Section 1181.242. Nursing staff allowance

(a) Except for special rehabilitation facilities, the allowable costs recognized for Medical Assistance may not exceed 3 nursing hours per patient per day for skilled nursing care and 2.6 nursing hours per patient per day for intermediate care.

(b) For special rehabilitation facilities, the allowable costs recognized for Medical Assistance may not exceed 3.75 nursing hours per patient per day for skilled nursing care and 3.2 nursing hours per patient per day for intermediate care.

(c) Allowable nursing hours are calculated in accordance with the instructions of the Department’s preprinted cost report.

The provisions of this § 1181.242 adopted August 5, 1983, effective July 1, 1983, 13 Pa.B. 2402; amended September 5, 1986, effective July 1, 1985, 16 Pa.B. 3294. Immediately preceding text appears at serial page (99421).

Notation

Authority

The provisions of this § 1181.242 amended under section 443.1(2) and (3) of the Public Welfare Code (62 P. S. § 443.1(2) and (3)).

Notes of Decisions

Allowable Costs

Department of Public Welfare’s regulations capping the amount of reimbursement to Medical Assistance providers for nursing care excludes salaries of unit managers and director of infection control program; even though the managers and director had nursing degrees, they did not provide direct patient care and therefore their salaries did not constitute ‘‘nursing costs.’’ St. Ignatius v. Department of Public Welfare, 918 A.2d 838, 845-846 (Pa. Cmwlth. 2007)

Nursing home’s purchase of bereavement flowers for nursing facility employees was not an expense that was related to the proper care of nursing home facility residents; therefore, Department of Public Welfare properly excluded the expense from facility’s medical assistance reimbursement. St. Ignatius v. Department of Public Welfare, 918 A.2d 838, 846-847 (Pa. Cmwlth. 2007)

Cross References

This section cited in 55 Pa. Code § 1181.2 (relating to definitions).