1. (1) A nursing home may use the low-wage worker add-on only for in-house staff and not for allocated, home office, or purchased service increases. A nursing home may use the add-on to:

   1. (a) Increase wages, benefits, or staffing levels for certified nurse aides;

   2. (b) Increase wages or benefits but not staffing levels for dietary aides, housekeepers, laundry aides, or any other category of worker whose statewide average dollars-per-hour wage was less than fifteen dollars in calendar year 2008, according to cost report data, including:

      1. (i) Activities directors and assistants;
      2. (ii) Patient choices coordinators;
      3. (iii) Central supply/ward clerks;
      4. (iv) Expanded community service workers; and
      5. (v) Social workers; and
   3. (c) Address wage compression for related job classes immediately affected by wage increases to low-wage workers.

2. (2) A nursing home that receives a low-wage add-on must report to the department its expenditure of that add-on by:

   1. (a) Completing cost report schedule L 1; and
   2. (b) Returning it to the department by January 31st.
3. (3) By examining cost report schedule L 1, the department will determine whether the nursing home complied with the statutory requirements for distribution of the low wage add-on. When the department is unable to determine or unsure that the statutory requirements have been met, it will conduct an on-site audit.
4. (4) When the department determines that the statutory requirements have been met, the low wage add-on will be reconciled at the same time as the regular settlement process but as a separate reconciliation. The reconciliation process will compare gross dollars received in the add-on to gross dollars spent.
5. (5) When the department determines that the low wage add-on has not been spent in compliance with the statutory requirements, then it will recoup the noncomplying amount as an overpayment.
6. (6) The department also will require the completing of cost report schedule L 1 for any calendar year in which the low wage add-on is paid for six months or more. Subsections (1) through (5) of this section will apply to all completions of cost report schedule L 1 irrespective of the calendar year in which it is paid.

[Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-758, filed 10/24/17, effective 11/24/17. Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-758, filed 2/14/11, effective 2/26/11. Statutory Authority: 2008 c 329 § 206(9). WSR 09-08-081, § 388-96-758, filed 3/30/09, effective 4/30/09.]