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Reporting Charity Care and Medicaid at Cost

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    Jody Branham

    Posted by: Shannon Jordan, Good Samaritan Hospital

    Date: November 2, 2009, 8:23 am

    I was wondering how others reported charity at cost and medicaid at cost in CBISA. Do you calculate this on a monthly basis or just report it once a year. For 2009 I have been reporting this data on a monthly basis. The cost of charge ratio I calculated using year end 2008 data. I was interested in others’ approach.

    Jody Branham

    Response: Deb Freeman, The Bellevue Hospital

    Date: November 2, 2009, 10:35 am

    I will report this after the year 2009 is closed and the Medicare Cost Report is completed, since the Cost Report is due before the Form 990 is due.

    Jody Branham

    Response: Mary Luthy, St. John’s Health Center

    Date: November 2, 2009, 10:51 am

    Our charity care cost is estimated by multiplying the overall hospital RCC by charity care write-offs, as obtained from the General Ledger.

    Jody Branham

    Response: Angela Haggard, Provena Health

    Date: November 2, 2009, 1:22 pm

    You will want to reference the worksheets for the IRS 990 H instructions – worksheet 1 for Charity and Worksheet 3 for Medicaid. You will also have to complete worksheet 2 for the cost to charge ratio. These calculations are slightly different than what we have done historically. I am working directly with our finance department.

    We report on a quarterly basis so we have some indication as to how we are trending compared to previous years. At year-end we make the necessary adjustments in CBISA software to assure the year-end # is accurate.

    Jody Branham

    Response: Melissa Hutchison, Allina Hospital and Clinics

    Date: November 2, 2009, 2:57 pm

    Allina reports Charity Care and Cost in Excess of Medicaid into CBISA on a quarterly basis using a quarterly calculated cost to charge ratio. The final annual numbers are true-d up at year end using the current annual cost to charge ratio.

    Allina does not have a tracking method for bad debt that is attributable to patients that may qualify for charity care, but do not submit the application.

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