Transforming Skilled Nursing Data Submission: Medicare's New Cost Report Impact
Skilled nursing providers are bracing for a pivotal transformation in their data submission processes as they approach the cost report season. This change, stemming from the introduction of new Medicare cost report forms by the Centers for Medicare & Medicaid Services (CMS), aims to gather data poised to shape the industry's landscape for years. According to the Zimmet Healthcare Services Group, these updates are tailored to boost verifiability and operational transparency.
The redesigned forms are in alignment with the Patient Driven Payment Model, focusing on detailed patient characteristics and associated services. This granularity aids CMS in accurately forecasting payment rates for skilled nursing facilities, potentially influencing a sector-specific wage index. Accurate reporting is critical as it significantly impacts future reimbursement policies and regulatory compliance requirements.
The updated CMS-2540-24 form mandates providers to detail census, payer, and staffing information. Providers must now break down revenue by sources—such as Medicare Advantage, Medicare, and state-managed care plans—rather than broader categories like Medicare, Medicaid, and private pay. Reporting requirements also extend to contract or agency labor use and related expenses for services such as resident activities, QAPI programs, and IV therapy.
A key element of the new reporting requirements is the completion of a full balance sheet and a statement of patient revenues and operating expenses. These reports will be publicly accessible, offering a transparent view of providers' financial statuses within and beyond the Medicare program.
One anticipated outcome of these requirements is enhanced transparency in margin reporting, allowing for a comprehensive understanding of financial health across payers and service types. Providers are encouraged to align operational and financial practices with these new demands to adequately manage the expanded data requirements, particularly concerning contract labor.
Cost reports are generally due five months after the fiscal year-end. However, CMS has offered a one-time 60-day filing extension this year to accommodate the transition to the new reporting format. Providers are advised to utilize this additional time to ensure data accuracy and reconciliation before returning to the standard filing deadline.