2007 HAR Education and Information Session

1. 2007 HAR Education and Information Session Amy Camp, MDH Joe Schindler, MHA Jonathan Peters, MHA

2. 2007 Education and Information Topics • New or Changed Sections in the 2007 HAR • Available Beds and Bassinets Section • Bad Debt Write Offs • Charges, Days, and Admissions Sections • Self Pay Discounts and Charity Care • Community Benefits • Capital Expenditures • Reminders, Resources, and Tips

3. Contact Information An additional Courtesy Contact was added A Capital Expenditure Contact was added. This should list the individual responsible for any questions relating to Capital Expenditures. The Capital Expenditure Contact is required, and is not optional.

4. Available Beds and Bassinets • Report number of available beds in each dedicated specialty unit. • Smaller facilities will most likely need to fill out only the Med/Surg Available Bed line. • According to MDH Licensing, Neonatal units are bassinets, and should be reported in account 7497 in Section 6. • Most cells in the Total Available column are over writable. Only cells grayed out have been locked. • Report Swing Beds if the hospital has a dedicated swing bed unit.

5. Bad Debt Write Offs • New section requests the breakouts of Insured vs. Uninsured of bad debt written off during the hospital’s 2007 fiscal year. • This is not related to the hospital’s provision for bad debt (which is an income statement item), but the actual debt that was written off and/or sent to collections.

6. Charges, Days, and Admissions by Hospital Service • Accounts above Total Acute Care Charges (7133) are service line information, not department level charges. • These accounts can be filled out using UB or billing data. • MHA can fill out the accounts above Total Acute Care Charges, if the preparer indicates “Yes” at the top of these sections. • Patient Days by Hospital Service (Section 39) and Total Admissions by Hospital Service (Section 44) follow the same structure and guidelines as the Charges section • MHA can also fill out the lines above account 4030 in section 39 and lines above account 4320 in section 44 if the preparer indicates “Yes” at the top of these sections. • If the preparer chooses to fill out the section themselves, please make sure that if a particular account has information in charges, days, or admissions, that all three contain data.

7. Self Pay and Charity Care The percentage discount offered Self Pay patients will be collected. Please note that this will be non public data. Charity Care Adjustments will be broken out into Insured vs. Uninsured. • Within Uninsured, three further pieces of data will be collected: • Amount that was 100% discounted • Amount that was only a partial discount of full bill • The average partial discount given to uninsured patients Please provide information only for accounts you have accurate data for, or can reasonably derive.

8. Community Benefits • Community benefits information should be hospital level data. • Work with the individual who has reported this information in surveys to MHA and MDH in prior years. • A number of these accounts will require calculations to be made that may not be found in the trial balance or accounting statements. • Communications/Marketing Director may be able to assist in the accurate completion of this section.

9. Capital Expenditures • A Capital Expenditure Fact Sheet is available on both the MDH and MHA HCCIS websites. • In addition to the reporting on the HAR, a separate file is required for each major capital spending project over one million dollars. • “Commitment” is defined as when the project has been officially approved (e.g. Board of Directors has approved the plan) • After the HAR has been audited, MDH will review this section and additional documents supplied by the hospital, and may contact the Capital Expenditure Contact (from the contacts section) with questions or requests for additional information. • All inquiries on Capital Expenditure reporting can be directed to: Tom Major (651) 201-3574 tom.major@health.state.mn.us

10. Reminders, Tips, and Resources for Preparers General Guidelines and Places for Further Information

11. Medicare Advantage and Small Balance Write Offs • Medicare Advantage to still be placed in Medicare Managed Care accounts on the HAR (accounts 742, 842, 7162, 7184, on pages 10, 12, 20, and 22). • Medicare Advantage Swing Bed Days should be included in the Medicare Reimbursed Swing Bed Patient Days (account 4033) on page 23. • Small balance write offs to be included in “Other Payers” and not Self Pay Discounts.

12. Common Reclasses • Please ensure the following accounts are included in Operating Expenses • Provision for Bad Debt • MA Surcharge • Interest Expense • The following accounts may need to be reclassed into Non-Operating Expenses/Income • Interest Income • Realized Gains/Losses on Sale of Properties/Assets • Unrealized Gains/Losses should be reclassed to Other Changes to Unrestricted Net Assets (accounts 340 and 840) • Amounts listed in accounts on the Institution Section (page 3) should never be less than amounts listed in the hospital specific accounts found later in the HAR (e.g. Institution Non-Operating Revenue, account 320, should not be less than account 820, Hospital Specific Non-Operating Revenue)

13. “Audit Checks” Tab • “Audit Checks” tab reflects the specific hospital’s average salaries and outpatient charges from FY 2006, as well as % change increase or decrease. • If this year’s averages for a given category show a dramatic change from prior year’s reporting, please indicate the reason why on the “Explanations of Adjustments” (last page in HAR). As a general guideline, if the average salary for a particular category changed by 15% or more, please provide an explanation. For outpatient charges, changes of 25% or more will also require further explanation.

14. Expense Allocation Methodology • If there is a Nursing Home, Clinic, Ambulance, etc., broken out on the Institution Section (page 3), their information should be excluded from the rest of the HAR. • In the Natural Expense Summary (page 7) all expenses associated with a listed institution on page 3 should be removed, including overhead and indirect expenses. • Review previous year’s HAR documentation for allocation methods • If they are reasonable, use same methodology • Following the same process creates consistency and comparability. • Medicare Cost Report may provide insight • Talk with the MCR preparer • Review documentation on MCR, worksheet B

15. Data Transmission Method Available • HTTPS data transmission available • Transmission encrypted and secure • As easy as web e-mail or online banking • Hospitals can download their prior year’s Commentary or Hospital Profile report from same site as well. • More safe and secure than postal mail or e-mail • No file size restrictions, unlike e-mail • This method is highly recommended by MDH and MHA for data transmission • Please contact MHA to receive your login and password • Web address: https://har.mnhospitals.org

16. Places for Further Information • Both MDH and MHA’s website have further information on HAR related issues. • MDH Website: http://www.health.state.mn.us/divs/hpsc/dap/hccis/index.html • MHA Website: http://www.mnhospitals.org/index/HCCIS_1 • All Deadlines and Events are posted on websites. • Power Point presentation of 2006 and 2005 HAR Education and Information Sessions available at sites above. • Electronic Newsletters covering the following topics: • Getting Started • Microsoft Excel Tips and Useful Tools • Expense Allocation Methodology • Primary Payer Charges and Adjustments • Outpatient Charges • If a question or problem arises while completing the Hospital Annual Report, please contact either Joseph Schindler or Jonathan Peters at MHA, or Amy Camp at MDH (see last slide for contact information).

17. Contact Information • MHA staff at (800) 462-5393 or (651) 641-1121 • Joseph Schindler, MHA (651) 659-1415 • Jonathan Peters, MHA (651) 659-1422 • Amy Camp, MDH (651) 201-3575 • Tom Major, MDH (651) 201-3574 (Capital Expenditure Reporting)