Attachment C - FY 22 Budget Summary Proposal for Outwood ICF.docx

This is a Budget Summary Proposal for Outwood Intermediate Care Facility/Intermediate Intermediate Dependency (ICF/IID), a twelve-month contract period ending June 30, 2022. The facility operates with a licensed bed capacity of 40 beds and covers the period from July 1, 2021, through June 30, 2022. The budget proposal outlines comprehensive operational and personnel costs required to maintain the facility's operations and care services during this contract term.

The budget structure is organized into two primary categories: Personnel costs (including salaries and wages, fringe benefits, other personnel costs, and personal service contracts) and Operating costs (encompassing utilities, rentals, maintenance and repairs, postage, miscellaneous services, telecommunications, supplies across multiple categories including drugs and clinical supplies, office and janitorial supplies, food, furniture and equipment, and care and support services). The proposal includes line items for total facility budget cost, capital equipment purchases exceeding $5,000, a management fee, and a grand total. The document requires completion by an authorized representative's signature and date, establishing accountability for the proposed budget submission.