www.eidebail ly.com

Presenters:

Karen JessConnie Heeren

COUNTY RATE INFORMATION SYSTEM 2013 TRAINING SEMINAR

Welcome

CRIS (County Rate Information System)

Began in 2000-2001

In the process of wrapping up the 12th year!

ISAC provides administrative support

The Electronic Transactions Clearinghouse is the governing body

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The role of Eide Bailly

• Maintain provider database• Administer & review the cost report• Issue reports• Provide support• Provide training• Solicit input for improving the process

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Forms

Service Information Form In Excel format Looks like an Iowa Basic Skills test form!Referred to as the SIF

Cost Report In Excel format Format is similar to other cost report forms (HCBS, HAB,

etc).Has 24 service columns. More available if necessary.

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Process flow……

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Prepare SIF

Complete cost report

Eide Bailly reviews & finalizes cost report

Reports issued

Negotiate rates

START HERE

What is a Service Information Form?

Converts the service information into a 7-digit code based on 6 unique criteria.

Establishes which services the Provider should be tracking the costs for and reporting on in the coming year.

This form is the FOUNDATION for the process.

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When to complete the SIF?

Prior to the start of the Provider fiscal year being reported.

The best time to complete the form is when you are negotiating rates.

The SIF should be completed TOGETHER – both the CPC & Provider should have input on services to be reported.

The CPC is responsible for submitting both a signed and an electronic SIF to Eide Bailly

The initial SIF may need to be updated if services change. 7

Develop a game plan

? Is the Provider already completing a CRIS report?? Could you work with other member counties to

identify which services the Provider should list?If several counties are involved, it could become

difficult for the provider to organize their information to satisfy everyone.

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Game plan continued ………………..

What services are provided? Who funds these services? What services should be detailed? Could services be combined? Is there subcontract or retail activity?

If so, how should the related revenue be reported?

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Game plan continued……

How is the unit defined—hourly, daily, etc.?

Do clinician credentials affect the rate? What is the staff to client ratio for the

service?

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Completing the SIF (Provider Info)

CRIS ID# - ignore this fieldProvider nameFederal ID #Provider AddressHost County No. (use dropdown list)Fiscal Year EndProvider SignatureCPC Signature

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Completing the SIF (Other Information)

• County No. – Host County 2-digit number• If more than 1 host county (reporting together),

then combine the 2-digit numbers (lowest to highest).

• Description Code- Should be “Z” unless specific service type is other, 2 or more of the same 7-digit code, or you need a unique description to appear on reports.

• Description of service is informational only, but is highly recommended.

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Completing the SIF (description code)

If the description code is something other than “Z”, a brief description of the service is needed in the table on the second tab of the Excel file.

This description will print on reports (following provider name), to further define the service.

Description codes MUST be consistent from year to year.

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Service Code Segments

The code is composed of 6 segments General Service Type Facility Size Specific Service Type Unit of Service Rate Dependent on Clinician Credentials Staff to Client Ratio

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General Service Types

3 = Support Services

4 = Treatment Services

5 = Vocational/Adult Day Care

6 = Residential

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Facility Size

0 = Not a residential service program3 = 1-5 beds4 = 6-15 beds5 = 16-49 beds6 = 50+ beds

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Facility Size

Residential services use codes 3-6, depending on the number of beds available

SCL typically uses code #3 (1-5 bed). SCL in this category would typically be focused on living skills training and not medical treatment support.

All other services will report using zero as the code

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Support Services

25 = Respite

XX = Transportation

99 = Other

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Treatment Services

05 = Therapy/Treatment09 = Partial Hospitalization63 = Adult Day Treatment96 = CSP/CSS97 = Psychiatric Rehabilitation (ACT)98 = Psychiatric Rehabilitation (IPR)04 = Consultation/Education39 = Activity Services99 = Other

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Vocational/Adult Day Care

60 = Shelter Workshop62 = Work Activity – Pre Voc64 = Job Placement67 = Adult Day Care – Day Hab68 = Supported Employment69 = Enclave99 = Other

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Residential

14 = RCF15 = RCFMR16 = RCF PMI17 = Nursing Facility29 = Supported Community Living99 = Other

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Unit of Service

• Daily = 1• Hourly = 2• Monthly = 3• ½ Day = 4• Mile = 5• Trip = 6

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Rate Dependent on Clinician’s CredentialsNormally only affects MHC’s

0 = No distinction1 = Psychiatrist2 = Psychologist – licensed PHD/Health Care

Register3 = Master Level Nurse/Social

Worker/Psychologist4 = Nurse Practitioner

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Rate Dependent on Clinician’s Credentials Cont.

5 = Licensed Mental Health Counselor

6 = Blended rate (one rate is developed for all mental health clinicians excluding psychiatrists.

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Staff to Client Ratio

0 = N/A – transportation only1 = 1:12 = 1:2-53 = 1:6-104 = 1:11-155 = 1:16 +

(RCF’s – use 3-11 shift)

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Staffing Target Number

Will help to standardize the calculation of units staffed on the cost report.

Staffing target number – This is the staffing ‘goal’. If the last digit in the code is 2 (1:2-5), then the target should be 2, 3, 4, or 5. This target number is used to compute units staffed for all hourly and daily services (except 24 hour RCF’s). If the target is 2, then the expectation is that for every 2 consumers, there will be 1 direct staff on duty.

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Subcontract

Expenses associated with production/contract work should NOT be reported with the vocational service. The host county will need to identify production/contract work as a separate service on the SIF(without a 7-digit code). The Provider will then report these costs in a separate column on the cost report (consumer wages, etc).

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Miscellaneous

PLEASE do not alter the form. It is designed to import into an Access database program

If you need additional columns, complete a 2nd form

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After the form is complete

1. Email a completed form to Eide Bailly for import into their database

2. Send a signed copy of the form to Eide Bailly for their files

3. Keep a copy for your records – both CPC and Provider

4. Highly recommended that the Provider send a copy to the person preparing the cost report

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Summary

Develop a game planUse the team approach – work togetherSimplify when possibleSend copies to Eide Bailly when completedRecommended that you send a copy to

whomever is preparing the cost reportUpdate codes as necessary

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Questions on the SIF??

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County Rate Information System (CRIS) Cost Report Form

Cost Report Components

Certification Page Units staffed worksheet - complete after Sch E Schedule A – revenue Schedule B – staff numbers & wages Schedule C – expense adjustment Schedule D – depreciation Schedule E – expenses Schedule F – balance sheet Schedule G – equity reconciliation Schedule H – allocated costs

Suggested Completion Order

1. Certification Page - leave units staffed blank for now2. Schedule A - make sure it ties to the audit - if

different, provide reconciliation. May be different due to expenses netted with revenues on audit, etc.

3. Schedule B - need payroll records showing FTE's etc. This cannot be completed by an outside accounting firm without help from management.

4. Schedule C5. Schedule D

Completion Order, cont.

6. Schedule Ea. Column 1 - agree to audit, with exceptions similar to #2 aboveb. Column 2 - make sure it agrees to Schedule Ac. Column 3 - should agree with Schedules C & Dd. Column 4 is a computed columne. Show allocation methods in Column 5 - put some thought into this!f. Direct cost section by serviceg. Statistical information table at bottom of page by serviceh. Compute allocation basis values - may want to do this at the bottom of

the schedule.i. Allocate admin, occupancy support care and other costs based on

allocation methods chosen. BE CONSISTENT from year-to-year.j. Review the calculated values at the bottom of the schedule - do they

make sense?

Completion Order, cont.

7. Units staffed worksheet - complete using the information you reported in the table at the bottom of Schedule E. The calculated value should then be input on the Certification Page in the Statistical section.

8. Schedule F - information should agree to audited figures.9. Schedule G - most of the information is carried from other

schedules. If the ending equity does not agree to Schedule F, you must make the adjustment on this schedule and explain it.

10. Schedule H - check yes or no. If yes, you must show how the parent arrives at the value of the expenses allocated to you.

Certification Page

Cost report is due 90 days after your fiscal year end - Provider is responsible for using the correct version of the form. (print preview: revised 5/21/07)

Complete ALL sections ALL services identified on the Service

Information Form (SIF) must be entered in the “Statistical Data for Period of Report” section. (even those without a code)

Certification Page – cont.

Required to have a CPA firm perform an audit of your financial statements (the CPC may elect to accept reviewed or compiled statements)

Required to send a copy of your agency’s audit/review/compilation report to Eide Bailly within six months after close of your agency’s fiscal year

VERY IMPORTANT TO COMPLETE PROPERLY

• Description Code from SIF – alpha-letter assigned to the service code.

• Description of service – highly recommended for easier identification on Sch E

• Service Code – this must be the same code as assigned on the SIF

Certification Page – cont.

Units of Service Staffed: recommended you complete this after completing Schedule E

Units of Service Provided – billable units as defined in instructions This number is NOT a guesstimate! Use correct unit type (hour, day, etc.)

Schedule A - revenue

Total revenue should agree to your audit report (provide reconciliation if different)

Adjustment Amount - make sure total agrees to Schedule E (column 2) – upper items automatically carry to this column on Sch E, others need to be manually entered on Sch E in the same column.

Schedule A – Grants

Grants that enhance services need to be recorded as reimbursement income (and offset against expenses).Expenses that enhance a service would be expenses that were not necessary to provide the service and only occurred because grant funding was received.

Schedule A – Grants

Enhancement grants should be listed in the upper section of Sch A and in column 2 on Sch E as an offset to the related expense, or on one of the “Other:” linesInclude a descriptionCan also report in a separate column

Schedule A - Subcontract & retailThese are listed on the SIF with no code

Schedule A – 3 ways to reportAll revenue offsetNo revenue offset Partial revenue offset

This needs to be discussed with CPC prior to completion of the report!

Schedule B – job classification

ADMINISTRATOR WAGES. Salary of the agency administrator only

BUSINESS OFFICE/CLERICAL WAGES. Include salaries and wages for other administrative positions such as assistant administrator, CFO, controller, bookkeeper, and clerical support.

Schedule B – job classification (cont)

OTHER SUPERVISORY WAGES. Salaries and wages for other supervisory staff not included in business office/clerical. Include supervisors of maintenance staff, direct care staff , and laundry/dietary service staff.

MAINTENANCE WAGES. Include salaries and wages for positions that provide maintenance services or housekeeping services.

Schedule B – job classification (cont)

PROFESSIONAL DIRECT STAFF WAGES. Salaries and wages of staff that provide professional services to the consumers and may provide supervision, assistance, and support to direct care staff. These staff must spend at least 50% of their time working directly with MHDD clients. Examples of positions include psychiatrists, psychologists, nurses, social workers, program supervisors, team leaders, and coordinators.

Schedule B – job classification (cont)

OTHER DIRECT STAFF WAGES. Employees who are working in a non-supervisory position with consumers. Duties of a direct care staff might include: assisting consumers with daily living skills, personal care needs, employment training or vocational activities, implementing behavior management plans, transporting consumers, and providing individual comprehensive plan training.

Schedule B – job classification (cont)

LAUNDRY/DIETARY SERVICE WAGES. Salaries and wages for positions that provide laundry or dietary services such as dietary supervisors, dietary aides, cooks, launderers, and dishwashers. OTHER SUPPORT STAFF WAGES. Salaries and wages for non-supervisory staff that do not fit into other staff descriptions.

Schedule B - wages

Number of Staff Enter the number of staff working full time or part time for each job title (body count) FTE’s (full-time equivalents) are based on 2,080 hours. FTE’s are an important analytical tool and need to be reported accurately An employee can be considered full-time and represent more or less than 1 FTE

Schedule B – wages – cont.

Employee’s time may be split between categories if you have accurate information available. Otherwise, determine which category describes the majority of their duties and report all their time to that category.

Direct Staff: Only employees with similar annual salaries may be grouped together.

Schedule B – gross wages

Gross wages includes all regular pay, overtime, sick, holiday, vacation, bonus and other compensation paid through payroll. (W-2 wages)

Consumer wages are NOT reported on this schedule.

Schedule B – wages – cont.

Calculated annual wage for each job title shows in the right outside margin. PLEASE check for reasonableness.This would be the employee’s annual salary assuming 2,080 hours worked. Please compare these calculations to your prior year report for reasonableness.

Schedule B – wages – cont.

Tax/Benefit calculation table will aide in the breakout of these expenses by type (admin, occupancy, etc). Use of this table is optional (it is not formatted to print with the Schedule). Calculations will populate automatically to the different sections in this table and the preparer will then have to enter this in column 1 on Sch E in the corresponding line.

Schedule C – exp adjust.

Purpose -To report expenses subject to limitation or not allowed

Amounts entered on lines 83-86 are non-allowable costs

Remaining amounts are subject to federal limitations. If the adjustment amount is less than zero, no adjustment is necessary

Schedule C – exp adjust. (cont)

• If you have fundraising expenses, you MUST report them on this schedule.

• Bad debt expense is a non-allowable cost and MUST be reported on this schedule.

• Donations/contributions given to others are non-allowed costs.

• Fines/penalties are non-allowed costs.

Schedule D - depreciationPurpose: Report information related to

depreciable assets and start-up costs

Total property and equipment recorded on Schedule D should equal property & equipment amounts included on Schedule F

If you use the straight-line method of depreciation, the depreciation per GL & straight-line depreciation column numbers should be the same.

Amounts entered on each line will flow to corresponding line on Sch E, column 1

Schedule E - expenses

Include county number(s) on yellow line above each service with a code

Expenses are reported by type: administrative, occupancy, direct service, support care & other

Expenses in column 1 should be amounts taken from your General Ledger and should equal the audit/review/compilation – remember, some of these amounts have been carried from other schedules!

Schedule E – expenses – cont.

Columns 2 & 3 are adjustments from Schedules A, C & D. Column 2 total must agree to Schedule A adjustment total.

Adjusted costs in column 4 are the costs to be allocated to the services.

Column 5 – The method used to allocate costs is entered here. Do not leave this blank! Methods used need to be consistent from year-to-year.

Common allocation basis methods % of direct cost Square footage % of direct FTE’s Bed days Blended – includes some actual costs

combined with one of the above methodsBe consistent from year to year

Schedule E – expenses – cont.

Columns 6 - 11 and 13 - 24 are for expenses associated with the services identified on the SIF. The code and description will flow from the Certification Page.

Costs for services not identified on the SIF and entered on the cost report are reported in column 12 – the Non-Covered Services column – you can use an empty column if you want.

Bottom of Sch. E – Required Info

Lines 114-119 (in Excel) are required and must be completed Line 114 - These are DIRECT FTE’s only (total direct FTE’s flow from Sch B to this line in column

12) Line 115 - direct FTE’s for Psychiatrist – if applicable,

how many of the FTE’s listed on line 114 are for the Dr. only?

Line 116 - # of operational days per the report year that the program was available. Ex: if no weekends this should be 260 days

Bottom of Sch. E – Required Info cont’d

Line 117 - Actual direct staff to client ratio (ex: 1:1, 1:4, not 1-2 or 1:2-5). Direct Staff only. Should agree to ratio reported on the SIF.

Line 118 - Maximum number of consumers that could be served per operational day. (list for daily services only)

Line 119 – Enter the number of contracted hours for the professional services listed on line 52 of Schedule E. These costs should be related to the direct care of consumers.

Bottom of Sch. E – Other Info

Average annual salary for direct staff – (Excel line 125) does this look reasonable? Takes wages from line 45 & 46 divided by FTE’s listed on line 114.

Percent of taxes and benefits as a percent of wages – (Excel lines 127-137) Do these look reasonable?

There is a hidden allocation sheet which shows the percentages of the expenses that have been allocated to each listed service.

Schedule E – Subcontract

• Subcontract activity is reported in a separate column on Sch E – this includes revenues and expenses.

• The net expense/revenue is then allocated on the pink line (Excel line 111) to the service(s) as requested by the CPC.

Schedule E – Subcontract

• A second unit rate calculates on line 112 which includes this net revenue/expense offset from the subcontract information.

• This rate is not used on any reports – it is informational only!

Retail

• Reporting of Retail activity is handled similarly to subcontract. Retail revenue has it’s own line on Sch A for reporting.

• If an agency has both retail and subcontract , Retail should be identified in a separate column

• The reporting of this, too, needs to be discussed between CPC and Provider

Schedule F – balance sheet

Check to see if prior year balance sheet numbers reported agree to last years cost report (if applicable). For 1st year Providers we look at the audit report for prior year numbers.

Total equity MUST agree to ending equity reported on Schedule G.

Schedule G – reconciliation of equity

Beginning equity, revenues, and expenses are linked from other Schedules.

Ending equity must agree to the value reported on Schedule F.

Non-material adjustments from prior year cost report are shown in this schedule.

Schedule H – allocated costs

Only applies if there are allocations from a parent corp. or subsidiaries of a parent corp.

If schedule applies – allocation method used is reviewed for consistency.

Questions on the cost report?

Eide Bailly contact information

• Email– kjess@eidebailly.com (563) 557-6151– cheeren@eidebailly.com (563) 557-6166– akelleher@eidebailly.com (563) 557-6140

• Phone (563) 556-1790• Fax (563) 557-7842• Mailing Address:

3999 Pennsylvania AvenueSuite 100Dubuque, IA 52002-2639

ISAC Contact information

• Andrea Jansen Iowa State Association of Counties (ISAC) Title: Program Support CoordinatorPhone: 515.244.7181Address: 5500 Westown Parkway, Suite 190 West Des Moines, Iowa 50266