| UNCOMPENSATED COST REPORT |
|
|
|
|
| HOSPITAL:
Orthopedic Specialty Hospital of Nevada |
Period: |
12/31/2019 |
|
|
|
|
|
|
|
|
| Line |
PART I - Calculate
Ratio of Cost to Charges (RCC) |
|
|
|
|
| 1 |
|
Total Operating Expenses (A) |
|
|
$ 24,129,385 |
|
| 2 |
|
Non - Operating Expense (A) |
|
|
$ - |
|
| 3 |
|
Total Hospital Expenses
(sum of oper & non-oper exp) |
|
|
$ 24,129,385 |
|
|
|
|
|
|
|
|
|
|
Less Cost Directly Assigned to Uninsured Patients |
|
|
|
|
| 4 |
|
Graduate
Medical Education Cost (B) |
|
|
$ - |
|
| 5 |
|
Emergency Room Physician
Professional Fees (C) |
|
$ - |
|
|
|
Other
Directly Assigned Cost (list) - (D) |
|
|
|
|
| 6 |
|
1) |
|
|
$ - |
|
| 7 |
|
2) |
|
|
$ - |
|
| 8 |
|
3) |
|
|
$ - |
|
| 9 |
|
4) |
|
|
$ - |
|
| 10 |
|
5) |
|
|
$ - |
|
|
|
|
|
|
|
|
|
|
Less Cost Prohibited by CMS for DSH Purposes |
|
|
|
|
| 11 |
|
Offsite Clinic
Cost (E) |
|
|
$ - |
|
|
|
Other Excluded
Cost (list) - (F) |
|
|
|
|
| 12 |
|
1) |
|
|
$ - |
|
| 13 |
|
2) |
|
|
$ - |
|
|
|
|
|
|
|
|
| 14 |
|
Total Expenses Excluded from Cost Pool |
|
|
$ - |
|
|
|
|
|
|
|
|
| 15 |
|
Adjusted Cost Pool (Total expenses less excluded items) |
|
|
$ 24,129,385 |
|
| 16 |
|
Billed Charges (G) |
|
|
$ 3,035,555,882 |
|
| 17 |
|
Average Ratio of Cost to Charges ( adj cost / charges) |
|
|
0.8% |
|
|
|
|
|
|
|
|
|
(A) |
From the Nevada Hospital Quarterly Reports found at: |
|
|
|
|
|
|
http://www.unlv.edu/Research_Centers/chia/utilizationandfinancial.htm |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(B) |
Resident /Faculty
Salaries and other costs in support of GME from hospital records. |
|
|
|
Exclude allied health
education programs. |
|
|
|
|
|
|
|
|
|
|
|
|
(C) |
ER / Trauma /Anesthesiology on-call coverage
and compensation to physicians for indigent patient care. |
|
|
From hospital records. Exclude directorship fees and other
services not directly related to patient care. |
|
|
|
|
|
|
|
|
(D) |
Any identifiable cost
that is solely related to uninsured patients from hospital records. |
|
|
|
Examples include payments to nursing
homes for placement of patients without pay source, |
|
|
|
and eligibility workers in excess of
standard social services staff. |
|
|
|
|
|
|
|
|
|
|
(E) |
All costs associated
with operating clinics not on hospital campus from hospital records. |
|
|
|
|
|
|
|
|
|
(F) |
Any other cost category
specifically prohibited for DSH by regulation or policy |
|
|
|
|
|
|
|
|
|
|
(G) |
From NHQR for your hospital for the reporting period. |
|
|
|
|
|
|
|
|
|
|
|
|
Note: Cost reported as
AB342 community benefits are included either in pool or directly
assigned. |
|
|
|
|
|
|
|
|