Online Nursing Facility Wage Survey Data Entry Form
Calendar Year 2016
The five categories of salary data requested in the wage survey are mutually exclusive.
If a nurse spends hours working in a non-nursing function, (e.g. in dietary), report the
related costs, hours worked and paid leave hours as non-nursing data (Part IV).
All salary costs related to nursing home services should be reported. Report
salaries, benefits cost, hours and paid leave hours for all nursing staff,
including direct care and nursing administration, (e.g. Directors of Nursing,
Assistant Directors of Nursing, nursing unit supervisors, patient care coordinators,
Minimum Data Set coordinators, and quality assurance nurses). Reference Schedule
A-4 or Schedule B-5, Part 1 and Schedule N of the PIRS 1090 Series cost reporting
forms as a basis for nurse salaries, benefits cost, hours and paid leave hour
allocations. Although not separately identified on the PIRS 1090 forms, quality
assurance nurses and home office quality assurance coordinator salaries, benefits
cost, hours and paid leave are included in direct care cost and should be reported
in this survey in Parts I through III, Nursing Data. No other home office staff
should be included. In cases where the facility administrator is a nurse, report the
associated salaries, benefits cost, hours and paid leave in Part IV, Non-Nursing Data.
Reference Schedule A-3 or B-5, Part 1 of the PIRS 1090 for non-nursing allocations.
Reference Schedule C of the PIRS 1090 cost reporting forms as a basis for Therapist
data (Part V of this survey).
Employee salary and hours data should be accrued and reported for the stated time
period of the survey in a manner similar to the cost report. If pay periods do not
begin and end with calendar months, it may be necessary to adjust salaries and hours
of the beginning and/or ending pay period, in order to reflect the number of calendar
days in the survey period. For example, if pay periods begin on the 5th day of the
month and end on the 25th day of the month, it will be necessary to adjust amounts to
include hours and salaries from January 1 through 4 and for December 26 through 31.
Do not include salaries or hours from any time period other than the specified survey
time period (calendar year 2016).
For purposes of this survey the following terms are defined below:
Any compensation paid/accrued to the employee, including bonuses and paid leave
Total hours providing patient related care or supervision, or performing other duties necessary to the operation of a nursing home
PAID LEAVE HOURS
Non-work hours including sick, vacation and holiday
EMPLOYEE BENEFITS COST
Costs incurred for employee health insurance, FICA, unemployment insurance, workers' compensation insurance, group life, pension plan, and other benefits costs incurred
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Cover Letter including submission instructions
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