S.C. Code Regs. § § 19-801

Current through Register Vol. 48, No. 10, October 25, 2024

Section 19-801 - Financial and Utilization Data (Annual)

A. All required items shall be reported to the Office of Research and Statistics, South Carolina Budget and Control Board, for the period October first through September thirtieth by March first of the following year.

B. The formats for submission of the required items are:

(1) "Annual Hospital Financial Data Report" or other format as specified by the Office of Research and Statistics for financial items;

(2) "Joint Annual Report of Hospitals" or other format as specified by the Office of Research and Statistics for utilization items.

C. When a format other than the Annual Report in B(1) or B(2) above is specified, the Office of Research and Statistics shall provide the format to hospitals thirty days prior to implementation of that format.

D. Financial data elements pertaining to patient charges shall be reported for "inpatients only" and for "all patients, inpatients and outpatient."

E. The financial and utilization data elements to be collected are:

(1) Gross patient revenue;

(2) Gross revenue from Medicare;

(3) Gross revenue from Medicaid;

(4) Gross revenue from Medically Indigent Assistant Program;

(5) Government contractual adjustments for:

(a) Medicare;

(b) Medicaid;

(c) Medically Indigent Assistant Program;

(d) TriCare; and

(e) Other Contractual Allowances;

(6) Total direct costs of medical education:

(a) Reimbursed, and

(b) Unreimbursed;

(7) Total indirect costs of medical education:

(a) Reimbursed, and

(b) Unreimbursed;

(8) Total costs of care for medically indigent:

(a) Reimbursed, and

(b) Unreimbursed;

(9) Bad debt expenses, net of recovery;

(10) Total patient days;

(11) Average length of stay;

(12) Total outpatient visits.

F. Hospitals shall submit to the Office of Research and Statistics a copy of their "Medicare Cost Reports" in accordance with the submission requirements of the U.S. Department of Health and Human Services, Centers for Medicaid and Medicare Services.

G. Hospitals shall maintain documentation to substantiate all items governed by R.19.801 for a period of three years from the March first deadline date.

S.C. Code Regs. § 19-801

Amended by State Register Volume 19, Issue No. 7, eff July 28, 1995; State Register Volume 29, Issue No. 6, eff June 24, 2005.