payment rate system used during initial global budget negotiations for each institutional provider, the Secretary shall take into account the appropriate prospective payment system from the most recent year under title XVIII of the Social Security Act to determine what operating base payment the institutional provider would have been paid for items and services covered under the Medicare for All Program furnished the preceding year with applicable adjustments, including adjustments due to any public health emergencies in the preceding year, and excluding value-based payment adjustments, based on such prospective payment system. (d) Operating expenses For purposes of this title, operating expenses of a provider include the following: (1) The cost of all items and services associated with the provision of inpatient care and outpatient care, including the following: (A) Wages and salary costs for physicians, nurses, and other health care practitioners employed by an institutional provider, including mandatory minimum safe registered nurse-to-patient staffing ratios and optimal staffing levels for physicians and other health care workers. (B) Wages and salary costs for all ancillary staff and services. (C) Costs of all pharmaceutical products administered by health care clinicians at the institutional provider’s facilities or through items or services provided in accordance with State licensing laws or regulations under which the institutional provider operates. (D) Costs for infectious disease response preparedness, including maintenance of a 1-year or 365-day stockpile of personal protective equipment, occupational testing and surveillance, medical items and services for occupational infectious disease exposure, and contact tracing. (E) Purchasing and maintenance of medical devices, supplies, and other health care technologies, including diagnostic testing equipment. (F) Costs of all incidental items and services necessary for safe patient care and handling. (G) Costs of patient care, education, and prevention