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Deletion
Row 2 with column headings A-R
[deleted]
Deletion
Rows 3, 4, and 5
Row 1
Revision
Burden Change
Reason for
Change
Type of Change
2023 (new
version)
2016 (old version)
"Definition of Uncompensated Care" field
Template field was not being utilized, and its removal allowed for a more simplified
form that translates between platforms more easily.
With the removal of the "Definition of Uncompensated Care" field, the form can
utilize the built in Excel column headings to navigate data, rendering this row
unnecessary.
Column headings were spread across three rows, complicating the form. This
change simplifies that for ease of use of the data and for screen readers.
No
No
No
Column heading: State Estimated HospitalColumn heading: Estimate of Hospital-Specific
Specific DSH Limit
DSH Limit
Column heading: State-Defined Eligibility Statistic Column heading: State-Defined DSH
Qualitification Criteria
Column heading: Regular IP/OP Medicaid FFS
Column heading: IP/OP Medicaid FFS Rate
Rate Payments
Payments
Column heading: Supplemental / Enhanced
Column heading: Supplemental / Enhanced
IP/OP Medicaid Payments
Medicaid IP/OP Payments
Column heading: Total Medicaid IP/OP Medicaid Column heading: Total Medicaid IP/OP Payments
Payments
Column heading: Total IP/OP Indigent Care/Self- Column heading: Total Uninsured IP/OP
Pay Revenues
Revenue
Column heading: Total IP/OP Uninsured Cost of Column heading: Total Cost of IP/OP Care for
Care
Uninsured
Column heading: Total Uninsured
Column heading: Total Uninsured IP/OP
Uncompensated Care Costs
Uncompensated Care Costs
Column heading: Total Eligible Uncompensated Column heading: Total Annual Uncompensated
Care Costs
Care Costs
[none]
New column heading: Disproportionate Share
Hospital Payments
Revision
Revised to align with regulatory language.
No.
Revision
Revised to align with regulatory language.
No
Revision
Revised to align with regulatory language.
No
Revision
Revised to align with regulatory language.
No
Revision
Revised to align with regulatory language.
No
Revision
Revised to align with regulatory language.
No
Revision
Revised to align with regulatory language.
No
Revision
Revised to align with regulatory language.
No
Revision
Revised to align with regulatory language.
No
Addition
No
Column heading: Total Hosptial Cost
Column heading: Total Hospital Cost
Revision
This data element was already required in DSH audit reports. In practice we found
inclusion of this in the template allowed for ease of reference between relevant
monetary figures.
Typo correction
[none]
New column heading: Financial Impact of Audit
Findings
Proposed
addition
This column heading relates to the proposed addiitional data element in CMS-2445- Yes, this represents a proposed
P. The placement aligns with the proposed placement in the regulation.
additional data element. The
additional burden to produce this
data point is reflected in the PRA
package.
[none]
Row divider for Institute for Mental Disease
Addition
The form requires states (through their auditors) to list DSH hospitals, Institutes for No
Mental Disease, and Out of State Hospitals. In practice, submitters have added this
text to the list of Hospital Names to denote the beginning of the list for IMDs. We are
adding it officially to align with that practice.
[none]
Row divider for Out of State DSH Hospitals
Addition
The form requires states (through their auditors) to list DSH hospitals, Institutes for
Mental Disease, and Out of State DSH Hospitals. In practice, submitters have
added this text to the list of Hospital Names to denote the beginning of the list for
out of state DSH hospitals. We are adding it officially to align with that practice.
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
No
No
Sheet name; Sheet 1
Sheet name: DSH DataElementsReport Template Revision
This revision adds a name to the sheet with the Data Elements Report template, to
differentiate the sheets of the template and assist users of screen readers.
No
[none]
New Sheet: Data Dictionary
We are adding a data dictionary we had provided to users of this template, to have
available in one location. The data dictionary serves as a guide for how the cells of
the DSH data elements report template should be populated, if required.
No
Addition
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
Type of Change: Rev = Revision, Del = Deletion, Add = Addition, and Red = Redesgnation.
| File Type | application/pdf |
| Author | Mitch Bryman |
| File Modified | 2023-02-24 |
| File Created | 2023-02-24 |