Attachment D - Line Item Detail Budget Outwood ICF.xls.xlsx

This is a Line Item Detail Budget document for Outwood Intermediate Care Facility (ICF) for the fiscal year ending June 30, 2022. The budget template provides a comprehensive breakdown of anticipated expenses across all operational categories, structured on a monthly basis from July 2021 through June 2022. The document is designed to capture personnel costs including salaries and wages by position and full-time equivalency, fringe benefits such as health insurance, life insurance, 401(k) contributions, and FICA taxes, as well as other personnel-related costs including unemployment taxes, workers' compensation, and professional licensure and continuing education fees. Additionally, the budget structure includes line items for personal service contracts and operating expenses spanning utilities, rentals, maintenance and repairs, telecommunications, supplies across multiple categories (drugs/clinical, office/janitorial, food, and miscellaneous items), furniture and equipment, travel and training, and care and support services.

The document includes sections for indirect costs and management fees to be applied against total expenses. However, all line items in the submitted budget show zero dollar amounts across all twelve months, indicating that this is a blank template or placeholder document rather than a completed budget submission with actual allocated funds. The form requires completion by the vendor with their name, address, telephone number, and authorization signature from an authorized representative, suggesting this serves as the official budget submission format for the Outwood ICF contract. The absence of populated figures prevents determination of the total contract value, specific funding sources, or detailed expense allocations for the fiscal year.