| 2016 (Active Version) |
2024 (Revised Version) |
Type of Change |
Reason for Change |
Burden Change |
| "Definition of Uncompensated Care" field |
[deleted] |
Deletion |
Template field was not being utilized, and its removal allowed for a more simplified form that translates between platforms more easily. |
No |
| Row 2 with column headings A-R |
[deleted] |
Deletion |
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. |
No |
| Rows 3, 4, and 5 |
Row 1 |
Revision |
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 |
| Column heading: State Estimated Hospital-Specific DSH Limit |
Column heading: Estimate of Hospital-Specific DSH Limit |
Revision |
Revised to align with regulatory language. |
No. |
| Column heading: State-Defined Eligibility Statistic |
Column heading: State-Defined DSH Qualitification Criteria |
Revision |
Revised to align with regulatory language. |
No |
| Column heading: Regular IP/OP Medicaid FFS Rate Payments |
Column heading: IP/OP Medicaid FFS Rate Payments |
Revision |
Revised to align with regulatory language. |
No |
| Column heading: Supplemental / Enhanced IP/OP Medicaid Payments |
Column heading: Supplemental / Enhanced Medicaid IP/OP Payments |
Revision |
Revised to align with regulatory language. |
No |
| Column heading: Total Medicaid IP/OP Medicaid Payments |
Column heading: Total Medicaid IP/OP Payments |
Revision |
Revised to align with regulatory language. |
No |
| Column heading: Total IP/OP Indigent Care/Self-Pay Revenues |
Column heading: Total Uninsured IP/OP Revenue |
Revision |
Revised to align with regulatory language. |
No |
| Column heading: Total IP/OP Uninsured Cost of Care |
Column heading: Total Cost of IP/OP Care for Uninsured |
Revision |
Revised to align with regulatory language. |
No |
| Column heading: Total Uninsured Uncompensated Care Costs |
Column heading: Total Uninsured IP/OP Uncompensated Care Costs |
Revision |
Revised to align with regulatory language. |
No |
| Column heading: Total Eligible Uncompensated Care Costs |
Column heading: Total Annual Uncompensated Care Costs |
Revision |
Revised to align with regulatory language. |
No |
| [none] |
New column heading: Disproportionate Share Hospital Payments |
Addition |
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. |
No |
| Column heading: Total Hosptial Cost |
Column heading: Total Hospital Cost |
Revision |
Typo correction |
No |
| [none] |
New column heading: Financial Impact of Audit Findings |
Proposed addition |
This column heading relates to the proposed addiitional data element in CMS-2445-P. The placement aligns with the proposed placement in the regulation. |
Yes, this represents a proposed 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 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. |
No |
| [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. |
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 |
Addition |
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 |
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