Spreadsheet: 07d70aba-ce1d-4e5f-b1e6-dc4956a4b233
Sheet: Sheet1

WYOMING DEPARTMENT OF HEALTH, AGING DIVISION, COMMUNITY LIVING SECTION | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10
QUARTERLY MEAL COSTING & PROGRAM INCOME REPORT FY 2013
PROJECT:
1.    Nutrition Services Incentive Program (NSIP)
[NAME] expended on food this quarter: |  |  |  |  |  | 0
2.     AoA ELIGIBLE SENIOR MEALS SERVED:
A. % Projected AoA Senior Meals Served YTD:
Actual number of eligible AoA senior meals served YTD divided by the projected/funded number of eligible AoA meals
Actual # of AoA Senior Meals Served Year-To-Date |  |  |  |  |  | 0
Projected # of AoA Senior Meals Year-To-Date |  |  |  |  |  | 0 |  | This is the number of meals funded x 25% for Qtr 1.
Percent of projected meals served year-to-date:
3.     FOOD COSTS:
A.  Raw Food Cost per Meal (Do not include catered/restaurant meals):
 |  | **Use either [NAME] #1 or Formula #2.
 |  | FORMULA #1:  Total expenditures on food this quarter (i.e., NSIP, AoA, Medicaid) divided by the total number of onsite and central kitchen meals prepared this quarter.
 |  | This assumes all meals are the same.  Do not include frozen Medicaid meals if they are  NOT prepared on site with groceries purchased for meals prepared on site.
 |  | Total Expenditures ($$) on Food this Quarter |  |  |  |  |  | 0
 |  | Total # of Onsite and Central Kitchen Meals this quarter |  |  |  |  |  | 0
 |  | Raw Food Cost per Meal Using Formula #1:
 |  | Raw Food Cost Per Meal Continued (Formula #2):
 |  | FORMULA #2:  Total cost of food served this quarter (based on physical  inventory) divided by the total number of onsite and central kitchen meals (all meals including Medicaid if prepared on site) served this quarter.
 |  | Include the dollar value of physical inventory plus the cost of food purchased this quarter, minus the dollar value of the ending inventory - Most accurate method.
 |  | Value ($) of Beginning Inventory |  |  | 0
 |  | + Cost ($) of Food this Quarter |  |  | 0
 |  |  | = |  | 0
 |  | minus [NAME] ($) of End Inventory |  |  | 0
 |  | (= value of beginning inventory  for next quarter)
 |  |  |  |  | 0
 |  | Number of meals served this quarter |  |  | 0
 |  | Raw Food Cost per meal
 | B. | Full-Cost per Congregate Meal this quarter:
 |  | Total expenditures, including NSIP, for congregate meals this quarter (i.e., personnel, consumable supplies, travel, other, equipment)* divided by the total number of congregate meals served this quarter.
 |  | * Must split these costs between programs, i.e. Medicaid, C2, catering, etc.
 |  | Raw food costs as calculated above are a part of the full cost
 |  |  |  |  | Total Expenditures |  |  | 0
 |  |  |  |  | Total number of C1 meals Served |  |  | 0
 |  |  |  |  | Total Cost per AoA C1 meal [NAME]
 | C. | Full-Cost per Home-delivered Meal (HDM) this Quarter:
 |  | Total expenditures, including NSIP, for home-delivered meals served this quarter (i.e., personnel, consumable supplies, travel, other, equipment)* divided by the total number of home-delivered meals served this quarter.
 |  | * Must split these costs between programs, i.e. Medicaid, C1, catering, etc.
 |  | Raw food costs as calculated above are a part of the full cost
 |  |  |  |  | Total Expenditures |  |  | 0
 |  |  |  |  | Total number of C2 meals Served |  |  | 0
 |  |  |  |  | Total Cost per AoA C2 meal Served
4.     PROGRAM INCOME:
 | A. | Program Income per Title III Congregate Meal this quarter:
 |  | Total Title III-C1 program income received this quarter |  |  |  |  |  | 0
 |  | divided by the total number of Title III-C1 meals served this quarter |  |  |  |  |  | 0
 |  | Total Title III-C1 Program Income per Meal this Quarter
 | B. | Program Income per Title III Home-Delivered Meal this quarter:
 |  | Total Title III-C2 program income received this quarter |  |  |  |  |  | 0
 |  | divided by the total number of Title III-C2 meals served this quarter |  |  |  |  |  | 0
 |  | Total Title III-C2 Program Income per Meal this Quarter
 | C. | % of Projected Income Received for Title III-C1 Year-to-Date:
 |  | Total Title III-C1 program income received Year-to-Date |  |  |  |  |  | 0 |  | Should match cell M18 on the "apple" form
 |  | the total amount of projected (see grant) Title III-C1 program income. |  |  |  |  |  | 0 |  | Total projected x 25% for Quarter 1
 |  | Percent of Title III-C1 Program Income Projected.
 | D. | % of Projected Income Received for Title III-C2 Year-to-Date:
 |  | Total Title III-C2 program income received year-to-date |  |  |  |  |  | 0 |  | Should match cell M18 on the "apple" form
 |  | divided by the total amount of projected (see grant) Title III-C2 program income. |  |  |  |  |  | 0 |  | Total projected x 25% for Quarter 1
 |  | Percent of Title III-C2 Program Income Projected.
Name of Authorized Official: |  |  |  |  |  |  |  | Date:
Signature of Authorized Official: