Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 101 - MAINECARE BENEFITS MANUAL (FORMERLY MAINE MEDICAL ASSISTANCE MANUAL) › Chapter III - Allowances for Services › Section 144-101-III-97 - Private Non-Medical Institution Services › Appendix 144-101-III-97-F - NON-CASE MIXED MEDICAL AND REMEDIAL SERVICES FACILITIES › Section 144-101-III-97-F-2400 - ALLOWABILITY OF COST

Current through 2024-29, July 17, 2024
2400.1
Salaries and Wages for Direct Service Staff
Allowable costs shall include salaries and wages for
						  direct service staff and services, as defined in Chapter II, Section 97, as
						  listed below:
Registered nurses
Licensed practical nurses
Licensed social workers
Personal care services staff
Other qualified medical and remedial staff
Other qualified mental health staff
Clinical consultant services
All staff must meet qualification requirements
						  specified in Chapter II, Section 97.
It is the responsibility of the PNMI to provide and
						  coordinate all covered services performed by direct care staff listed in this
						  Section to assure that members receive the full range of services necessary to
						  meet members' needs without duplication of services. See
MaineCare
						  Benefits Manual
(MBM), Chapter II, Section 97, Sections 97.04 and
						  97.05 regarding covered services and non-duplication of services.
2400.2
A program
						allowance,
expressed as a percentage of the allowable costs, as defined
						in Chapter III, Section 97, Sections 2400 will be allowed in lieu of indirect
						and/or PNMI related cost.
2400.3
Personal care services
include salaries, wages, benefits, and
						consultant fees for laundry, housekeeping, and dietary services.
The personal care services component is determined by
						  inflating the most recent audited costs for these services to the facility's
						  fiscal year ending after July 1, 2002. This becomes the PNMI's
						  facility-specific personal care cap. The personal care cap is deducted from the
						  facility's routine costs as of July 1, 2002. The actual allowable personal care
						  services costs will be settled at audit up to this facility-specific
						  cap.
2400.4
Tax and
						Benefit Costs
Allowable costs include, in addition to salaries and
						  wages, the taxes and benefit costs described in Chapter III.
2400.5
Staffing Approvals
The Department shall approve staffing based on the
						  services necessary to carry out individualized service plans at an accepted
						  standard of care. In the case of services that were created as a result of a
						  competitive bidding (request for proposal) process, the provider must deliver
						  the services accepted and approved by the Department during that process. The
						  Department will use the description of the PNMI services, and any additional
						  information from onsite review or surveys of the facility, including payroll
						  information, as the basis for reviewing/approving staff.
2400.5.1
Additional Requirements for
						Staffing Approvals
Staffing approvals may, at the discretion of the
						  Department, be accompanied by requirements with regard to admission, discharge
						  and service provision, non-discrimination, reasonable accommodation, dispute
						  resolution procedures, quality improvement practices, access to departmental
						  consultants, training, and other areas as may be required to provide members
						  with a person centered service plan.
2400.5.2
Audit of Approvals
All approvals are subject to audit. Those staffing
						  hours not utilized for the purpose approved by the Department will be
						  disallowed at audit, either in whole or in part.