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MANAGEMENT SERVICES DIVISION OFFICE OF RATES MANAGEMENT

MANAGEMENT SERVICES DIVISION OFFICE OF RATES MANAGEMENT. Reporting Year 2013 DDD RESIDENTIAL SUPPORT PROGRAMS ANNUAL COST REPORTING. PURPOSE OF COST REPORTING. Provides program cost data to regional managers and residential providers,

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MANAGEMENT SERVICES DIVISION OFFICE OF RATES MANAGEMENT

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  1. MANAGEMENT SERVICES DIVISIONOFFICE OF RATES MANAGEMENT Reporting Year 2013 DDD RESIDENTIAL SUPPORT PROGRAMS ANNUAL COST REPORTING

  2. PURPOSE OF COST REPORTING • Provides program cost data to regional managers and residential providers, • Provides information to establish rates and/or allocate appropriated funds, • Determine settlement for the ISS staff cost centers • Provides information to the legislature and department management for budget development and policy decisions, • Provides accountability and transparency for the use of public tax dollars.

  3. SCHEDULE AGENERAL INFORMATION PART A – PROVIDER IDENTIFYING INFORMATION • This schedule is used to provide basic information about the agency and the report preparer contact information. • Item 1 – Provider will select from a drop down list. • Item 1 – Select the correct agency name & region ID as some agencies are listed in two or more regions. • Item 2(a-b) & 8 will auto-fill the provider ID number(s) once the provider name is selected for item 1.

  4. PART B – PROVIDER CERTIFICATION Schedule A (Part B) The Individual who signs the provider's federal income tax return must also sign the certification. Enter the signer’s title and the date signed Scan and email Schedule A or mail the original directly to your resource manager

  5. Schedule BPROGRAM INFORMATION SECTION Schedule B – Business & Program Information • Line 1: Indicate if you provide or purchase medical services. This would include medical personnel such as nurses and doctors on staff or contracted. • Line 2: Indicate your type of business organization. • Line 3: Indicate the type of accounting method used for this report. • Line 4: Allocation of Shared Costs • Indicate if your agency operate multiple programs • Indicate if you allocate program costs • Indicate the method used to allocate costs

  6. Schedule B (Paid Hours Worked Section) • Paid Hours Worked (ISS Staff) – Actual annual paid hours less vacation, sick leave, holidays or other hourly adjustments to equal actual paid hours worked. • Paid Hours Worked includes direct staff hours worked by the Administrator (if permitted**) and excludes summer program and client evaluation hours. **GH programs are permittedto include direct staff hours worked by Administrator on J Summary, Line 2. **SL & Combined SL/GH programs are permitted to claim ISS hours worked by Administrator only if they have 20 or fewer FTE’s (41,600 hours or less). Administrator ISS hours are reported on J Summary, Line 3. **The above guidelines only apply if the Administrator provides direct care for clients for any program.

  7. Schedule B (Paid Hours Worked Section) • For programs subject to settlement the total paid hours worked column (g) = Total Paid ISS Hours Worked on Schedule J Summary, Line 4. • Hours reported should tie to the agencies ISS payroll records • Use rows 1(A-D) for programs subject to settlement – List each program in column (a). • Use row 1(E) for SSP programs. • Use rows 1(F-G) for “Other” programs not subject to settlement or to use for allocation purposes. • For each program listed enter the following information:

  8. Schedule CADMINISTRATIVE & OPERATING COSTS • The totals listed on line 1 are carried over from schedule B • Schedule C is used to: • Report administrative & Non-ISS hours worked • Report administrative & operating costs • Expense Descriptions: (not discussed in this training) • Refer to the Cost Report Instructions, DDA Policy 6.04 & the DDA Chart of Accounts. • Allocated & Non-allocated Sections: • For sections labeled “Allocated” enter amounts in the “Agency Totals” column. The allocated amounts for each program will auto-fill based on the percentage of total hours worked on Line 2. • For sections labeled “Non-Allocated” enter program specific costs in columns A-G. The “Agency Totals” column will auto-fill the sum of each line item for all programs.

  9. Schedule CADMINISTRATIVE & OPERATING COSTS Line 3 Hours- Report all “Administrative and Other Non-ISS Staff Hours” using the “Allocated” and “Non-allocated” sections Administrators who are eligible to claim worked hours as ISS – will report only their admin hours here (ISS hours are reported on Schedule B) Lines 4 Administrative Expense - Report costs using the “Allocated” and “Non-allocated” sections • GH – Report only the portion of compensation that pertains to administrative hours worked (the portion relative to ISS hours will be reported on Schedule E, Line 3) • SL & Combined (if eligible) – Report total Administrator compensation on Schedule C Line 4 (Hours worked as ISS will be calculated on Schedule J Summary, Lines 10-12, using the average reimbursement rate, not actual compensation) Lines 5 - 7 Program Costs - For the following categories, report program expenses using the “Allocated” and/or the “Non-allocated” sections. 5) Program Operations Expense 6) Capital & Property Expense 7) Interest & Tax Expense Line 8 Totals (Auto-fill) - Calculates the total expenses or each program and should equal the agencies expense records. (Note: Line 8 totals are carried forward to Schedule E for each program.)

  10. SCHEDULE EPROGRAM SUMMARY and DIRECT CARE RELATED COSTS • Records client services costs and accumulates total expenses at the program level. • Costs from Schedule C, Line 8 (A-G) are carried forward to Schedule E, Line 1 (A-G). • Amounts entered in columns A-G will auto-sum in the “Totals” column. • Line 7(a-c) provides cost per ISS hour data • use for reasonability & analysis purposes

  11. SCHEDULE EDIRECT CARE COSTS LINE 2 – Direct Care Staff Compensation • For each program report direct care staff compensation on Line 2(a-e). • For programs subject to settlement, sum the “Total Direct Care Staff Compensation” and carry forward to Schedule J Summary, Line 9. • Note: GH’s will also include total costs from Schedule E, Line 3(a-b).

  12. SCHEDULE EDIRECT CARE COSTS Line 2 - Staff Lodging Expense • ISS Compensation Expense: In this section, staff lodging expenses are the cost of a primary residence for ISS personnel as part of their compensation package and would be reported as income to the IRS. • Overnight staff accommodation expenses for on-duty staff is reported on Line 4a.

  13. SCHEDULE EDIRECT CARE COSTS (Group Homes Only) LINE 3 - ADMINISTRATIVE STAFF DIRECT CARE COMPENSATION • For each program report the administrator’s compensation & related costs paid for the time involved with direct care for clients on Line 3(a-b), (if any). • For programs subject to settlement, sum the “Total Admin Staff Direct Care Compensation” and carry forward to Schedule J Summary, Line 9; along with the costs derived from Line 2(a-e).

  14. SCHEDULE EOTHER CLIENT RELATED EXPENSES Line 4 – Overnight Staff Coverage Lodging Expense • Non-ISS Lodging Expense: In this section, staff lodging expenses are the cost of maintaining a residential unit for on-duty overnight staff when it is not the primary residence of the staff person.

  15. SCHEDULE EOTHER CLIENT RELATED EXPENSES Line 4 – Transportation Expense • This section is for reporting the cost of providing transportation for and on behalf of clients. • Do not include non-client related transportation such as travel to meetings, trainings or other administrative activities in this section.(Administrative transportation expenses are reported on Schedule C, Lines 5 & 6)

  16. SCHEDULE EOTHER CLIENT RELATED EXPENSES Line 4 - Maintenance/Laundry/Housekeeping/Dietary • This is typically a Group Home cost category. • Supported Living Programs may have costs in this category • the agency paid for maintenance or repair of client’s homes and was not reimbursed by the department or the client • if there is a staff person or contractor whose job duties are to maintain/repair client’s homes • If you had maintenance/repair costs that were reimbursed by DDA, include your net cost only (total cost less DDA reimbursement).

  17. SCHEDULE FPROPERTY AND RELATED EXPENSES • This schedule details the depreciation for owned buildings, equipment, furniture, & vehicles • Assets are reported at their purchase price from unrelated, arm’s length transactions. Assets received by donation or acquired at below market value are recorded at the appraised value. • The beginning balances should equal the ending balances from the prior year’s report. • If an asset is fully depreciated the accumulated depreciation equals cost less salvage value (if any).

  18. SCHEDULE FPROPERTY AND RELATED EXPENSES TOTAL ALLOWABLE PROPERTY & RELATED ASSETS Line 1 – Record beginning balances (should match previous report ending balances) Line 2 – Record all asset additions for the reporting period Line 3 – Record all asset retirements for the reporting period Line 4 (Auto-filled) – The asset ending balance (Line 1+Line 2-Line 3) Line 5 – Record the cost of any assets included in Line 4 that are not used to provide resident care Line 6 (Auto-filled) – The Total Allowable Property & Related Asset amounts (Line 4-Line 5)

  19. SCHEDULE FPROPERTY AND RELATED EXPENSES CURRENT PERIOD DEPRECIATION Line 7 – Identify the depreciation method for each asset grouping. Line 8 – Identify the useful life for each asset grouping. Buildings useful life must be at least 30 years. Line 9 – Identify the estimated salvage value for each asset grouping (if any). Line 10 – Enter the current allowable depreciation expense for each asset grouping.

  20. SCHEDULE FPROPERTY AND RELATED EXPENSES CURRENT PERIOD DEPRECIATION con’t • Line 10 totals, columns B-F are posted to Schedule C, Line 6. Amounts may be split between allocated and non-allocated as appropriate; however, total depreciation expense must agree with this detail. • Line 10’s total for column G is posted to Schedule E, Line 4h if it is client related transportation cost. If the vehicle(s) are used for administrative purposes the total is posted to Schedule C, Line 6 and may be split between allocated and non-allocated as appropriate. • If the vehicle(s) is used for both administrative and client(s) transportation purposes the depreciation may be split between both schedules E & C; however, total depreciation expense must agree with this detail.

  21. SCHEDULE FPROPERTY AND RELATED EXPENSES Note that depreciation expense on Schedule F agrees with depreciation expense on Schedule C. (Schedule F 667+10,833+750 = Schedule C 800+11,450)

  22. SCHEDULE FPROPERTY AND RELATED EXPENSES ACCUMULATED DEPRECIATION Line 11 – Record the accumulated depreciation amount for each asset grouping. (should match the ending balance from the previous cost report) Line 12 (Auto-filled) – Current period depreciation from Line 10 Line 13 – Record the accumulated depreciation amounts by asset group for any retirements made this period. Line 14 (Auto-filled) – Ending Accumulated Depreciation Balance (Line 11+Line 12-Line 13) Line 15 – Space for notes or explanations to information reported on Schedule F.

  23. SCHEDULE GDEBT EXPENSE (INTEREST) • Schedule G is used to detail the debt expense for three categories: Working Capital, Property and Other Related Debt, and Vehicle Debt Expenses. • Record the debt obligation(s) for which interest expense was incurred during the reporting period. For each debt record the following: Column A: Date of Loan Column B: Creditor Column C: Purpose and Security Column D: Original Term of the Loan Column E: Annual Interest Rate Column F: Original Loan Amount Column G: Balance at Beginning of the Period Column H: Reporting Period Payments – Principal Column I: Reporting Period Payments – Interest Column J: Balance at the End of the Period

  24. SCHEDULE GDEBT EXPENSE (INTEREST) CURRENT PERIOD INTEREST EXPENSE (COLUMN I) • Column I auto-sums the total interest paid for each Section, 1-3. (Yellow fields) • These amounts are transferred to Schedule C and/or E. • Sections 1-2, Working Capital / Property and Other Related Debt • These amounts are posted to Schedule C, line 7. • Amounts may be split between allocated and non-allocated as appropriate. • Total interest expense must agree with this detail. • Section 3, Vehicle Debt • If the interest is client related transportation cost post it to Schedule E, line 4h. • If the interest is administrative related transportation cost post it to Schedule C, line 7. • Amount may be split between allocated and non-allocated as appropriate. • If the vehicle(s) is used for both administrative and client(s) transportation purposes the interest may be split between Schedule C and E. • Total interest expense must agree with this detail. • Section 4 • Space for notes or explanations for information reported on Schedule G.

  25. SCHEDULE GDEBT EXPENSE (INTEREST) Note that interest expense on Schedule G agrees with interest expense on Schedule C. Schedule G (120+4,267) = Schedule C (2,120+2,200+67)

  26. SCHEDULE HPROGRAM REVENUES REVENUE RECEIVED OR EARNED DURING THE REPORT PERIOD (The revenue for residential services must be reported on an accrual basis). • Revenue for Services includes total ISS, admin and transportation. • Amounts reported in the Revenue for Services section must be received or earned during the reporting year regardless of when the payments were actually received (accrual basis). • Revenues reported in the Other Operating Revenue and Non-Operating Revenue sections may be on either the accrual or cash basis. • Revenue identified with SSP client(s) should be reported on Line 5 “Other.”

  27. Schedule J SummaryProgram Settlement • Schedule J is used for settlement calculation for SL, GH, & Combined programs that are subject to the settlement process as explained in DDA policy 6.04, Section VII. • Settlement consists of 5 schedules: Schedule J Summary, J Detail, J Detail pg 2- COCA, J Detail pg 3 – Prof Svs, and J-Adm. Providers may also use Schedule J Detail by Client a provider use only form. • Settlement (Schedule J Summary) is a comparison of actual ISS staff hours worked (plus hours worked as ISS by administrator, if eligible) (Line 4), to ISS staff hours reimbursed (Line 1). If Line 1 is greater than Line 4, the difference (Line 5) is multiplied by the average reimbursement rate (Line 6) to produce Settlement A (Line 7). • Settlement then compares the actual ISS staff costs incurred by the provider (Line 13) to the ISS staff reimbursement (Line 8), for the reporting period (Settlement B). If Line 8 is greater than Line 13, the difference will produce Settlement B (Line 14). • The actual settlement is the greater of Settlement A or Settlement B plus the Administration Rate Settlement (Line 18), if any.

  28. Schedule J SummaryProgram Settlement PROVIDERS ONLY NEED TO ENTER AMOUNTS ON LINE 2, 3 & 9

  29. Schedule J SummarySettlement A, Line 2 For programs subject to settlement, post the total actual paid ISS hours worked from Schedule B, column (g) to Schedule J Summary, Line 2 (113,400+17,200 = 130,600). • Note: SL and Combined programs will deduct total Paid Hours Worked as ISS by Administrator from Schedule B, column (g) and enter the result on Line 2. The total Paid Hours Worked as ISS by Administrator will be posted to Line 3, providing the agency meets the requirements to claim those hours. SCHEDULE B

  30. Schedule J SummarySettlement A, Line 2 • GH programs: Total paid hours worked as ISS by Administrator (if any) should be included on Schedule J Summary, Line 2. • SL & Combined programs: Only the total paid hours worked by ISS staff will be reported on Line 2. Total paid hours worked as ISS by Administrator will be reported on Line 3, (if permitted).

  31. Schedule J SummarySettlement A, Line 3 • GH programs – No entry is made on Line 3 as the total paid hours worked as ISS by Administrator are included on Line 2. • SL & Combined programs – Post the total paid hours worked as ISS by Administrator (if permitted), on Line 3. • The sum of Line 2 & 3 is auto-filled on Line 4; this total should match Schedule B, column (g), rows A-D total paid ISS hours worked.

  32. Schedule J SummarySettlement B, Line 9 • For programs subject to settlement, post Total Direct Care Staff Compensation (ISS) from Schedule E, line 2. • GH programs include administrator salaries & related costs claimed as ISS cost on Schedule E, line 3. Note: Schedule E, Line 3 is only used by GH’s • SL or combined programs, do not include administrator salary & related costs as these costs (if permitted) are determined using the average reimbursement rate on Schedule J Summary, Line 11 multiplied by the hours reported on Schedule J Summary, Line 3.

  33. Schedule J SummarySettlement B, Line 9 • SL and combined SL/GH programs subject to settlement need to post Total Direct Care Staff Compensation, Schedule E, Line 2 to Schedule J Summary, Line 9. (1,761,550+267,000 = 2,028,550) • Group Home programs need to post the sum of Total Direct Care Staff Compensation, Schedule E, Line 2 and Total Admin Staff Direct Care Compensation, Schedule E, Line 3, if any, to Schedule J Summary, Line 9.

  34. Schedule J Detail by Client • The Schedule J Detail by Client can be used to record the periods of service and individual rates associated with each client. The rates and time periods for each client are constructed using contract Exhibit C and COCA information received throughout the year. • This is an optional form and is intended for provider use only. Do not submit this form, it will contain client names and ID numbers. • Schedule J Detail by Client is the same form cost analysts use to determine final settlement. Previously, providers could request for an unreconciled Schedule J Detail by Client to be emailed to them. However, 2013 will be the last year providers can request for this pre-filled form. • Providers that choose to use this form will need to compile the information (Exhibit C’s & COCA’s) and fill out the form using the template and instructions available on the web.

  35. Schedule J Detail by Client • Although Schedule J Detail by Client is optional there are benefits to using it: • Provides figures needed for settlement schedules J Detail & J-Adm: • Resident Days Paid • Total ISS Hours Paid • Total Admin Paid • Total Admin at Standard Rates • Professional Service Hours by Rate • Allows providers, at any point in time during the year, to compare or reconcile ISS payroll hours & costs to total ISS hours contracted & reimbursed. This would allow providers to monitor throughout the year whether they have under or over provided ISS hours (Settlement A) or have unspent ISS reimbursements (Settlement B). • For training purposes the final two schedules will refer to the Schedule J Detail by Client for information to complete settlement. Providers have the option of using other sources or processes to obtain the necessary data.

  36. Schedule J DetailNon-Benchmark & Professional Services • For each professional service enter the following: • Service Description • Hours Reimbursed • Rate Reimbursed • Report reimbursements on an accrual basis • Services provided in Dec 2013 are reported even though they were paid in Jan 2014 • Payments received in Jan 2013 for services provided in 2012 should not be included • Information Sources • Schedule J Detail by Client (recommended) • Billing and payment remittance documents

  37. Schedule J DetailNon-Benchmark & Professional Services • Calculation for Professional Services • Multiply hourly percentage x number of days for each client • Example: – Refer to Schedule J Detail by Client (Client 1) • .20 (Hourly Percentage, Column L) x 365 (Client days, Column H) = 73 (Annual Hours) • Sum the results from each client calculation for each different rate/service • 73 Hours (Client 1) + 73 Hours (Client 16) = 146 Total Annual Hours at $38.75 • Post the total annual hours for each rate to Schedule J Detail using Lines 23-27

  38. Schedule J DetailNon-Benchmark & Professional Services • Schedule J Detail by Client - Professional Services Calculation • Enter a professional services rate listed in columns M or O in cell AD1 • Cell AE1 will display the total annual hours at that rate • Use the same process for each different rate, reporting the results on Schedule J Detail using Lines 23-27 • If additional lines are needed use Schedule J Detail pg 3 – Prof Svs • Totals from this tab will carry forward to Schedule J Detail, Line 28

  39. Schedule J DetailNon-Benchmark & Professional Services Schedule J Detail by Client (left) calculated 207.475 professional service hours at $26.50 The total hours and rate are posted to Schedule J Detail, Line 23 (above) The process is repeated for each professional service rate

  40. Schedule J DetailReimbursed ISS Hours • For each service type enter the following: • Dates of Service • ISS Hours Reimbursed • Related Benchmark • Report reimbursements on an accrual basis • Report services provided in Dec 2013 but were not paid until Jan 2014 • Do not report payments received in Jan 2013 for services provided in 2012 • Information Sources • Schedule J Detail by Client (recommended) • Billing and payment remittance documents

  41. Schedule J DetailReimbursed ISS Hours • Schedule J Detail by Client Calculation • Sort schedule by Service Type, Benchmark, Client ID, & Rate Data Start Date • Sum Regular ISS Hours Paid (Column Z) for each program for a single benchmark • Regular ISS Hours Paid = The sum of each clients ISS Hours PCD (Column I) x Resident Days Paid (Column H) for each different benchmark • Example: 15 Hours (Column I) x 365 Client Days = 5475 Regular ISS hours Paid • Sum for GH at $15.18 benchmark = 43,315.50 Hours Reimbursed (Schedule J Detail, Lines 1-11) • Use the same process for each different service type and benchmark, recording the results on Schedule J Detail

  42. Schedule J DetailReimbursed ISS Hours

  43. Schedule J DetailReimbursed ISS Hours (COCA) • All COCA’s must be included with reported ISS Hours Line 12 • COCA’s are included on Schedule J Detail by Client (recommended) and will be reported with SL or GH Hours Reimbursed (Schedule J Detail pg 2 – COCA will not be needed). • If COCA’s are not reported with SL or GH Hours Reimbursed they must be reported on Schedule J Detail pg 2 - COCA. • Totals from this tab will carry forward to Schedule J Detail, Line 12 • For each COCA received report: • Dates of Service • Hours Reimbursed • Benchmark Rate(s)

  44. Schedule J DetailNurse Delegation & Staff Add-On Hours • Report Nurse Delegation Training Hours & Staff Add-On Hours (if any) on Schedule J Detail, Lines 14-21 • Number of Hours • Benchmark Paid

  45. Schedule J DetailAdministrative Revenue/Expenditures for Administrative Settlement Calculation • The Administrative Rate Settlement applies only if the following criteria exist: • There is a settlement due to hours not provided (Settlement A) and, • The agency’s average administrative rate is higher than the average standard rate (Refer to your Exhibit C to determine if your agency’s average administrative rate was above standard) • If yes, complete Lines 31-33 • Line 31 - Administrative Reimbursement at Contracted Rates • Schedule J Detail by Client (cell AB2) or other source • Line 32 – Administrative Reimbursement at Standard Rates • Schedule J Detail by Client (cell AE2) or other source • Line 33 – If Line 31 is greater than 32 and there is a settlement A, complete Schedule J-Adm

  46. Schedule J-Adm • This schedule is used to determine Administrative rate settlement for hours not provided when the average administrative rate reimbursed during the reporting period is higher than the administrative rate standard. • Line 1 – Enter Client Days subject to settlement Schedule J Detail by Client (cell H2) or other source • Lines 2-14 will auto-fill • If Line 14 is greater than zero, the amount will carry forward to Schedule J Summary, Line 18

  47. Schedule J-Adm • Line 15 (Auto-filled) – Total itemized costs from Schedule E, Line 5 • Line 16 (Auto-filled) – ISS Staff Direct Service Cost from Schedule J Summary, Line 9 • Line 17 (Auto-filled) – Total Non-ISS Costs (Line 15 – Line 16) • Line 18 – Administrative/ Indirect Client Support/ Non-Staff Reimbursement Received for Services from Schedule J Detail by Client (cell AC2) (recommended) or from your billing and payment remittance documents (Report on an accrual basis) • Line 19 (Auto-filled) – Non-ISS costs greater than Non-ISS reimbursement (Zero if Line 18 > than Line 17 otherwise Line 17 minus Line 18)

  48. SettlementSchedule J Summary Lines 15-19 • After completing Schedule J Detail and related schedules return to Schedule J Summary and review settlement Lines 15-19 • Line 15 (Auto-filled) - The settlement amount is the greater of Settlement A or Settlement B • Line 16 – Do not enter any amount on this line, your rate analyst will determine settlement for approved 2-year settlements • Line 17 (Auto-filled) – Total ISS settlement amount, Lines 15 plus 16 • Line 18 (Auto-filled) – Amount carried forward from Schedule J-Adm (if any) • Line 19 (Auto-filled) – Total Preliminary Settlement amount

  49. SCHEDULE LDESCIPTION OF “OTHER” EXPENSES • Schedule L is used to describe expenses reported as “Other” for any amounts in excess of $1,000. • The purpose of this schedule is to identify major expenditures or items that do not fall into the category titles provided on Schedules C or E. • For each expense in excess of $1,000 record the schedule reported on, account number, brief description, and amount.

  50. Schedule MOWNER AND RELATED INDIVIDUALS COMPENSATION Schedule M is used to report ISS salary, wages and other compensation for owner(s) and/or related individuals.

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