Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 06 - Medical Services › Rule 016.06.07-064 - Point of Care Medication Management System

Current through Register Vol. 49, No. 6, June, 2024
3-8
Point of Care Medication
			 Management Software Applications (POCMM)
Effective November 1, 2007 software applications for medication
				management employing point of care technology is afforded special treatment for
				cost reporting periods beginning July 1, 2007. Characteristics of point of care
				technology include software applications installed on medication carts allowing
				point of care based medication management. The allowable cost of software and
				associated hardware (used exclusively for this application) required to operate
				a point of care software application will be treated as direct care cost for
				cost reporting purposes. All costs associated with the point of care
				application must continue to meet all allowable cost principles as defined in
				Chapter 3 including capitalization requirements. Chapter 4-A and Chapter 4-B of
				the state Manual of Cost Reimbursement Rules for Long Term Care Facilities
				dated July 1, 1999 include specific instructions on how these costs will be
				reported on provider cost reports.
Line 1-27, Over-the-Counter Drugs
Cost of over-the-counter drugs provided by the facility to its
				residents.
Line 1-28, Oxygen
Cost of oxygen and related supplies.
Line 1-29, Medical Supplies - Direct Care
Cost of providing direct medical care. Includes by
				illustration:
* Single use disposable items and consumable supplies that are
				used in the course of providing direct medical care to a resident, such as
				catheters, syringes, sterile dressings, prep supplies, alcohol pads, Betadine
				solution in bulk, tongue depressors, and cotton balls.
* Pressure relieving devices that cannot be used by more than a
				single resident or that would be classified as minor equipment.
* Minor medical equipment used in providing direct medical care
				such as thermometers, sphygmomanometers, stethoscopes, etc.
* Costs of supplies for which Medicare Part B revenue is
				received must be reclassified to Line 5-11 in Column 2 or removed in Column 5
				per Form 5 revenue adjustments.
Cost associated with point of care software
				applications.
* Cost of operating a point of care software application that
				does not require capitalization.
* Depreciation of capitalized cost associated with a point of
				care software application reclassified from Section 3.
* Interest expense associated with a point of care software
				application reclassified from Section 3.
* Rent expense associated with a point of care software
				application reclassified from Section 3.
Line 1-30, Therapy Supplies
The cost of supplies used directly by the therapy staff for
				rendering therapeutic service to the residents of the facility. Costs of
				therapy supplies for which other third party income is received (Medicare Part
				A, Medicare Part B, etc.) must be reclassified to Line 5-11 in Column 2 or
				removed in Column 5 per Form 5 revenue adjustments.
Line 1-31, Raw Food
Cost of food products used to provide meals and snacks to
				residents.
Line 1-32, Food - Supplements
Cost of food products given in addition to normal meals and
				snacks under doctor's orders.
Line 1-33, Incontinence Supplies
Cost of incontinence supplies to include both disposable and
				linen diapers, and disposable underpads.
Line 1-34, Dental (Schedule)
Cost of dentist advisory services (not individual resident
				specific). All other dental expenses must be reclassified to Line 5-11 in
				Column 2. A schedule must be attached that details the amount on this
				line.
For Arkansas Health Center Nursing Facility (AHC), all dental
				services are allowable.
Line 1-35, Drugs Legend
Cost of prescription drugs are allowable only for AHC. Other
				nursing facilities must reclassify these costs to Line 5-11 in Column 2.
Line 1-36, Lab and X-Ray
Cost of lab and x-ray services are allowable only for AHC.
				Other nursing facilities must reclassify these costs to Line 5-11 in Column
				2.
3. Form 6, Section 3 Property
Amounts for depreciation, Rent - Building and Rent - Furniture
				and Equipment must be identified for historical purposes only. A Fair Market
				Rental Payment is made in lieu of these expenses.
Line 3-01, Amortization Expense - Capital (Schedule)
Legal and other costs incurred when financing the facility
				should be amortized over the life of the mortgage. Attach a detail amortization
				schedule for these costs. These costs are not to be included on the Form 7
				depreciation schedule.
Line 3-02, Depreciation - Fair Market Rental
Depreciation on the facility's buildings, furniture, equipment,
				leasehold improvements and land improvements. Items costing $300 or more will
				be capitalized.
Depreciation expense associated with point of care software
				applications must be reclassified to Line 1-29.
Line 3-03, Depreciation - Generator
Depreciation on generators approved by the Office of Long Term
				Care under Act 1602 of 2001.
Line 3-04, Interest Expense - Fair Market Rental
Interest paid or accrued on notes, mortgages and other loans,
				the proceeds of which were used to finance the fixed assets or major movable
				equipment. The total of Line 3-04, Column 6 must agree with the Form 10, Page
				3, Totals Column, Line 10.
Interest expense associated with point of care software
				applications must be reclassified to Line 1-29.
Line 3-05, Interest Expense - Generator
Interest paid or accrued on notes the proceeds of which were
				used to purchase a generator approved by the Office of Long Term Care under Act
				1602 of 2001. The total of Line 3-05, Column 6 must agree with the Form 10,
				Page 3, Totals Column, Line 11.
Line 3-06, Property Insurance
Cost of fire and casualty insurance on facility buildings and
				equipment.
Line 3-07, Professional Liability Insurance
Cost of insuring the facility against injury and malpractice
				claims.
Line 3-08, Property Taxes
Taxes levied on the facility's land, buildings, furniture and
				equipment.
Line 3-09, Rent - Building
Cost of leasing the facility's real property.
Line 3-10, Rent - Furniture and Equipment
Cost of leasing the facility's furniture, equipment and
				vehicles.
Rent expense associated with point of care software
				applications must be reclassified to Line 1-29.
Line 3-11, Total Property
Line 3-11 is the sum of Line 3-01 through Line 3-10.
4. Form 6, Section 4 Quality
			 Assurance Fee
Cost of the quality assurance fee paid monthly to the
				Department Human Services.
5. Form 6, Section 5 Non-Allowable Costs
Line 5-01, Advertising
Costs of unallowable advertising.
Line 5-02, Bad Debts
Accounts receivable written off as uncollectable.
Line 5-03, Barber and Beauty Expense
The cost of barber and beauty services provided by non-facility
				personnel.
Line 5-04, Contributions
Amounts donated to charitable or other organizations.
Line 5-05, Depreciation Over Straight Line
Depreciation charged above straight line. Amounts posted to
				this line should result from reclassifications (Column 2) from Line 3-02.
				Column 1 should equal zero.
Line 5-06, Income Taxes - State and Federal
Taxes on net income levied or expected to be levied by the
				Federal or State government.
Line 5-07, Insurance - Officers
Cost of unallowable life insurance on officers and key
				employees of the facility per Section 3-3.T.
Line 5-08, Non-Working Officer's Salaries
Salaries and other compensation paid to non-working
				officers.
Line 5-09 and 5-10, Nurse Aide Testing and Training
Costs incurred in having nurse aides tested or trained in order
				to meet OBRA 1987 provisions. This includes both the Medicaid and non-Medicaid
				portion of the expenses. Example - A nursing facility incurs
617.00
Other Fringe Benefits -Direct Care
Cost of other fringe benefits offered to direct care
						  staff not specifically listed in the categories above. These must be included
						  in the facility's benefits policy.
618.00
Contract - Aides
Cost of Certified Nurse Aides hired through contract
						  that are not on the facility payroll.
619.00
Contract - LPN's
Cost of LPN's and graduate practical nurses hired
						  through contract that are not on facility payroll.
620.00
Contract - RN's
Cost of RN's and graduate nurses hired through contract
						  that are not on facility payroll.
621.00
Contract - Occupational Therapists
Cost of occupational therapists hired through contract
						  that are not on the facility payroll.
622.00
Contract - Physical Therapists
Cost of physical therapists hired through contract that
						  are not on facility payroll.
623.00
Contract - Speech Therapists
Cost of speech therapists hired through contract that
						  are not on facility payroll.
624.00
Contract - Other Therapists
Cost of therapists other than occupational, physical,
						  and speech therapists hired through contract that are not facility
						  employees.
625.00
Consultant Fees - Nursing
Fees paid to nursing personnel, not on the facility
						  payroll for providing advisory and educational services to the
						  facility.
626.00
Training - Direct Care
Cost of training related to resident care for RN's,
						  LPN's and Certified Nurse Aides. Also includes travel costs associated with
						  this training. Does not include training cost for Nurse Aide
						  certification.
627.00
Over the Counter Drugs
Cost of over the counter drugs provided to its
						  residents such as pain relievers, cough and cold medications, Rubbing Alcohol,
						  aspirin.
628.00
Oxygen
Cost of oxygen and related supplies.
629.00
Medical Supplies - Direct Care
Cost of providing direct medical care, including single
						  use disposable items and consumable supplies that are used in the course of
						  providing direct medical care to a resident, such as catheters, syringes,
						  sterile dressings, prep supplies, alcohol pads, Betadine solution in bulk,
						  tongue depressors, and cotton balls. Includes minor medical equipment used in
						  providing direct medical care such as thermometers, sphygmomanometers,
						  stethoscopes, etc.
629.10
Medical Supplies - Point of Care
Cost of Point of Care Software Applications that does
						  not require capitalization.
630.00
Therapy Supplies
Cost of supplies used directly by the therapy staff for
						  rendering therapeutic services to the residents of the facility.
631.00
Raw Food
Cost of food products used to provide meals and snacks
						  to residents.
632.00
Food Supplements
Cost of food products given in addition to normal meals
						  and snacks under doctor's orders (Ensure, etc.).
633.00
Incontinence Supplies
Cost of incontinence supplies to include diapers and
						  underpads.
634.00
Dental
Cost of dental services.
807.00
Health Insurance
Cost of Employer's contribution to employee Health
						  Insurance.
808.00
Group Life Insurance
Cost of Employer's contribution to employee Group Life
						  Insurance Plan.
UTILITIES
821.00
Heating (Fuel)
Cost of heating oil, natural gas or coal.
822.00
Electricity
S elf-Explanatory.
823.00
Water, Sewer and Garbage
Self-Explanatory.
831.00
Real Property Taxes
Amount of taxes levied on the facility's land and
						  buildings.
832.00
Personal Property Taxes
Amounts of taxes levied on the facility's property and
						  equipment.
833.00
Insurance - (Property)
Cost of fire and casualty insurance on facility
						  buildings and equipment.
COST OF CAPITAL
DEPRECIATION
841.00
Land Improvements
Depreciation on improvements having a limited life made
						  to the land of the facility, (e.g., paving, landscaping).
842.00
Building
Depreciation on the facility's buildings.
843.00
Building Improvements
Depreciation on major additions or improvements to the
						  facility. For example, new laundry or dining room.
844.00
Equipment
Depreciation on items of equipment. For example beds,
						  chairs, floor polishers, office machines, stoves and washing
						  machines.
844.10
Point of Care Equipment
Depreciation expense associated with point of care
						  software applications.
845.00
Leasehold Improvements
Depreciation on major additions or improvements to
						  building or plant where the facility is leased and the costs of the changes are
						  incurred by the lessee (tenant).
RENT
851.00
Building
Rental amounts paid by the facility on all rented or
						  leased real property (land and building).
852.00
Equipment
Rental amounts paid by the facility for leased or
						  rental furniture and equipment.
852.10
Point of Care Equipment
Rent expense associated with point of care software
						  applications.
INTEREST
856.00
Building
Interest paid or accrued on notes, mortgages and other
						  loans, the proceeds of which were used to purchase the facility's real
						  property. (Land and building).
857.00
Equipment
Interest paid or accrued on notes, chattel mortgages
						  and other loans, the proceeds of which were used to purchase the facility's
						  equipment.
857.10
Point of Care Equipment
Interest expense associated with point of care software
						  applications.
Line 10, Medical Supplies
Medical supplies furnished by the facility as part of required
				medical or nursing care, as ordered by a physician.
Cost associated with point of care software
				applications.
* Cost of operating a point of care software application that
				does not require capitalization.
* Depreciation of capitalized cost associated with a point of
				care software application reclassified from Line 26.
* Interest expense associated with a point of care software
				application reclassified from Line 35.
* Equipment rental associated with a point of care software
				application reclassified from Line 21.
Line 11, Laboratory
Salaries and supplies, or purchased services.
Line 12, X-Rays
Salaries of technicians and supplies or purchased
				services.
Line 13, Physical Therapy and Rehabilitation
Salaries and therapeutic supplies for physical therapy,
				occupation therapy and purchased services.
Line 14, Social Service
Salary or agreement cost of social workers and support staff
				used on a full or part-time basis to provide social services required and
				performed by the facility.
Line 15, Resident Activities
Cost of resident activities should include recreational
				activities and pastoral activities.
Line 16, Volunteer Services
Cost of supporting services and staff functions related to the
				use of volunteers which are resident related and are for improving resident
				care.
Line 17, Gift, Flower, Coffee Shop
Costs of non-resident related services. Include beauty and
				barber shop, etc., on this line. These are non-allowable expenses and no profit
				or loss should affect the allowable cost; therefore, it is necessary to
				completely eliminate these items. Expenses listed in Columns 1, 2, and 3 for
				this line will be adjusted to zero by an entry of the same amount in Column 6.
				A zero is already shown in Columns 7 and 9 for this item.
Line 18, Personal Purchases for Residents
Same as policy for Line 17, applies for personal purchases for
				residents.
Line 19, Oxygen
Cost of Oxygen, its administration, and related
				medications.
Line 20, Incontinence Cost of supplies.
Line 21, Equipment Rental
Cost of renting any equipment necessary for resident
				care.
Rent expense associated with point of care software
				applications must be reclassified to Line 10.
Line 22, Unassigned.
(ICF/MR 16 Bed Private; Expense included on this line should
				meet the criteria for the Administrative and Operating Cost Category)
Line 23, Total Health Care.
3. Maintenance and Operation
Line 24, Housekeeping
Wages of housekeepers and maids, housecleaning supplies.
Line 25, Plant Operations, Maintenance, and Utilities
Utilities, repairs, engineers' salaries, handyman wages,
				contractual repairs, maintenance supplies. Utilities include water, sewer,
				garbage and waste disposal, electricity, heating fuel, and cable TV.
Line 26, Depreciation and Amortization
Total straight-line depreciation and amortization. The detail
				of depreciation and amortization is shown on Form 6. The total of the detailed
				schedule should agree with the depreciation shown on this line.
Depreciation expense associated with point of care software
				applications must be reclassified to Line 10.
Line 27, Rent
Rentals paid for buildings, equipment and land used in the
				operation of the facility.
Line 28, Real Estate Taxes and Insurance
School taxes, other taxes on land and buildings, capital stock
				tax, insurance, etc.
Line 29, Unassigned
(ICF/MR 16 Bed Private; Expense included on this line should
				meet the criteria for the Administrative and Operating Cost Category)
Line 30, Total Maintenance and Operation
4. General Administration
Line 31, Salaries
Administrator's salaries, officers' salaries, and wages of
				general administrative personnel.
Line 32, Professional Services
Legal fees, outside accounting, data processing, management
				services, etc.
Line 33, Insurance
Officers' life insurance.
Line 34, Travel and Education
Seminars and educational programs. Any cost related to a
				particular cost center should be apportioned to that cost center. For example,
				the travel expense of a nurse should be included in the health care cost center
				and not with this line.
Line 35, Interest
Interest expense incurred on short-term and long-term loans and
				mortgages.
Interest expense associated with point of care software
				applications must be reclassified to Line 10.
Line 36, Other General Administrative Expenses
This line is provided to cover costs for such various general
				administrative expenses as office supplies, telephone, postage, bank service
				charges, dues, licenses, subscriptions, advertising, etc. Attach a schedule
				listing the account names and amounts used for this total.
Line 37, Unassigned
(ICF/MR 16 Bed Private; Expense included on this line should
				meet the criteria for the Administrative and Operating Cost Category)
Line 38, Total General Administration
5. Other Costs
Line 39, Federal and State Income Taxes
Federal and State Income Taxes (not personal taxes). These are
				non-allowable expenses and should be adjusted to zero by an entry of the same
				amount in Column 6. A zero is already shown in Columns 7 and 9 for this
				item.