Arkansas Code of 1987 (2023) › Title 20 - PUBLIC HEALTH AND WELFARE (§§ 20-2-101 — 20-86-113) › Subtitle 2 - HEALTH AND SAFETY (§§ 20-6-101 — 20-38-113) › Chapter 10 - LONG-TERM CARE FACILITIES AND SERVICES (§§ 20-10-101 — 20-10-2510) › Subchapter 24 - COST-REPORTING OF ASSISTED LIVING FACILITIES (§§ 20-10-2401 — 20-10-2405) › Section 20-10-2402 - Cost reports

(a)
An assisted living facility participating in, or seeking to participate in, the Arkansas Medicaid Program, including any Medicaid waiver program under
42 U.S.C. § 1396n(c)
or
42 U.S.C. § 1315
, shall file a cost report with the Department of Human Services:
(1)
Annually not later than ninety (90) days after the end of the fiscal year of the facility;
(2)
Within sixty (60) days of any significant change in the facility's ownership, management, or financial status or solvency; and
(3)
At any time within sixty (60) days of a written request from the department or the Office of Medicaid Inspector General.
(b)
(1)
The department shall post the cost-reporting instructions, forms, and schedules on its website.
(2)
The department may revise the cost-reporting instructions, forms, and schedules at any time, following consultation with representatives of the assisted living facility industry and sixty (60) days before written notice to each Medicaid-certified Level II licensed assisted living facility.
(3)
In the cost-reporting instructions, the department may require electronic submission of cost reports and accompanying information.
(c)
In preparation and filing of cost reports, each assisted living facility shall:
(1)
Comply with generally accepted accounting principles and cost-reporting instructions of the department;
(2)
Follow the accrual method of accounting; and
(3)
Maintain the working trial balance used in completing the cost reports for each reporting period for a minimum of three (3) years.
(d)
To be considered complete and timely filed, each cost report shall:
(1)
Include:
(A)
(i)
All information required by the forms, schedules, certifications, and instructions specified by the department and otherwise comply with generally accepted accounting principles and cost-reporting instructions of the department.
(ii)
Failure of full disclosure as required by generally accepted accounting principles and cost-reporting instructions shall constitute an incomplete and misleading cost report;
(B)
Identification of individuals and firms responsible for facility management, accounting and financial reporting, cost report preparation, and internal or independent audits;
(C)
Owner and related party information;
(D)
Statistical, occupancy, and staffing information;
(E)
Certification by the authorized facility officer;
(F)
Compilation report by the preparer of the cost report or any portion thereof;
(G)
General operating expenses, including housekeeping, laundry, dietary services, food and dietary supplies, maintenance, utilities, software, and computer equipment;
(H)
Direct care expenses for providing medically necessary assistance with Medicaid covered activities of daily living and instrumental activities of daily living;
(I)
General administrative expenses, including administration, marketing, and property, general liability, and professional liability insurance;
(J)
Employee benefits and payroll taxes expenses;
(K)
Ownership costs, property related expenses, and all other room and board expenses;
(L)
Home office expenses and other shared or allocated expenses within or among organizations, owners or related parties, multiple facilities, or different healthcare-related operations;
(M)
Legal-related and compliance-related expenses, including attorney's fees, payment of court judgments, court costs, civil momentary penalties, other fines or penalties incurred, cost of corrective actions, and other expenses to remedy a deficiency;
(N)
Copy of any management report, audit report, or written opinion issued by a certified public accountant, accounting or audit firm, or internal auditor or compliance officer concerning the facility's accounting or financial reporting practices, internal auditing practices, or the preparation or contents of the current or any prior cost report;
(O)
Balance sheet for facility operations and for the consolidated company;
(P)
Additional information and attachments as necessary to explain cost report contents, provide backup documentation, and describe and justify any variations from the department forms, schedules, or instructions; and
(Q)
Any other information that the department deems necessary to:
(i)
Support state or facility compliance with federal requirements, including Medicaid waiver terms and conditions;
(ii)
Meet generally accepted accounting principles;
(iii)
Facilitate the performance of independent audits consistent with generally accepted auditing standards and federal and state cost finding standards;
(iv)
Apply federal and state cost finding standards; or
(v)
Assess the reasonableness, efficiency, and adequacy of Medicaid payments; and
(2)
Provide complete, correct, and timely information that the department determines reasonably necessary to:
(A)
Identify, document, verify, analyze, and audit all facility costs, expenses by type, cost-finding and allocation methods, and cost-related statistics;
(B)
Identify, document, verify, analyze, and isolate:
(i)
Reasonable and necessary allowable costs of Medicaid covered direct care services and other reasonable and necessary federally allowable costs; and
(ii)
Unallowed costs, including all room and board expenses, costs attributable to non-Medicaid residents or non-covered services, and costs that would otherwise be disallowed or considered unreasonable under Medicaid nursing facility cost finding principles;
(C)
Assist the department in ascertaining and monitoring the financial stability and solvency of assisted living facilities;
(D)
Verify facility compliance with generally accepted accounting principles and cost-reporting instructions of the department; and
(E)
Facilitate independent audits consistent with generally accepted auditing standards and federal and state cost finding standards.
(e)
(1)
The department and a designated contractor of the department may request corrections or additional information, including supporting documentation.
(2)
Facility responses shall be complete, correct, filed timely, certified as true by the facility's authorized executive, and include a preparer's statement if the information was prepared or reviewed by an accountant or auditor.
(3)
Responses to the department are due within ten (10) days of the request, unless the department authorized additional time in writing.
(f)
(1)
Neither this subchapter nor the content of the cost reports, individually or collectively, requires or implies that the Arkansas Medicaid Program to reimburse for expenses or of cost-based or other payment methodology.
(2)
This subchapter does not limit the authority of the department regarding assisted living facility licensing or Medicaid provider certification, reimbursement, program integrity, or waiver program policy and operations.
Added by Act 2023, No. 198,§ 1, eff. 8/1/2023.