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CMS Proposes Revisions to the Home Health Cost Report (CMS 1728-19 & 1728-94)

Posted on Thursday, April 18, 2019 12:54 AM

CMS’ current intention is that these changes would be applicable for cost reporting years starting on or after January 1, 2019. 

CMS indicates that the changes are designed to capture a cost per visit by type of clinician, report bad debt, and account for negative wound pressure therapy paid under OPPS. Additionally, the forms are revised to remove obsolete data collections, such as unduplicated census counts and per beneficiary limits, as well as to eliminate worksheets for a rural health clinic and a federally qualified health center.  CMS anticipates that the changes will reduce the paperwork burden on freestanding home health agencies by an average of 32 hours (from 227 to 195 hours).  As of this time CMS plans to make these changes effective for cost reporting years beginning on or after January 1, 2019.

The following are several changes that CMS is proposing as part of the new package:

Addition to Worksheet S-3: Part I – census stats (visits and patients by discipline)

  • Non-Medicare visits/patients are separately reported as Medicaid and Other.  On forms that are currently in use the visits are combined.
  • Visits by discipline are further segregated as follows:
    • Skilled Nursing – RN and LPN
    • PT/PTA
    • OT/OTA

Addition to Worksheet S-3:  A new Part V containing:

  • Occupational cost data – salaries and fringes by occupational category
  • Cost of contract labor by occupational category
    • Each line item requires paid hours
    • CR will calculate average hourly wage by occupational category

Addition to Worksheet A, Trial Balance of Expenses:

  • New cost center
    • Remote Patient Monitoring – overhead cost center
    • Skilled Nursing Care – separate cost centers for RNs and LPNs
    • PT – separate cost centers for PT and PTA / OT and OTA

Worksheet O series:  Does not contain changes made to freestanding hospice cost report and put in place in 2018

They have opened a 60-day comment period on these changes.  Click here for directions on how to submit comments. 

Source: NAHC

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