Institutional Cost Report (ICR) Edit Listing
- ICR Edits are also available in Portable Document Format (PDF)
| 2022-23 ICR Edits | 3 eenn = Fatal edit 4 eenn = Non-fatal edit 5 eenn = Informational edit ee = Exhibit Number nn = Edit number for that specific exhibit |
|---|---|
| Edit Number | Edit Text |
| 30001 | The NAME of the Hospital Contact #1 has not been filled out on page 1. (20000/007) |
| 30002 | The NAME of the Hospital Contact #2 has not been filled out on page 1. (20000/010) |
| 30003 | The PHONE NUMBER of the Hospital Contact #1 has not been filled out on page 1. (20000/009) |
| 30004 | The PHONE NUMBER of the Hospital Contact #2 has not been filled out on page 1. (20000/012) |
| 30005 | The EMAIL ADDRESS of the Hospital Contact #1 has not been filled out on page 1. (20000/032) |
| 30006 | The EMAIL ADDRESS of the Hospital Contact #2 has not been filled out on page 1. (20000/033) |
| 30007 | The NAME of the individual acting in the capacity of CFO has not been filled out on Page 2. (20000/034) |
| 30008 | The NAME of the individual acting in the capacity of CEO has not been filled out on Page 2. (20000/042) |
| 30009 | The TITLE of the individual acting in the capacity of CFO has not been filled out on Page 2. (20000/035) |
| 30010 | The TITLE of the individual acting in the capacity of CEO has not been filled out on Page 2. (20000/043) |
| 30011 | The EMAIL information of the individual acting in the capacity of CFO has not been filled out on Page 2. (20000/041) |
| 30012 | The EMAIL information of the individual acting in the capacity of CEO has not been filled out on Page 2. (20000/049) |
| 30013 | The New York State Hospital Operating Certificate number has been omitted from Page 1. |
| 30101 | The provider name has not been entered on Exhibit 1 (S-2) for the (hospital or hospital-based component) but a PTO Code is present. |
| 30102 | The provider number has not been entered on Exhibit 1 (S-2) for the (hospital or hospital-based component) but a PTO Code is present. |
| 30103 | The beginning report date on Exhibit 1 (S-2), Line 20 is after the ending report date. |
| 30104 | The beginning report date on Exhibit 1 (S-2), Line 20 is after the ending report date. |
| 30105 | You have reported ambulance cost but not answered Question 164.89 in Exhibit 1. (FYE on/after 6/30/2021) |
| 30201 | No certified ancillary service responses have been provided on Exhibit 2, lines 197 to 231. This Exhibit must be completed prior to submitting your NYSICR. |
| 30202 | No certified outpatient service responses have been provided on Exhibit 2, lines 232 to 284. This Exhibit must be completed prior to submitting your NYSICR. |
| 30203 | No teaching status has been indicated on Exhibit 2, line codes 286 or 287. This Exhibit must be completed prior to submitting your NYSICR. |
| 30301 | All amounts on Exhibit 3 (Wkst S-3), Part I must not be less than zero. |
| 30401 | End-of-period beds must be entered in column 218 on Exhibit 4. |
| 30402 | Certified bed days available during the year must be entered in column 220 on Exhibit 4. |
| 30601 | The total entered for Exhibit 6, column (4825 or 4826) does not equal the detail. Amount entered = (amount) Amount computed = (amount) Difference = (amount) |
| 30901 | You must affirm that Exhibit 9, column 0595 reports all the officers, owners, stockholders, directors and trustees of the facility that received compensation reported on Exhibit 11, by completing class code 0595 line 091. |
| 31001 | On Exhibit 10, compensation of the five highest paid administrative positions, has not been fully filled out. Line LLL is missing data. |
| 31101 | Cost Centers LLL1 AND LLL2 have both been assigned cost center code (HCRIS code) - each cost center code must be unique |
| 31102 | Cost Center LLL does not have a cost center code assigned. |
| 31103 | Line 200, column 4 of Worksheet A does not equal 0 Amount Computed = (amount) |
| 31105 | Line xxx.xx does not have a Step-down Allocation Code assigned on Exhibit 11 (Wkst A) |
| 31106 | Line (3, 113 or 114) of Exhibit 11 (Wkst A) does not equal 0 for Medicare purposes (Column 9) |
| 31107 | Line xxx.xx does not have an ancillary Step-down Allocation Code assigned on Exhibit 11 (Wkst A) Column 0043 |
| 31108 | Line xxx.xx does not have a sequence code assigned on Exhibit 11 (Wkst A). |
| 31201 | The following reclassification increase on Exh 12 (Wkst A-6) does not have an Exh 11 transfer line entered in column 3: Alpha: aa Line: LLL Column: cccc Amount: (amount) |
| 31202 | The following reclassification decrease on Exh 12 (Wkst A-6) does not have an Exh 11 transfer line entered in column 3: Alpha: aa Line: LLL Column: cccc Amount: (amount) |
| 31203 | The following capital-related reclassification on Exh 12 (Wkst A-6) has been incorrectly entered in the salary column: Alpha: aa Line: LLL Column: cccc Amount: (amount) |
| 31204 | The following capital-related reclassification on Exh 12 (Wkst A-6) has been incorrectly entered in the fringe benefit column: Alpha: aa Line: LLL Column: cccc Amount: (amount) |
| 31401 | An amount has been entered on line xx.xx (Line Code LLL) but no cost center has been entered in column code 0708, 0709 or 0073. |
| 31501 | A Medicaid post-stepdown adjustment has been made to an ancillary cost center on Exhibit 15, Line LLL . |
| 31601 | On Wkst A-8-1 Part A, an amount has been entered for line x.xx (line code LLL) column 4/5, but there is no corresponding Wkst A line number in column 1 |
| 31602 | (Formerly Edit 41602) The hospital states that it has 'related organization or home office costs' in Exhibit 1 (S-2 Part I) but does not report them in Exhibit 16 (A-8-1). (FYE on/after 6/30/2021)
Criteria: 1) 00345/14000 (S-2 Part I, Line 140) = Yes and 00453/490 = zero and 00454/490 = zero |
| 31901 | Exhibit 19 (Wkst B-1), Column ccc.cc does not have any stats but Exhibit 11 (Wkst A), Column 7 (9,11), CMS Line xxx.xx does not equal zero. |
| 31902 | There are statistics on CMS Line xxx.xx of Exhibit 19 (Wkst B-1), but there is no cost in Column 7 (9,11), of Exhibit 11 (Wkst A) nor are there statistics at the top of the Column for that cost center. |
| 31903 | Exhibit 19 (Wkst B-1), Column ccc.cc does not have any stats but Exhibit 11 (Wkst A), Column 7 (9,11), CMS Line xxx.xx has an allocation code. |
| 31904 | A negative stat has been input on Exhibit 19 (Wkst B-1) on Line xxx.xx, Column ccc.cc |
| 32001 | A negative value has been input on Exhibit 20 (Wkst B-3) on Line xxx.xx, Column ccc.cc |
| 32002 | A negative value has been input on Exhibit 20 (Wkst B-3) on ICR Line LLL, Column Code ccc |
| 32003 | There is cost to be allocated in Column ccc of the Medicaid Ancillary Step-Down, but there are no allocation statistics in that column. |
| 32003 | There is cost to be allocated in Column ccc of the Medicaid Ancillary Step-Down, but there are no allocation statistics in that column. |
| 33101 | The Transfer Basis for Emergency Services has been toggled to Visits and must be reset to Charges (FYE on/after 6/30/2019) |
| 33102 | The Transfer Basis for CPEP Emergency Services has been toggled to Visits and must be reset to Charges (FYE on/after 6/30/2019) |
| 33103 | The Transfer Basis for Clinic Services has been toggled to Visits and must be reset to Charges (FYE on/after 6/30/2019) |
| 33104 | The Transfer Basis for Emergency Services on Exhibit 31A, Line 001, does not match the value in the NYSDOH table. (FYE on/after 6/30/2019) |
| 33105 | The Transfer Basis for CPEP Emergency Services on Exhibit 31A, Line 002, does not match the value in the NYSDOH table. (FYE on/after 6/30/2019) |
| 33106 | The Transfer Basis for Clinic Services on Exhibit 31A, Line 003, does not match the value in the NYSDOH table. (FYE on/after 6/30/2019) |
| 33201 | You have entered data for Med-Surg on Exhibit 32 Part I but have not entered a Medicaid Service Code on Line 301. |
| 33202 | You have entered data for the CAH on Exhibit 32 Part II but have not entered a Medicaid Service Code on Line 301. |
| 33203 | (First variation if MSC=0) You have entered data for the (Service Category) Unit on Exhibit 32 Part II but have not entered a Medicaid Service Code on Line 301. (Second variation if MSC <>0 but invalid) You have entered an invalid Medicaid Service Code for the (Service Category) Unit on Exhibit 32. |
| 33204 | (First variation if MSC = 0) You have not entered a valid Medicaid Service Code for the Critical Access Hospital (Acute) component on Exhibit 32. (Second variation if MSC<>0 but invalid) You have entered an invalid Medicaid Service Code for the Critical Access Hospital (Acute) component on Exhibit 32. |
| 33205 | The total number of inpatient discharges reported as Medicaid FFS (Exh 32 line 014), HMO/PHSP Medicaid (Exh 32 line 200) and Medicaid dual-eligible (Exh 30 line 060) exceeds the total for all patients in Exhibit 32. (FYE on/after 6/30/2019) |
| 33206 | The total number of inpatient days reported as Medicaid FFS (Exh 32 line 014), HMO/PHSP Medicaid (Exh 32 line 200) and Medicaid dual-eligible (Exh 30 line 060) exceeds the total for all patients in Exhibit 32. (FYE on/after 6/30/2019) Includes ALC Days in the comparison . |
| 33207 | A negative entry has been made on Exhibit 32, Class Code cccc, line lll. (When any Class 4318-4507, line 012-020 or 200-209 value is negative. Line 300, Uncompensated Care Collections, may be negative. FYE on/after 6/30/2019.) (Added 10/20/2021) |
| 33208 | Line lll, class codes (days class) and (discharges class), the number of discharges exceeds the number of days, in the (category name) category on Exhibit 32. (FYE on/after 6/30/2021) |
| 33227 | Line lll, class codes (days class) and (discharges class), either days or discharges equals zero but the other does not, in the (category name) category on Exhibit 32. (FYE on/after 6/30/2021) This will issue as Non-fatal Edit 43227 if Exhibit 1, Line 23, Column 1 contains "1" or "2", OR Line 23, Column 2 is "YES". |
| NOW NON-FATAL EDIT 43310 | |
| 33302 | Visits have not been entered on Exhibit 33, but visits excl. inpat. admissions have been entered on the following line(s): Line LLL, Class Codes (0160/0240, 0161/0241, or 0162/0242) |
| 33303 | You have entered (either "zero as the" or "an invalid") Medicaid Service Code for the (Service Category) Unit on Exhibit 33. |
| 33304 | Visits have been entered on Exhibit 33 excl. inpatient admissions which exceed those incl. inpatient admissions on the following line(s): Line LLL, Class Codes (0160/0240, 0161/0241, or 0162/0242) (New edit added 8/7/2019) |
| 33305 | A negative entry has been made on Exhibit 33, Class Code cccc, line lll. (When any Class 0160-0162 or 0240-0242, line's value is negative. Lines 700-750, Uncompensated Care Collections, may be negative. FYE on/after 6/30/2019.) (Added 10/20/2021) |
| 33401 | You have entered home health agency visits or hours on Exhibit 34 without providing the HHA NYS Operating Certificate Number. (FYE on/after 6/30/2019) |
| 33402 | You have entered the Hospital's NYS Operating Certificate number as the HHA NYS Operating Certificate number on Exhibit 34. (FYE on/after 6/30/2019) |
| 33403 | You have entered what appears to be a Medicare Provider Number or an otherwise invalid value as the HHA NYS Operating Certificate number on Exhibit 34. (FYE on/after 6/30/2019) |
| 33404 | A negative entry has been made on Exhibit 34, Class Code cccc, line lll. (When any Class 00209, lines 036-107 or 163-172 value is negative. Line 110, Uncompensated Care Collections, may be negative. FYE on/after 6/30/2019.) (Added 10/20/2021) |
| 33501 | An average hourly wage on Exhibit 35, class code 4819, line 040 cannot be computed because there is no adjusted hours totals in class code 4815. This Exhibit must be completed prior to submitting your NYSICR. |
| 33502 | An average hourly wage on Exhibit 35, class code 4819, line 040 cannot be computed because there is no adjusted payroll total in class code 4818. This Exhibit must be completed prior to submitting your NYSICR. |
| 34001 | The sum of capital related costs on Exhibit 11 (Wkst A) for Buildings & Fixtures on line 1 (and subscripts), col 5, does not equal Exhibit 40, line 090, column 0140. Exh 11 amount = (amount) Exh 40 amount = (amount) Difference = (amount) |
| 34002 | The sum of capital related costs on Exhibit 11 (Wkst A) for Movable Equipment on line 2 (and subscripts), col 5, does not equal Exhibit 40, line 090, column 0335. Exh 11 amount = (amount) Exh 40 amount = (amount) Difference = (amount) |
| 34003 | The sum of capital related costs on Exhibit 40, line 90, column 0402 does not equal the capital-related costs to be allocated, column 3A, line 960 of the Medicaid Capital Cost Allocation. Medicaid Capital Cost to be Allocated = (amount) Exh 40 Capital-related costs = (amount) Difference = (amount) |
| 34101 | This provider has been identified on Exhibit 1, Line Code 046, as Voluntary and therefore must provide information on Exhibit 41. |
| 34102 | You have reported payments made to reduce capital debt in Exhibit 41 Class 00054 Line 007 which equal the NET of Reduction in Long-term Debt reported on the Statement of Cash Flows at Exhibit 25, Class 00283, line 012 and Increases in Long-term Debt on Line 061. (FYE on/after 6/30/2019, for voluntary hospitals) |
| 34103 | You have reported the depreciation fund ending balance as less than zero on Exhibit 41, Class 00054, Line 019. Resetting value to zero. (FYE on/after 6/30/2019, for voluntary hospitals) |
| 34104 | You have reported the depreciation fund beginning balance as less than zero on Exhibit 41, Class 00054, Line 011. (FYE on/after 6/30/2019, for voluntary Article 28 hospitals, EXCEPT for Article 31 hospitals) |
| 34401 | The sum of directly assigned capital-related costs on Exhibit 44 line 960, col 0580, does not equal Exhibit 40, line 090, column 0401. Exh 44 amount = (amount) Exh 40 amount = (amount) Difference = (amount) |
| 34402 | (First variation) Directly assigned capital-related cost has been entered on line code LLL of Exhibit 44 column 580, but there is no cost to be allocated for that cost center on Worksheet B, Part I, Column 0. (Second variation) Directly assigned capital cost has been entered on line LLL of Exhibit 44, Column 0580 but there is no cost to be allocated for that Cost Center on Wkst B Part I, Col 0. |
| 34601 | No statistics were entered for Exhibit 20 (Wkst B-3) nor were any statistics transferred from Exhibit 46. If you want these statistics to transfer from Exhibit 46, please turn off Option 45. Otherwise, be sure you entered data on Exhibit 20 (Wkst B-3). |
| 34602 | On Exhibit 46, Total Gross Charges to Patients on Line 200, Column cccc does not equal the total of Gross Charges by Payor, Line 330. Line 200 amount = (amount) Line 330 amount = (amount) Difference = (amount) |
| 34603 | Data has been entered in column cccc but either the Medicaid Service Mapping Code is missing or not recognized on Line 099 in Exhibit 46. |
| 35001 | Exhibit 50, question 3C (Line Code 067) has not been answered. You must enter Y or N. |
| 35002 | Exhibit 50, question 3D (Line Code 068) has not been answered. You must enter Y or N. |
| 35003 | Exhibit 50, question 7 (Line Code 053) has not been answered. You must enter Y or N. |
| 35004 | Exhibit 50, question 8A (Line Code 069) has not been answered. You must enter Y or N. |
| 35005 | Exhibit 50, question 9 (Line Code 064) has not been answered. You must enter Y or N. |
| 35006 | Exhibit 50, question 9B (Line Code 070) has not been answered. You must enter Y or N. |
| 35007 | Exhibit 50, question 9C (Line Code 065) has not been answered. You must enter Y or N. |
| 35008 | Exhibit 50, question 9E (Line Code 071) has not been answered. You must enter Y or N. |
| 35009 | Exhibit 50, question 11 (Line Code 072) has not been answered. You must enter Y or N. |
| 35010 | Exhibit 50, question 8 (Line Code 059) must be less than or equal to zero. |
| 35011 | Exhibit 50, line code LLL has a patient count that is greater than zero, but no ZIP code has been entered on that line. |
| 35012 | The ZIP code entered on Exhibit 50, line code LLL is not valid. It should be entered as a five-digit code (xxxxx), or as a nine-digit code (xxxxx-xxxx). The value that was entered is: (what the user entered). |
| 35101 | On Exhibit 51, Part 1, Line Code LLL, Cost Center Group CCG is not valid. |
| 35102 | Exhibit 51, Part 1, Line Code LLL does not have a Cost Center Group assigned. |
| 35103 | On Exhibit 51, Part 2, Cost Center Group CCG is invalid. |
| 35104 | On Exhibit 51, Part 3, Cost Center Group CCG is invalid. |
| 35105 | On Exhibit 51, Part 2, Cost Center Group CCG has been used, but this Group has not been identified on Part 1. |
| 35106 | On Exhibit 51, Part 3, Cost Center Group CCG has been used, but this Group has not been identified in Part 1. |
| 35107 | On Exhibit 51, Part 2, Revenue Code rrrr is a duplicate. |
| 35108 | On Exhibit 51, Part 3, Revenue Code rrrr is a duplicate. |
| 35109 | On Exhibit 51, you have indicated that you are neither an Article 31 provider nor was non-submission of Exhibit 51 requested by the Department, but Parts 2 and 3 have not been completed. |
| 35110 | (First variation) You have Revenue on Exhibit 46 Line 001 but have not designated a cost center on Exhibit 51, Part 1B for that revenue.
(Second variation) You have Revenue on Exhibit 46 Line 002 but have not designated a cost center on Exhibit 51, Part 1B for that revenue. (Third variation) You have Revenue on Exhibit 46 Line 013 but have not designated a cost center on Exhibit 51, Part 1B for that revenue. (Fourth variation) You have Revenue on Exhibit 46 Line LLL but have not designated a cost center on Exhibit 51, Part 1B for that revenue. |
| 35111 | Cost Center Group gg has charges but no cost on Exhibit 51 Part 1C |
| 35112 | Cost Center Group gg has cost but no charges on Exhibit 51 Part 1C |
| 35113 | The total calculated on Exhibit 46, Line 200, Column 0036 must equal Exhibit 51 Part 1A Line 960 Column 45140, excluding adjustments in Column 45137. Exh 46 Total = (amount) Exh 51 Part 1A amount = (amount) Difference = (amount) |
| 35114 | Cost Center Group gg has an RCC that exceeds the Medicare Ceiling of 1.604. Please provide an explanation on Exhibit 51 Part 1D |
| 35201 | The Service Code that you entered for ICR line code LLL Exhibit 52 does not match a valid Service Code from the standard list of Service Codes. Please check your entry. |
| 35202 | Exhibit 52, ICR line code LLL contains costs in cc10200 and/or cc11200, but no Medicaid Service Code has been assigned to that cost center. Please assign a valid MSC to this cost center via the screen for Exhibit 52. (FYE on/after 6/30/2019) |
| 35203 | The Medicaid Service Code in Exhibit 52, ICR line code LLL is the same as the ICR line code. This is not expected for this cost center. Please change the MSC for this cost center via the screen for Exhibit 52. (FYE on/after 6/30/2019) |
| 35301 | The Total Final Allocated Medicaid Cost from Exhibit 52 does not equal the Total Final Stepdown Costs in Exhibit 53. This may be due to one or more missing Medicaid Service Codes on Exhibit 52. Review this edit list for occurrences of edits 35201, 35202 or 45307. Exhibit 52, class code 10200, line 960 = (amount) Exhibit 53, class code 44000, line 960 = (amount) (FYE on/after 6/30/2019) |
| 35302 | The Total Final Allocated Medicaid Capital Related Costs from Exhibit 52 does not equal the Total Final Reported Capital in Exhibit 53. This may be due to one or more missing Medicaid Service Codes on Exhibit 52. Review this edit list for occurrences of edits 35201, 35202 or 45307. Exhibit 52, class code 11200, line 960 = (amount) Exhibit 53, class code 44005, line 960 = (amount) (FYE on/after 6/30/2019) |
| 40101 | The date certified has not been entered on Exhibit 1 for the (hospital or hospital-based component) but a PTO Code is present. |
| 40102 | The provider number has not been entered on Exhibit 1 (S-2) for the (hospital or hospital-based component). |
| 40103 | (First variation) The date certified has not been entered on Exhibit 1 (S-2) for the (hospital or hospital-based component). (Second Variation) The date certified input on Exhibit 1 (S-2) is after the ending report date for the (hospital or hospital-based component). |
| 40104 | The date certified input on Exhibit 1 (S-2) is after the ending report date for the (hospital or hospital-based component). |
| 40105 | The date certified specified on Exhibit 1 (S-2) for the (hospital or hospital-based component) is invalid for Medicare. (Year is before 1966) |
| 40106 | The date certified specified on Exhibit 1 (S-2) for the hospital component is after the beginning report date. |
| 40107 | The beginning cost report period month on Exhibit 1 (S-2), Line 20 is not between 01 and 12. |
| 40108 | The beginning cost report period day on Exhibit 1 (S-2), Line 20 is not between 01 and 31. |
| 40109 | The ending cost report period month on Exhibit 1 (S-2), Line 20 is not between 01 and 12. |
| 40110 | The ending cost report period day on Exhibit 1 (S-2), Line 20 is not between 01 and 31. |
| 40111 | The dates indicated on Exhibit 1 (S-2), Line 20 show a cost report shorter than one month. |
| 40112 | The cost report period indicated on Exhibit 1 (S-2), Line 20 is greater than 13 months. |
| 40112 | The Fiscal Year End date for this cost report is after the system date. Fiscal Year End date: mm/dd/yyyy System run date: mm/dd/yyyy |
| 40113 | The type of control has not been entered on Exhibit 1 (S-2), Line 21, column code 0340. |
| 40114 | The type of (hospital or hospital-based component) has not been entered on Exhibit 1 (S-2), Line LLL . |
| 40115 | One SCH period has been entered on Exhibit 1, Line 35, but line 36, Columns 1 and 2 have not been input. |
| 40116 | On Exhibit 1, you have answered 'Y' that you are a multi-campus organization, but no data has been entered on Exhibit 1, Line 166. |
| 40117 | On Exhibit 1, you have not answered line 165 'Y' to indicate that you are a multicampus organization, but data has been entered on Exhibit 1, Line 166. |
| 40118 | You have answered "Y" to Exhibit 1, Line 164.91, but none of lines 164.92 through 164.98 has a "Y" response. (FYE on/after 6/30/2020) (when 00345/16491 = "Y" and none of the responses to 00345/16492-16498 = "Y".) |
| 40119 | You have answered "Y" to Exhibit 1, Line 164.98, but no description has been entered on Line 164.99. (FYE on/after 6/30/2020) (when 00345/16498 = "Y" and 00345/16499 is empty.) |
| 40201 | Inpatient weighted certified beds were not reported in Exhibit 2, lines 160 through 189. (FYE on/after 6/30/2021) |
| 40202 | All Authorized Ancillary Services were reported as not provided in Exhibit 2, lines 197 through 231. (FYE on/after 6/30/2021) |
| 40203 | All Outpatient Services were reported as not provided in Exhibit 2, lines 232 through 284. (FYE on/after 6/30/2021) |
| 40204 | The response on Exhibit 2, Line 286 states that this is not a teaching hospital, but Intern & Resident FTEs have been reported on Exhibit 3, column 9. |
| 40301 | The total Inpatient Days on Line LLL, Column 8 of Exh 3 (Wkst S-3) is greater than the bed days available in Col 3. |
| 40302 | The total Inpatient Days on Line LLL, Column 8 of Exh 3 (Wkst S-3) is less than the sum of program patient days in Columns 6 and 7. |
| 40303 | The total Outpatient Visits on Line LLL, Column 8 of Exh 3 (Wkst S-3) is less than the sum of program visits in Columns 6 and 7. |
| 40304 | Total discharges on Line LLL, Column 15 of Exhibit 3 (Wkst S-3) is less than the sum of program discharges in Columns 13-14. |
| 40305 | Exhibit 3 (Wkst S-3), Line 14, Column 2 should be greater than zero. |
| 40306 | Exhibit 3 (Wkst S-3), Line 14, Column 8 should be greater than zero. |
| 40307 | Exhibit 1 (Wkst S-2), Line 90 has been answered 'Yes', but Title XIX days on Exhibit 3 (Wkst S-3), Line 14, Column 7 are zero. |
| 40308 | Exhibit 1 (Wkst S-2), Line 90 has been answered 'Yes', but Title XIX discharges on Exhibit 3 (Wkst S-3), Line 14, Column 14 are zero. |
| 40309 | Hospital FTE's on Exhibit 3 (Wkst S-3), Line 14, Column 10 are not greater than zero. |
| 40310 | Medicare Hospital discharges on Exhibit 3 (Wkst S-3), Line 14, Column 13 are not greater than zero. |
| 40311 | Total Hospital discharges on Exhibit (Wkst S-3), Line 14, Column 15 is not greater than zero. |
| 40312 | Exhibit 3 (Wkst S-3), Line 27, Column 2 should be greater than zero. |
| 40313 | Exhibit 3 (Wkst S-3), sum of lines 14-26, Column 8 should be greater than zero. |
| 40314 | Line 27 Column 9 of Exhibit 3 (Wkst S-3) is not zero but there is no Intern & Residents cost on Exhibit 11 (Wkst A), lines 21 AND/OR 22, Column 7, 9 or 11 |
| 40401 | (Three variations): (1 - Available bed days are inconsistent with the number of days in the cost reporting period, beginning and ending bed capacity are the same): "The hospital reported a Certified Bed Days Available amount in Exhibit 4, Class Code 00220, Line LLL which is not consistent with the number of days in the cost reporting period." (2 - Available bed days are inconsistent with the number of days in the cost reporting period, there was a change in the bed capacity, but no explanation has been entered on Lines 071-075): "The hospital reported a Certified Bed Days Available amount in Exhibit 4, Class Code 00220, Line LLL which is not consistent with the number of days in the cost reporting period. The hospital also reported a difference in the Certified Bed Capacity between the Beginning of the Period and the End of the Period in Class Codes 00216 and 00218, respectively, without an explanation in Exhibit 4, Lines 071-075. Please confirm the change in certified beds by providing an explanation in Lines 071-075." (3 - Available bed days are inconsistent with the number of days in the cost reporting period, there was a change in the bed capacity, and an explanation has been entered on Lines 071-075): The hospital reported a Certified Bed Days Available amount in Exhibit 4, Class Code 00220, Line LLL which is not consistent with the number of days in the cost reporting period. The hospital also reported a difference in the Certified Bed Capacity between the Beginning of the Period and the End of the Period in Class Codes 00216 and 00218, respectively. Please confirm that this change is correct and explained in Exhibit 4, Lines 071-075." |
| 40901 | Exhibit 9 does not contain data. You are affirming that no officers, owners, stockholders, directors, or trustees of the faciity receive compensation as reported on Exhibit 11. |
| 41001 | On Exhibit 10, line LLL, total compensation of (amount) has been entered. Is this amount correct? |
| 41101 | This provider has a Chemical Dependency Detoxification unit. Therefore, cost center code 203 on Exhibit 11, Column 11 should be present and be greater than zero. |
| 41102 | This provider has a CPEP (Psychiatric) unit. Therefore, cost center code 288 or 216 on Exhibit 11, Column 11 should be present and be greater than zero. |
| 41103 | Exhibit 11 (Wkst A), Line 19 (Non-Physician Anesthetists), Col 7 is not equal to zero but Exhibit 1 (Wkst S-2), Line 108 is not equal to 'Y' |
| 41104 | This provider has a Women & Infant Program (WIC). Therefore, cost center code 418 on Exhibit 11, Column 11 should be present and be greater than zero. |
| 41201 | The sum of the increases does not equal the sum of the decreases for alpha code: aaa Increase total = (amount) Decrease total = (amount) Difference = (amount) |
| 41301 | The hospital has reported depreciation as a negative amount in Exhibit 13 (Wkst A-7), Part II, Class Code 00441, Line Code LLL. (CMS Line x.xx) |
| 41302 | The hospital has reported depreciation as a negative amount in Exhibit 13 (Wkst A-7), Part III, Class Code 00441, Line Code LLL. (CMS Line x.xx) |
| 41401 | No Medicaid adjustments have been made on Exhibit 14. |
| 41402 | The hospital reported outpatient Cancer Treatment or Oncology Services but did not report a Medicaid adjustment for cost of drugs billable outside the rate system in Exhibit 14, Line 632. |
| 41501 | A/An (All Program / Medicare / Medicaid) Adjustment on Exhibit 15, Line LLL doesn't have a Cost Center specified. Please enter the appropriate cost center, otherwise the adjustment amount will be set to zero. |
| 41601 | On Wkst A-8-1 Part A, there is no amount entered for line x.xx (line code LLL) column 4/5, but there is a Wkst A line number entered in column 1 |
| This is now a FATAL edit, 31602 (see above.) | |
| 41701 | Total remuneration in column 3 of Wkst A-8-2 does not equal the sum of the professional and provider components on line LLL (cost center xxx.xx) |
| 41702 | Medicare Wkst A-8-2, line LLL, column 7 and/or 8 input is missing. This input may be required to correctly calculate this worksheet |
| 41801 | Exhibit 11 (Wkst A) admin & general total Medicaid expense (including fragmented A & G), Column 11 does not match Exhibit 18, line 050, Column cccc Exh 11 amount = (amount) Exh 18 amount = (amount) Difference = (amount) |
| 41802 | Exhibit 11 (Wkst A) total Medicaid expense, Column 11 does not match Exhibit 18, line 080, Column cccc Exh 11 amount = (amount) Exh 18 amount = (amount) Difference = (amount) |
| 41803 | Exhibit 11 (Wkst A) total Medicaid expense, Column 11, Line 003 (and any subscripts of line 3) + total Fringe Benefits (Column 2.01) does not match Exhibit 18, line 090, Column cccc Exh 11 amount = (amount) Exh 18 amount = (amount) Difference = (amount) |
| 41804 | Exhibit 18, line 25 + 81, column 0061, medical malpractice, should be greater than zero. |
| 41805 | On Exhibit 18, an amount has been entered on line 81, but a cost center, or reclassification code has not been entered on line 82. |
| 41806 | On Exhibit 18, no amount has been entered on line 83; your are affirming that there was no operating interest in the current reporting period. |
| 41807 | The hospital has not reported 'Metropolitan Commuter Transport Mobility Tax' on Exhibit 18, Class 00062, Line 33, and is located in the MCT District. (FYE on/after 6/30/2019. The first two digits of the OpCert number indicate whether or not the hospital is located in the MCT District: 13 – Dutchess, 29 – Nassau, 35 – Orange, 39 – Putnam, 43 – Rockland, 51 – Suffolk, 59 – Westchester and 70 – NYC.) |
| 41808 | The hospital has reported 'Metropolitan Commuter Transport Mobility Tax' on Exhibit 18, Class 00062, Line 33, but is not located in the MCT District. (FYE on/after 6/30/2019) |
| 41809 | On Exhibit 18, the hospital reported parking expense less than zero in Class 00062, Line 068 and/or Line 069. |
| 41810 | The hospital reported Exhibit 18 parking cost in a line other than 068, Parking Cost (Public), or 069, Parking Cost (Employees). |
| 41811 | Parking Lot Receipts may not have been fully offset for Exhibit 18. |
| 41812 | The hospital did not report Exhibit 18 malpractice costs on lines 025 and/or 081. (FYE on/after 6/30/2021) |
| 41813 | The hospital reported net negative Exhibit 18 malpractice costs on lines 025 and/or 081. (FYE on/after 6/30/2021) |
| 41901 | A statistic has been input on Exhibit 19 (Wkst B-1) on Line xxx.xx, Column 0 |
| 41902 | A negative stat has been input on Exhibit 19 (Wkst B-1) on Line xxx.xx, Column ccc.cc |
| 41903 | Exhibit 11 (Wkst A), Column 7 (9,11), CMS Line xxx.xx equals 0 but there are statistics in Column ccc.cc of Exhibit 19 (Wkst B-1) |
| 41904 | (First variation) Exhibit 19 (Wkst B-1), Column ccc.cc does not have any stats but Exhibit 11 (Wkst A), Column 7 (9,11), CMS Line xxx.xx does not equal zero. (Second variation) Exhibit 19 (Wkst B-1), Column ccc.cc does not have any stats but Exhibit 11 (Wkst A), Column 7 (9,11), CMS Line xxx.xx has an allocation code. |
| 42001 | Exhibit 20 (Wkst B-3), Line 201 is not a '0' (indicating a stat base of charges or a '1' (indicating statistics) in Column ccc.cc |
| 42002 | Exhibit 11 (Wkst A), Column 7 (9, 11), Line xxx.xx does not equal 0 but charges for that cost center have not been entered on Exhibit 20 (Wkst B-3) |
| 42003 | Exhibit 11 (Wkst A), Column 7 (9, 11), Line xxx.xx equals zero but charges for that cost center are on Exhibit 20 (Wkst B-3) |
| 42004 | Exhibit 19 (Wkst B-1), Line xxx.xx has statistics but no charges for that cost center been entered on Exh 20 (Wkst B-3). |
| 42005 | Exhibit 19 (Wkst B-1), does not have any statistics on line xxx.xx but charges for that cost center are on Exhibit 20 (Wkst B-3). |
| 42301 | Exhibit 23 (Wkst G) balance sheet is out of balance Total assets = (amount) Total liabilities and fund balances = (amount) Difference = (amount) |
| 42302 | Exhibit 24 (Wkst G-1) end-of-period fund balances do not equal Exhibit 23 (Wkst G) fund balances for column cccc. Fund balance per Exh 23 = (amount) Fund balance per Exh 24 = (amount) Difference = (amount) |
| 42303 | Wkst G-2 Part I total patient revenues does not equal the total gross charges on Exh 46 column 1 line 200. Wkst G-2 revenues = (amount) Exhibit 46 charges = (amount) Difference = (amount) |
| 42501 | You may not have completed entry of Exhibit 25, Statement of Cash Flows, for a voluntary Article 28 hospital, when Type of Control, (Exhibit 1, Line 21) is blank, 1 or 2, AND Exhibit 25, cc00283, line 002 is zero. (FYE on/after 6/30/2019, for voluntary hospitals EXCEPT Article 31 hospitals) |
| 42701 | You have entered a cost center line code on Exhibit 27 on line code LLL that does not appear on Exhibit 11. |
| 42702 | You have entered a cost center line code on Exhibit 27 on line code LLL that does not appear on Exhibit 11. |
| 43001 | This provider has a swing-bed unit but has not entered swing-bed patient days on Exhibit 30, Part 2, Line 110, Column 0210. |
| 43002 | No dual-eligible days were entered on Exhibit 30, Line 060, class code 00260. -OR- No dual-eligible discharges were entered on Exhibit 30, Line 060, class code 00270. (New, for FYE on/after 6/30/2019. Does not apply to Article 31 hospitals.) |
| 43101 | You have toggled the transfer basis for Emergency Services to Charges (from Visits) and this change will be permanent if the ICR is submitted without resetting the basis to Visits (FYE on/after 6/30/2019) |
| 43102 | You have toggled the transfer basis for CPEP Emergency Services to Charges (from Visits) and this change will be permanent if the ICR is submitted without resetting the basis to Visits (FYE on/after 6/30/2019) |
| 43103 | You have toggled the transfer basis for Clinic Services to Charges (from Visits) and this change will be permanent if the ICR is submitted without resetting the basis to Visits (FYE on/after 6/30/2019) |
| 43104 | You have not reported non-transferred visits for the Clinic (on Exhibit 3 1A, Class 00217, ICR Lines 235, 240, 250 plus 472) when (1) the Clinic Prior Year Cost Comparison Basis = 1, (2) Exhibit 33, the sum of the total visits in (00161/025 + 00161/125 + 00161/675) is greater than zero and (3) total visits in Exhibit 33, (00161/025 + 00161/125 + 00161/675) and total visits in Exhibit 33, (00241/025 + 00241/125 + 00241/675) do not equal. (FYE on/after 6/30/2019, revised for FYE on/after 6/30/2020 to exclude references to 00161/075 and 00241/075) |
| 43105 | You have not reported non-transferred visits for Emergency Service (Exhibit 31A, Class 00222, ICR Line 236) when (1) the Emergency Service Prior Year Cost Comparison Basis = 1, (2) Exhibit 33, 00160/025 is greater than zero, and (3) visits in Exhibit 33, 00160/025 and 00240/025 do not equal. (FYE on/after 6/30/2019) |
| 43106 | You have not reported non-transferred visits for CPEP (Exhibit 31A, Class 00221, ICR Line 288) when (1) the CPEP Prior Year Cost Comparison Basis = 1, (2) Exhibit 33, 00161/225 is greater than zero and (3) visits in Exhibit 33, 00161/225 and 00241/225 are not equal. (FYE on/after 6/30/2019) |
| 43107 | The Clinic visits and transfers in Exhibit 31A do not equal the total of the four sources from Exhibit 33. (FYE on/after 6/30/2019) The Clinic visits and transfers in Exhibit 31A do not equal the total of the three sources from Exhibit 33. (FYE on/after 6/30/2020) |
| 43108 | The hospital reported charges for Emergency Service in Exhibit 31A instead of visits. |
| 43109 | The hospital reported charges for CPEP Emergency in Exhibit 31A instead of visits. |
| 43110 | The hospital reported charges for Clinic in Exhibit 31A instead of visits. |
| 43201 | Total Medicare adults & peds patient days on Exhibit 32 Line 012 (incl. ALC), does not match Exhibit 3 (S-3) Column 0692 (incl. Subproviders, excl. Nursery, HMO, and Swing Beds) Exh 3 amount = (amount) Exh 32 (all units) amount = (amount) Difference = (amount) |
| 43202 | If there are inpatient discharges present on Exhibit 32, Line 011, then there should be Inpatient Uncompensated Care Collections on Exhibit 32, Line 300. |
| 43203 | Total adults & peds days on Exhibit 32, Line 011 (incl. ALC) (all Service Codes) does not match Exhibit 30, Line 060, Column 0214 (excl. newborn and premature). Exh 30 amount = (amount) Exh 32 amount = (amount) Difference = (amount) Edit disabled for FYE on/after 6/30/2019 |
| 43204 | Total Medicare newborn patient days on Exhibit 32, Line 012, Column (04503 or 04319) does not match Exhibit 3 (S-3) Lines 007 and 039, Column 0692. Exh 3 Amount entered = (amount) Exh 32 Amount entered = (amount) Difference = (amount) |
| 43205 | Total adults & peds discharges on Exhibit 32, Line 011 (all units) does not match Exhibit 30, Line 060, Column 4031 (excl. newborn). Exh 30 amount = (amount) Exh 32 amount = (amount) Difference = (amount) Edit disabled for FYE on/after 6/30/2019 |
| 43206 | Total Medicare adults & peds discharges on Exhibit 32, Line 012 (all units) does not match Exhibit 3 (S-3), Line 008, Column 0088 (incl. Subprovider, excl. nursery, swing beds). Exh 3 amount = (amount) Exh 32 amount = (amount) Difference = (amount) |
| 43207 | Total adults & peds patient days on Exhibit 32 for (service category) Line 011 does not equal Column 0214 of Exhibit 30. Exh 30 amount = (amount) Exh 32 amount = (amount) Edit disabled for FYE on/after 6/30/2019 |
| 43208 | Total adults & peds discharges on Exhibit 32 for (service category) Line 011 does not equal Column 4031 of Exhibit 30. Exh 30 amount = (amount) Exh 32 amount = (amount) Edit disabled for FYE on/after 6/30/2019 |
| 43209 | Total acute newborn days on Exhibit 32, Line 011 Column 4319 or Exhibit 32, Line 011 Column 4503 does not equal Column 0214 of Exhibit 30 Exh 30 Amount = (amount) Exh 32 Amount = (amount) Edit disabled for FYE on/after 6/30/2019 |
| 43210 | Total acute newborn discharges on Exhibit 32, Line 011 Column 4321 or Exhibit 32, Line 011 Column 4504 does not equal Column 4031 of Exhibit 30 Line 052 Exh 30 Amount = (amount) Exh 32 Amount = (amount) Edit disabled for FYE on/after 6/30/2019 |
| 43211 | Total Acute ALC Days on Exhibit 32, Line 011, Class 04322 does not match Exhibit 30, Line 043, Class 00214. Exh 30 amount = (amount) Exh 32 amount = (amount) Difference = (amount) (FYE on/after 6/30/2018 but before 6/30/2019) |
| 43212 | Acute ALC Days were entered on Exhibit 30 for an exempt or specialty hospital. (FYE on/after 6/30/2018 but before 6/30/2019. Applies to LTCH, Cancer, Children's, Extended Neoplastic Disease Care hospitals. For other provider types, do not apply the edit if the provider is PPS for Medicare.) |
| 43214 | There are (amount) (Payor category) discharges reported on Exhibit 32 but there are no corresponding charges reported on Exhibit 46 for (Service category) |
| 43215 | The hospital has assigned MSC 204 on Exhibit 32, Line 301, for (service area), but it is not NYS Medicaid certified for Dual-Diagnosis Psychiatric services. (FYE on/after 6/30/2020) |
| 43216 | Non-CAH: MSC 201 (Acute) was reported on Line 301 for one or more Exhibit 32 categories, but this is not a General Short-Term hospital. CAH: MSC 201 (Acute) was reported on Line 301 for one or more Exhibit 32 categories. This is not appropriate for a Critical Access Hospital. (FYE on/after 6/30/2021) |
| 43217 | Medicaid FFS or HMO utilization, but not both, reported for Class ccccc (days/discharges) in the category name category on Exhibit 32. (FYE on/after 6/30/2021) |
| 43218 | The sum of Exhibit 3 Class 00694 hospital inpatient days does not equal the sum of patient days and ALC days reported as Acute/CAH, TBI/Coma and 'Other' (if the MSC for 'Other' is 201 or 216). (FYE on/after 6/30/2021) |
| 43219 | Exhibit 32 Acute/CAH inpatient days differ from related Exhibit 3 days by the same amount reported as Labor and Delivery Days in Exhibit 3, Class 00694, Line 612. (FYE on/after 6/30/2021) |
| 43220 | Exhibit 32 Acute/CAH inpatient days differ from related Exhibit 3 days by the same amount reported as Swing Bed SNF Days in Exhibit 3, Class 00694, Line 019. (FYE on/after 6/30/2021) |
| 43221 | The sum of Exhibit 3 IPF and Psychiatric Days does not equal the sum of Exhibit 32 Psychiatric and Dual-diagnosis patient days and ALC days. (FYE onafter 6/30/2021) |
| 43222 | There are different IRF Employee Discount Days in Exhibit 3 than Physical Medicine Rehabilitation Courtesy Days (with ALC) in Exhibit 32. (FYE onafter 6/30/2021) |
| 43223 | There are different Employee Discount Days in Exhibit 3 than non-IRF Total Courtesy Days (with ALC) in Exhibit 32. (FYE onafter 6/30/2021) |
| 43224 | There are different IRF/Physical Medicine Days in Exhibit 3 than Exhibit 32 Days (with ALC). Check variable inpatient cost center lines 318 to 371. (FYE onafter 6/30/2021) |
| 43225 | There are different Chemical Dependency Detox Days in Exhibit 3 than Exhibit 32 Days (with ALC). Check variable inpatient cost center lines 318 to 371. (FYE onafter 6/30/2021) |
| 43226 | There are different Chemical Dependency Rehab Days in Exhibit 3 than Exhibit 32 Days (with ALC). Check variable inpatient cost center lines 318 to 371. (FYE onafter 6/30/2021) |
| 43227 | Line lll, class codes (days class) and (discharges class), either days or discharges equals zero but the other does not, in the (category name) category on Exhibit 32. (FYE on/after 6/30/2021) This will issue as Fatal Edit 33227 if Exhibit 1, Line 23, Column 1 is either "3" or blank, and Line 23, Column 2 is "NO". |
| 43301 | If there are Outpatient Visits present on Exhibit 33, then there should be Outpatient Uncompensated Care Collections on Exhibit 33 (Sum of all services). |
| 43302 | Total emergency room visits on Exhibit 31A, Line 960, Column 0222, does not match Exhibit 33, Line 025, Column 0160. Exh 31A amount = (amount) Exh 33 amount = (amount) Difference = (amount) |
| 43303 | Total CPEP visits on Exhibit 31A, Line 960, Column 0221, does not match Exhibit 33, Line 225, Column 0161. Exh 31A amount = (amount) Exh 33 amount = (amount) Difference = (amount) |
| 43304 | Total outpatient clinic visits on Exhibit 31A, Line 960, Column 0217, does not match Exhibit 33, Line 025, Column 0161. Exh 31A amount = (amount) Exh 33 amount = (amount) Difference = (amount) (Edit disabled 6/28/2020 for cost reporting periods ending on/after 6/30/2019 - it has been replaced by edit 43107) |
| 43305 | (First variation) None of the Emergency Services utilization reported in Exhibit 33, 00160/025 was reported as part of Inpatient Admissions at 00240/025. (Second variation) Few visits from the Emergency Services utilization reported in Exhibit 33, 00160/025 were reported as part of Inpatient Admissions at 00240/025. The difference is xxx.xx%. (Applies only to Emergency Services, cc0160/0240, line 025) |
| 43306 | The default MSC for Exhibit 33, Chemical Dependency Clinic / Rehab (00241 / 901) is 248 for cost reporting periods ending on/after 6/30/2020. You have entered msc instead. The default MSC for Exhibit 33, OASAS Programs (00242 / 908) is 959 for cost reporting periods ending on/after 6/30/2020. You have entered msc instead. (FYE on/after 6/30/2020) |
| 43307 | Outpatient Medicaid FFS or HMO utilization, but not both, reported for Exhibit 33, Class ccccc (Category Name) (FYE on/after 6/30/2021) |
| 43308 | There were no Uninsured (Emergency Service or CPEP Emergency Service) visits reported at (0160/018 or 0161 / 218). (FYE on/after 6/30/2021, when total visits for the category are > zero and uncompensated care collections for the category are > zero.) |
| 43309 | There were no Free (Charity) (Emergency Service or CPEP Emergency Service) visits reported at (0160/018 or 0161 / 218). (FYE on/after 6/30/2021, when total visits for the category are > zero and uncompensated care collections for the category are > zero.) |
| 43310 | Visits have been entered on Exhibit 33, but visits excl. inpatient admissions are zero on the following line(s): Line LLL, Class Codes (0160/0240, 0161/0241, or 0162/0242) (Replaces edit 33301) |
| 43401 | If total nursing visits on line 008, column 0209 is greater than zero on Exhibit 34, then uncompensated care collections on line 110 on Exhibit 34 should also be greater than zero. |
| 43402 | You have entered Home Health Agency visits/hours or costs without providing HHA FTEs. (FYE on/after 6/30/2019) |
| 43403 | You have entered Home Health Agency costs without providing visits or hours. (FYE on/after 6/30/2019) |
| 43404 | Home Health skilled nursing and therapy visits, Medicaid FFS or HMO utilization, but not both, reported for Class 00209 on Exhibit 34. (FYE on/after 6/30/2021) |
| 43405 | Home Health aide hours, Medicaid FFS or HMO utilization, but not both, reported for Class 00209 on Exhibit 34. (FYE on/after 6/30/2021) |
| 43501 | The total entered for Exhibit 35 column (4811, 4813, 4814, 4816 or 4817) does not equal the detail. Amount entered = (amount) Amount computed = (amount) Difference = (amount) |
| 43502 | On Exhibit 35, in column 4812, you have entered an amount greater than 40 and/or less than 30 hours for the standard work week on line LLL . |
| 43601 | Total full time equivalent employees on Exhibit 36 line 960 Col 0255 does not match Exh 3 (Wkst S-3), line 018 col 0085. Exh 3 amount = (amount) Exh 36 amount = (amount) Difference = (amount) The edit will not issue if the absolute value of the difference is less than 1.0. |
| 43602 | Total non-paid FTE workers on Exhibit 36 line 274 Col 0255 does not match Exh 3 (Wkst S-3), line 018 col 0086. Exh 3 amount = (amount) Exh 36 amount = (amount) Difference = (amount) |
| 43603 | On Exhibit 36, in column 0249, you have entered an amount greater than 40 and/or less than 30 hours for the standard work week on line LLL . |
| 44101 | On Exhibit 41, line code 024, you have entered a negative amount for investment income. This will be reset to zero. |
| 44102 | You have reported disbursing from the Depreciation Fund (Exhibit 41, line 004) for acquiring capital assets but you have not reported a depreciation fund balance in Exhibit 41, lines 011 and 019. (FYE on/after 6/30/2019, for voluntary hospitals) |
| 44103 | You have reported Total capital asset purchases in Exhibit 41 Class 00054 Line 006 which exceed those reported on the Statement of Cash Flows at Exhibit 25, Class 00283 Line 011. (FYE on/after 6/30/2019, for voluntary hospitals)
FYE on/after 6/30/2022: You have reported Total capital asset purchases in Exhibit 41 Class 00054 Line 036 which exceed those reported on the Statement of Cash Flows at Exhibit 25, Class 00283 Line 011. |
| 44104 | You have not reported in Exhibit 41 at Class 00054 Line 007 any payments made to reduce capital debt. (FYE on/after 6/30/2019, for voluntary hospitals) |
| 44105 | You have reported payments made to reduce capital debt in Exhibit 41 Class 00054 Line 007 which exceed the amount of those reported on the Statement of Cash Flows at Exhibit 25, Class 00283 Line 012. (FYE on/after 6/30/2019, for voluntary hospitals)
FYE on/after 6/30/2022: You have reported payments made to reduce capital debt in Exhibit 41 Class 00054 Line 037 which exceed the amount of those reported on the Statement of Cash Flows at Exhibit 25, Class 00283 Line 012. |
| 44106 | You have reported payments made to reduce capital debt in Exhibit 41 Class 00054 Line 007 which equal the increase (not reduction) in long-term debt reported on the Statement of Cash Flows at Exhibit 25, Class 00283, Line 061. (FYE on/after 6/30/2019, for voluntary hospitals) The edit will not issue if both amounts equal zero. |
| 44107 | You have reported a negative value for a depreciation fund component value on Exhibit 41, Class 00054, Line LLL. (FYE on/after 6/30/2019, for voluntary hospitals) |
| 44109 | You have reported all Exhibit 23 balance sheet general fund cash as being in the Depreciation Fund (see Exhibit 23, Class 00010, Line 001 and Exhibit 41, Class 00054, Line 016.) FYE on/after 6/30/2019, for voluntary hospitals) |
| 44110 | You have reported all Exhibit 23 balance sheet general temporary investments at Class 00010 Line 002 as being in the depreciation fund (Exhibit 41, Class 00054, Line 017.) (FYE on/after 6/30/2019, for voluntary hospitals) |
| 44111 | You have reported a reduction in the depreciation fund balance without any disbursement from the depreciation fund or plant fund. (Exhibit 41, Line 011 is greater than Line 019 and the sum of Line 003 and Line 004 equals zero.) (FYE on/after 6/30/2019, for voluntary hospitals) |
| 44112 | You have reported a depreciation fund cash balance that exceeds the cash total reported in the balance sheet. (Exhibit 41, Line 016 is greater than Exhibit 23, sum of Column 00010, Line 001, Column 00011, Line 001, Column 00011, Line 101 and Column 00011, Line 051.) (FYE on/after 6/30/2019, for voluntary hospitals) |
| 44113 | You have reported an increase in the depreciation fund balance when depreciation was fully funded for the period. (Exhibit 41, Line 022 is zero and Line 019 is greater than Line 011.) (FYE on/after 6/30/2019, for voluntary hospitals) |
| 44201 | You have reported Depreciation as Not Funded and have not requested a waiver of funding requirements. (FYE on/after 6/30/2019, for voluntary hospitals) |
| 44202 | You have requested a waiver of depreciation funding requirements and not provided an explanation. --- OR --- You have not requested a waiver of depreciation funding requirements but an explanation is present. (FYE on/after 6/30/2019, for voluntary hospitals.) |
| 44601 | Exhibit 11 (Wkst A), Line xxx.xx, Col 11 is not equal to zero but Exhibit 46, Col cccc Line 300 is zero. |
| 44602 | Exhibit 11 (Wkst A), Line xxx.xx, Col 11 is equal to zero but Exhibit 46, Col cccc Line 300 is not zero. |
| 44603 | The hospital reported no Inpatient Net Revenue Assessment in Exhibit 46, Line 363, Column 00036. |
| 44604 | On Exhibit 46, Column 0036, Payor's Gross Charges on Line LLL are less than appropriate Allowances on Line LLL Payor Name . |
| 44605 | On Exhibit 46, Column 0036, Bad Debts have not been reported for Payor Name on Line LLL . |
| 44606 | (First variation) Exhibit 26A, line 001 total patient revenues does not equal the total gross charges on Exh 46 column 0036 line 200. (Second variation) Exhibit 26A, line 002 contractual allowances does not equal the contractual allowances on Exh 46 column 0036 line 290. (Third variation) Exhibit 26A, line 003 net patient revenues does not equal the net charges on Exh 46 column 0036 line 300. Exhibit 26A revenues = (amount) Exhibit 46 charges = (amount) Difference = (amount) |
| 44607 | The hospital reported no Public Goods Surcharge (HCRA) in Exhibit 46, Line 231, Column 00036. (Non-psych hospitals only) |
| 44608 | The Article 28 hospital reported no Health Facility Cash Assessment / Hospital Quality Distribution in Exhibit 46, Line 364, Column 0036. (Non-psychiatric hospitals only) |
| 44609 | At least one HCRA Public Goods Surcharge total is negative. See Exhibit 46, Line 231, Column 00036 (Total), 00023 (Inpatient), or 00048 (Outpatient). (FYE on/after 6/30/2021) |
| 44610 | There were HCRA Public Goods Surcharges reported for other than inpatient and outpatient hospital services. See Exhibit 46, Line 231, Columns 00047 (SNF & LTC), 00049 (HHA). (FYE on/after 6/30/2021) |
| 44611 | There were no HCRA Public Goods Surcharges reported for outpatient hospital services. See Exhibit 46, Line 231, Column 00048. (FYE on/after 6/30/2021) |
| 44612 | There were no HCRA Public Goods Surcharges reported for inpatient hospital services. See Exhibit 46, Line 231, Column 00023. (FYE on/after 6/30/2021) |
| 44613 | Exhibit 46 Line 002 includes charges for encounters which did not begin in a General Clinic service area. (FYE on/after 6/30/2021) |
| 44614 | Exhibit 46 Class ccccc, a non-General Clinic service area, has Line 002 charges which exceed 10% of that class's Total Gross Charges to Patients on Line 200. (FYE on/after 6/30/2021) The edit will not issue if Line 002 amount is negative. |
| 44615 | Exhibit 46 does not report total charges on Line 200 for Class ccccc, related to reported costs on Exhibit 52, ICR line code lll. (Applies to cost centers assigned to MSC 235, FYE on/after 6/30/2021) |
| 44616 | The UPL Amount on Exhibit 46, Class 00036 (Summary - All Services), Line 357 is positive indicating a net payback of UPL. (FYE on/after 6/30/2021) |
| 44617 | CPEP Observation Days and CPEP Observation charges are not consistent. (FYE on/after 6/30/2022) |
| 45001 | Exhibit 50, line 001 is equal to zero. You are affirming that no costs were incurred in rendering services to uninsured patients. |
| 45002 | Exhibit 50, line 002 should be equal to or greater than 12% of line 001. |
| 45003 | Exhibit 50, line 003 should be equal to or greater than 12% of line 001. |
| 45004 | Exhibit 50, line 064 has a 'YES' response. Line 060 should be greater than zero. |
| 45005 | On Exhibit 50, Column 4930, Line 060, you have reported in excess of 1000 liens on primary residences. Is this correct? |
| 45006 | There were no Medicaid services Financial Losses reported on Line 8 (Line Code 059) of Exhibit 50. (FYE on/after 6/30/2021) |
| 45007 | Indigent Care Pool Reimbursement was not reported on Line 5 of Exhibit 50. The Exhibit 46 amount was $ (from 00036/230). (FYE on/after 6/30/2021) |
| 45008 | The total uninsured costs were negative (Exhibit 50, Line 001). (FYE on/after 6/30/2021) |
| 45009 | The financial-aid-eligible uninsured costs were negative or zero. (Exhibit 50, Line 002). (FYE on/after 6/30/2021) |
| 45010 | The financial-aid-eligible uncollected amounts were negative or zero. (Exhibit 50, Line 003). (FYE on/after 6/30/2021) |
| 45101 | You have not indicated on Exhibit 51 if you are an Article 31 provider or if non-submission has been requested by the Department. |
| 45102 | The hospital reported an adjustment to Exhibit 46 charges on Exhibit 51 Line LLL (Class 45137) which was positive. (NOTE: Positive adjustments increase the denominator of and decrease the computed value of the cost center's Ratio of Costs to Charges.) (FYE on/after 6/30/2019) |
| 45103 | Final Accumulated Routine Costs Used for RCC in class code 45110 on Exhibit 51, Part 1A, Line LLL is negative. |
| 45104 | Total All Service Charges in class code 45140 on Exhibit 51, Part 1A, Line LLL is negative. |
| 45105 | The hospital reported outpatient Cancer Treatment or Oncology Services but did not report an Adjustment reducing Charges for drugs billable outside the rate system in Exhibit 51. |
| 45204 | The Medicaid Service Code in Exhibit 52, ICR Line Code LLL does not match the default MSC for this cost center. You have entered msc as the MSC. The default MSC is msc. Please review the MSC assignment and correct it on Exhibit 52 if necessary. (FYE on/after 6/30/2019) |
| 45205 | The hospital has assigned MSC 204 to ICR cost center LLL on Exhibit 52, but it is not NYS Medicaid certified for Dual-Diagnosis Psychiatric services. (FYE on/after 6/30/2020) |
| 45206 | The Final Allocated Medicaid Cost for ICR Line LLL is negative in Exhibit 52. |
| 45207 | The Final Medicaid Capital Related Cost for ICR Line LLL is negative in Exhibit 52. |
| 45208 | The skilled nursing facility MSC (MSC code) has been assigned to multiple cost centers. (FYE on/after 6/30/2022) |
| 45301 | Costs or utilization, but not both, were reported in Exhibit 53 for Medicaid Service Code msc msc_description (FYE on/after 6/30/2019) |
| 45302 | Hospital reported that it is a CAH and has no CAH days reported in Exhibit 53, Medicaid Service Code 216. (FYE on/after 6/30/2019) |
| 45303 | Hospital reported that it is or contains an IPF and has no Psychiatric days reported in Exhibit 53, Medicaid Service Code 202 or 204. (FYE on/after 6/30/2019) |
| 45304 | Hospital reported Exhibit 3, Line 301 Psychiatric utilization and has no Psychiatric days reported in Exhibit 53, Medicaid Service Code 202. (FYE on/after 6/30/2019) |
| 45305 | Hospital reported that it is or contains an IRF and has no Medical Rehabilitation days reported in Exhibit 53, Medicaid Service Code 218. (FYE on/after 6/30/2019) |
| 45306 | Hospital reported that it is a LTCH and has no Specialty Hospital days reported in Exhibit 53, Medicaid Service Code 205. (FYE on/after 6/30/2019) |
| 45307 | Cost, charges and revenue were not ALL reported for Medicaid Service Code msc on Exhibit 53. (FYE on/after 6/30/2019) |
| 45308 | The MSC of '201' assigned to Ambulance Services is not consistent with requirement that only a short-term general hospital that is not a CAH and that 'provides' the services may code them as 201. (FYE on/after 6/30/2021) |
| 45309 | The Ambulance Services MSC is not 201 (See Instructions), 237 or 959. (FYE on/after 6/30/2021) |
| 49101 | The transfer of Clinic costs based on visits and on charges is not consistent (more than 10% different). (FYE on/after 6/30/2019) (Modified to exclude Alcohol / Chemical Dependency visits and charges for FYE on/after 6/30/2020.) |
| 49102 | The transfer of Emergency Services costs based on visits and on charges is not consistent (more than 10% different). (FYE on/after 6/30/2019) For FYE on/after 6/30/2020, the threshold is 15%. |
| 49103 | The transfer of outpatient CPEP Emergency Services costs based on visits and on charges is not consistent (more than 10% different). (FYE on/after 6/30/2019) |
| 50101 | The provider name has not been entered on Exhibit 1 (S-2) for the (hospital or hospital-based component) . |
| 50301 | The Total FTE 's on Exhibit 3 (Wkst S-3), Line 27, Column 7 = (amount) |
| 51703 | A direct input entry has been made to line LL column 8 of Medicare Worksheet A-8-2 (Exhibit 17) |
| 51901 | An A & G offset has been input on Exhibit 19 (Wkst B-1) on Line xxx.xx, Column ccc.cc No cost will be allocated to this cost center. |
| 51902 | An offsetting entry has been made in A & G Column ccc.cc on Exhibit 19 (Wkst B-1), Line xxx.xx. This stat will be used instead of accumulated cost. |
| 51903 | Data has been entered into A & G Column ccc.cc of Exhibit 19 (Wkst B-1). These statistics will be used instead of computing accumulated cost |
| 52001 | Option 45 has not been selected but data has been input on Exhibit 20 (Wkst B-3) into Column Code ccc - These will be added to values transferring from Exhibit 46 |
