Md. Code Regs. 10.09.10.17-1

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.09.10.17-1 - Selected Costs - Not Allowable for Payments for Services Provided Effective January 1, 2015

The following costs are not allowable in establishing prospective rates:

A. Costs not adequately documented;

B. Costs for chaplaincy training and other religious training programs;

C. Bad debts incurred by private pay or Medicare patients or third-party payers and bad debts resulting from denied costs of the Program;

D. Recipient resources certified as available for medical and remedial care by the Department of Human Resources which are uncollected;

E. Advertising expenses, except those necessary for personnel recruitment;

F. Stockholder costs incurred primarily for the benefit of stockholders or other investors, including the costs of stockholders' annual reports and newsletters, annual meetings, mailing of proxies, stock transfer agent fees, stock exchange registration fees, stockbroker and investment analysis, stock issuance costs, and accounting and legal fees for consolidating statements for Securities and Exchange Commission purposes;

G. Any contributions, whether charitable or not, to any individual or organization;

H. Public relations expenses;

I. Costs of maintaining a recipient in a private room which exceeds costs of a semiprivate room;

J. Cost of depreciable assets and minor equipment useful for a lifetime of at least 2 years, with a historical cost of at least $500 or an aggregate historical cost of at least $500 if they are purchased in a quantity of like or similar items;

K. Civil money penalties, fines, and all costs associated with sanctions, including receivership, initiated by the Department or any other local, State, or federal government agency;

L. Interest paid by a provider under Regulations .14J(2) or .30E(5) of this chapter;

M. Administrator compensation for any owner, or relative of the owner, in excess of the limits established based on the results of the 2001 nonowner administrator compensation survey, trended forward based on the percentage of the annual increase or decrease in the All Items category of the Consumer Price Index for All Urban Consumers (CPI-U), as follows:

(1) For facilities with 1-74 beds, the median compensation from that group;

(2) For facilities with 75-199 beds, the median compensation from that group; and

(3) For facilities with 200 or more beds, the median compensation from all facilities with 200 or more beds;

N. Compensation for any administrator, who is not an owner, or relative of the owner, in excess of the limits established based on the results of the 2001 nonowner administrator compensation survey, trended forward based on the percentage of the annual increase or decrease in the All Items category of the Consumer Price Index for All Urban Consumers (CPI-U), as follows:

(1) For facilities with 1-74 beds, the 75th percentile compensation from that group plus 15 percent;

(2) For facilities with 75-199 beds, the 75th percentile compensation from that group plus 15 percent;

(3) For facilities with 200-299 beds, the 75th percentile compensation from all facilities with 200 or more beds plus 15 percent; and

(4) For facilities with 300 or more beds, 15 percent more than the limit established in §N(3) of this regulation for the facilities with 200-299 beds;

O. Assistant administrator compensation for any owner, or relative of the owner, in excess of 80 percent of the maximum administrator compensation for the facility established in accordance with §M of this regulation;

P. Compensation for any assistant administrator, who is not an owner, or relative of the owner, in excess of 80 percent of the maximum administrator compensation for the facility established in accordance with §N of this regulation;

Q. Central office employee compensation for any owner or relative of the owner in excess of the amount established in accordance with §M of this regulation, for the bed size category determined as the sum of beds if multiple facilities, plus 10 percent;

R. Compensation for any central office employee, who is not an owner, or relative of the owner, in excess of the amount established in accordance with §N of this regulation, for the bed size category determined as the sum of beds if multiple facilities, plus 10 percent;

S. Costs incurred in any effort to acquire a Certificate of Need or an exemption from a Certificate of Need for nursing home beds;

T. Costs incurred for specialized support surfaces used for pressure ulcer care;

U. Legal, accounting, and other professional expenses related to an appeal challenging a payment determination pursuant to Regulations .28 and .30E of this chapter unless a final adjudication is issued sustaining the nursing facility's appeal;

V. A percentage of the legal, accounting, and other professional expenses related to an appeal as described in §U of this regulation, based upon the proportion of additional reimbursement denied to the total additional reimbursement sought on appeal, if a facility prevails on some but not all issues raised in the appeal or action;

W. Any charges assessed by the Department for recovery of overpayments; and

X. Direct service costs for physical, occupational, and speech therapy.

Md. Code Regs. 10.09.10.17-1

Regulations .17-1 adopted effective 42:7 Md. R. 567, eff.4/13/2015; amended effective 45:13 Md. R. 664, eff. 7/2/2018