SA Expenses for Training of SA Personnel

4542.2 - SA Expenses for Training of SA Personnel (Rev. 126, Issued: 11-21-14, Effective: 11-21-14, Implementation: 11-21-14) The cost of training personnel engaged in title XVIII and title XIX survey activities is chargeable to the State survey program when the training is related to the State’s responsibilities for survey and certification activities. Training includes attendance at job-related meetings, conferences, seminars, workshops, or training courses. Training which is considered related to the SA’s responsibilities includes attendance at meetings, courses, etc., where the subject matter concerns one or more areas in the certification requirements related to appraising the activities of a health facility. This may include areas such as medical records, dietary services, infection control, etc. Other training considered related to the SA’s responsibilities includes attendance at professional meetings that enable individuals in the various health disciplines who are engaged in titles XVIII and XIX to stay abreast of pertinent developments affecting the inspection and approval of health facilities. Examples of professional meetings at which attendance could possibly be funded, subject to the considerations outlined here and in succeeding paragraphs, are the annual meetings of the Association of Health Facility Survey Agencies (AHFSA), American Hospital Association, American Public Health Association, American Dietetic Association, and similar national or regional organizations. 4542.2A - Funding (Rev. 1, 05-21-04) The CMS will fund the entire cost of such approved training of full-time employees and generally will pay a proportionate share for the training of part-time employees, e.g., 50 percent for employees who work one-half time on State survey activity. The State should include the cost of travel relating to training in the dollar figure requested for training. However, with specific justification, where the training meeting or course is primarily concerned with subject matter that directly relates to the SA’s responsibilities in carrying out survey and certification activities, CMS will fund the entire cost of training of part- time employees. All funding for training is subject to the following considerations: • Out-of-State attendance must be in accord with established State rules and regulations (NOTE: When Federal requirements mandate that the training is necessary, a State’s travel policy for out-of-State travel is not an excuse for non- participation in the Federal training); • Federal funds may not be used for attendance at any meetings, if the attendee is paid by the sponsoring organization for attending, for speaking, or for rendering other services in connection with the meeting; and • Attendance will not significantly impair progress of certification activities. 4542.2B - Requesting Approval (Rev. 1, 05-21-04) Request funds for conferences and short-term training activity in the annual budget submittal. Activity of this nature that has not been provided for in the approved budget must be approved by the RO on a case-by-case basis. At a State’s request, CMS will include a dollar authorization for short-term training activity over and above the cost of attendance at CMS-sponsored meetings within the funds approved for each fiscal year. This authorization covers travel, per diem, admission fees, and any other costs related to attendance at the meetings. Justification for the request, other than the relationship to professional staff-years, is not required provided that the total amount requested does not exceed the approved budget. (If the agency believes it necessary to exceed the allotment, see Subsection C below.) Up to the limit of funds approved in response to such a request, the SA can make expenditures for short-term training activities without consulting the RO for specific authorization provided that all of the following conditions are met: • No single meeting will be attended more than five working days; • The proposed attendees are professional State employees who regularly perform State survey functions; • The training is related to SA responsibilities as defined at the beginning of §4542.2; and • A State can not charge a higher percentage of the cost of attendance by part-time employees than the percentage of time they devote to the State survey program, as indicated by the percentage of the employee’s salary reported on the State Survey Agency Budget/Expenditure Report (Form CMS-435) for the most recent complete calendar quarter. If the employee came on duty during that quarter or later, the SA charges the percentage applicable to the employee in the budget approval. The SA ensures that there is adequate documentation of every expenditure following State practice, for subsequent audit. Where one or more of the preceding conditions are not met with respect to any particular meeting, the SA furnishes detailed justification as explained in Subsection C below. Authorization of funds for short-term training is in addition to the cost of attending any meetings called by CMS. The SA should consult the RO for budget information about proposed CMS meetings as part of the process of preparing the budget submittal. 4542.2C - Justification for Attendance (Rev. 1, 05-21-04) Where it is necessary to furnish detailed justification to the RO for attendance at short- term meetings, either in the original budget or later in the fiscal year, e.g., the criteria in Subsection B, Above, will not be met, or the allotment has been exhausted, the SA provides the following information: • Name and position title of each person proposed for attendance; • A list of previous out-of-State training meetings attended by each proposed attendee during the current fiscal year (other than CMS-sponsored meetings) which were charged to Federal funds; • Whether each proposed attendee is full-time or part-time. If part-time, the SA provides the percentage of time charged to State survey activities on the most recent Quarterly Expenditure Report (or for a new employee, the percentage approved in the budget) and the percentage of costs the SA proposes to charge to the State survey program. If the latter percentage is higher, the SA includes justification explaining how the meeting or course directly relates to the employee’s State survey activities or, where appropriate, showing how the percentage of the employee’s time reflected in the most recent Quarterly Expenditure Report is not indicative of the time the employee regularly devotes to the program; • An itemized listing of proposed expenditures for attendance, including travel, per diem, and admission fees; and • Name, location, and dates of the meeting, the subject matter on the agenda and the name and address of the sponsoring organization. Where the description of the subject matter does not clearly establish that the subject matter relates to SA responsibilities, it includes an explanation of how the subject matter relates to the survey and certification process. 4542.2D - Fiscal and Reporting Considerations (Rev. 1, 05-21-04) This pertains to the amount requested for travel costs of such activity. The total amount approved and expended is shown on line 11 of Form CMS-435. The amounts reported as expended need not be broken down by specific meetings or conferences. However, the SA keeps detailed records of all expenditures for regular audit purposes. 4542.2E - Educational and Training Leave (Rev. 1, 05-21-04) Educational leave is leave granted for specialized professional or technical study in an accredited educational institution. Training leave is leave granted to an employee for attendance at short-term courses that will run longer than five working days, outside the agency. Approval of educational or training leave can only be granted if it is for purposes related to carrying out SA survey responsibilities. Additionally, State rules and regulations and practice must permit taking of leave for such purposes. Approval of training or educational leave is claimed in advance from the RO. Such proposals are considered individually, based on the specific circumstances involved. Requests are to include the following: • Employee’s name, type of appointment held, position and grade, length of service with the SA, previous experience and education; • Description of any other specialized training or courses taken by the employee within the previous 24 months; • Name and location of training institution; • Title and description of training in sufficient detail to demonstrate its scope, content, and how it relates to the SA’s survey and certification responsibilities; • A statement indicating how this training will benefit the employee’s work and improve the agency’s activity; • The training period, showing the number of days and hours the employee will be absent from duty; • A statement from the supervisor dealing with the ability of the unit to forego the services of the trainee during his/her absence; and • The cost of tuition, fees, books, in detail. 4542.2F - Agreements by Employees to Continue on Job (Rev. 1, 05-21-04) In order to discourage resignation of an employee for whom there has been a considerable expenditure for formal training, some States require the employee to sign an agreement that he/she will remain on the job for a certain length of time (e.g., 6 months) after completion of the training. If State regulation or practice provides for such agreements, after obtaining RO approval for the activity, the SA has the selected employee sign such an agreement.