CMS-2552-96 Revisions - Crosswalk from old to new

Revisions to Form CMS-2552-96 HOSPITAL COST REPORT APPLICATION/UPDATE FORM

Statutory changes

Issue #	Page #	Section	Changes to the Application	Reason for the Change
	36-164, 36-597	3633.3	Modified lines 38-40. Added instructions for Worksheet E-3, Part III and modified the worksheet accordingly	Section 5004 of DRA 2005 to reduce allowable bad debt by 30% for beneficiaries treated in Skilled Nursing Facilities (SNF) who are not “full benefit dual eligible” as defined in 42 CFR Sec. 423.772 effective for cost reporting periods beginning on or after October 1, 2005.
	36-27 36-142 36-504	3604 3630.2	Added line 21.06 on Worksheet S-2 and modified Worksheet E, Part B, line 1.06	Section 5105 of DRA 2005 pays hold harmless transitional outpatient payment (TOPs) to small rural hospitals with 100 or fewer beds for services rendered from January 1, 2006 through December 31, 2008. (See Change Request 4367, transmittal 877, dated February 26, 2006)
	36-155	3633.1	Modified the instructions for Worksheet E-3, Part I	For Inpatient Rehabilitation Facilities (IRF) the low income patient (LIP) payment is revised effective for discharges occurring on or after October 1, 2005. Also, the IRF teaching adjustment is implemented for discharges occurring on or after October 1, 2005. (See Federal Register , Vol. 70, FR 156, dated August 15, 2005) and Change Request 4037 (CMS Pub. 100-04, transmittal 680)

Regulatory changes

36-156

3633.1

Modified the instructions for Worksheet E-3, Part I

For Inpatient Rehabilitation Facilities (IRF) the low income patient (LIP) payment is revised effective for discharges occurring on or after October 1, 2005. Also, the IRF teaching adjustment is implemented for discharges occurring on or after October 1, 2005. (See Federal Register , Vol. 70, FR 156, dated August 15, 2005) and Change Request 4037 (CMS Pub. 100-04, transmittal 680)

Clarification of Instructions

Issue #	Page #	Section	Changes to the Application	Reason for the Change
	36-22	3603	Worksheet S revising the form and the instructions	Incorporated Healthcare Cost Report Information System (HCRIS) data collection elements indicating the cost report status. Impacts HCRIS not the Electronic Cost Report ECR).
	36-503	Bottom of Worksheet	Added the new wording to the bottom of the worksheet. Revise the PRA statement on Worksheet S	New OMB requirements
	36-27	3604	Worksheet S revising the form and the instructions	Added simplified question to initiate TOPS calculation.
	36-28.2 36-507	3604	Worksheet S revising the form and the instructions	Added home office identifying information when the provider is part of a chain.
	36-28.4	3604	Worksheet S revising the form and the instructions	Reflects the election of ambulance data collection for services on or after January 1, 2006.
	36-28.4	3604	Worksheet S revising the form and the instructions	Added IRF question to initiate IRF teaching adjustment.
	36-30	3605.1	Worksheet S-3, Part I	Clarifies instructions regarding the coverage of SNF & NF swing beds.
	36-36.3	3606	Worksheet S-4	Revised instructions to reflect transition to core based statistical areas (CBSA).
	36-56	3610	Worksheet A	Added line 85.20 to record the costs of islet cells transplanted (extracted from pancreases) in accordance with CR 5505 effective for discharges on or after 10/1/04. A non-standard cost center code of 8620 will identify this cost center.
	36-100	3621.4	Worksheet D, Part III & IV	Clarified instructions regarding payment for certified registered nurse anesthetists (CRNA).
	36-102	3621.5	Worksheet D, Part V	Revised instructions to reflect the elimination of ambulance fee payments for services rendered on or after January 1, 2006
	36-116	3622.2	Worksheet D-1, Part II	Revised instructions to reflect long-term care hospital (LTCH) update budget neutrality factor.
	36-137.1	3630.1	Worksheet E, Part A	Revised instructions to reflect clarification to the three year rolling average.
	36-136	3630	Worksheet E, Part A	Effective for discharges occurring on or after October 1, 2006, this worksheet incorporates revisions impacting Medicare dependent hospitals (MDHs).

Clarification of Instructions

Issue #	Page #	Section	Changes to the Application	Reason for the Change
	36-140.2	3630.1	Worksheet E, Part A	Revised the outlier reconciliation section of the worksheet.
	36-144	3630.2	Worksheet E, Part B	Revised instructions to reflect the implementation of TOPs for small rural non-sole community hospitals (SCH). This worksheet also clarifies 101% calculation for critical access hospitals (CAH).
	36-156	3633.1	Worksheet E-3, Part I	Revised instructions to reflect the implementation of the IRF teaching adjustment and the update of the LIP payment.
	36-158.3	3633.2	Worksheet E-3, Part I	Added an outlier reconciliation section to this worksheet.
	36-158.1	3633.1	Worksheet E-3, Part IV	Clarified instructions regarding the redistribution of interns & residents (I&R).
	36-212	3660.1	Worksheet L, Part I	Revised instruction to comport with worksheet E-3, Part VI.
	36-171.3	3634	K Series Worksheets	Added the following cost centers: line 10.20 - Nursing Care - Continuous Home Care; 18.20 - Home Health Aide and Homemaker - Continuous Home Care; 20.30 - Analgesics; 20.31 - Sedatives/Hypnotics; and 20.32 - Other Specify.
	36189	3647.1	H Series Worksheets	Added a cost center to record the cost of administering influenza and pneumococcal vaccines effective for services rendered on or after July 1, 2006.

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