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Summary of Changes – New SNF-CR

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Overview of the Skilled Nursing Facility Cost Report (SNF-CR)

The new nursing facility cost report has been reformatted and redesigned to take advantage of newer platforms and to streamline information being reported. Some of the major changes are listed below.


Data Fields Characterized by Line Numbers and Line Descriptions

CHIA is no longer using account numbers to store and report cost report information. CHIA has transitioned to using line numbers and descriptions to database and store cost reported data. For example, Line 1.1 in Schedule 6 Cash and Cash Equivalents is now being stored and is accessible as that line number and description. This allows for ease of use when obtaining the nursing facility dataset.


Fewer Schedules

There are total of 13 schedules in the newly redesigned cost report as compared to 24 schedules in the previous report. Several previous schedules with similar information are now merged into new schedules. For example, non-nursing facility programs, revenues and expenses were reported in 3 different schedules in the previous cost report. The SNF-CR showcases a new schedule called “Other Business Revenues and Expenses”.


Linking Between Schedules

A number of the values no longer require duplicate entry in certain schedules. Some of these values are carried from other schedules or tables to reduce the need to enter the same number in 2 locations.


Hover Messaging and Validations

The new cost report provides a significant amount of hover messaging and validation checks to provide instruction on what values should be reported in a certain field and to provide checks and balances to ensure consistency of reporting across and within schedules.

 

Expense Categories Simplified and Descriptions Modernized

Many outdated line descriptions have been modernized, including removal of gender specificity. Also, a number of expenses and staff categories were merged. For example, Laundry and Housekeeping costs were merged; “Telephone: Phone” is now “Telecommunications (phone and internet)”; and the 3 separate lines for “GLH Insurance”, “Pensions”, and “Benefits Other” is now only one line called “Employee Benefits”. 

 

Brief Update on Specific Schedules

Schedule Number and NameChanges and Updates

 

  Schedule 1
  General Information

 
  • New Table requiring reporting of information on any other MA public payer programs that the direct and indirect owner operate.

  • Questions on Determination of Need Projects moved to Detail of Fixed Assets Schedule.

 

  Schedule 2
  Revenue

 
  • Expanded list of insurance payer options.

  • Other nursing facility revenue lines added.

 

  Schedule 3
  Expenses

 
  • All cost center expenses are now reported on this one schedule.

  • Line descriptions modernized and new lines added for new staff types such as security and resident care assistant.

 

  Schedule 4
  Other Business Revenue and Expenses

 
  • This is a new schedule and allows providers to report all other business activities in one place.

 

  Schedule 5
  Statement of Operations

 
  • Financial and cost reported operational activity into separate tables for ease of reporting.

  • Relocated and reorganized the reconciliation of cost reported to financial statement net income.

 

  Schedule 6
  Balance Sheet

 
  • Reduced duplicate reporting of fixed assets that are reported in detail on the newly reformatted Schedule 7 Detail of Fixed Assets.

  • Added a new table for reporting the reconciliation of Owner’s Equity

 

  Schedule 7
  Detail of Fixed Assets

 
  • Additional tables to segregate financial statement fixed assets from allowable cost reported fixed assets.

  • New tables for reporting necessary information on Determination of Need construction projects.

  • New questions on the physical plant added.

 

  Schedule 8
  Statement of Cash Flows

 
  • No significant changes.

 

  Schedule 9
  Licensure and Patient Statistics

 
  • Modernization of payer e.g. Medicare Management Part C and Senior Care Options.

  • Modernization and expansion of patient categories e.g. Head Trauma and ALS.

  • Hover messaging to guide preparers to report patient day information in the proper sections.

 

  Schedule 10
  Detail of Facility Compensation

 
  • Reorganization of all detailed information regarding employee and owner/officers hours and salaries in one place. This includes hours, shift differential, and salary information for all direct care nursing services, for employees and for purchased services.

 

  Schedule 11
  Notes Payable

 
  • No significant changes.

 

  Schedule 12
  Footnotes

 
  • Easy to use up loadable preformatted excel templates for reporting ownership and facility, related party debt and markup information.

 

  Schedule 13
  Attestation

 
  • New attestation process the first requires preparers to “lock” the cost report prior to owner/officer review and attestation.