PS&R with splits not required for SNF/Swing-bed SNF providers
According to the cost reporting worksheet S-7 instructions found at CMS Pub. 15-2, Section 3609, "For cost reporting periods beginning on or after July 1, 2001 the only data required to be reported are the days associated with each RUG. Those days will be reported in column 3.01 regardless of the periods designated . The calculation of the total payment for each RUG is no longer required. All payment data will be reported as a total amount paid under the RUG PPS payment system on Worksheet E-3, Part III, line 24 and will be generated from the PS&R or your records."
Pub. 15-2 Section 3633.3 Part III also states, "SNFs electing 100 percent Federal rate for cost reporting periods beginning on or after July 1, 2001, providers are required to input the total RUG payments. Obtain this from your books and records or the PS&R." This means that SNFs are required to complete worksheet S-7, column 3.01 only, and the prospective payment amount no longer flows from worksheet S-7 to worksheet E-3, Part III. The prospective payment amount can easily be obtained from the PS&R without the need for 09/30 and 12/31 rate change splits.
With respect to swing-bed SNF, for worksheet E-2, Pub. 15-2 Section 3632, states "effective for cost reporting periods beginning on or after July 1, 2002 swing beds are paid on the basis of SNF PPS and are required to input the total PPS payments in column 1 or 2, as applicable, from the provider's books and records or the PS&R." Swing-beds are still required to complete worksheet S-7, column 4.06, which does not require any splits.
Effective immediately, WPS will therefore no longer furnish SNF or swing-bed SNF PS&Rs split at 09/30 and 12/31. Providers will receive SNF PS&Rs for the entire cost reporting period without any splits except in unique situations, such as terminations.
If you would like to continue to receive a PS&R with the splits then you may order the additional PS&R and normal fees will apply.
If you have any further questions regarding this topic, please contact the Audit Supervisor assigned to your provider.
Page Last Updated: Thursday, 18-Mar-2010 05:48:24 CDT
