Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 115 - PRINCIPLES OF REIMBURSEMENT FOR RESIDENTIAL CARE FACILITIES - ROOM AND BOARD COSTS › Section 144-115-30 - ROUTINE COSTS

Current through 2024-29, July 17, 2024
30.1
Allowable Costs
Routine costs are those items of expense that providers must
				  incur in order to provide room and board to members receiving medical and
				  remedial services, providing the sum of the expenses, in whole or in part, are
				  reasonable and necessary. Allowable routine costs include:
30.1.1 Maintenance wages, payroll taxes and
				fringe benefits.
30.1.2 Other room
				and board expenses, such as food and supplies (except medical supplies), fuels
				for heating and cooking, towels, linens, costs associated with repairs and
				maintenance, insurance (other than fire), utilities (except water and sewer)
				and electricity.
30.1.3 General and
				administrative costs, excluding the administrative allowance which is part of
				the fixed/capital component, but including reasonable support costs. Examples
				of allowable general and administrative costs include telephone, dues and
				subscriptions, vehicle or transportation costs (other than interest and
				depreciation), office supplies, legal and accounting, bookkeeping, software and
				associated ongoing support costs, and interest on current
				indebtedness.
30.1.4 Allowable
				costs shall also include the following taxes and benefits applicable to routine
				service staff: pay roll taxes, unemployment, health insurance, dental
				insurance, employer term life/disability insurance, and qualified retirement
				contributions.
30.1.5 The PNMI's
				facility-specific routine services rate will be reduced by the actual amount of
				wages, taxes, and benefits of laundry, housekeeping, and dietary direct
				services covered under Section 97, PNMI Services as of July 1, 2002.
For a new facility, the routine component will initially be
				  determined by including all laundry, housekeeping and dietary direct service
				  wages, taxes and benefits and applying those costs against the routine upper
				  limit. Once the laundry, housekeeping and dietary direct service costs are
				  removed, the routine rate will be reduced accordingly.
30.1.6 For the state fiscal year ending June
				30, 2019, a special supplemental allowance must be made to Appendix C PNMIs to
				provide for increases in wages and wage-related benefits in the routine cost
				component. An amount equal to ten percent (10%) of wages and associated
				benefits and taxes in the routine cost component as reported on each facility's
				as-filed cost report for its fiscal year ending in calendar year 2016 must be
				added to the cost per resident day in calculating each facility's prospective
				rate, notwithstanding any otherwise applicable caps or limits on reimbursement.
				This supplemental allowance must also be allowed and paid at final audit to the
				full extent that it does not cause reimbursement to exceed the facility's
				allowable cost per day in the routine cost component in that fiscal year.