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Reporting Charity Care and Medicaid at Cost

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    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.


    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.


    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.


    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.


    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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