(a)

1. (1) This section sets forth policy for direct reimbursement for allowable nursing assistant training costs incurred by Medicaid-certified nursing facilities.
2. (2) Allowable training costs will be separately tracked, documented, and submitted monthly as described herein.
3. (3) All reimbursements shall be made directly to the Medicaid-certified nursing facility.

(b)

1. (1) Based on federal regulations, nursing assistants who are employed by, or who have a letter of intent to be employed by, a Medicaid-certified nursing facility may not be charged for any portion of the program, including any fees for textbooks or other required course material.
2. (2) The Department of Human Services shall be responsible to pay for the training costs one (1) time for individuals who are employed by or have a letter of intent to be employed by a Medicaid-certified nursing facility as set forth in this section.

(c) The criteria required for reimbursements under the letter of intent arrangement must meet the following:

1. (1) The facility must have on file a job application completed and signed by the individual receiving the letter of intent;
2. (2) The facility must complete a criminal record check on the individual in accordance with Arkansas Code § 20-38-101 et seq.; and
3. (3) The facility must retain copies of documents to verify compliance with these provisions as specified in 20 CAR § 403-905.

(d)

1. (1) Allowable costs for nursing assistant training reimbursement may include the costs:

   1. (A) For operation of an approved nursing assistant training program;
   2. (B) Associated with a cooperative training effort with a neighboring approved training program, not claimed by that program; and
   3. (C) Of having nursing assistants trained in an approved nonfacility-based training program, paid by the facility.
2. (2) Nursing assistant salaries and fringe benefits, including amounts paid while in training, and in-service or continuing education costs are not directly reimbursable but are included on the facility's annual cost report and reimbursed through the per diem rates.

(e)

1. (1) Reimbursement of nursing facility costs for training of nursing assistants must be allocated between Medicaid, Medicare, and private pay patients.
2. (2) Medicaid may not be charged for that portion of these costs that are properly charged to Medicare or private pay activities.
3. (3) Therefore, the department will pay only the percentage of the total billed or maximum limit (see 20 CAR § 403-904) for nursing assistant training based on the percentage of Medicaid recipients indicated on the billing.
4. (4) Facilities should continue to bill for the total amount of expenses incurred.
5. (5) The recipient information should reflect the midnight census for the last day of the month.