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Library: Policy

317:30-5-67. Cost reports

Revised 7-1-13

    Each long term care facility is required to submit, on uniform cost reports designed by the Authority, an annual cost report for the fiscal year just completed.  The fiscal year is July 1 through June 30.  The reports must be submitted to the Authority on or before the first day of September.

  • (1) When there is a change of operation or ownership, the selling or closing ownership is required to file a cost report for that portion of the fiscal year it was in operation.  The successor ownership is correspondingly required to file a cost report for that portion of the fiscal year it was in operation.

  • (2) Cost report forms and instructions are mailed annually to each facility before the first of July.  The completed forms are to be returned to the Authority, Attention: Reimbursement and Audit.

  • (3) Normally, all ordinary and necessary expenses incurred in the conduct of an economical and efficiently operated business are recognized as allowable.

  • (4) All reports are subject to on-site audits and are deemed public records.

    • (A) Only "allowable costs" may be included in the cost reports, (costs should be net of any offsets of credits).  Allowable costs include all items of Medicaid-covered expense which pediatric long term care hospitals incur in the provision of routine services.  "Routine services" include, but are not limited to:

      • (i) regular room,

      • (ii) dietary and nursing services,

      • (iii) minor medical and surgical supplies,

      • (iv) over-the-counter medications,

      • (v) transportation, and

      • (vi) the use and maintenance of equipment and facilities essential to the provision of routine care.

    • (B) Allowable costs must be considered reasonable, necessary and proper, and shall include only those costs that are considered allowable for Medicare purposes and that are consistent with federal Medicaid requirements.  (The guidelines for allowable costs in the Medicare program are set forth in the Medicare Provider Reimbursement Manual ("PRM"), HCFA-Pub. 15.)

    • (C) Ancillary items reimbursed outside the long term care hospital rate should not be included in the cost report and are not allowable costs.

    • (D) A supplemental addendum to the cost report, including all inpatient and outpatient charges by payor source, will be included with the annual cost report.

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