REPORT ON THE COST REPORT REVIEW SAN FRANCISCO GENERAL HOSPITAL SAN FRANCISCO, CALIFORNIA _part4 ppt

... COST This is trial version www.adultpdf.com REPORT ON THE COST REPORT REVIEW CENTINELA HOSPITAL MEDICAL CENTER INGLEWOOD, CALIFORNIA PROVIDER NUMBER: HSC30240H NATIONAL PROVIDER IDENTIFIERS: ... examined the provider's Medi-Cal Cost Report for the above-referenced fiscal period. Our examination was made under the authority of Section 14170 of the...

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... Findings) COMPUTATION OF MEDI-CAL CONTRACT COST This is trial version www.adultpdf.com STATE OF CALIFORNIA CONTRACT SCH 4A Provider Name: Fiscal Period Ended: CENTINELA HOSPITAL MEDICAL CENTER DECEMBER ... charges exceed reasonable cost, no further calculation necessary for this schedule. COMPUTATION OF LESSER OF MEDI-CAL REASONABLE COST OR CUSTOMARY CHARGES This is trial version w...

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... ACCUMULATE TRATIVE & COST BENEFITS COST COST COST COST COST COST COST COST COST GENERAL 4.08 5.00 6.01 6.02 6.03 6.04 6.05 6.06 6.07 6.08 6.00 COMPUTATION OF COST ALLOCATION (W/S B) 0 48,943 0 0 0 0 0 0 0 0 13,482,643 2,319,651 0 0 0 0 0 0 0 0 0 0 0 0 0 25,346 0 0 0 0 0 0 0 0 3,536,622 608,466 0 594 0 0 0 0 0 0 0 0 234,930 40,419 029,265000000004,737,187815,020 08,2750000000...

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... ) STATISTICS FOR COST ALLOCATION (W/S B-1) This is trial version www.adultpdf.com STATE OF CALIFORNIA Provider Name: CENTINELA HOSPITAL MEDICAL CENTER GENERAL SERVICE COST CENTERS 1.00 Old Cap Rel Costs-Bldg ... trial version www.adultpdf.com STATE OF CALIFORNIA Provider Name: CENTINELA HOSPITAL MEDICAL CENTER GENERAL SERVICE COST CENTERS 1.00 Old Cap Rel Costs-Bldg & Fi...

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... Col. Reported (Decrease) Adjusted Report References CENTINELA HOSPITAL MEDICAL CENTER Adjustments Explanation of Audit Adjustments FEBRUARY 1, 2008 THROUGH DECEMBER 31, 2008 HSC30240H Cost Report ADJUSTMENTS ... HSC30240H Cost Report ADJUSTMENTS TO REPORTED MEDI-CAL SETTLEMENT DATA - NONCONTRACT 4 4A Not Reported Medi-Cal Administrative Days (Feb 1, 2008 through Jul 31, 2008)...

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... CHARGES AUDITEDREPORTED ADJUSTMENTS This is trial version www.adultpdf.com STATE OF CALIFORNIA CONTRACT SCH 7 Provider Name: Fiscal Period Ended: SETON MEDICAL CENTER JUNE 30, 2008 Provider No: ... COSTS** This is trial version www.adultpdf.com STATE OF CALIFORNIA DPNF SCH 2 Provider Name: Fiscal Period Ended: SETON MEDICAL CENTER JUNE 30, 2008 Provider No: LTC55235G...

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... version www.adultpdf.com STATE OF CALIFORNIA Provider Name: SETON MEDICAL CENTER TRIAL BALANCE EXPENSES GENERAL SERVICE COST CENTER 1.00 Old Cap Rel Costs - Bldg and Fixtures 2.00 Old Cap Rel Costs ... CALIFORNIA Provider Name: SETON MEDICAL CENTER TRIAL BALANCE EXPENSES GENERAL SERVICE COST CENTER 1.00 Old Cap Rel Costs - Bldg and Fixtures 2.00 Old Cap Rel Costs -...

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... 13,441 0 0 STATISTICS FOR COST ALLOCATION (W/S B-1) This is trial version www.adultpdf.com STATE OF CALIFORNIA Provider Name: SETON MEDICAL CENTER GENERAL SERVICE COST CENTERS 1.00 Old Cap Rel Costs - Bldg ... is trial version www.adultpdf.com STATE OF CALIFORNIA Provider Name: SETON MEDICAL CENTER GENERAL SERVICE COST CENTER 1.00 Old Cap Rel Costs - Bldg and Fixtu...

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... adjust the provider& apos;s Obstetrics/Nursery reclassification to agree with the provider& apos;s records. CMS Pub. 15-1, Sections 2300 and 2304 Page 1 Report References SETON MEDICAL CENTER Adjustments Explanation ... Services Provider Name Fiscal Period Provider Number 18 Adj. Audit Work As Increase As No. Report Sheet Part Title Line Col. Reported (Decrease) Adjusted...

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... reasonable cost, no further calculation necessary for this schedule. COMPUTATION OF LESSER OF MEDI-CAL REASONABLE COST OR CUSTOMARY CHARGES This is trial version www.adultpdf.com STATE OF CALIFORNIA ... 4) COMPUTATION OF MEDI-CAL INPATIENT ROUTINE SERVICE COST This is trial version www.adultpdf.com STATE OF CALIFORNIA SCHEDULE 5 PROGRAM: NONCONTRACT Provider Name: Fiscal Period Ended...

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... NEW CAP NEW CAP NEW CAP NEW CAP NEW CAP NEW CAP NEW CAP NEW CAP COSTS COSTS COSTS COSTS COSTS COSTS COSTS COSTS COSTS COSTS COSTS COSTS MVBLE EQ BLDG & FIX BLDG 2 BLDG 3 BLDG 5 BLDG 9 BLDG ... CAP OLD CAP OLD CAP OLD CAP OLD CAP OLD CAP TRIAL BALANCE COST ALLOC BLDG & COSTS COSTS COSTS COSTS COSTS COSTS COSTS COSTS COSTS COSTS EXPENSES (From Sch 10) FIXTURES BLDG 2 BLDG 3 BLDG 5 ......

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... TOTAL COMPUTATION OF COST ALLOCATION (W/S B) SCHEDULE 8.2 Fiscal Period Ended: JUNE 30, 2009 NEW CAP NEW CAP NEW CAP NEW CAP NEW CAP NEW CAP ADMINIS- OPERATIONS LAUNDRY & COSTS COSTS COSTS COSTS COSTS COSTS ... version www.adultpdf.com STATE OF CALIFORNIA Provider Name: SAN FRANCISCO GENERAL HOSPITAL GENERAL SERVICE COST CENTERS 1.00 Old Cap Rel Cost - Buildings and Fix...

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... Adjusted Report References SAN FRANCISCO GENERAL HOSPITAL Adjustments Explanation of Audit Adjustments JULY 1, 2008 THROUGH JUNE 30, 2009 HSC00228W Cost Report RECLASSIFICATIONS OF REPORTED COSTS 7 ... be reversed on the audit report as they are not applicable to the Medi-Cal Program. CMS Pub. 15-1, Sections 2300, 2302, 2304, and 2306 Page 1 Report References SAN FR...

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... (Decrease) Adjusted Report References SAN FRANCISCO GENERAL HOSPITAL Adjustments Explanation of Audit Adjustments JULY 1, 2008 THROUGH JUNE 30, 2009 HSC00228W Cost Report ADJUSTMENTS TO REPORTED MEDI-CAL ... Line Col. Reported (Decrease) Adjusted Report References SAN FRANCISCO GENERAL HOSPITAL Adjustments Explanation of Audit Adjustments JULY 1, 2008 THROUGH JUNE 30,...

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