GET A HEAD START: Gathering Cost Report Information Now Will Ease Some Tension Later

As the year end quickly approaches, it's time to start thinking about filing the Medicare cost report and gathering the appropriate data for timely and accurate completion. Consider these key reminders:
  • Check/update IACS registration status (needed to obtain the PS&R report)
  • Update cost report software to the most recent version
  • Set Trial Balance on the "accrual basis of accounting" as stated by Medicare regulations
  • Gather the statistical data
  • Review the general ledger for inaccurate postings
  • Make the following accounts distinguishable by discipline:
    • Payroll
    • Mileage (travel)
    • Contract service cost
  • Segregate medical supplies into billable and routine
  • Determine allowable versus non-allowable marketing/advertising costs
  • Analyze dues expense and disallow all lobbying costs
  • Update asset register and record current depreciation expense (Medicare regulations require that assets be depreciated using the straight-line methodology.)
  • Report (at cost) all related party transactions
  • Make telehealth costs easily identifiable (They must be reported in a non-reimbursable cost center.)
    • Payroll cost
    • Equipment lease costs
For hospice providers, this additional preparation must also be completed for the cost report:  
  • Segregate the cost of the volunteer coordinator
  • Detail volunteer hours by category
  • Make continuous care expenses distinguishable by RN and HHA
  • Place fundraising costs in a separate account (and not netted against fundraising revenue)
  • Maintain nursing home room & board revenue and expense in two separate accounts (not netted together)
  • Separate complimentary therapies (art, massage, music & pet) in their own expense account. (These costs must be reported in a non-reimbursable cost center.)
For freestanding hospice providers, it is imperative to pay close attention to the recent changes made to the hospice cost report (CMS Form 1984-14), effective for cost reporting years beginning on or after October 1, 2014. Start revamping the chart of accounts now. Home health-based hospice's can also expect changes to the K-schedules in the very near future, so be pro-active and don't wait until the last minute.

Cost reports are utilized for future reimbursement rates, so it is imperative they are filed accurately. The more detailed the general ledger, the easier it becomes to accurately gather data and file the cost report. 
The Importance of OASIS Accuracy

When OASIS assessments are not completed properly, this can lead to reduced reimbursement, risk of audit, or even claim denial. Ensuring the accuracy of each episode ensures that you are properly paid for the services you provide, while minimizing your risk of audit.

With the implementation of OASIS-C1 coming January 1, 2015, there is no better time to make sure that you have a plan in place to ensure your OASIS accuracy.

Here are some helpful tips to help you get started:
  • Look at the "big picture" and not just portions of the assessment. Review the full chart, including physician orders, care plans/visit frequencies and clinical assessments. This allows for a more comprehensive and accurate review.
  • Identify negative trends in documentation so that you can train your clinical staff on improving the quality of their assessments.
  • Educate your clinicians so they are well-trained in OASIS accuracy. Ongoing training is essential to making sure that they are continuously up to date on the latest changes in regulations.
If you are struggling with your OASIS accuracy, or if you have concerns about being ready for the January 1 transition to OASIS-C1, Premier Returns can help. Our certified OASIS review experts are specialists in home health clinical documentation and are always up to date on the latest regulations and requirements.

If you are interested in exploring ways to address your OASIS accuracy challenges, please contact us at 888.345.3947.  

Simione Welcomes Susan Chickosky to Cost Reporting Team


Susan Chickosky of Rohnert Park, California, has joined Simione Healthcare Consultants as a full-time financial consultant to support cost reporting activities. While a new employee at Simione, Susan has worked recurrently with the former Boyd & Nicholas team in California as both an employee and contractor since 1993.  Susan brings more than 25 years of progressive experience in business and office management to Simione, including running her own administrative services firm and holding office management and bookkeeping positions for companies in a variety of industries. A Certified Quickbooks ProAdvisor, she earned a master's degree in Organizational Leadership from Gonzaga University, Spokane, Washington, and a B.S. in Business Management from the University of Phoenix.  

Honoring Excellence in Home Care and Hospice


Simione Healthcare Consultants has made a tribute donation to The Wounded Warrior Project in honor of our dedicated clients and colleagues working to provide outstanding home care and hospice services in their communities.  The mission of the Wounded Warrior Project is to foster the most successful, well-adjusted generation of wounded service members in our nation's history.  We extend our very best wishes to all for a Happy Holiday Season and a Bright, Successful New Year! 

Stay Current with Industry Trends, Rules and Findings

Simione Healthcare Consultants is committed to helping home care and hospice teams improve patient care and accelerate their business performance. Register for one of our free upcoming webinars:

Simione webinars are color-coded in green on our event calendar. View the full event schedule.
Grow Your Private Duty Business in 2015

OneSource HomeCare Consultants, a Simione private duty company, guides existing agencies and agency start-ups with proven expertise in operations, systems, standards, policy and procedures, software, IT support, licensing and accounting. OneSource also specializes in providing agencies with marketing strategies to enhance community outreach and increase profitability. Please call us with any questions at 602.368.4555 or visit www.onesourcehcc.com
Promote Better Decisions with Quarterly Cost Analysis

Simione Financial Monitor is the industry's only real-time benchmarking tool available to compare your home care or hospice agency's performance against others across the nation. Join the growing number of agencies who use the Simione Financial Monitor for quarterly cost analysis to help increase their profitability. For more information, call 844.215.8826 or visit simionefinancialmonitor.com.