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Title: Section 86-5.2 - Financial and statistical data required

Effective Date


86-5.2 Financial and statistical data required.

(a) Each LTHHCP shall complete and file, with the New York State Department of Health and/or its agent, annual financial and statistical report forms supplied by the department and/or its agent. LTHHCP certified for title XVIII of the Federal Social Security Act (Medicare) shall use the same fiscal year for title XIX of the Federal Social Security Act (Medicaid) as is used for title XVIII. All LTHHCP's must report their operations from January 1, 1978 forward on a calendar-year basis. For a LTHHCP also certified as an AHCP, a combined annual financial and statistical report shall be submitted for both programs.

(b) Based on the financial report, the facility will be required to convert all allowable costs to a visit/hourly cost basis for the services it will be providing.

(c) All required financial and statistical reports shall be submitted to the department. Such reports shall indicate the time period within which such report shall be filed.

(d) In the event an LTHHCP fails to file the required financial and statistical reports on or before the due dates, or as the same may be extended by the department, the State Commissioner of Health shall reduce the current rate paid by state governmental agencies by two percent for a period beginning on the first day of the caledar month following the due date of the required reports and continuing until the last day of the calendar month in which the required reports are filed.

(e) In the event that any information or data which an LTHHCP has submitted to the State Department of Health on required reports, budgets or appeals for rate revisions, intended for use in establishing rates, is inaccurate or incorrect, whether by reason of subsequent events or otherwise, such agency shall forthwith submit to the department a correction of such information or data which meets the same certification requirements as the document being corrected. Failure to do so shall subject the LTHHCP to the provisions of subdivision (d) of this section.

(f) A cost report shall be filed in accordance with this section by each new program with budget based rates for the first six-month period during which the program has achieved 75 percent of the approved patient case load. This report shall be filed and properly certified within 120 days following the end of the six-month period covered by the report. All new programs shall follow the requirements of subdivision (a) of this section, and complete and file a report at the end of the first full calendar year after admission of its first patient. Facilities that have filed cost reports in accordance with the provisions of this subdivision shall be deemed to have adequate cost experience for the purpose of establishing a prospective cost-based rate.

(g) If the financial and statistical reports required by this Subpart are determined to be incomplete, inaccurate or incorrect, the LTHHCP will have 30 days from date of receipt of notification to provide the corrected or additional data. Failure to file the corrected or additional data within 30 days, or within such period as extended by the Commissioner, will result in application of subdivision (d) of this section.

(h) Each LTHHCP shall file with the New York State Department of Health a complete copy of the Department of the Treasury, Internal Revenue Service Form 990, for that facility. The Form 990 shall be submitted to the department no later than 30 days following the annual filing with the Internal Revenue Service. Failure to submit the Form 990 shall result in application of the provisions set forth in subdivision (d) of this section.


VOLUME A-2 (Title 10)