When CMS issued the 1728-20 software for Home Health Agencies, Worksheet S-3 Part V was included in the software. CMS noticed that this worksheet was being ignored, so they have now added Edit 1280S to ensure that preparers fill out this worksheet.
Here are some tips to understand what is being requested on Form 1728-20 S-3 Part V.
The first half of the form is for Direct Care Salary information.
The amount reported in column 1 can be taken either from your worksheet A, if you have the nursing and therapy information reported in column 1. If you have any reclasses to salary, these should be added to the salary reported on worksheet A column 1.
For the “Fringe Benefits” in column 2, you can make a calculation of total salaries to total benefits. Use this percentage to multiply by the salary reported in column 1, and enter the benefits calculated in column 2.
For the “Paid Hours”, you can either use actual hours or you can calculate by taking the number of visits multiplied by the average length per visit.
The second part of the form asks for Contract Labor information.
In column 1, enter the breakdown of the nursing and therapy subcontractor amounts. This is either a direct breakdown or a calculation of an average rate per visit times the number of visits. (You would first need to calculate how many of the visits were contracted vs. salaried.)
In column 4, enter “Paid Hours”. As above, you can either use actual hours or you can calculate by taking the number of visits multiplied by the average length per visit. Again, keeping in mind how many visits were contracted vs. salaried.
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Disclaimer: This blog does not contain legal advice. What it does contain are our best
explanations, advice, and suggestions to help facilities and cost report preparers to understand the cost report forms and reporting process and offer suggestions for their preparation. Progressive Provider Services assumes no legal responsibility for the content of this blog, nor for cost reports or other reports prepared based on the content herein.
