Cost Reports Frequently Asked Questions (FAQ)
- Why do I have three comma separated value files (.csv) instead of one file with worksheet variable names?
- When I download the cost reports and open them, all I see are numbers instead of variable names. How do I find a specific worksheet variable?
- What if I only want a subset of the Cost Report files based on provider number or state?
- Why can't I find a specific provider number in the cost reports that I know should have filed a cost report?
- Why am I finding two cost reports filed for the same provider for the same time period?
- How are the annual CMS cost report files created?
- Why didn't this provider submit a complete cost report?
- I downloaded the Renal Dialysis Facilities Cost Reports, why don't I have all of the Renal Dialysis providers?
- I downloaded the Hospice Cost Reports, why don't I have all of the Hospice Cost Report Facilities?
- What is the definition of "Usage" in the Worksheet Record Layout?
- What is the order of the "Report Status" variable?
Providers are required to submit a cost report to their Fiscal Intermediary (FI) within 5 months after the close of their fiscal year. After that time, the FI processes the cost report and establish the provider's settlement. As part of the process, the cost report goes through a series of edit checks and validation testing before being added to the HCRIS database. A minimum amount of time necessary to complete the process would be about 12 months. For more information, please see a flowchart of the cost report process.
The cost report data are in a relational database format, meaning that each table contains a set of like information. You will need to link all of the tables together in order to get all variables for the worksheets, for each provider.
In the relational database format, the researcher will need to know the location of the variable within a worksheet in order to find it in the database. For example, if you wanted to find out the number of inpatient adult and pediatric beds for a hospital provider, that information is found on Worksheet S3-Part I, Column 1, and Line 1. Because the data type is numeric, it would be found in the numeric file. It would be identified in the numeric file with worksheet value of S300001, column value of 0100, and line value of 00100. Please see the technical document "Cost Report Database Formats: Traditional Flat File versus Relational Database."
The downloadable database contains only those cost reports that were filed electronically during the time period specified in the README file. If the researcher is looking for a specific provider and the cost report is not present, then the researcher should request the cost report information from the provider's Fiscal Intermediary.
Certain types of providers are not required to file a cost report, such as Indian Health Services Hospitals, VA Hospitals, and low utilization hospitals. For more information please see Paper Based Manuals (PBM), 13-Intermedicary Manual, Part 4 - Audit Procedures, Section 4022 and PBM, 15-2-The Provider Reimbursement Manual - Part 2, Chapter 1 - Cost Reporting General, Section 130.3.
Occasionally, a provider may submit more than one cost report during one fiscal year. This happens when a provider changes their fiscal year or has a change in ownership status.
The federal fiscal year files cover the time period 10/1 and ends on 9/30 of the following year. CMS assigns the cost report to a fiscal year based on the provider defined cost report fiscal year begin date. As an example, if a provider's cost report fiscal year begin date is 7/1/02, then CMS will assign this to the fiscal year 2002 file because the provider's fiscal year begin date is between 10/1/2001 and 9/30/2002, which is considered FY 2002.
The exception is for Renal Dialysis facilities. The federal fiscal year is defined based on the Calendar year and CMS assigns the Renal Dialysis cost reports based on the provider's fiscal year end date.
Hospitals FY Begin Date 10/1/YYYY-9/30/YYYY Hospice FY Begin Date 10/1/YYYY-9/30/YYYY Renal Dialysis FY End Date 1/1/YYYY-12/31/YYYY SNF FY Begin Date 10/1/YYYY-9/30/YYYY Home Health FY Begin Date 10/1/YYYY-9/03/YYYY
If a provider has no or low Medicare utilization as defined by the local Fiscal Intermediary, then the provider can submit an abbreviated cost report. In addition, the Fiscal Intermediary can advise the provider to submit less than a full cost report before the end of the provider's fiscal year. (PBM, 15-2-The Provider Reimbursement Manual - Part 2, Chapter 1 - Cost Reporting General)
For Hospice, you could find cost reports in 4 different places. They are found in the Hospice downloadable cost reports for the free-standing Hospices. They can also be found as part of the following provider cost reports, Hospital and Health Care Complexes, Home Health Agency, and Skilled Nursing Facilty.
The variable "Usage" refers to the variable type. Here are some examples and the definition for each:
Variable Variable Description X represents alpha or character data 9 represents a whole number -9 represents a whole number. The number could be a negative number. 9(5).9(6) represents a number with up to 5 positions before the decimal and 6 positions after the decimal. For example 1.213544. 9(9).9(2) represents a number with up to 9 positions before the decimal and 2 positions after the decimal. For example 4.25.
Providers may submit more than one cost report, an initial report and then subsequent reports that would contain adjustments and revisions. Each cost report is assigned a status and the order is from 1 to 5 with 1 being the lowest. 1- as submitted, 2-settled without audit, 3-settled with audit, 4-reopened, 5-amended.
Last Modified September 24, 2008