New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter V - Medical Facilities › Subchapter A - Medical Facilities-minimum Standards › Article 8 - New York State Annual Hospital Report › Part 446 - Reporting Requirements › Section 446.6 - Definitions and sources of statistics for Medicaid cost allocation

Current through Register Vol. 46, No. 28, July 10, 2024
Statistic
Definition or Method of
									 Computation
Source
(a) OTHER OPERATING EXPENSES
(1)
Assigned Time- Nursing Education
Number of hours worked by enrolled nursing
									 students (RN or LPN) by assigned program service area.
Education curriculum and work
									 records
(2)
Assigned Time- Post Grad. Med. Ed. (Approved
									 Program)
Number of hours worked on premises by interns
									 and residents in the approved postgraduate medical education programs by
									 assigned cost center. Outside time is excluded.
Education curriculum and work
									 records
(3)
Assigned Time- Post Grad. Med Ed. (Non-Approved
									 Prog.)
Number of hours worked on premises by interns
									 and residents in the non-approved postgraduate medical education programs by
									 assigned cost center. Outside time is excluded.
Education curriculum and work
									 records
(4)
Time spent- Social Work Services
Number of hours utilized by social workers
									 handling specific patient's needs, by program service area to which the
									 patients are assigned. Time spent not related to a specific patient is not to
									 be counted.
Departmental records or Time Study
(5)
Number of rooms Occupied by Dept. Assigned-
									 Housing
The average number of rooms rented to hospital
									 employees, non-paid workers and students participating in education programs
									 carried on by the hospital by department to which the personnel are assigned.
									 Exclude common areas (i.e., recreation room) in the room count. A monthly
									 census as of the last day of every month must be taken and averaged for the
									 year.
Personnel and General Accounting
									 records
(6)
Net Square Feet Maintained- Plant
									 Maintenance
For each cost center for which maintenance is
									 provided, allocate based upon the total net square feet of the cost center
									 maintained. Net square feet is defined as: The interior square feet in each
									 functional cost center of the hospital determined by either a physical
									 measurement of the hospital or a measurement from blueprints. Floor area
									 measurements must be taken from the center of interior walls to the center of
									 adjoining corridors, if such corridors service more than one cost center.
									 Exclude stairwells, elevators, and other shafts. General and unused areas are
									 also to be excluded. Hallways, waiting rooms, storage areas, etc., serving only
									 one cost center must be included in that cost center. When changes in area have
									 been made during the year as a result of new construction, cost center
									 relocation, expansion or contraction, statistical data must be maintained to
									 allow for the development of "weighted" areas for the fractional part of the
									 year. For example, the addition or deletion of 1200 square feet for a six-month
									 period would be an adjustment of 600 square feet; where the same area serves
									 more than one functional cost center, this area must be apportioned between or
									 among the appropriate functions.
Blueprints of the Hospital plant or actual
									 measurement if blueprints are not available
(7)
Net Square Feet-Plant Operation, Energy,
									 Security, and Parking, Plant Operation & Maintenance
Net square feet by department is defined as
									 follows: The interior square feet in each functional cost center of the
									 hospital determined by either a physical measurement of the hospital or a
									 measurement from blueprints. Floor area measurements must be taken from the
									 center of interior walls to the center of adjoining corridors, if such
									 corridors service more than one cost center. Exclude stairwells, elevators and
									 other shafts. General and unused areas are also to be excluded. Hallways,
									 waiting rooms, storage areas, etc.. serving only one cost center must be
									 included in that cost center. When changes in area have been made during the
									 year as a result of new construction, cost center relocation, expansion or
									 contraction, statistical data must be maintained to allow for the development
									 of "weighted" areas for the fractional part of the year. For example, the
									 addition or deletion of 1200 square feet for a six-month period would be an
									 adjustment of 600 square feet; where the same area serves more than one
									 functional cost center, this area must be apportioned between or among the
									 appropriate functions.
Blueprints of the Hospital plant or actual
									 measurement if blueprints are not available
(8)
Assigned Time- Housekeeping
Scheduled housekeeping hours of service to be
									 spent in maintaining cleanliness and sanitation of each functional cost center.
									 Hours to be spent cleaning general and unused areas must be
									 excluded.
Housekeeping Cost Center records
(9)
Assigned Time- Other Health Professional
									 Ed.
Number of hours worked on premises by health
									 profession student, excluding RN, LV(P)N, intern and resident students, by
									 assigned cost centers.
Education curriculum and work
									 records
(10)
Patient Meals Served- Dietary
									 Services
Number of patient meals served shall include
									 only regular scheduled meals and exclude snacks and fruit juices served between
									 regular scheduled meals.
Actual count maintained by Dietary Services
									 cost center
(11)
Adjusted F.T.E. Employees- Non-Patient Food
									 Service
Divide the total annual paid hours (including
									 vacation, sick leave and overtime) for all those employees for whom the
									 cafeteria is available for use by cost center by 40 hours; divide the result by
									 52. If employees are paid for unused sick leave, exclude the hours so paid from
									 the calculation. Please round to nearest tenth of an F.T.E. only.
Payroll or Personnel Records
(12)
Dry and Clean Pounds Distributed- Laundry and
									 Linen
The weight of linen processed plus the
									 equivalent weight of disposable linen substitutes used. Include uniforms and
									 linen from Personnel quarters and employee housing. If linen is not weighed, a
									 conversion from pieces to pounds is allowed. If soiled linen is weighed, divide
									 by 1.1.
Actual count maintained by the Laundry and
									 Linen Dept.
(13)
Costed requisitions and Cost of Sales- Central
									 Services and Supply
Central Services Costed requisitions means:
									 Total dollar amount (based on invoice cost) of nonchargeable supplies
									 transferred from the central services and supplies cost center to each using
									 cost center. Central Services Cost of Sales means: The invoice cost of all
									 supplies sold to patients and others regardless of the issuing cost
									 center.
Copies of cost center requisitions or other
									 documentation
(14)
Costed Requisitions ad Cost of Sales-
									 Pharmacy
Pharmacy costed requisitions means: Total
									 dollar amount (based on invoice cost) of nonchargeable pharmaceutical items
									 transferred from the Pharmacy Cost Center to each using cost center Pharmacy
									 Cost of Sales means: The invoice cost of all pharmaceutical items sold to
									 patients and others regardless of issuing cost center.
Copies of cost center requisitions or other
									 documentation
(15)
Accumulated Cost-General Accounting; Patient
									 Accounting; Admitting and Registration; Hospital Administration; Insurance-
									 Malpractice; Insurance- Other; Licenses and Taxes; Interest-
									 Short-Term
To be generated through computer software.
									 Nothing is to be reported.
Not Applicable
(16)
Direct Cost of Supplies Expensed- Purchasing
									 and Stores
Total direct cost of medical and surgical
									 supplies (natural classification.40) and nonmedical and nonsurgical supplies
									 (natural classification.50) by cost center, as reclassified, excluding pharmacy
									 (accounts 8470 and 7150), patient dietary service (account 8310), and
									 non-patient food services (account 8320).
General Accounting records
(17)
Hours of Service- Medical Records
Accumulated hours of service to program service
									 centers. If this is unavailable, a questionnaire time survey may be
									 used.
Departmental records or Time Study
(18)
Percent of Effort- Medical Staff
									 Administration
Percent of time spent by the Chief of Medical
									 Staff in the ancillary or program service areas for which he has
									 responsibility.
Time Study
(19)
Professional Component by Cost Center Assigned-
									 Medical Staff Services
Using the calculations made to generate the
									 reclassification necessary to create this cost center, distribute costs back to
									 the appropriate ancillary or program service area from which the physician cost
									 arose (i.e., Radiology, Laboratory, Emergency Room, etc.).
General Accounting records
(20)
Number of Discharges- Medical Care
									 Review
The number of patients discharges from the
									 Hospital accumulated by program service centers, excluding routine
									 newborn.
Medical Records or statistical
									 reports
(21)
Hours of Total Direct Nursing Service- Nursing
									 Administration
Actual hours worked of nurses for which
									 administration is provided by assigned area.
Personnel, Payroll or Departmental
									 records
(22)
Dollars of Depreciation/ Amortization by Cost
									 Center- Depreciation &Amortization (Fixed Assets). Refer to subdivision (c)
									 of this section for an example.
The depreciation expense related to each
									 building (or wing) distributed through square feet to departments in that
									 building (or wing) (resulting statistic reported as a weighted statistic,
									 dollars of depreciation). The square feet used to distribute the expense is Net
									 Square Feet by building (or wing) defined as follows: The interior square feet
									 in each functional cost center of the hospital determined by either a physical
									 measurement of the hospital or a measurement from blueprints. Floor area
									 measurements must be taken from the center of interior walls to the center of
									 adjoining corridors, if such corridors service more than one cost center.
									 Exclude stairwells, elevators and other shafts. General and unused areas are
									 also to be excluded. Hallways, waiting rooms, storage areas, etc. serving only
									 one cost center must be included in that cost center. When changes in area have
									 been made during the year as a result of new construction, cost center
									 relocation, expansion or contraction, statistical data must be maintained to
									 allow for the development of "weighted" areas for the fractional part of the
									 year. For example, the addition or deletion of 1200 square feet for a six-month
									 period would be an adjustment of 600 square feet; where the same area serves
									 more than one functional cost center, this area must be apportioned between or
									 among the appropriate functions.
General Accounting records and blueprints of
									 the Hospital plant or actual measurement of blueprints are not
									 available
(23)
Dollars of Lease/Rent by Cost Center- Leases
									 and Rentals (Fixed Assets). Refer to subdivision (c) of this section for an
									 example.
The lease and rental expense related to each
									 building (or wing) distributed through square feet to departments in that
									 building (or wing) (resulting statistic reported is a weighted statistic,
									 dollars of rentals and leases). The square feet used to allocate the expense is
									 Net Square Feet by building (or wing) defined as follows: The interior square
									 feet in each functional cost center of the hospital determined by either a
									 physical measurement of the hospital or a measurement from blueprints. Floor
									 area measurements must be taken from the center of interior walls to the center
									 of adjoining corridors, if such corridors service more than one cost center.
									 Exclude stairwells, elevators and other shafts. General and unused areas are
									 also to be excluded. Hallways, waiting rooms, storage areas, etc., serving only
									 one cost center must be included in that cost center. When changes in area have
									 been made during the year as a result of new construction, cost center
									 relocation, expansion or contraction, statistical data must be maintained to
									 allow for the development of "weighted" areas for the fractional part of the
									 year. For example, the addition or deletion of 1200 square feet for a six-month
									 period would be an adjustment of 600 square feet; where the same area serves
									 more than one functional cost center, this area must be apportioned between or
									 among the appropriate functions.
General Accounting records and blueprints of
									 the Hospital plant or actual measurement if blueprints are not
									 available
(24)
Dollars of Depreciation by Cost Center-
									 Depreciation & Amortization- Movable Equipment. Refer to subdivision (c) of
									 this section for an example.
The cost of depreciation on movable equipment
									 must be allocated to the functional cost center utilizing that equipment. Where
									 the cost center of depreciation on movable equipment is utilized by two or more
									 functional cost centers, the depreciation must be allocated between the cost
									 centers based upon cost center usage.
Plant Ledger records
(25)
Dollars of Lease/Rent by Cost Center- Leases
									 and Rentals- Movable Equipment. Refer to subdivision (c) of this section for an
									 example.
The cost of leases/rentals on movable equipment
									 must be allocated to the functional cost center utilizing the equipment. Where
									 the cost of leases/rentals on movable equipment is utilized by two or more
									 functional cost centers, the lease/rent must be allocated between the cost
									 centers based upon cost center usage.
General Accounting records and Lease/ Rent
									 Agreements
(26)
F.T.E. Employees- Employee Benefits-
									 Non-Payroll-Related
Divide the total annual paid hours (including
									 vacation, sick leave and overtime) for all employees by cost center by 40
									 hours; divide the result by 52. If employees are paid for unused sick leave,
									 exclude the hours so paid from the calculation. Please round to nearest tenth
									 of an F.T.E. only.
Payroll or Personnel records
(27)
Dollars of Interest by Cost Center- Interest-
									 Long-term. Refer to subdivision (c) of this section for an example.
The interest expense related to capital debt
									 will be allocated through square feet to departments in the building (or wing)
									 for which the debt was incurred (weighted statistic, dollars of interest). The
									 square feet used to allocate the expense is Net Square Feet by building (or
									 wing) defined as follows: The interior square feet in each functional cost
									 center of the hospital determined by either a physical measurement of the
									 hospital or a measurement from blueprints. Floor area measurements must be
									 taken from the center of interior walls to the center of adjoining corridors,
									 if such corridors service more than one cost center. Exclude stairwells,
									 elevators and other shafts. General and unused areas are also to be excluded.
									 Hallways, waiting rooms, storage areas, etc. serving only one cost center must
									 be included in that cost center. When changes in area have been made during the
									 year as a result of new construction, cost center relocation, expansion or
									 contraction, statistical data must be maintained to allow for the development
									 of "weighted" areas for the fractional part of the year. For example, the
									 addition or deletion of 1200 square feet for a six-month period would be an
									 adjustment of 600 square feet; where the same area serves more than one
									 functional cost center, this area must be apportioned between or among the
									 appropriate functions.
General Accounting records and blueprints of
									 the Hospital plant or actual measurement if blueprints are not
									 available
(28)
Time Spent- Medical Photography and
									 Illustration
The number of hours utilized by another
									 functional cost center of personnel in the Medical Photography and Illustration
									 cost center.
Departmental records or Time Study
(b) ANCILLARY SERVICES
(1)
Number of Procedures- Labor and Delivery
									 Services
Refer to the definition of the Standard Unit of
									 Measure in section
									 444.20(a) of this
									 Article. Report this statistic by the required program service
									 areas.
Departmental records or Statistical
									 reports
(2)
Surgery Minutes- Surgery Services
Refer to the definition of the Standard Unit of
									 Measure in section
									 444.20(b)(1) of
									 this Article. Report this statistic by the required program service
									 areas.
Departmental records or Statistical
									 reports
(3)
Recovery Minutes- Recovery Services
Refer to the definition of the Standard Unit of
									 Measure in section
									 444.20(b)(2) of
									 this Article. Report this statistic by the required program service
									 areas.
Departmental records or Statistical
									 reports
(4)
Anesthesia Minutes- Anesthesiology
Refer to the definition of the Standard Unit of
									 Measure in section
									 444.20(b)(3) of
									 this Article. Report this statistic by the required program service
									 areas.
Departmental records or Statistical
									 reports
(5)
Departmental Gross Charges- Medical Supplies
									 Sold; Durable Medical Equipment-Sold; Durable Medical Equipment- Leased/Rented;
									 Drugs Sold; Cardiac Catheterization Laboratory; Respiratory Therapy;
									 Speech/Language Pathology Audiology; Psychiatric/Psychological
									 Services
Report gross charges for the specific
									 department by the required program service areas. All-inclusive rate hospitals
									 have the option of using the Standard Units of measure for the applicable
									 functional cost center reported by the required program service areas in lieu
									 of Departmental Gross Charges, if charges are not available.
General accounting records
(6)
C.A.P. Workload-Laboratory Services- Clinical;
									 Laboratory Services- Pathological; Whole Blood and Packed Red Cells;
									 Electrocardiology; Pulmonary Function Testing
Most recent College of American Pathologists
									 Workload Measurement Unit Manual. Refer to subdivisions (e), (f) and (j) of
									 section 444.20 of this Article for a
									 further definition of the Standard Unit of Measure. Report this statistic by
									 the required program service areas.
Departmental records or Statistical
									 reports
(7)
California R.V.U.-Radiology -Diagnostic;
									 Radiology- Therapeutic; Nuclear Medicine; Neurology-Diagnostic
California Medical Association, 1974 California
									 Relative Value Studies. Refer to the definitions of the Standard Units of
									 Measure in section
									 444.20(h)(1), (h)(3), (h)(4) and
									 (k) of this Article. Report this statistic by
									 the required program service areas.
Department records or Statistical
									 reports
(8)
Number of Procedures -C.T. Scanner
Refer to the definition of the Standard Unit of
									 Measure in section
									 444.20(h)(2) of
									 this Article. Report this statistic by the required program service
									 areas.
Departmental records or Statistical
									 reports
(9)
American Physical Therapy Association R.V.U.
									 -Physical Therapy
Refer to the definition of the Standard Unit of
									 Measure in section
									 444.20(l)(1) of
									 this Article for Physical Therapy (account 7530). Report this Statistic by the
									 required program service areas.
Departmental records or Statistical
									 reports
(10)
American Occupational Therapy Association
									 R.V.U.-Occupational Therapy
Refer to the definition of the Standard Unit of
									 Measure in section
									 444.20(l)(2) of
									 this Article for Occupational Therapy (account 7530). Report this statistc by
									 the required program service areas.
Departmental records or Statistical
									 reports
(11)
Assigned Time -Recreational Therapy
Number of hours worked by Recreational
									 Therapists with patients, by program service to which patients are
									 assigned.
Departmental records
(12)
Number of Treatments- Other Physical
									 Medicine
Refer to the definition of the Standard Unit of
									 Measure in section
									 444.20(l)(6) of
									 this Article. Report this Statistic by the required program service
									 area.
Departmental records or Statistical
									 reports
(13)
Number of Treatments- Renal
									 Dialysis
Refer to the definition of the Standard Unit of
									 Measure in section
									 444.20(m) of this
									 Article. Report this statistic by the required program service
									 area.
Departmental records or Statistical
									 reports
(14)
Provider Specify-Other Ancillary
									 Services
If a provider has a specific ancillary service
									 that they feel is not provided for above, a complete description of that
									 service along with a proposed Cost Allocation Statistic should be submitted to
									 OHSM for prior approval (prior means six months before a fiscal year
									 ends).
Departmental records or Statistical
									 reports
(c)
EXAMPLE
(1) Wherever dollars are
					 required as the Cost Allocation Base, the intent is to accomplish the
					 allocation of the applicable mandatory zero-level account's cost through the
					 direct expensing of that cost. For example, if the direct expense of
					 Interest-Long-Term (account 8880) contains interest related to two long-term
					 financing agreements, one related to the purchase of a C.T. Scanner and one
					 related to a new addition, the method to be used in structuring the
					 statistics-Dollars of Interest-is illustrated in the following
					 paragraphs.
(2) Procedure outline.
(i) Allocate interest on the new addition on
					 the basis of Net Square Feet, within the new addition.
(ii) Allocate interest on the C.T. Scanner
					 directly to the C.T. Scanner cost center (account 7340).
(iii) Combine the results of the above
					 producing the statistic Dollars of Interest, as illustrated below.
(3) Calculations.
(i)
Cost Center
(1) Interest on
									 addition
(2) Interest on C.T.
									 Scanner
(1 + 2) Statistic
									 Reported
Laboratory-
Clinical
15,000
-
15,000
Pathological
20,000
-
20,000
Dietary
10,000
-
10,000
Nuclear Medicine
50,000
-
50,000
C.T. Scanner
5,000
20,000
25,000
TOTAL
100,000
20,000
120,000
(ii) The
					 interest on the addition is distributed on Net Square Feet in the addition, as
					 follows:
Cost Center
Square Feet
Percent
Expense Distribution
Laboratory-
Clinical
1,500
15
15,000
Pathological
2,000
20
20,000
Dietary
1,000
10
10,000
Nuclear Medicine
5,000
50
50,000
C.T. Scanner
500
5
5,000
TOTAL
10,000
100
100,000