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Home Health Agencies Cost Reports

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Identification, Utilization, Statistical Data

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Worksheet Section	Description	Reference
Wkst. S, Parts I & II	Home Health Agency Cost Report. Certification and Settlement Summary	3203
Wkst. S-2	Home Health Agency Complex Identification Data.	3204
Wkst. S-3	Home Health Agency Statistical Data.	3205
Wkst. S-4	HHA-Based Rural Health Clinic/Federally Qualified Health Center Provider Statistical Data	3233
Wkst. S-5, Parts I & II	Hospice Identification Data, Enrollment Days, Census Data	3239
Wkst. S-6	HHA-Based CORF Statistical Data.	3220

Reclassification And Adjustment Of Trial Balance Of Expenses

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Worksheet Section	Description	Reference
Wkst. A	Reclassification and Adjustment of Trial Balance of Expenses.	3206
Wkst. A-1	Compensation Analysis – Salaries and Wages	3207
Wkst. A-2	Compensation Analysis – Employee Benefits (Payroll Related).	3208
Wkst. A-3	Compensation Analysis – Contracted Services/Purchased Services.	3209
Wkst. A-5	Adjustments to Expenses.	3211
Wkst. A-6	Statement of Costs of Services from Related Organizations.	3212
Wkst. A-7	Analysis of Changes in Capital Asset Balance.	3213

Cost and Cost Allocation

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Worksheet Section	Description	Reference
Wkst. B, Part I	Cost Allocation – General Service Costs and	3214
Wkst. B-1	Cost Allocation – Statistical Basis.	3214

Computation of Cost Per Visit

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Worksheet Section	Description	Reference
Wkst. C, Parts I-V	Apportionment of Patient Service Costs	3215
Wkst. C, Part I	Aggregate Agency Cost Per Visit Computation	3215.1
Wkst. C, Part II	Computation of the Aggregate Medicare Cost and the Aggregate of the Medicare Limitation	3215.2
Wkst. C, Part III	Supplies and Drugs Cost Computation	3215.3
Wkst. C, Part IV	Comparison of the Lesser of the Aggregate Medicare Cost, the Aggregate of the Medicare Per Visit Limitation and the Aggregate Per Beneficiary Cost Limitation	3215.4
Wkst. C, Part V	Outpatient Therapy Reduction Computation	3215.5

Calculation of Reimbursement Settlement

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Worksheet Section	Description	Reference
Wkst. D, Parts I & II	Calculation of Reimbursement Settlement – Part A and Part B Services.	3216
Wkst. D, Part I	Computation of Lesser of Reasonable Cost or Customary Charges.	3216.1
Wkst. D, Part II	Computation of Reimbursement Settlement	3216.2
Wkst. D-1	Analysis of Payments to Home Health Agencies for Services Rendered to Program Beneficiaries.	3217

Financial Statements

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Worksheet Section	Description	Reference
Wkst. F, F-1, F-2	Financial Statements.	3218

Provider Based Hospice

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Worksheet Section	Description	Reference
Wkst. K	Reclassification and Adjustment of Trial Balance of Expenses.	3240
Wkst. K-1	Compensation Analysis – Salaries and Wages	3241
Wkst. K-2	Compensation Analysis – Employee Benefits (Payroll Related).	3242
Wkst. K-3	Compensation Analysis – Contracted Services/Purchased Services.	3243
Wkst. K-4, Parts I & II	Cost Allocation – General Service Costs and Statistical Basis	3244
Wkst. K-5, Parts I-III	Allocation of General Service Costs to Hospice Cost Centers	3245
Wkst. K-5, Part I	Allocation of General Service Costs to Hospice Cost Centers	3245.1
Wkst. K-5, Part II	Allocation of General Service Costs to Hospice Cost Centers – Statistical Basis.	3245.2
Wkst. K-5, Part III	Apportionment of Hospice Shared Services .	3245.3
Wkst. K-6	Calculation of Per Diem Cost	3246

Home Health Agencies Cost Reports:

Home Health Agencies (HHAs) participating in the Medicare program submit annually to CMS cost reports in a standardized electronic format. HHAs file the form CMS-1728-94 in accordance with 42-CFR Part 413.20 and the Provider Reimbursement Manual Part I. Hospital-based HHAs continue to use Form CMS 2552-96, Hospital and Hospital Health Care Complex Cost Report.

The HHA cost reports are a valuable database and provide unique nationwide information for facility characteristics, utilization, cost, charges, reimbursement, financial and income statements.

The Healthcare Cost Report Information System (HCRIS) for HHAs collects annual facility Cost Report -Data files and stores them in a relational database. The database is continuously updated and is made public quarterly (March, June, September, and December).

Idatareport makes all data available in many formats (Excel, SAS, Stata, etc) ready for download. The data is available by PPS year in the familiar worksheet format for all reporting facilities.

HCRIS keeps the highest level of HHA cost report based on its status. From lowest to highest the report status is: as submitted, Settled without audit, Settled with audit, Reopened, Amended.

Many times HHAs submit more than one cost report for a FY with the same status. This can happen if a change in ownership or FY occurs during the year. Idatareport flags the duplicate reports and selects the most representative (e.g., higher number of months) for the analysis. A reporting length indicator is calculated and included with every data set.

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