1. Hospital cost report modernization
April 15, 2015

2. Agenda Introductions & Meeting Format Updates on the Project
Walkthrough:
Cost Report
Instructions
Data Dictionary
Submission File/ XML Schema
Next Steps

3. Updates 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

4. Leverage the CMS-2552-10 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

5. Differences from CMS-2552-10
“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

6. Cost Report Basics 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

7. Cost Report 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
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

8. Cost Report 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

9. Cost Report 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
Eliminate adjustments for RCE and removing physicians
Adjustments affecting Line 30 Adults and Pediatrics needs to be edited

10. Cost Report 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

11. Cost Report 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

12. Cost Report
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
Tab 12: Allocation of Observation Beds Cost to a Non Distinct Units
Same manner as 403
New – Report only observation bed day equivalents

13. Cost Report 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

14. Data Dictionary
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
Cell Identifier
Tab#
Line#/Vertical
Column#/Horizontal
Cross reference Name
SubScript?
Input
Type
Length
Usage
Description 1
Hospital N
Text 64 X
Enter Hospital Name 2
Reporting Year
Numeric 4 9
Enter the reporting year that is being documented 3
Address
Enter the Hospital's Address
Filer Name 35
Enter the name of the person responsible for filing

15. Data Dictionary 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

16. Data Dictionary 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 Cost Report
If Blank, data is not required

17. Data Dictionary Type: “Numeric” – Value is a Number
“Text” – Value is an Alpha-Numeric
Blank – Value not required

18. Data Dictionary 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

19. Submission File
XML submitted through INET
One file per hospital

20. Submission File – Basic Example

21. 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.

22. Submission File – Example with Modifiers

23. Breakdown by Data Entry
Hospital input
2,627
Transferred from CMS Report
2,712
Calculations
7,819
Cells Linked within the Report
2,384
No Action Required Cells
1,485
Total Data Cells
17,027
15%

24. Next Steps
If you have questions or comments, please respond by April 29th to
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:
(617)
(617)