About Medicare Cost Reports

The Skilled Nursing Facility Medicare Cost Report data is available to researchers in machine-readable format through the Healthcare Cost Report Information System (HCRIS), which is maintained by the Centers for Medicare and Medicaid Services (CMS). Historically these files could be purchased from CMS in a user-friendly format. Now, however, the data are only available in a very user-unfriendly "variable length" format.

CMS organizes the data by federal fiscal year, i.e., cost report periods beginning during a specific federal fiscal year. Each year's data are updated quarterly, usually in the month following the end of the federal fiscal year quarter.

We routinely download and archive the skilled nursing facility (SNF) Medicare Cost Report data from the HCRIS system. To identify which fields are captured by HCRIS, download the Medicare Cost Report Form CMS 2540-96. Fields marked with an "x" are captured in the HCRIS system. Variables are defined by unique combinations of schedule (or worksheet), row, and column. The schedules and worksheets from which the data are drawn can be loosely categorized by letter as follows:

S	-	information about the providers: demographics, statistical data, etc
A	-	cost data from the provider's general ledger
B	-	overhead cost allocation to the revenue cost centers
C	-	ratio of cost to charges
D	-	computations of routine cost
E	-	computations of reimbursement settlements
G	-	balance sheets
H	-	home health agency data
I	-	RHC and FQHC services
J	-	outpatient rehab cost
K	-	hospice data

Beware that some of the worksheets/fields are not widely used and therefore have very little data (i.e., are very sparsely populated).

A more powerful research database is created by merging two files - the Online Survey Certification and Reporting (OSCAR) data and SNF Medicare Cost Report data. We routinely merge the OSCAR and cost report data by selecting the OSCAR survey occurring closest to the cost report period midpoint. Every nursing home cost report file that we sell is merged with OSCAR and contains the following fifteen variables from OSCAR:

1. Six digit CMS provider number
2. Name
3. Address
4. City
5. State
6. Zip code
7. County
8. Telephone number
9. Survey date
10. Total residents
11. Medicare census
12. Medicaid census
13. Whether they are part of a chain
14. Name of chain
15. Whether they are a hospital-based facility

Of course all of the OSCAR variables are available if needed.

Pricing

We produce a "merged nursing home cost report file" for $1,250 per cost report year. The year is defined as Medicare cost reports for cost report periods beginning during a particular federal fiscal year and updated as of a specific calendar quarter. In addition to the fifteen OSCAR variables listed above, the merged nursing home cost report file includes cost report status (as-submitted, desk reviewed, audited, re-opened, etc.), and all of the available fields from Worksheets A, B, B-1, E, S, S-2, and S-3 in the Medicare Cost Report Form CMS 2540-96.

Please ask for a price quote if you need additional cost report or OSCAR variables.

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