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HOSPITAL COST REPORT MODERNIZATION
April 15, 2015
Introductions & Meeting Format
Updates on the Project
Walkthrough:
1. Cost Report
2. Instructions
3. Data Dictionary
4. Submission File/ XML Schema
Next Steps
Agenda
2
• Received and reviewed comments/suggestions
• Reached out for clarification
• Incorporated most, if not all, comments
• Finalized our Draft Cost Report and Instructions
• Worked with CHIA IT on the Data Dictionary and Submission Requirements
Updates
3
• Same cost finding methods
• Same cost (and revenue) centers
• Same reporting timeframe – 150 Days after FYE
• Initial Filing would be on March 1, 2016 for 6/30 & 9/30 FYE
Leverage the CMS-2552-10
4
Differences from CMS-2552-10
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• “Full Cost” cost report for analytic purposes
• Retained cost centers for Medical & Surgical, Pediatric, Obstetric
• Retained and simplified 403 Schedules deemed necessary
• Supplemental Information
• Payer Revenue
• Allocation to derive IP and OP costs
• 340B pharmacy
Cost Report Basics
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• Tabs 1-20 • Same cost center line/column numbers
whenever possible• Line 300 series are Subtotals• Line 500 series are Totals• Color coded the template • Other Reimbursable and Special Purpose Cost
Centers were grouped with Outpatient
Tab 1: Identification and Index• New – ECR CMS Submission Number / Preparation Date
Tab 2: Summary Schedule of Revenue and Expense• Same layout as 403• Deleted the FTEs by cost center
Tab 3: Patient Service Statistical Data• Same layout as 403• Deleted admissions and transfers in/out
Tab 4: Supplementary Information• Similar to 403• New – Reporting for physician assistant and nurse practitioner• New – Malpractice Insurance • New – Free Standing CHC• Simplified Supplementary Revenue
Cost Report
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Tab 5: Statistical Data and Revenue by Payer•Similar to 403•Payer categories are the same •New – Report GPSR and NPSR only •Deleted – Lines for Deductions and Bad Debt W/Os
Tab 6: Gross Patient Service Revenue•Collects revenue in the same manner as 403•Include hospital based physicians revenue •Updated to 2552 cost centers
Cost Report
8
Tab 9: Direct Expense• Same layout as 403
Tab 7: Reclassifications• Hospitals can edit to bring costs up to full costs• Reclassifications affecting Line 30 Adults and Pediatrics needs to be edited
Tab 8: Adjustments • Hospitals can edit to bring costs up to full costs
• Eliminate adjustments for RCE and removing physicians• Adjustments affecting Line 30 Adults and Pediatrics needs to be edited
Cost Report
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Tab 10: Reconciliation to Audited Financial Statements• Same layout as 403
Tab 11: Financials Statements • Non-Acute hospitals only• Same reporting format as Acute Hospitals
Cost Report
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Tab 13: Statistics for General Cost Step-down• Similar to 403 and same as 2552• Statistics affecting Line 30 Adults and Pediatrics needs to be edited
Tab 14: Expenses after General Service Costs Stepdown INCLUDING Capital
• Same layout as 403
Tab 15: Expenses after General Service Costs Stepdown EXCLUDING Capital
• Same layout as 403
Cost Report
11
Tab 16: Statistic using GPSR for Ancillary Service Costs Allocation• New - Uses GPSR as the statistic for allocation• No entry on line for Observation Beds Cost /Non Distinct Unit
Tab 17: Allocation of Ancillary Expenses to IP & OP Routine Cost Centers INCLUDING CAPITAL
• Same layout as 403
Tab 18: Allocation of Ancillary Expenses to IP & OP Routine Cost Centers EXCLUDING CAPITAL
• Same layout as 403
Tab 12: Allocation of Observation Beds Cost to a Non Distinct Units• Same manner as 403• New – Report only observation bed day equivalents
Cost Report
12
Tab 19: Pharmacy Schedule • Hospitals with a 340B Pharmacy only• Same layout as 403
Tab 20: Provider Based Physician Adjustment• Same layout as 2552• Will substitute for the 403’s Schedule XXV
Cost Report
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• Explains the identity of each cell that in the Cost Report• Each column displays the attributes of each cell• Cell Identifier – Unique code for each cell• Tab# – Which Tab the cell can be found
Data Dictionary
14
Cell IdentifierTab# Line#/Vertical
Column#/Horizontal Cross reference Name SubScript? Input Type Length Usage Description
01.00.001.00.001 1 1 1Hospital N Hospital Text 64 XEnter Hospital Name
01.00.002.00.001 1 2 1Reporting Year N Hospital Numeric 4 9Enter the reporting year that is being documented
01.00.003.00.001 1 3 1Address N Hospital Text 64 XEnter the Hospital's Address
01.00.004.00.001 1 4 1Filer Name N Hospital Text 35 XEnter the name of the person responsible for filing
• Line# – The Line number that the cell can be found
• Column# – The Column number that the cell can be found
• Cross Reference Name – Identifies the Line Name and the Column Name for each field listed
• Subscript? – Determines if the entire Line can be subscripted with the Tab
Data Dictionary
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Input: •“Hospital” – Hospital data required•“Calculated” – Calculated value•“Linked” – Value will match another field found within this Cost Report •“CMS” – Value will match a field in the CMS 2552-10 Cost Report •If Blank, data is not required
Data Dictionary
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Type:•“Numeric” – Value is a Number•“Text” – Value is an Alpha-Numeric•Blank – Value not required
Data Dictionary
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• Length – Max length for value
• Usage – Follows CMS defined format
• Description – Any additional information to find value for cell, such as formulas or location of linked value
Data Dictionary
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• XML submitted through INET • One file per hospital
Submission File
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Submission File – Basic Example
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Submission File – Modifiers
Tag Use
<RowName></RowName> Alters or adds name to row or sub row.
<HCRIS></HCRIS> Add HCRIS to given row.
<ColumnName></ColumnName> Alters or adds column name.
<SubColumnName Name =""></SubColumnName> Only used on Tab 13 to add allocation method text.
<SubColumn></SubColumn> Indicates the following tags are part of a sub column connected to parent.
<SubRow></SubRow> Indicates the following tags are part of a sub row connected to parent.
Submission File – Example with Modifiers
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Breakdown by Data Entry
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DATA Hospital input 2,627
DATA Transferred from CMS-2552-10 Report 2,712
DATA Calculations 7,819
DATA Cells Linked within the Report 2,384
DATA No Action Required Cells 1,485
DATA Total Data Cells 17,027
15%15%
Next Steps
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If you have questions or comments, please respond by April 29th to [email protected]
CHIA will review all comments received and communicate decisions.
CHIA IT will communicate the plan for submitting test files.
Updates will be on our Hospital TAG webpage.
Contacts:[email protected] (617) [email protected] (617) 701-8109
