New York Codes, Rules and Regulations › Title 10 - DEPARTMENT OF HEALTH › Chapter II - Administrative Rules and Regulations › Subchapter L - Hospitals and Related Facilities › Part 86 - Reporting and Rate Certifications for Facilities › Subpart 86-5 - Long-term Home Health Care Programs › Section 86-5.2 - Financial and statistical data required

Current through Register Vol. 46, No. 28, July 10, 2024
(a) Each LTHHCP shall complete and file, with
					 the New York State Department of Health and/or its agent, annual financial and
					 statistical report forms supplied by the department and/or its agent. LTHHCP
					 certified for title XVIII of the Federal Social Security Act (Medicare) shall
					 use the same fiscal year for title XIX of the Federal Social Security Act
					 (Medicaid) as is used for title XVIII. All LTHHCP's must report their
					 operations from January 1, 1978 forward on a calendar-year basis. For a LTHHCP
					 also certified as an AHCP, a combined annual financial and statistical report
					 shall be submitted for both programs.
(b) Based on the financial report, the
					 facility will be required to convert all allowable costs to a visit/hourly cost
					 basis for the services it will be providing.
(c) All required financial and statistical
					 reports shall be submitted to the department. Such reports shall indicate the
					 time period within which such report shall be filed.
(d) In the event a LTHHCP fails to file the
					 required financial and statistical reports on or before the due dates, or as
					 the same may be extended by the department, the State Commissioner of Health
					 shall reduce the current rate paid by State governmental agencies by two
					 percent for a period beginning on the first day of the calendar month following
					 the due date of the required reports and continuing until the last day of the
					 calendar month in which the required reports are filed.
(e) In the event that any information or data
					 which an LTHHCP has submitted to the State Department of Health on required
					 reports, budgets or appeals for rate revisions, intended for use in
					 establishing rates, is inaccurate or incorrect, whether by reason of subsequent
					 events or otherwise, such agency shall forthwith submit to the department a
					 correction of such information or data which meets the same certification
					 requirements as the document being corrected. Failure to do so shall subject
					 the LTHHCP to the provisions of subdivision (d) of this section.
(f) A cost report shall be filed in
					 accordance with this section by each new program with budget based rates for
					 the first six-month period during which the program has achieved 75 percent of
					 the approved patient case load. This report shall be filed and properly
					 certified within 120 days following the end of the six-month period covered by
					 the report. All new programs shall follow the requirements of subdivision (a)
					 of this section, and complete and file a report at the end of the first
					 calendar year after admission of its first patient. Facilities that have filed
					 cost reports in accordance with the provisions of this subdivision shall be
					 deemed to have adequate cost experience for the purpose of establishing a
					 prospective cost-based rate.
(g) If
					 the financial and statistical reports required by this Subpart are determined
					 to be incomplete, inaccurate or incorrect, the LTHHCP will have 30 days from
					 the date of receipt of notification to provide the corrected or additional
					 data. Failure to file the corrected or additional data within 30 days, or
					 within such period as extended by the commissioner, will result in application
					 of subdivision (d) of this section.
(h) Each LTHHCP shall file with the New York
					 State Department of Health a complete copy of the Department of the Treasury,
					 Internal Revenue Service Form 990, for that facility. The Form 990 shall be
					 submitted to the department no later than 30 days following the annual filing
					 with the Internal Revenue Service. Failure to submit the Form 990 shall result
					 in application of the provisions set forth in subdivision (d) of this
					 section.