2014 Adult Care Cost Report Overview Training Susan Kesler Sibbett DHHS – Office of the Controller

1. 2014 Adult Care Cost Report Overview Training Susan Kesler Sibbett DHHS – Office of the Controller Rate Setting Branch

2. Why Are We Here • Per Senate Bill 744, section 12H.11 passed by the General Assembly and signed by the Governor in August 2014 states “… shall require compliance with the adult care home cost reporting requirements set forth in GS 131D-4.2.” • Per GS 131D-4.2 – facilities that receive State/County Special Assistance or Medicaid personal care are required to file a cost report

3. Why Are We Here • IF you ONLY provide PCS and DO NOT receive any State/County Special Assistance there is no need to do this cost report • For this year, PCS amounts are being lumped together on the Miscellaneous Line of the PCS cost centers, no detail required • Small group homes with 6 or less beds are exempt from the cost reporting requirement

4. Overview • I. Chart of Accounts • II. Downloading Program • III. Completing the Cost Report IV. AUPs V. Sending in Report

5. I. Chart of Accounts • Can be found on the DHHS Office of the Controller’s web site. Has been available since September 10, 2014 • For this cost reporting cycle please use figures from the most recently audited fiscal year. No earlier than 2013 • It contains all the line item expenses in the cost report and gives examples of the expenses that go on each line • Homes with both HA and SCU beds need to capture revenue & expenses separately

6. I. Chart of Accounts • For any employee working in more than one cost center (example dietary & housekeeping or nurse covering both HA and SCU beds) a timesheet to keep up with how many hrs they 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

7. II. Downloading Cost Report Program • Go to the Office of the Controller’s webpage • www.ncdhhs.gov/control/acf/acfac.htm • Click on ‘2013-2014 Cost Report’ link • Cost Report Versions available • Microsoft Access 2003 and 2007 • Access 2007 version should be used if using Access 2010 or 2013 • PRINT OFF DOWNLOAD INSTRUCTIONS • For Access 2007, 2010 & 2013 please follow the additional instructions related to security

8. III. Completing the Cost Report • Schedule A • Contains basic information • Mailing address, physical address of the home, phone number, contact person, Medicaid #, NPI #, etc. • Please give license number given by DHSR (Dept of Health Service Regulations) • Input licensed bed capacity given by DHSR. If home has SCU beds indicate the # of SCU beds and the # of other beds • Again in box 16 use dates of most recent fiscal year, no earlier than 2013 • Give total # of Resident days and SA Days

9. III. Completing the Cost Report • Helpful hint – Do not use the scroll rollerball on your mouse when entering data in the cost report program. It can remove data on the screen already entered. Best to use the tab key, enter key to move to the next field or scroll bar and click a field on the screen.

11. III. Completing the Cost Report • 2. Schedule B • Revenue Information • Revenue related to Special Assistance (SA) residents • Revenue related to private pay residents • Revenue related to non residents • Net Profit or Loss

13. III. Completing the Cost Report • 3. Schedule C • Schedule C-Direct and C-Ind/Oth • PCS section is made up of 3 cost centers: Personal Care, Health Services, Initial/Orientation Aide Training • For each of the three cost centers enter a lump sum on the Miscellaneous line, which would be lines 59, 72 & 88 • All other cost centers need to be completed with both hours paid, unpaid and total expenditures.

15. III. Completing the Cost Report • 4. Schedule D • Related Party Transactions • Nursing Homes are exempt from reporting • Related party - meaning the home is associated or affiliated with an organization or individual furnishing the services, facility or supplies. • The cost report expense line item where this happens has to be listed on Sch D along with the expense.

17. III. Completing the Cost Report • 5. Schedule E • Allocation Method • Only used by homes with Special Care Unit (SCU) beds • Explains how expense allocated between SCU beds and non SCU beds within the home • Allocation basis are: Direct, Resident Days, Square Footage or Other. If other is used an explanation is required • Other could mean a combination of Direct, Resident Days and/or Square Footage

19. IV. Agreed Upon Procedures (AUPs) • Per GS 131D-4.2 adult care homes are required to submit audited reports. • AUPs are used to satisfy the audit requirement and generally are less expensive • Because they only look at specific cost report related info and are not a full blown audit with an opinion • AUPs have to be done by an outside, independent accountant or CPA

20. IV. Agreed Upon Procedures (AUPs) • Homes with 21 beds or more have to submit AUPs every year. • Homes with 7 to 20 beds have to submit AUPs every other year. They are not required for this cost reporting cycle • Homes with 6 beds or less are exempt from this cost reporting cycle.

21. IV. Agreed Upon Procedures (AUPs) • AUPs will be available online at the Office of the Controller’s website on Wednesday, Oct. 22nd • AUPs remain consistent with those from the last reporting cycle in 2009 with the exception of PCS. PCS has been eliminated except for grand totals by cost center • AUP questions should be addressed via email to: AUP.Questions@dhhs.nc.gov

22. V. Sending in Cost Report Finished entering cost report data Make sure the box is green Hint: sometime have to click on another schedule for it to turn green Never a bad idea to click the Save/Refresh button every now and then Print off a copy of the finished report Have to export the finished home Click on Administrator Option button Use the drop down arrow and choose home to export, then click the Export Data button Even if only one home is entered in database please follow the same procedure

24. V. Sending in Cost Report Home is exported out of database DomCareWeb subdirectory is created on the computer’s C drive Access 2007, 2010 and 2013 users will also need to make this subdirectory a trusted location (see download instructions) File name will be the name of the home This is the file that needs to be saved on a flash drive/CD or attached to an email.

25. V. Sending in Cost Report Submitting the Cost Report Required to be considered complete Electronic copy of database file for each home/license #. File can be saved on a flash drive, CD and mailed in or emailed A signed Sch A. This can be a paper copy mailed in with flash drive, CD or faxed or scanned and sent as an electronic pdf file. Highly recommended to include printed copy of cost report. It can be on paper, scanned and included as a pdf file or faxed. In case there are issues with importing on this end our office will already have a backup copy

26. V. Sending in Cost Report Submitting the Cost Report Required to be considered complete For homes with 21 beds or more a copy of their AUPs. Again this can be a scanned copy submitted electronically or paper copy or faxed document If submitting information by email, please do one email per home/license # Depending on your server you may need to send scanned electronic copies of Sch A and AUPs (if required) in a separate email from the cost report file. If it can be done all in one that would be great

27. 2 Versions: Access vs. Runtime The Access versions of the cost report that are available on our website are Access 2003 or 2007. 2007 will work on 2010 and 2013 • Has only 2 files that have to be downloaded • A runtime version is available for those with Access versions older than 2003 or no Access at all. This has to be installed.

28. VI. Reminders • Again helpful hint – Do not use the scroll rollerball on your mouse when entering data in the cost report program. It can remove data on the screen already entered. Best to use the tab key, enter key to move to the next field or scroll bar and click a field on the screen.

29. VI. Reminders • Cost Reports are due December 31, 2014 • Make sure the box is green • A signed Sch A must be submitted before Cost Report is considered complete

30. VI. Reminders • Strongly recommend cost report be submitted electronically • Paper cost reports may be typed or handwritten but must be legible • If applicable to your facility, AUPs can be submitted by paper, electronically or by fax

31. VI. Reminders • Strongly recommend submitting a printed copy of the cost report along with the electronic file. The printed copy can be a scanned electronic pdf file, paper or faxed. • Cost Report not considered complete until all required information has been received

32. Finalize Package to Submit Electronic media: flash drive, CD Export home into an individual file. Click the Admin Options button. Save each file to flash drive or CD Hard Copy: Printed A signedSch A is required. Include with electronic files or fax. Cost report considered incomplete without signed Sch A Printed or scanned copy of cost report and AUP (if required) also required Print a copy for your own records

33. Access 2007, 2010 & 2013 • MS A2007, 2010 and 2013 have built in security. • Follow the download instructions for setting up trusted locations. • Both subdirectories AdultCare 2014 and DomCareWeb need to be trusted locations • Ensure you “Allow” or “Unblock” macros and security settings.

34. Final Reminders • Please check the web site often! • The web site address is:http://www.ncdhhs.gov/control/acf/acfac.htm New information will be posted here as soon as it is available.

35. If required cost report is not submitted • Per GS 131D-4.2 (g) – if a facility fails to submit a cost report by the due date the Office of the Controller will notify DHSR and they will suspend admission to the facility • If a facility continues to refuse to submit a cost report the statue also allows for licenses to be suspended or even revoked. • As soon as the late cost report with all required documentation is received DHSR is notified and the suspend admissions is lifted.

36. Hot Button Issues • If information is missing our office will call or email to get the information • Check that the data was written to media • If you leave a message, please provide a call back time. • Paul Cole will be the backup for answering questions. He can be reached at 919-855-3685 or Paul.j.cole@dhhs.nc.gov

37. Questions

38. Contact Info Points 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