Iowa Administrative Code › Agency 441 - Human Services Department › Title VIII - Medical Assistance › Chapter 82 - Intermediate Care Facilities for Persons With an Intellectual Disability › Rule 441-82.5 - Financial and Statistical Report

Current through Register Vol. 47, No. 3, July 24, 2024
All facilities wishing to participate in the program shall
				  submit a Financial and Statistical Report, Form 470-0030, to the department.
				  These reports shall be based on the following rules.
(1)
Failure to maintain
				records.
Failure to maintain and submit adequate accounting or
				statistical records shall result in termination or suspension of participation
				in the program.
(2)
Accounting procedures.
Financial information shall be based on
				that appearing in the audited financial statement. Adjustments to convert to
				the accrual basis of accounting shall be made when the records are maintained
				on other accounting bases. Facilities which are a part of a larger health
				facility extending short-term, intensive, or other health care not generally
				considered nursing care may submit a cost apportionment schedule prepared in
				accordance with recognized methods and procedures. The schedule shall be
				required when necessary for a fair presentation of expense attributable to
				intermediate care facility patients.
(3)
Submission of reports.
The facility's cost report shall be received by the Iowa Medicaid provider cost
				audit and rate setting unit no later than September 30 each year except as
				described in subrule 82.5(14).
a. The
				submission shall include a working trial balance that corresponds to all
				financial data contained on the cost report. The working trial balance must
				provide sufficient detail to enable the Iowa Medicaid provider cost audit and
				rate setting unit to reconcile accounts reported on the general ledger to those
				on the financial and statistical report. For reporting costs that are not
				directly assigned to the facility in the working trial balance, an allocation
				method must be identified for each line, including the statistics used in the
				calculation. Reports submitted without a working trial balance shall be
				considered incomplete, and the facility shall be subject to the rate reductions
				set forth in paragraph 82.5(3)
"c."
b. If the financial statements have been
				compiled, reviewed or audited by an outside firm, a copy of the compilation,
				review or audit, including notes, for the reporting period shall be included
				with the submission of the financial and statistical report.
c. Failure to timely submit the complete
				report shall reduce payment to 75 percent of the current rate.
(1) The reduced rate shall be effective
				October 1 and shall remain in effect until the first day of the month after the
				delinquent report is received by the Iowa Medicaid provider cost audit and rate
				setting unit.
(2) The reduced rate
				shall be paid for no longer than three months, after which time no further
				payments will be made until the first day of the month after the delinquent
				report is received by the Iowa Medicaid provider cost audit and rate setting
				unit.
d. Amended reports.
				The department, in its sole discretion, may reopen a review of a financial and
				statistical report at any time. No other entity or person has the right to
				request that the department or its contractor reopen a review of a financial
				and statistical report, or submit an amended financial and statistical report
				for review by the department, after the facility is notified of its per diem
				payment rate following a review of a financial and statistical
				report.
e. When an intermediate
				care facility for persons with an intellectual disability continues to include
				in the total costs an item or items which had in a prior period been removed
				through an adjustment made by the department or its contractor, the contractor
				shall recommend to the department that the per diem be reduced to 75 percent of
				the current payment rate for the entire quarter beginning the first day of the
				fourth month after the facility's fiscal year end. If the adjustment has been
				contested and is still in the appeals process, the facility may include the
				cost, but must include sufficient detail so the Iowa Medicaid provider cost
				audit and rate setting unit can determine if a similar adjustment is needed in
				the current period. The department may, after considering the seriousness of
				the offense, make the reduction.
f.
				Nothing in this subrule relieves a facility of its obligation to immediately
				inform the department that the facility has retained Medicaid funds to which
				the facility is not entitled as a result of any cost report process. A facility
				shall notify the Iowa Medicaid when the facility determines that funds have
				been incorrectly paid or when an overpayment has been detected.