Section 29-6518. COST REPORTING AND RECORD MAINTENANCE

 

6518.1Each nursing facility shall submit an annual cost report to the Medicaid Program within one hundred and twenty days (120) days of the close of the facility's cost reporting period, which shall be concurrent with its fiscal year used for all other financial reporting purposes.

 

6518.2MAA reserves the right to modify the cost reporting forms and instructions and shall send written notification to each nursing facility regarding any changes to the forms, instructions and copies of the revised cost reporting forms.

 

6518.3A delinquency notice shall be issued if the facility does not submit the cost report on time and has not received an extension of the deadline for good cause.

 

6518.4Only one extension of time shall be granted to a facility for a cost reporting year and no extension of time shall exceed thirty (30) days. MAA shall honor all extensions of time granted to hospital-based facilities by the Medicare program.

 

6518.5If the cost report is not submitted within thirty (30) days of the date of the notice of delinquency, twenty percent (20%) of the facility's regular monthly payment shall be withheld each month until the cost report is received.

 

6518.6Each nursing facility shall submit one (1) original hard-copy and (1) one electronic copy on CD-ROM format of the cost report. Each copy shall have an original signature.

 

6518.7Each cost report shall meet the following requirements:

 

(a)Be properly completed in accordance with program instructions and forms and accompanied by supporting documentation;

 

(b)Include copies of audited financial statements or other official documents submitted to a governmental agency justifying revenues and expenses;

 

(c)Include and disclose payments made to related parties in accordance with section 6512.11 and the reason for each payment to a related party; and

 

(d)Include audited cost allocation plans for nursing facilities with home office costs, if applicable.

 

6518.8Computations included in the cost report shall be accurate and consistent with other related computations and the treatment of costs shall be consistent with the requirements set forth in these rules.

 

6518.9In the absence of specific instructions or definitions contained in these rules or cost reporting forms and instructions, the decision of whether a cost is allowable shall be determined in accordance with the Medicare Principles of Reimbursement and the guidelines set forth in Medicare Provider Reimbursement Manual 15.

 

6518.10All cost reports shall cover a twelve (12) month cost reporting period, which shall be the same as the facility's fiscal year, unless MAA has approved an exception.

 

6518.11A cost report that is not complete as required by subsections 6518.6 through 6518.8 shall be considered an incomplete filing and the nursing facility shall be so notified.

 

6518.12If, within thirty (30) days of the notice of incomplete filing, the facility fails to file a completed cost report and no extension of time has been granted by MAA, twenty percent (20%) of the facility's regular monthly payment shall be withheld each month until the filing is complete.

 

6518.13MAA shall pay the withheld funds promptly after receipt of the completed cost report and documentation required meeting the requirements of this section.

 

6518.14Each facility shall maintain adequate financial records and statistical data for proper determination of allowable costs and in support of the costs reflected on each line of the cost report. The financial records shall include the facility's accounting and related records including the general ledger and books of original entry, all transactions documents, statistical data, lease and rental agreements and any original documents which pertain to the determination of costs.

 

6518.15Each nursing facility shall maintain the records pertaining to each cost report as described in subsection 6518.14 for a period of not less than seven (7) years after filing of the cost report. If the records relate to a cost reporting period under audit or appeal, records shall be retained until the audit or appeal is completed.

 

6518.16All records and other information may be subject to periodic verification and review. Each cost report may be subject to a desk review.

 

6518.17Each nursing facility shall:

 

(a)Use the accrual method of accounting; and

 

(b)Prepare the cost report in accordance with generally accepted accounting principles and all program instructions.

 

6518.18Audits shall be conducted to establish the initial rates and upon rebasing as set forth in section 6517.

 

source

Final Rulemaking published at 53 DCR 1370 (February 24, 2006).