records pertaining to each cost report for at least 4 years following the date the nursing facility submits the MA-11 to the Department.(The provisions of this § 1187.71 amended February 8, 2002, effective July 1, 2001, 32 Pa.B. 734.)