Veterans Health Administration Office of Community Care State Home Per Diem Program

1. Veterans Health Administration Office of Community Care State Home Per Diem Program Daily Cost of Care (from the ETT to 10-5588 to SHPD Web Application) January 10, 2018

2. Daily Cost of Care How is the Daily Cost of Care Calculated? • Receive the direct and indirect cost from the facility and enter it into the ETT. • The ETT will take that value and calculate the Daily Cost of Care using the formula built into the ETT. (Facility direct and indirect cost for the month divided by the total days of care of All Residents (regardless of Payer Source) equals the Daily Cost of Care). • Advise the SVH of the value from the ETT who will confirm value and enter it on the 10-5588 (items 21, 22, and/or 23 column C). • Enter the 10-5588 into SHPD Web Application ensuring the Daily Cost of Care matches the ETT.

3. Daily Cost of Care Receive the direct and indirect cost from the facility and enter it into the ETT. If there is a discrepancy between ETT and SVH reporting the Daily Cost of Care, verify the bed days of the civilians and Veterans; this should match ETT and SVH Census. If issue is not resolved, contact Steve Pellicer for assistance.

4. Daily Cost of Care Calculating the Monthly Daily Cost of Care in the SHPD Web Application Data entered affects the Daily Cost of Care calculation.

5. Entering the Monthly Daily Cost of Care in the SHPD Web Application Data entered affects the Daily Cost of Care calculation. 5

6. Daily Cost of Care Daily Cost of Care drives Per Diem Rate If the SVH miscalculates the Cost can lessen per diem rate

7. Daily Cost of Care • Summary • The daily cost of care is the direct cost plus the indirect cost for the month, divided by the total days of care of all enrollees or residents present in thefacility during the month regardless of the payer source. • If a SVH is using an fixed annual rate; the Daily Cost of Care on the10-5588 needs to match the SHPD Web Application Value. • As a Reminder, if there is a discrepancy between ETT and SVH reporting the Daily Cost of Care, verify the bed days of the civilians and Veterans; this should match ETT and SVH Census. If issue is not resolved, contact Steve Pellicer for assistance. • Communicate the SVH daily movement with the VAMC so the ETT is up to date at the end of month in order for the invoices are ready to be paid timely. If issues have not been resolved and payment has been delayed, please contact VACO SHPD Program for assistance to mediate.

8. Daily Cost of Care §§ 51.40(angel)(1) and 51.41(beer)(2) Resources include: • Office of Management and Budget (OMB) Circular number 2 CFR 200, (dated 12/26/2013), "Uniform Administrative Requirements, Cost Principles, and Audit Requirement in Federal Awards" (2 CFR Part 200.400 to 475 for cost principles) • State Veterans Home (SVH) Per Diem Payment Program , VHA Directive 1601SH.01 • Policies, Laws, and Regulations (§§ 51.40(a)(1) and 51.41(b)(2)) • 10-5588, ETT, SHPD Web Application (to include user guides) • Training Presentations • Conference Call Minutes If you find that you have exhausted all of these resources, then please send your questions/concerns to: VHA10D1B3StateHomePerDiemInquiries@va.gov

9. Questions 9

10. Thank You!