| (xiv) For central office and/or home office costs, documentation must be maintained that indicates the organization of the business entity, including position, titles, functions, and compensation. For multi-state organizations, documentation must be maintained that clearly defines the relationship of costs associated with any level of management above the individual Texas contracted entity which are allocated to the individual Texas contracted entity. (xv) Documentation regarding depreciable assets includes, at a minimum, historical cost, date of purchase, depreciable basis, estimated useful life, accumulated depreciation, and the calculation of gains and losses upon disposal. (xvi) Providers must maintain documentation clearly itemizing their employee relations expenditures. For employee entertainment expenses, documentation must show the names of all persons participating, along with classification of the person attending, such as employee, nonemployee, owner, family of employee, client, or vendor. (xvii) Adequate documentation substantiating the offsetting of grants and contracts from federal, state, or local governments prior to reporting either the net expenses or net revenue must be maintained by the provider. As specified in §355.103(b)(15) of this title (relating to Specifications for Allowable and Unallowable Costs), such offsetting is required prior to reporting on the cost report. The provider must maintain written documentation as to the purpose for which the restricted revenue was received and the offsetting of the restricted revenue against the allowable and unallowable costs for which the restricted revenue was used. (xviii) During the course of an audit or an audit desk review, the provider must furnish any reasonable documentation requested by DHS auditors within ten working days of the request or a later date as specified by the auditors. If the provider does not present the requested material within the specified time, the audit or audit desk review is closed, and DHS automatically disallows the costs in question. (xix) Any expense which cannot be adequately documented or substantiated is disallowed. DHS is not responsible for the contracted provider's failure to adequately document and substantiate reported costs. (xx) Any cost report which is determined unauditable through a field audit or which cannot have its costs verified through a desk review will not be used in the reimbursement determination process. (3) Cost report and methodology certification. Providers must certify the accuracy of cost reports submitted to DHS in the format specified by DHS. Providers may be liable for civil and/or criminal penalties if the cost report is not completed according to DHS requirements or is determined to contain misrepresented or falsified information. Cost report preparers must certify that they received reimbursement methodology rules regarding allowable and unallowable costs, that they read the reimbursement methodology and cost report instructions, and that they understand that the cost report must be prepared in accordance with the methodology rules and cost report instructions. Not all persons who contributed to the completion of the cost report must sign the certification page. However, the certification page must be signed by a responsible party with direct knowledge of the preparation of the cost report. A person with supervisory authority over the preparation of the cost report who reviewed the completed cost report may sign a certification page in addition to the actual preparer. (4) Requirements for cost report completion. (A) A completed cost report must: (i) be completed according to the cost determination rules of this chapter, program-specific allowable and unallowable rules, cost report instructions, and policy clarifications; (ii) contain a signed, notarized, original certification page; (iii) be legible with entries in sufficiently dark print to be photocopied; (iv) contain all pages and schedules; (v) be submitted on the proper cost report form; (vi) be completed using the correct cost reporting period; and (vii) contain a copy of the state-issued cost report training certificate, beginning with the 1997 cost report. (B) Providers are required to report amounts on the appropriate line items of the cost report pursuant to guidelines established in the methodology rules, cost report instructions, and/or policy clarifications. Refer to program-specific reimbursement methodology rules, cost report instructions, and/or policy clarifications for guidelines used to determine placement of amounts on cost report line items. (i) For nursing facilities, placement on the cost report of an amount which was determined to be inaccurately placed may result in vendor hold as specified in §355.403 of this title (relating to Vendor Hold). (ii) For all other programs, placement on the cost report of an amount which was determined to be inaccurately placed constitutes an administrative contract violation. In the case of an administrative contract violation, procedural guidelines and informal reconsideration and/or appeal processes are specified in §355.111 of this title (relating to Administrative Contract Violations). (C) A completed cost report must be filed by the cost report due date. (i) For nursing facilities, failure to file a completed cost report by the cost report due date may result in vendor hold as specified in §355.403 of this title (relating to Vendor Hold). (ii) For all other programs, failure to file a completed cost report by the cost report due date constitutes an administrative contract violation. In the case of an administrative contract violation, procedural guidelines and informal reconsideration and/or appeal processes are specified in §355.111 of this title (relating to Administrative Contract Violations). (D) DHS may excuse providers from the requirement to submit a cost report. Exceptions are granted by DHS as described by the program-specific reimbursement methodology rules. Providers who are excused from cost report submission will receive written notice from DHS verifying that an exception has been granted. (5) Cost report year. A provider's cost report year must coincide with the provider's fiscal year as used by the provider for reports to the Internal Revenue Service (IRS). Providers are responsible for reporting to DHS any change in their IRS fiscal year and subsequent cost report year by submitting written notification of the change to DHS along with supportive IRS documentation. DHS must be notified of the provider's change in IRS fiscal year no later than 30 days following the provider's receipt of approval of the change from the IRS. (6) Failure to report allowable costs. DHS is not responsible for the contracted provider's failure to report allowable costs, however any omitted costs which are identified during the desk review or audit process will be included in the cost report or brought to the attention of the provider to correct by submitting an amended cost report. (c) Cost report due date. (1) Providers must submit cost reports to DHS no later than 90 days following the end of the provider entity's fiscal year or 90 days from the transmittal date of the cost report forms, whichever due date is later. (2) DHS may grant extensions of due dates for good cause. A good cause is defined as a circumstance which the provider could not reasonably be expected to control and for which adequate advance planning and organization would not have been of any assistance. Providers must submit requests for extensions in writing to DHS. Requests for extensions must be received by DHS prior to the cost report due date. DHS staff will respond in writing to requests within 15 days of receipt. (3) DHS may require additional financial and other statistical information, in the form of special surveys or reports, to ensure the fiscal integrity of the program. Providers must submit such additional information and/or special surveys or reports to DHS upon request by the date specified by DHS in its transmittal or cover letter to the special survey, report, or request for additional information. (d) Amended cost report due dates. DHS accepts submittal of provider-initiated or DHS-requested amended cost reports as follows. (1) Provider-initiated amended cost reports must be received no later than the date in subparagraph (A) or (B) of this paragraph, whichever occurs first. Amended cost reports received after the required date have no effect on the reimbursement determination. Amended cost report information that cannot be verified will not be used in reimbursement determinations. Provider-initiated amended cost reports must be received no later than the earlier of: (A) 60 days after the original due date of the cost report; or Cont'd... |
