DOH Posts Nursing Home Cost Report Software

(May 20, 2025) The Department of Health (DOH) has posted the 2024 Nursing Home Medicaid Cost Report software on the Health Commerce System (HCS). The report and associated certifications are due July 31, 2025. The Dear Administrator Letter (DAL) is available here. In it, DOH points to some relevant resources and stresses that the use of third-party Cost Report software is NOT acceptable and may cause errors. If the Cost Report does not load correctly, it will be deemed unsubmitted by DOH, and the provider may be subject to penalty. We urge members, especially those with new Administrators or financial staff, to ensure that they have the necessary HCS permissions in place well in advance of the due date to allow for the timely submission and certification of the report.

Complete and accurate Cost Reports are always important for the correct calculation of the capital component of the Medicaid rate, which has updated annually based on a two-year lag. While Cost Report data has not been used to develop the operating component of the Medicaid rate since statewide pricing was implemented, considering the process underway to update the case mix methodology, it may be wise to ensure precision throughout the report given the possibility that the reported data may impact operating rates in the future. In addition, we urge members to provide complete and correct data on Schedule P (Staff Turnover), as it may impact eligibility for Advanced Training Initiative (ATI) funding.

When completing the report, members should also keep minimum spending requirements in mind and verify that costs are assigned to the appropriate cost centers. Although legislation enacted last year reduces the likelihood of penalties for homes that use low rates of contract nursing staff, the requirement that nursing homes spend at least 70 percent of revenue on direct care and at least 40 percent on resident-facing staff remain in effect. We expect that the vast majority of members will easily meet the 70 and 40 percent thresholds, especially when capital reimbursement is excluded from revenue.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841