2015 Adult Care Cost Report Overview Training Susan Kesler Sibbett DHHS – Office of the Controller Rate Setting Branch

2015 Adult Care Cost Report Overview Training

Susan Kesler SibbettDHHS – Office of the Controller

Rate Setting Branch

Why Are We Here

Why Are We Here* IF you ONLY provide PCS and DO NOT receive IF you ONLY provide PCS and DO NOT receive

any State/County Special Assistance there is any State/County Special Assistance there is no need to do this cost reportno need to do this cost report

* PCS costs are being lumped together on the PCS costs are being lumped together on the Miscellaneous Line of the PCS cost center(s), Miscellaneous Line of the PCS cost center(s), no detail costs can be enteredno detail costs can be entered

* Mental Health homes under Chapter 122C Mental Health homes under Chapter 122C with 6 or less beds are required to file the with 6 or less beds are required to file the cost reportcost report

* Not required to send audited reportsNot required to send audited reports

Overview

III.III. Completing the Cost Report Completing the Cost Report

IV. AUPsAUPs

V. Sending in ReportV. Sending in Report

II.II. Downloading ProgramDownloading Program

I.I. Chart of AccountsChart of Accounts

I. Chart of Accounts* Reporting PeriodReporting Period

* Homes licensed under Chapter 122C - the Homes licensed under Chapter 122C - the reporting period is July 1, 2014 through reporting period is July 1, 2014 through June 30, 2015.June 30, 2015.

* Nursing Homes – use the same reporting Nursing Homes – use the same reporting period as the most recently completed period as the most recently completed Medicare cost report.Medicare cost report.

* All other homes – the reporting period is All other homes – the reporting period is October 1, 2014 through September 30, October 1, 2014 through September 30, 2015.2015.

I. Chart of Accounts* Can be found on the DHHS Office of the Can be found on the DHHS Office of the

Controller’s web site. Controller’s web site.

* It contains all the line item expenses in the It contains all the line item expenses in the cost report and gives examples of the cost report and gives examples of the expenses that go on each lineexpenses that go on each line

* Homes with both HA and SCU beds need to Homes with both HA and SCU beds need to capture revenue & expenses separatelycapture revenue & expenses separately

* Not required for nursing homesNot required for nursing homes

I. Chart of Accounts* For any employee working in more than one For any employee working in more than one

cost center (example dietary & cost center (example dietary & housekeeping) a timesheet to keep up with housekeeping) a timesheet to keep up with how many hrs they work in each cost center how many hrs they work in each cost center can be very usefulcan be very useful

* Need to keep up with contract hours too. Need to keep up with contract hours too. Contract with a service to do housekeeping? Contract with a service to do housekeeping? How many hrs of work did the contract How many hrs of work did the contract cover?cover?

* For PCS expenses, a one line total on the For PCS expenses, a one line total on the Miscellaneous Line of the cost center is all Miscellaneous Line of the cost center is all that can be enteredthat can be entered

II. Downloading Cost Report Program1.1. On the Office of the Controller’s On the Office of the Controller’s

webpagewebpagea)a) www.ncdhhs.gov/control/acf/acfac.htmwww.ncdhhs.gov/control/acf/acfac.htm

b)b) Click ‘2014-2015 Cost Report-AUPs’ linkClick ‘2014-2015 Cost Report-AUPs’ link

2.2. Cost Report Version availableCost Report Version available

a.a. Microsoft Access 2013Microsoft Access 2013

b.b. Don’t have Access 2013, click the free Don’t have Access 2013, click the free runtime to get it. Use the 32 bit runtime to get it. Use the 32 bit version (AccessRuntime_x86_en-version (AccessRuntime_x86_en-us.exe)us.exe)

c.c. PRINT OFF DOWNLOAD INSTRUCTIONSPRINT OFF DOWNLOAD INSTRUCTIONS

d.d. Please follow the additional Please follow the additional instructions related to security instructions related to security

II. Downloading Cost Report Program• Most common error when downloading Most common error when downloading

and saving cost report program to and saving cost report program to computercomputer

• Subdirectory name must be: Subdirectory name must be: Adultcare 2015Adultcare 2015

III. Completing the Cost ReportSchedule ASchedule A

III. Completing the Cost ReportSchedule ASchedule A•Contains basic informationContains basic information

o Mailing address, physical address of the home, phone Mailing address, physical address of the home, phone number, contact person, Medicaid #, NPI #, etc.number, contact person, Medicaid #, NPI #, etc.

o Please use license number given by DHSR (Dept. of Please use license number given by DHSR (Dept. of Health Service Regulations)Health Service Regulations)

o Input licensed bed capacity given by DHSR. If home Input licensed bed capacity given by DHSR. If home has SCU beds indicate the # of SCU beds and the # of has SCU beds indicate the # of SCU beds and the # of other bedsother beds

o In box 16 use the dates discussed earlierIn box 16 use the dates discussed earlier

o Give total # of Resident days and SA Days Give total # of Resident days and SA Days

III. Completing the Cost ReportSchedule ASchedule A•7+ Bed homes – for this cost report year7+ Bed homes – for this cost report year

o On line 13 after 7 or more has been On line 13 after 7 or more has been keyed the following screen will pop upkeyed the following screen will pop up


•Prepared By drop down box - pick either Accountant or Prepared By drop down box - pick either Accountant or CPA or NewCPA or New

• Use New if the Accountant or CPA doing the AUP is Use New if the Accountant or CPA doing the AUP is not shown in the next drop down boxnot shown in the next drop down box

•Select Accountant/CPA drop down box – shows the current Select Accountant/CPA drop down box – shows the current list of accountants and CPAs to choose from.list of accountants and CPAs to choose from.

•Enter new information or choose from the list (make Enter new information or choose from the list (make corrections if needed) and click OK when done. Takes you corrections if needed) and click OK when done. Takes you back to Schedule A, line 14back to Schedule A, line 14


•Any new accountants/CPAs entered and/or Any new accountants/CPAs entered and/or corrections made to addresses, phone numbers, corrections made to addresses, phone numbers, email address, etc. will show in your copy of the email address, etc. will show in your copy of the program only. To get corrections made in the program only. To get corrections made in the program for next year, please email Susan with program for next year, please email Susan with corrections.corrections.

III. Completing the Cost Report

Helpful hint – Do not use Helpful hint – Do not use the scroll rollerball on your the scroll rollerball on your mouse when entering data in mouse when entering data in the cost report program. It the cost report program. It can remove data on the screen can remove data on the screen already entered. Best to use already entered. Best to use the tab key, enter key or scroll the tab key, enter key or scroll bar to move to the next field.bar to move to the next field.

III. Completing the Cost ReportSchedule BSchedule B

III. Completing the Cost ReportSchedule BSchedule B

• Revenue InformationRevenue Informationo Revenue related to Special Assistance (SA) Revenue related to Special Assistance (SA)

residentsresidentso Revenue related to private pay residentsRevenue related to private pay residentso Revenue related to non residentsRevenue related to non residents

• Net Profit or LossNet Profit or Loss

III. Completing the Cost ReportSchedule C1 – for 6 beds or lessSchedule C1 – for 6 beds or less

III. Completing the Cost ReportSchedule C1 – for 6 beds or lessSchedule C1 – for 6 beds or less

• PCS section is the first cost center: Personal PCS section is the first cost center: Personal Care ServicesCare Services

• The Miscellaneous line 13, is the only line where The Miscellaneous line 13, is the only line where data can be keyeddata can be keyed

• All other cost centers need to be completed with All other cost centers need to be completed with both hours paid, unpaid and total expenditures.both hours paid, unpaid and total expenditures.

III. Completing the Cost ReportSchedule C-Direct and C-Ind/Oth – 7+ bedsSchedule C-Direct and C-Ind/Oth – 7+ beds

III. Completing the Cost ReportSchedule C-Direct and C-Ind/Oth – 7+ bedsSchedule C-Direct and C-Ind/Oth – 7+ beds

• PCS section is made up of 3 cost centers: PCS section is made up of 3 cost centers: Personal Care, Health Services, Personal Care, Health Services, Initial/Orientation Aide TrainingInitial/Orientation Aide Training

• Data can only be keyed on the Miscellaneous Data can only be keyed on the Miscellaneous lines (59, 72 & 88)lines (59, 72 & 88)


III. Completing the Cost ReportSchedule C-Direct and C-Ind/Oth – SCU bedsSchedule C-Direct and C-Ind/Oth – SCU beds

III. Completing the Cost ReportSchedule C-Direct and C-Ind/Oth – SCU bedsSchedule C-Direct and C-Ind/Oth – SCU beds

• Looks is just like the screens for 7 beds or more Looks is just like the screens for 7 beds or more but with additional columns. This is why but with additional columns. This is why breaking out the expenses (and revenues too) breaking out the expenses (and revenues too) between the Adult Care and SCU beds is between the Adult Care and SCU beds is importantimportant

• Again PCS data can only be keyed on the Again PCS data can only be keyed on the Miscellaneous lines (59, 72 & 88)Miscellaneous lines (59, 72 & 88)


III. Completing the Cost ReportSchedule DSchedule D

III. Completing the Cost ReportSchedule DSchedule D• Related Party TransactionsRelated Party Transactions

o Nursing Homes are exempt from reportingNursing Homes are exempt from reporting

o Related party - meaning the home is associated Related party - meaning the home is associated or affiliated with an organization or individual or affiliated with an organization or individual furnishing the services, facility or supplies.furnishing the services, facility or supplies.

o The cost report expense line item where this The cost report expense line item where this happens has to be listed on Sch D along with happens has to be listed on Sch D along with the expense.the expense. If expense is related to PCS use the If expense is related to PCS use the

Miscellaneous line (13, 59, 72 or 88)Miscellaneous line (13, 59, 72 or 88)

III. Completing the Cost ReportSchedule ESchedule E

III. Completing the Cost ReportSchedule ESchedule E

• Only used by homes with Special Care Unit Only used by homes with Special Care Unit (SCU) beds(SCU) beds

• Allocation MethodAllocation Methodo Explains how expense allocated between Explains how expense allocated between

SCU beds and non SCU beds within the SCU beds and non SCU beds within the homehome

o Allocation basis are: Direct, Resident Days, Allocation basis are: Direct, Resident Days, Square Footage or Other. If other is used an Square Footage or Other. If other is used an explanation is requiredexplanation is required These are the only basis allowedThese are the only basis allowed Other could mean a combination of Direct, Other could mean a combination of Direct,

Resident Days and/or Square FootageResident Days and/or Square Footage

IV. Agreed Upon Procedures (AUPs) Per GS 131D-4.2 adult care homes are required Per GS 131D-4.2 adult care homes are required

to submit audited reports. to submit audited reports.

AUPs are used to satisfy the audit requirement AUPs are used to satisfy the audit requirement and generally are less expensiveand generally are less expensive Because they only look at specific cost report Because they only look at specific cost report

related info and are not a full blown audit related info and are not a full blown audit with an opinionwith an opinion

AUPs have to be done by an outside, AUPs have to be done by an outside, independent accountant or CPAindependent accountant or CPA

IV. Agreed Upon Procedures (AUPs)• Homes with 21 beds or more have to submit Homes with 21 beds or more have to submit

AUPs every year.AUPs every year.

• Homes with 7 to 20 beds have to submit AUPs Homes with 7 to 20 beds have to submit AUPs every other year. They every other year. They are requiredare required for this for this cost reporting cycle.cost reporting cycle.

• Homes with 6 beds or less are Homes with 6 beds or less are not requirednot required to to submit AUP; cost report yes, AUPs no.submit AUP; cost report yes, AUPs no.

IV. Agreed Upon Procedures (AUPs) AUPs are available online at the Office of the AUPs are available online at the Office of the

Controller’s websiteController’s website

AUPs have been updated but remain consistent AUPs have been updated but remain consistent with those from prior reporting periodswith those from prior reporting periods

AUP questions should be addressed via email to: AUP questions should be addressed via email to: [email protected]@dhhs.nc.gov

V. Sending in Cost Report Finished entering cost report data

Make sure the box is green Hint: sometime have to click on another schedule

for it to turn green Never a bad idea to click the Save/Refresh button

every now and then Print off a copy of the finished report

Have to export the finished home Click on Administrator Option button Use the drop down arrow and choose home to

export, then click the Export Data button Even if only one home is entered in database

please follow the same procedure

V. Sending in Cost Report

Home is exported out of database

DomCareWeb subdirectory is created on the computer’s C drive

Access 2013 users will also need to make this subdirectory a trusted location (see download instructions)

File name will be the name of the home

This is the file that needs to be saved on a flash drive/CD or attached to an email.


Submitting the Cost Report

Required to be considered complete

Electronic copy of database file for each home/license #. File can be saved on a flash drive, CD and mailed in or emailed

A signed Sch A. This can be a paper copy mailed in with flash drive, CD or faxed or scanned and sent as an electronic pdf file.

Highly recommended to include printed copy of cost report. It can be on paper, faxed or scanned and included as a pdf file.

In case there are issues with importing on this end our office will already have a backup copy

Only need information sent in one way. By fax, by mail or by email. Please don’t send it multiple ways.


Submitting the Cost Report

Required to be considered complete

For homes with 7 beds or more a signed copy of their AUPs. Again this can be a scanned copy submitted electronically or paper copy or faxed document

If submitting information by email, please do one email per home/license #

Depending on your server you may need to send scanned electronic copies of signed cost report and AUPs (if required) in a separate email from the cost report file. If it can be done all in one that would be great

1 Version: Access vs. Runtime

The Access version of the cost report The Access version of the cost report available on website is Access 2013 available on website is Access 2013

Has only 2 files that have to be Has only 2 files that have to be downloadeddownloaded

A runtime version is available for those with Access versions A runtime version is available for those with Access versions older than 2013 or no Access at all. This has to be installed. older than 2013 or no Access at all. This has to be installed. Use the 32 bit version, program will not run on the 64 bit.Use the 32 bit version, program will not run on the 64 bit.

When the download button is pressed from the Microsoft webpage this will be the next screen. Pick the AccessRuntime_x86 version on the bottom for a 32 bit program.

VI. RemindersVI. Reminders

Again helpful hint – Do not Again helpful hint – Do not use the scroll rollerball on use the scroll rollerball on your mouse when entering your mouse when entering data in the cost report data in the cost report program. It can remove data program. It can remove data on the screen already entered. on the screen already entered. Best to use the tab key, enter Best to use the tab key, enter key or scroll bar to move to key or scroll bar to move to the next field.the next field.

VI. RemindersVI. Reminders

Cost Reports are due December 31, 2015Cost Reports are due December 31, 2015

Make sure the box is greenMake sure the box is green

A signed Sch A must be submitted before A signed Sch A must be submitted before Cost Report is considered completeCost Report is considered complete

VI. RemindersVI. Reminders Strongly recommend cost report Strongly recommend cost report

be submitted electronicallybe submitted electronically

Paper cost reports may be typed or handwritten but Paper cost reports may be typed or handwritten but must be legiblemust be legible

If applicable to your facility, AUPs If applicable to your facility, AUPs can be submitted by paper, can be submitted by paper, electronically or by faxelectronically or by fax

VI. RemindersVI. Reminders Strongly recommend submitting a printed copy of the cost report Strongly recommend submitting a printed copy of the cost report

along with the electronic file. The printed copy can be a scanned along with the electronic file. The printed copy can be a scanned electronic pdf file, paper or faxed. electronic pdf file, paper or faxed.

Cost Report not considered complete until all required information Cost Report not considered complete until all required information has been receivedhas been received

Finalize Package to SubmitElectronic media: flash drive, CDElectronic media: flash drive, CD

1.1. Export home into an individual file. Click the Admin Options button.Export home into an individual file. Click the Admin Options button.

2.2. Exported file found C:\DomCareWebExported file found C:\DomCareWeb

3.3. Drag and drop file to flash drive or CD (if using a CD, please remember to write the files to the CD)Drag and drop file to flash drive or CD (if using a CD, please remember to write the files to the CD)ororAttach file to an emailAttach file to an email

Finalize Package to SubmitHard Copy: PrintedHard Copy: Printed

1.1. A complete printed cost report. Sch A A complete printed cost report. Sch A has to be signedhas to be signed. .

2.2. Printed or scanned Printed or scanned signedsigned copy of the AUP (if required) also required copy of the AUP (if required) also required

Remember to keep a copy for your own recordsRemember to keep a copy for your own records

Access 2013

• MS A2013 has built in security.

• Follow the download instructions for setting up trusted locations.

• Both subdirectories AdultCare 2015 and DomCareWeb need to be trusted locations

• Ensure you “Allow” or “Unblock” macros and security settings.

Final RemindersFinal Reminders Please check the web site often!Please check the web site often!

New information will be posted here as New information will be posted here as soon as it is available.soon as it is available.

The web site address is: The web site address is: http://www.ncdhhs.gov/control/acf/acfhttp://www.ncdhhs.gov/control/acf/acf

ac.htmac.htm

If required cost report is not submitted• Per GS 131D-4.2 (g) – if a facility fails to Per GS 131D-4.2 (g) – if a facility fails to

submit a cost report by the due date the submit a cost report by the due date the Office of the Controller will notify DHSR and Office of the Controller will notify DHSR and they will suspend admission to the facilitythey will suspend admission to the facility

• If a facility continues to refuse to submit a If a facility continues to refuse to submit a cost report the statute also allows for cost report the statute also allows for licenses to be suspended or even revoked.licenses to be suspended or even revoked.

• As soon as the late cost report with all As soon as the late cost report with all required documentation is received DHSR is required documentation is received DHSR is notified and the suspend admissions is notified and the suspend admissions is lifted.lifted.

Hot Button Issues• If information is missing our office will call or If information is missing our office will call or

email to get the informationemail to get the information

• Check that the data was written to mediaCheck that the data was written to media

• Make sure to spell my last name correctlyMake sure to spell my last name correctly

• Paul ColePaul Cole will be the backup for answering will be the backup for answering non cost report program questions. He can non cost report program questions. He can be reached at be reached at 919-855-3685919-855-3685 or or [email protected]

• Transitioning in new supervisor, Suzanne Transitioning in new supervisor, Suzanne BeasleyBeasley

Questions

Contact Info

Points of contact:

Susan Kesler Sibbett – 919.855.3680

[email protected]

Fax number is 919.715.3095

www.ncdhhs.gov/control/acf/acfac.htm

Documents

2015 Adult Care Cost Report Overview Training Susan Kesler Sibbett DHHS – Office of the Controller Rate Setting Branch