UPSTATE BLUE CROSS SUPPLEMENTAL DATA

Section 446.30 - Cost allocation adjustments

UPSTATE BLUE CROSS SUPPLEMENTAL DATA
446.30 Cost allocation adjustments.
Account
Description of adjustment Cost center affected number
(a) Interest on inter-fund borrowing
(1) Funded depreciation (i) Interest--Short-Term, or 8870
(ii) Interest--Long-Term 8880
(2) Donor-restricted funds (i) Interest--Short-Term, or 8870
(ii) Interest--Long-Term 8880
(3) Other (specify) (i) Interest--Short-Term, or 8870
(ii) Interest--Long-Term 8880
(b) Unincorporated business tax Provision for Income Taxes 9410
(c) Corporate income taxes Provision for Income Taxes 9410
(d) Unrecovered cost of courtesy Employee Benefits-- allowances to employees and Non-Payroll-Related 8830 dependents
(e) Voluntary Agency Proficiency Testing Program
(1) Clinical laboratory Laboratory Services--Clinical 7210
(2) Other (specify) Specify Specify
(f) Grants, gifts and income for specific purposes Specify Specify
(g) Depreciation--straight Depreciation and Amortization-- line to accelerated Movable Equipment 8820
(h) 28B funding requirements
(1) Building and fixtures Depreciation/Amortization-- Fixed Assets 8810
(2) Movable equipment Depreciation/Amortization-- Movable Equipment 8820
(i) Hospital-based physicians on direct physician billing
(1) Diagnostic X-ray (i) Radiology--Diagnostic, and/or 7320
(ii) CT Scanner, and/or 7340
(iii) Radiology--Therapeutic, and/or 7360
(iv) Nuclear Medicine 7380
(2) Laboratory (i) Laboratory Services-- Clinical, and/or 7210
(ii) Laboratory Services-- Pathological, and/or 7230
(iii) Blood Storing and 7260 processing
(3) Electrocardiology Electrocardiology 7290
(4) Emergency room physicians Emergency Services 6710
(j) Other (specify) Specify Specify
(k) Amounts may be expressed as:
(1) increases; or
(2) decreases

 

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Section 446.31 - Lease schedule

446.31 Lease schedule. (a) For each individual lease arrangement, please provide:

(1) Name of the leasing company.

(2) Description of equipment leased.

(3) Term (from-to) of lease agreement.

(4) Amount of the monthly lease payment.

(5) Total cost recorded on the cost report.

The grand total of cost reported on the cost report should equal the amount reported for account 8825, Leases and Rentals--Movable Equipment.
 

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Section 446.32 - Statistical data

446.32 Statistical data. (a) Sick baby statistics.

(1) Specific statistics required:

(i) Sick baby patient days.

(ii) Sick baby discharges (excluding transfers).

(2) Program services for which statistics are to be reported:

(i) Newborn Nursery (account 6510).

(ii) Premature Nursery (account 6520).

(iii) Pediatric Acute Care (account 6170).

(iv) Pediatric intensive Care (account 6350).

(v) Neo-Natal Intensive Care (account 6370).

(3) A sick baby is defined as a baby diagnosed sick or premature.

(b) Leave day statistics. (1) Leave days are defined as days occurring after the admission and prior to the discharge of a hospital inpatient when the patient is not present at the census-taking hour.

(i) Patient is charged for the days he is on leave.

(ii) Bed is reserved for that patient.

(2) If the hospital has leave days, the following information is required: (i) Were leave days included in the Standard Unit of Measure Statistics for Daily Hospital Services (accounts 6010-6690)?

(ii) If so, please detain where they were reported (refer to section 446.44 (b) of this Part for all program services for which this statistic must be reported).

(iii) If not, please detail how they should be reported (refer to section 446.44 (b) of this Part for all program services for which this statistic must be reported).
 

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