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Five_20Cost_20Categories

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									                                                                    Five Cost Categories
  The facility-specific cost-based per diem payment for FS/NFs is based on the sum of the projected costs of the five cost categories, each subject to ceilings
                          described in this Section. Costs within a specific cost category may not be shifted to any other cost category.

1. Labor                                                                    2. Indirect care        3. Administrative         4. Fair Rental           5. Direct
- Direct, Indirect, and Labor-driven operating allocation                      non-labor                                         Value System             Pass-through
                                                                                                                                 (FRVS)

            q                      q                         q                         q                        q                        q                        q
 Direct resident care     Indirect care labor          Labor-driven           Indirect care non-     Administrative costs        Fair Rental Value      Direct pass-through
  labor costs include      cost category shall           operating           labor costs include       include allowable       System (FRVS) will      of proportional Medi-
 salaries, wages, and       include all labor      allocation includes       the non-labor costs      administrative and      be used to reimburse          Cal costs for
   benefits related to   costs related to staff     an amount equal to        related to services    general expenses of          FS/NF property           property taxes,
     routine nursing          support in the         8% of direct and           supporting the      operating the facility,    (capital) costs. The     facility license fees,
 services personnel,       delivery of patient    indirect resident care    delivery of resident     including a FS/NF's      FRVS will be used in       caregiver, training
 defined as nursing,      care including, but         labor costs, less      care, including the            allocated           lieu of actual costs       costs, liability
 social services, and        not limited to,          expenditures for      non-labor portion of     expenditures realted           and/or lease        insurance costs, and
 activities personnel.       housekeeping,        agency staffing, such            nursing,           to allowable home         payments on land,      new state and federal
 Direct resident care       laundry & linen,      as nurse registry and         housekeeping,           office costs. The         buildings, fixed      mandates, including
  labor costs include       dietary, medical        temporary staffing         laundry & linen,       administrative cost     equipment and major      the Medi-Cal portion
  labor expenditures       records, in service       agency costs. The        dietary, in-service   category will include      movable equipment           of the Quality
     associated with     education, and plant           labor-driven        education and plant       allowable property         used in providing       Assurance Fee for
 FS/NF's permanent            operations &         operating allocation          operations &        insurance costs, and     resident care. Capital     the applicable rate
       direct care       maintenance. These       may be used to cover       maintenance costs.     exclude expenditures      payments are limited               year.
employees, as well as     costs are limited to     allowable Medi-Cal           These costs are          associated with         as specific below
      expenditures       the 90th percentile.           expenditures        limited to the 75th       caregiver training,       Section V.C.4.i of
     associated with                              incurred by a FS/NF        percentile of each       liability insurance,     Supplement 4 of the
   temporary agency                               to care for Medi-Cal      facility's respective    facility license fees,          State Plan.
staffing. These costs                               residents. Can not            peer group.              and medical
    are limited to the                               exceed the 5% of                                records.These costs
  90th percentile of                                 the facility's total                              are limited to the
      each facility's                                     Medi-Cal                                    50th percentile of
     respective peer                               reimbursement rate.                                    each facility's
          group.                                                                                    respective peer group

								
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