Methodology for Calculation of Hospital Overall CCR for

10.11.8.1 - Methodology for Calculation of Hospital Overall CCR for Hospitals That Have Nursing and Paramedical Education Programs for Cost Reporting Periods Beginning On or After May 1, 2010, Under Cost Report 2552-10 (Rev. 2296, Issued: 09-02-11, Effective: 10-01-11, Implementation: 10-03-11) Do not include departmental CCRs and charges for services not subject to the OPPS (such as physical, occupational and speech language therapies, clinical diagnostic laboratory services, ambulance, rural health clinic services, non-implantable DME, etc.) in calculating the hospital‘s costs or charges. See §10.11.10 for the location of the list of the exact cost centers that should be included in the overall CCR. Step 1 -- Determining costs for each department: From Worksheet B, Part 1 - Column 26, deduct the nursing and paramedical education costs found on the applicable line in Columns -20, and 23 of Worksheet B, Part I to calculate a cost for each cost center. Exception: The costs for 9200 are not calculated on this worksheet. For cost center 9200, Observation Beds (Non-Distinct Part), use the cost reported on Worksheet D-1, Part IV, line 89, and deduct the nursing and paramedical education costs found on Worksheet D- 1, Part IV, line 93 and subscripts, column 5. See Step 3 below. Step 2 - Determining charges for each department: From worksheet C, Part 1 - Column 8 (sum of columns 6 and 7), identify ―total charges. Step 3 - Determining the CCRs for each department without nursing and paramedical education costs: For each line, divide the costs from Step1 by the charges from Step 2 to acquire CCRs for each line, without inclusion of nursing and paramedical education costs. Exception: For cost center 9200, Observation Beds (Non-Distinct Part), use the cost reported on Worksheet D-1, Part IV, line 89, and deduct the nursing and paramedical education costs found on Worksheet D-1, Part IV, line 93 and subscripts, column 5. Step 4 - Determining Overall Costs: Multiply the CCR in step 3 by the Medicare outpatient charges for that cost center (and subscripts thereof) from Worksheet D Part V, Columns 2, 3, and 4,. Sum the costs calculated for each cost center to arrive at Medicare outpatient cost of services subject to OPPS. Step 5 - Determining Overall Charges: Calculate charges by summing the Medicare outpatient charges from Form CMS 2552-10, Worksheet D, Part V, Columns 2, 3, and 4, for each cost center (and subscripts thereof) that reflect service subject to the OPPS. Step 6 - Calculating the Overall CCR: Divide the costs from Step 4 by the charges from step 5 to calculate the hospital‘s Medicare outpatient CCR.