§ 1187.55. Selected resident care and other resident related cost policies.
Policies for selected resident care and other resident related costs are as follows:
(1) Drug services.
(i) The costs of nonlegend drugs, such as laxatives, aspirin and antacids that are provided directly by a nursing facility from its own supply are allowable costs if the drugs are medically necessary and administered according to a physician’s written order or prescription.
(ii) Costs of legend drugs are not allowable costs.
(iii) Costs related to a pharmacy consultant shall be reported as general administrative costs on the cost report.
(2) Practitioner and therapy services.
(i) Costs for practitioner and therapy services which are provided on a contract or salary basis by the nursing facility are allowable costs.
(ii) The direct and indirect costs associated with noncompensable cost centers, such as a pharmacy or space rented or used by an independent practitioner, are not allowable costs.
(3) Volunteer and donated services of individuals.
(i) The actual costs that a nursing facility incurs when the nursing facility regularly uses the services of volunteer or religious organizations in positions that are normally held by full-time employes who provide resident care or assist with the operation of the nursing facility are allowable costs. The following conditions and limitations apply:
(A) The costs shall be limited to the fair market value of customary compensation of full-time personnel who perform similar services.
(B) The costs shall be based on regular working hours, excluding overtime.
(C) The actual costs for these services shall be supported by substantiating documentation.
(D) The costs will be reimbursed as part of the net operating costs.
(ii) The Department will recognize costs as allowable for nonpaid workers only if the following conditions are met:
(A) The nonpaid workers shall be members of an organization of nonpaid workers.
(B) Membership of a nonpaid worker in the organization shall be substantiated by adequate documentation in the files of the organization of nonpaid workers.
(C) A legally enforceable agreement between the nursing facility and the organization of nonpaid workers shall exist and establish the nursing facility’s obligation to remunerate the organization for services rendered. If the nursing facility’s legal obligation to pay the organization of nonpaid workers is nullified by an offsetting legal obligation by the organization of nonpaid workers to pay or make a contribution to the nursing facility of all or part of the salary liability, the amount paid or contributed by the organization of nonpaid workers is not an allowable cost.
(iii) A payment made by the organization of nonpaid workers to the nursing facility for the nonpaid workers’ maintenance, perquisites or fringe benefits shall be used as an offset to the total of the cost actually incurred by the nursing facility.
(iv) Staff services relating to the use of volunteer workers are allowable costs.
(4) Pastoral services.
(i) Salary costs for pastoral services rendered directly to residents by professional staff employed by, or under contract with, the nursing facility are allowable costs.
(ii) Costs for a chaplaincy training program and pastoral housing are not allowable costs.
Cross References This section cited in 55 Pa. Code § 1187.55a (relating to clarification of the term ‘‘written’’—statement of policy); and 55 Pa. Code § 1187.59 (relating to nonallowable costs).
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