Chapter 514 - Nursing Facility Services - DHHR - State of West ...

“Reasonable” means that the compensation must be comparable for the same servicesprovided by facilities in the bed group. The method used to calculate “reasonable” will be asfollows: The (90 th) ninetieth percentile of the hourly wage of the employee classification for eachbed group. No owners, operators and relatives will be included in the calculation. If the servicesare provided less than full time, the compensation must reflect this fact. Full time is consideredapproximately 1,040 hours per cost report period worked in resident related duties and includesdocumented vacation and sick time.Compensation must include the total benefits paid for the services rendered, i.e., fees, salaries,wages, payroll taxes, fringe benefits and other increments paid to or for the benefit of thoseproviding the services.If bonuses are a part of an employee’s compensation a clearly established non-discriminatorybonus plan (covering owners and related parties of owners) must be set in writing to employeesbefore the cost reporting period begins. Otherwise the bonus or bonus plan will not beconsidered allowable. The amount of the bonus must be accrued to the period earned.514.13.25 AdministratorsNo owners, operators or relatives will be included in the calculation. Full time is considered atleast 1,040 documented hours which include vacation and sick time, per cost reporting periodfor resident related duties. If the services are provided less than full time, the compensationmust reflect this fact. The administrator cannot act as director of nursing.The facility must be able to document, upon request for desk review or audit, that thecompensation for the non-administrator position does not exceed the market rate for thoseservices.514.13.26 OwnersAdministrators-Owners will be compensated for administrative duties performed. Where thecosts of administrative services are allowed, additional services performed by the administratorwho is also an owner are considered rendered primarily to protect their investment and are notallowed.Owners that do not serve as administrators will be compensated for duties performed, excludingservices rendered primarily to protect their investment. To be included on the cost report, thefacility must be able to document that the services provided by the owner are not duplicated byother positions.Compensation is not allowed for owners, operators or their relatives who claim to provide someadministrative or other function required to operate the facility, but who do not actually providesaid service. Where functions claimed to be provided by owners, operators or their relatives aremerely a duplication of services already provided by other employees or are functions whichshould reasonably be expected to be performed by other employees, such services are notDepartment of Health and Human Resources Chapter 514: Nursing Facility Services Page 63January 1, 2013DISCLAIMER: This manual does not address all the complexities of Medicaid policies and procedures,and must be supplemented with all State and Federal Laws and Regulations.