2014 Adult Care Cost Report Overview Training

Susan Kesler SibbettDHHS – Office of the Controller

Rate Setting Branch

Why Are We Here

* Per Senate Bill 744, section 12H.11 passed Per Senate Bill 744, section 12H.11 passed by the General Assembly and signed by the by the General Assembly and signed by the Governor in August 2014 states “… shall Governor in August 2014 states “… shall require compliance with the adult care home require compliance with the adult care home cost reporting requirements set forth in GS cost reporting requirements set forth in GS 131D-4.2.”131D-4.2.”

* Per GS 131D-4.2 – facilities that receive Per GS 131D-4.2 – facilities that receive State/County Special Assistance or Medicaid State/County Special Assistance or Medicaid personal care are required to file a cost personal care are required to file a cost reportreport

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

* For this year, PCS amounts are being lumped For this year, PCS amounts are being lumped together on the Miscellaneous Line of the together on the Miscellaneous Line of the PCS cost centers, no detail requiredPCS cost centers, no detail required

* Small group homes with 6 or less beds are Small group homes with 6 or less beds are exempt from the cost reporting requirementexempt from the cost reporting requirement

OverviewOverview

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

IV. AUPs

V. Sending in Report

II.II. Downloading ProgramDownloading Program

I.I. Chart of AccountsChart of Accounts

I. Chart of AccountsI. 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. Has been available Controller’s web site. Has been available since September 10, 2014since September 10, 2014

* For this cost reporting cycle please use For this cost reporting cycle please use figures from the most recently audited fiscal figures from the most recently audited fiscal year. No earlier than 2013year. No earlier than 2013

* 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 capture revenue & expenses separately

I. Chart of AccountsI. Chart of Accounts

* For any employee working in more than one For any employee working in more than one cost center (example dietary & housekeeping cost center (example dietary & housekeeping or nurse covering both HA and SCU beds) a or nurse covering both HA and SCU beds) a timesheet to keep up with how many hrs timesheet to keep up with how many hrs they work in each cost center is neededthey work in each cost center is needed

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

* For PCS expenses, a one line total on the Miscellaneous Line of the cost center is all that is required

II. Downloading Cost Report ProgramII. Downloading Cost Report Program1.1. Go to the Office of the Controller’s Go to the Office of the Controller’s

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

b)b) Click on ‘2013-2014 Cost Report’ linkClick on ‘2013-2014 Cost Report’ link

2.2. Cost Report Versions availableCost Report Versions available

a.a. Microsoft Access 2003 and 2007Microsoft Access 2003 and 2007

b.b. Access 2007 version should be used if Access 2007 version should be used if using Access 2010 or 2013using Access 2010 or 2013

c.c. PRINT OFF DOWNLOAD INSTRUCTIONSPRINT OFF DOWNLOAD INSTRUCTIONS

d.d. For Access 2007, 2010 & 2013 please For Access 2007, 2010 & 2013 please follow the additional instructions follow the additional instructions related to security related to security

III. Completing the Cost ReportIII. Completing the Cost Report1.1. Schedule ASchedule A

a.a. Contains basic informationContains basic information

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

ii.ii. Please give license number given by DHSR Please give license number given by DHSR (Dept of Health Service Regulations)(Dept of Health Service Regulations)

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

iv.iv. Again in box 16 use dates of most recent Again in box 16 use dates of most recent fiscal year, no earlier than 2013fiscal year, no earlier than 2013

v.v. Give total # of Resident days and SA Days Give total # of Resident days and SA Days

III. Completing the Cost ReportIII. 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 to move the tab key, enter key to move to the next field or scroll bar to the next field or scroll bar and click a field on the screen.and click a field on the screen.

III. Completing the Cost ReportIII. Completing the Cost Report2.2. Schedule BSchedule B

a.a. Revenue InformationRevenue Information

i.i. Revenue related to Special Assistance (SA) Revenue related to Special Assistance (SA) residentsresidents

ii.ii. Revenue related to private pay residentsRevenue related to private pay residents

iii.iii. Revenue related to non residentsRevenue related to non residents

b.b. Net Profit or LossNet Profit or Loss

III. Completing the Cost ReportIII. Completing the Cost Report3.3. Schedule C Schedule C

a.a. Schedule C-Direct and C-Ind/Oth Schedule C-Direct and C-Ind/Oth

i.i. 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

ii.ii. For each of the three cost centers enter a For each of the three cost centers enter a lump sum on the Miscellaneous line, which lump sum on the Miscellaneous line, which would be lines 59, 72 & 88would be lines 59, 72 & 88

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

III. Completing the Cost ReportIII. Completing the Cost Report4.4. Schedule DSchedule D

a.a. Related Party TransactionsRelated Party Transactions

i.i. Nursing Homes are exempt from reportingNursing Homes are exempt from reporting

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

iii.iii. 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 happens has to be listed on Sch D along with the expense.with the expense.

III. Completing the Cost ReportIII. Completing the Cost Report5.5. Schedule ESchedule E

a.a. Allocation MethodAllocation Method

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

ii.ii. 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

iii.iii. 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• 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)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 Because they only look at specific cost

report related info and are not a full blown report related info and are not a full blown audit with an opinionaudit with 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)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 are every other year. They are not requirednot required for for this cost reporting cyclethis cost reporting cycle

• Homes with 6 beds or less are exempt from Homes with 6 beds or less are exempt from this cost reporting cycle.this cost reporting cycle.

IV. Agreed Upon Procedures (AUPs)IV. Agreed Upon Procedures (AUPs)• AUPs will be available online at the Office of AUPs will be available online at the Office of

the Controller’s website on Wednesday, Oct. the Controller’s website on Wednesday, Oct. 22nd22nd

• AUPs remain consistent with those from the AUPs remain consistent with those from the last reporting cycle in 2009 with the exception last reporting cycle in 2009 with the exception of PCS. PCS has been eliminated except for of PCS. PCS has been eliminated except for grand totals by cost centergrand totals by cost center

• AUP questions should be addressed via AUP questions should be addressed via email to: AUP.Questions@dhhs.nc.govemail to: AUP.Questions@dhhs.nc.gov

V. Sending in Cost ReportV. Sending in Cost Report Finished entering cost report dataFinished entering cost report data

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

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

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

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

then click the Export Data buttonthen click the Export Data button Even if only one home is entered in database please Even if only one home is entered in database please

follow the same procedure follow the same procedure

V. Sending in Cost ReportV. Sending in Cost Report

Home is exported out of databaseHome is exported out of database DomCareWeb subdirectory is created on DomCareWeb subdirectory is created on

the computer’s C drivethe computer’s C drive Access 2007, 2010 and 2013 users will also Access 2007, 2010 and 2013 users will also

need to make this subdirectory a trusted need to make this subdirectory a trusted location (see download instructions)location (see download instructions)

File name will be the name of the homeFile name will be the name of the home This is the file that needs to be saved on a This is the file that needs to be saved on a

flash drive/CD or attached to an email.flash drive/CD or attached to an email.

V. Sending in Cost ReportV. Sending in Cost Report Submitting the Cost ReportSubmitting the Cost Report

Required to be considered completeRequired to be considered complete Electronic copy of database file for each Electronic copy of database file for each

home/license #. File can be saved on a flash drive, home/license #. File can be saved on a flash drive, CD and mailed in or emailedCD and mailed in or emailed

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

Highly recommended to include printed copy of cost Highly recommended to include printed copy of cost report. It can be on paper, scanned and included as report. It can be on paper, scanned and included as a pdf file or faxed.a pdf file or faxed. In case there are issues with importing on this end our In case there are issues with importing on this end our

office will already have a backup copyoffice will already have a backup copy

V. Sending in Cost ReportV. Sending in Cost Report Submitting the Cost ReportSubmitting the Cost Report

Required to be considered completeRequired to be considered complete For homes with 21 beds or more a copy of For homes with 21 beds or more a copy of

their AUPs. Again this can be a scanned copy their AUPs. Again this can be a scanned copy submitted electronically or paper copy or submitted electronically or paper copy or faxed documentfaxed document

If submitting information by email, please do If submitting information by email, please do one email per home/license #one email per home/license # Depending on your server you may need to send Depending on your server you may need to send

scanned electronic copies of Sch A and AUPs (if scanned electronic copies of Sch A and AUPs (if required) in a separate email from the cost report required) in a separate email from the cost report file. If it can be done all in one that would be greatfile. If it can be done all in one that would be great

2 Versions: Access vs. Runtime2 Versions: Access vs. Runtime

The Access versions of the cost report that are available The Access versions of the cost report that are available on our website are Access 2003 or 2007. 2007 will work on our website are Access 2003 or 2007. 2007 will work on 2010 and 2013on 2010 and 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 2003 or no Access at all. This has to be installed.older than 2003 or no Access at all. This has to be installed.

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 to move to the next field key to move to the next field or scroll bar and click a field or scroll bar and click a field on the screen.on the screen.

VI. RemindersVI. Reminders

Cost Reports are due December 31, 2014Cost Reports are due December 31, 2014

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. Save each file to flash drive or CDSave each file to flash drive or CD

Hard Copy: PrintedHard Copy: Printed

1.1. A A signedsigned Sch A Sch A is requiredis required. Include with electronic files or fax. Cost report considered incomplete without signed Sch A. Include with electronic files or fax. Cost report considered incomplete without signed Sch A

2.2. Printed or scanned copy of cost report and AUP (if required) also requiredPrinted or scanned copy of cost report and AUP (if required) also required

3.3. Print a copy for your own recordsPrint a copy for your own records

Access 2007, 2010 & 2013Access 2007, 2010 & 2013

• MS A2007, 2010 and 2013 MS A2007, 2010 and 2013 have built in security.have built in security.

• Follow the download Follow the download instructions for setting up instructions for setting up trusted locations.trusted locations.

• Both subdirectories AdultCare Both subdirectories AdultCare 2014 and DomCareWeb need to 2014 and DomCareWeb need to be trusted locationsbe trusted locations

• Ensure you “Allow” or Ensure you “Allow” or “Unblock” macros and “Unblock” macros and security settings.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 submittedIf 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 statue also allows for cost report the statue 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 IssuesHot 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• If you leave a message, please provide a call If you leave a message, please provide a call

back time. back time. • Paul ColePaul Cole will be the backup for answering will be the backup for answering

questions. He can be reached at questions. He can be reached at 919-855-919-855-36853685 or or Paul.j.cole@dhhs.nc.govPaul.j.cole@dhhs.nc.gov

QuestionsQuestions

Contact InfoContact InfoPoints of contact:

Susan Kesler Sibbett – 919.855.3680

susan.sibbett@dhhs.nc.gov

Fax number is 919.715.3095

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