adhc cost report training

1. ADHC Cost Report Training 1 ADHC Cost Report Training Goals of the Training Mechanics of the new ADHC Cost Report Meet and Greet Put you at ease Questions and FAQ’s Handouts Completed Cost Report Example (DHCS 9089) Websites for Statutes, Regulations, & Medicare Reimbursement Principles (CMS Pub 15-1 / CMS Pub 15-2) 25% Retention – i.e. use the e-mail address Repeat Repeat Repeat

2. ADHC Cost Report Training 2

3. ADHC Cost Report Training 3 Upfront Hints/Suggestions Create a binder – keep reminder notes on where cost report data was obtained. copy the C/R and behind each Section, place copies of supporting documentation, hints, and directions on where numbers came from and what documents were used to complete. General Ledger / Accounting System Use OSHPD’s website as a guide to developing your own G/L and account system. A uniform Chart of Accounts is not required...DHCS A&I simply recommends www.oshpd.ca.gov/HID/Products/ltc/manual/Chpt0000.pdf General Ledger vs. Check Register Wikepedia Definition of a General Ledger

4. ADHC Cost Report Training 4

5. ADHC Cost Report Training 5 Cover Page Legal Name is noted on the ADHC Center’s License NPI – National Provider Identification May 2008 – must comply with NPI implementation specifications (check DHCS website for details) Register NPI with Provider Enrollment Division of DHCS Medi-Cal Provider Number – ADU******* Reporting Period – Fiscal Year or Fiscal Period

6. ADHC Cost Report Training 6 General Information and Certification Item #4: Service Address...where the ADHC Center is actually located...not mailing address Item #6 – County...one of the 58 in CA (drop down menu) Item #7: Zip Code – must be the nine-digit zip code number that is used for billing purposes Items #10-12: Report Contact Person – name, telephone number, and e-mail Item #19: Authorized Signature – Administrator, Program Director, Chief Financial Officer, etc. Person certifying that information is true and correct Sign under “penalty of perjury”

7. ADHC Cost Report Training 7 Sections: A – Services Available B – Licensee Description C – ADHC Center Census Section A - Services Available Drop-down menus Separately Billable Services – August 2010 Non-ADHC / Enhanced Program Services Section B – Licensee Description Section C - ADHC Center Census Participant Days (Line 4)– report all days (Assessment, Transition, Non-paid/Visitor) Use Monthly Statistical Summary Reports...revenue is not the preferred method Initial Assessment Days (Line 5) – report Initial Assessment Days, even though they are already included in the line above

8. ADHC Cost Report Training 8 Section D - Separately Billable Utilization Unit of Service – use the CAADS Guidance Paper at www.caads.org . DHCS to update Provider Manual soon Time Studies if no data is available (CMS Pub 15-1, Section 2312.2(E)) Start keeping data now...for the future Section E- Statement of Related Organizations Chain organization – two or more healthcare related entities CMS Pub 15-1, Section 2150 and 2153 / CMS Pub 15-2, Section 3903 Shared Services – not related, just share a service Section F Owner’s Compensation For-Profit Only

9. ADHC Cost Report Training 9 Section G – Revenue Information / Funding Sources Gross Revenue vs. Net Revenue Importance of Booking Revenue Deductions, Allowances, Scholarships, Sliding Fee Discriminatory Billing (CCR, Title 22, Section 51480) Medi-Cal vs. Third Party Payers vs. Private Pay Grants Government Grants (CMS Pub 15-1, Section 612) Other Grants

10. ADHC Cost Report Training 10 Section H: Cols 1 thru 6Summary of Costs C/R Line vs. Line No. Cost Center Description Working Trial Balance / General Ledger Cost Report Groupings Cost Report Grouping Example Patterned Areas vs. Shaded Areas The Four Basic Cost Groups Administrative & General (Overhead) Core Services Separately Billable Services Non-ADHC / Enhanced Program Services Columns 1 thru 6 Salaries, Benefits, Contract Staff, Other

11. ADHC Cost Report Training 11 Things to keep in mind while completing Section H, Cols. 1-6 Imputed costs of in-kind services Donated services are not allowable as an expense to the ADHC Center. Do not impute or estimate a cost associated with the donated service (CCR, Title 17, Section 57436 – Costs not to be reported) In a limited number of instances, wages can be imputed or estimated and included as an expense for nonpaid workers (42 CFR, Section 413.94 and CMS Pub 15-1, Section 700) Reasonable / Prudent Buyer Concept Booked in the ADHC Center’s General Ledger Discounted Services (building / transportation) Allowable Costs recognized under Medicare Reimbursement Principles

12. ADHC Cost Report Training 12 Section H: Col 7 - Reclasses Complete Sections I and J-1 prior to completing this column Reclass: a C/R entry that transfers costs from one cost center to another Medi-Cal reporting purposes Cost related to Separately Billable Services (calculated in Section I) Show the reclassification amounts on Section J-1 Section H, Column 7 must be manually input and must reconcile to Section J-1 BOTTOM LINE TOTAL MUST EQUAL ZERO!

13. ADHC Cost Report Training 13 Separately Billable Services Core Services vs Separately Billable Services Unbundling of Services in August 2010 (2011, or 2012) Six services that will be separately billable per SB 1755 Occupational Therapy Physical Therapy Mental Health Therapy Speech and Language Pathology Registered Dietician Services Transportation

14. ADHC Cost Report Training 14 Separately Billable Services (cont’d) General Definition of a Unit of Service Check the CAADS Guidance Paper (www.caads.org) Transportation –pick up or delivery of a participant to/from the ADHC Center Example: John is working for Plus8 ADHC. John leaves Plus8 to pick up participant, Kate, at her home. John and Kate safely arrive at Plus8. One trip or one unit of service logged. Example: After a full day at Plus8, Kate calls out to John...”Hey it’s time to go!” John drives Kate to her home, helps her off the van. Kate yells to John “remember to pick up the kids!” to which John replies “you’re mean!” John returns to Plus8 for the end of his shift. One more trip or unit of service logged.

15. ADHC Cost Report Training 15 Section H: Col 8 - Adjustments Complete Section J-2 prior to completing this column A cost adjustment is used to... include costs that have not been booked in the ADHC Center’s general ledger during the fiscal period remove non-allowable costs under Medicare Reimbursement Principles Adjusts cost for Medi-Cal reporting purposes Show the adjustment amounts on Section J-2 Section H, Column 8 must be manually input Bottom line must reconcile to Section J-2, Line 31

16. ADHC Cost Report Training 16 Home Office Costs What is a Home Office? (CMS Pub 15-1, Section 2150) Does my ADHC Center need to file a Home Office Cost Report? Why do I need to file a HO Cost Report? (CMS Pub 15-1, Section 2153 / CMS Pub 15-2, Section 3903 ) DHCS Form 9090 on the website When in doubt...fill it out!

17. ADHC Cost Report Training 17 Section I – Allocation of Separately Billable Services Cost

18. ADHC Cost Report Training 18 Section J-1 – Reclassification of Expenses

19. ADHC Cost Report Training 19 Section J-2 – Adjustments of Expenses

20. ADHC Cost Report Training 20 Section K – Allocation of Administrative Overhead

21. ADHC Cost Report Training 21 Section L – Determination of Average Cost per Unit of Service