AGING AND DISABILITY SERVICES ADMINISTRATION
2008 NH "Dear Administrator" Letters
December 19, 2008
ADSA NH 2008-007
SUBJECT: 2008 MEDICAID COST REPORT
Dear Nursing Facility Administrators and Interested Parties:
In years past, this letter would have been accompanied by a thick packet, including a paper copy of the cost report, instructions for its completion, a CD with the cost report programmed in Excel, and a list of facilities and their responsible rate analysts.
Times change.
As you know, the state faces an extremely difficult budget environment. State revenues are down, so the department is looking for all ways to be more economically efficient. In an effort to reduce our administrative costs, we are no longer sending out copies of the materials listed above. Instead, the cost report, the completion instructions, and the facility/analyst list can now all be found on the website of the Office of Rates Management. If you have not already visited the site, the address is: http://www.adsa.dshs.wa.gov/professional/rates/
In addition, there is a new requirement this year: FACILITIES MUST SUBMIT THEIR OWN CD AND TWO PAPER COPIES OF THE 2008 COST REPORT, WITH ORIGINAL SIGNATURES ON BOTH.
Each year it takes the agency four or five days to receive the cost reports; disassemble, copy, and reassemble them; and distribute them to the rate analysts. By requiring facilities to submit two signed copies, the agency will save these four or five days. This will allow us to begin the review of the cost reports sooner, and respond to the facilities in a more timely manner. We sincerely appreciate your cooperation in this matter.
Further, we would appreciate any assistance you can give us by filing your cost report before the due date of March 31. Typically, almost all facilities submit their cost reports right at the statutory due date. If some facilities filed their reports earlier, it would significantly improve our workflow in processing the reports. The sooner we review the reports, the sooner we can prepare preliminary settlements.
It is essential that your cost report be correctly completed and submitted on time. As noted, RCW 74.46.040 (1) requires annual cost reports to be submitted by March 31. RCW 74.46.040 (3) and WAC 388-96-107 (2) permit the department to grant two extensions for extraordinary circumstances of up to 30 days each upon receipt of a written request at least ten days prior to the due date of the report. We will review all requests for extensions and will consider the time limitation placed on all providers during our review. Please keep in mind that if a facility has requested extensions for several years, each year citing the same “extraordinary circumstance,” it becomes difficult to accept that the circumstance is truly “extraordinary” any longer.
Each year, rate staff make hundreds of contacts to try to resolve cost report questions prior to rate setting. If on initial submission, reports are complete, arithmetically correct, appropriately footnoted, and filed in accordance with rules, regulations, and instructions, many issues can be resolved with providers eliminating the need for many adjustments to reported costs.
REMINDER: Please DO NOT use pages larger than 8 1/2" x 14". Larger pages simply do not fit in our files.
In order to expedite processing, we ask that you type the title of each supporting item on colored paper and place the colored paper on top of the item, using only the titles identified below:
- Census
- Depreciation Schedule
- Facility General Ledger
- Facility Working Trial Balance
- Organizational Chart
- Home Office Cost Report
- Home Office Reconciliation to Schedule G-2
- Home Office Trial Balance
- Other (specify)
In accordance with RCW 74.46.100 and WAC 388-96-202, all cost reports are subject to a full audit or examination by the department. Full audits and/or examinations may be executed on all years’ cost reports even if the year is not a rebase year for rate setting purposes.
I hope that this information will assist you in the completion of the 2008 Medicaid cost report and provide for uniform reporting throughout the industry.
Thank you for your cooperation. Again, please note the new requirement that facilities must submit their own CD and two paper copies of the 2008 cost report, both with original signatures. If you have any questions, please call the analyst assigned to your facility. We look forward to working with you, and we are trying to improve our level of service to you even as we cope with this difficult budget environment.
Sincerely,
Ken Callaghan, Chief
Office of Rates Management
cc: Cost Reimbursement Analysts
