Section 7-4 - General Provisions (a) Cost terms and hierarchy. This rule includes the following cost terms, even though such cost may not be reimbursable because of other provisions of this rule, in the following hierarchy: - (i) General ledger cost. A cost properly recorded on a nursing facility's general ledger in accordance with GAAP. This includes cost incurred at an individual nursing facility as well as central office or pooled cost reasonably allocated to an individual nursing facility;
- (ii) Reported cost. General ledger cost properly reported on the cost report. It is composed of allowable cost and non-allowable cost;
- (iii) Non-allowable cost. Cost which is not reasonably related to covered services; and
- (iv) Allowable cost, as defined in Chapter 1 of the Wyoming Medicaid Rules, Definitions.
(b) General methodology. - (i) Costs related to direct patient care are more likely to benefit quality of patient care than indirect costs.
- (ii) Costs incurred in the actual delivery of patient care are more likely to contribute to the quality of care offered by a nursing facility than costs incurred at a distance from the delivery of services.
- (iii) To be allowable, costs shall be reasonable, ordinary, necessary and related to patient care. Providers shall incur costs to ensure that economical and efficient delivery of quality health.
- (iv) Except as otherwise specified in this Chapter, the Department shall determine per diem rates using the methodology set forth in the Medicare Provider Reimbursement Manual ("PRM") and CMS instructions for administering the PRM. The PRM and the CMS instructions are published by CMS, are incorporated by reference, and are available from that agency.