Profile Definitions and Methodology


The report you are viewing for LIFECARE HOSPITAL OF MUSKEGON with period ending 12/31/2004 uses the 2552-96 format.

The following definitions are also based on that format.

Please note:

Hospital provider number, name, and address

A hospital's Medicare provider number, name, and address are taken from Worksheet S-2. The Electronic Code is a code assigned by to assist in resolving questions.

Other Reporting Periods

Hospitals are required to file a cost report for each fiscal year. After searching for a hospital and selecting a particular reporting period, you can subsequently change to other periods on the Profile or on the header of any worksheet. This convenient feature is available to navigate among periods ending in 1996 through 2010 (CMS-2552-96 format) or ending in 2011 through the present (2552-10 format)

The Other Reporting Periods pulldown on the Profile and in the header of each worksheet can be used to change to a different year’s cost report.

Filing Date and Status

Once you have selected a reporting period (ending in 2011 through the present), you can then select among prior filings. After initial submission, cost reports may be amended, audited or otherwise updated. Multiple filings are included in HCRIS data and are identified by their filing date and status. (If there are two filings within a quarter, however, only the latest filing is included in HCRIS.)

The Filing Date & Status pulldown on the Profile and in the header of each worksheet can be used to change to a different filing.

Type of Facility

The type of facility is determined from the last four digits of its Medicare provider number:

Short Term Acute Care 0001-0899
Childrens 3300-3399
Critical Access 1300-1399
Long Term 2000-2299
Psychiatric 4000-4499
Rehabilitation 3025-3099
Other none of above
Type of Control

A hospital's type of control is taken from the HCRIS file:

  • Voluntary Nonprofit, Church
  • Voluntary Nonprofit, Other
  • Proprietary, Individual
  • Proprietary, Corporation
  • Proprietary, Partnership
  • Proprietary, Other
  • Governmental, Federal
  • Governmental, City-County
  • Governmental, County
  • Governmental, State
  • Governmental Hospital District
  • Governmental, City
  • Governmental, Other
Urban/Rural Classification

Medicare classifies a hospital as either "Urban" or "Rural" based on their Metropolitan Statistical Area.  Hospital's can, however, be reclassified from rural to urban if they meet certain criteria.  A hospital's designation (and reclassification date, if applicable) are taken from their most recent Medicare Cost Report (Worksheet S-2, Line 21, Col 1 for FYE <2/29/04 / Line 21.05, Col 1 for PE >2/29/04 (or Line 21.03, Col 1 if not reported on 21.05).

Bed Size

The number of staffed beds is taken from Worksheet S-3, Part I, line 12, col.1. Cost report instructions define staffed beds as, "the number of beds available for use by patients at the end of the cost reporting period.  A bed means an adult bed, pediatric bed, birthing room, or newborn bed maintained in a patient care area for lodging patients in acute, long term, or domiciliary areas of the hospital. Beds in labor room, birthing room, postanesthesia, postoperative recovery rooms, outpatient areas, emergency rooms, ancillary departments, nurses' and other staff residences, and other such areas which are regularly maintained and utilized for only a portion of the stay of patients (primarily for special procedures or not for inpatient lodging) are not termed a bed for these purposes."

Total Annual Discharges

The total number of inpatient discharges (all payors) is taken from Worksheet S-3, part I, line 12, column 15.

Total Patient Revenue

The total patient revenue (inpatient and outpatient) is taken from Worksheet G-2, part I, line 25, column 3.


The beginning and ending dates for a cost report are taken from Worksheet S-2, line 17.


The status of a cost report is taken from the HCRIS file:

  • As Submitted
  • Settled Without Audit
  • Settled With Audit
  • Reopened
  • Amended
Medicare Administrative Contractor

A Medicare Administrative Contractor (MAC) is a private health care insurer that has been awarded a geographic jurisdiction to process Medicare Part A and Part B (A/B) medical claims or Durable Medical Equipment (DME) claims for Medicare Fee-For-Service (FFS) beneficiaries. CMS relies on a network of MACs to serve as the primary operational contact between the Medicare FFS program and the health care providers enrolled in the program. MACs are multi-state, regional contractors responsible for administering both Medicare Part A and Medicare Part B claims. Prior to 2003 these contractors were referred to as Fiscal Intermediaries (FIs).

Disproportionate Share (DSH Amount and DSH Ratio)

Medicare provides additional payment to hospitals that treat a disproportionate share of low-income patients.  Qualifying hospitals receive a percentage increase in Medicare payments.  This percentage increase varies depending on the ratio of low income patients and on certain statutory calculations.  The Disproportionate Share (DSH) ratio is taken from Worksheet E, Part A, line 4.03. The amount of DSH payments is from Worksheet E, Part A, line 4.04.

Outlier Amount

Medicare makes additional payments to hospitals for patients with costs that are extraordinarily high due to severity of illness and/or complicating conditions.  The amount of outlier payments is from Worksheet E, Part A, line 2.01 (or line 2 for discharges occurring prior to October 1, 1997).

IME Amount

Teaching hospitals receive additional Medicare payment due to the indirect costs associated with medical education programs.  These payments are intended to cover the costs of additional tests and procedures ordered by interns and residents over and above what would have been ordered by more experienced physicians.  The amount of the Indirect Medical Education (IME) adjustment is from Worksheet E, Part A, line 3.24 (or line 3.03 for cost reporting periods ending on or before September 30, 1997).

GME Amount

Medicare pays a hospital for the costs of an approved direct Graduate Medical Education (GME) program.  These costs include the direct cost of salaries and benefits for interns, residents, and teachers.  The amount of GME payment is from Worksheet E, Part A, line 11.

Total IP Reimbursement

The total amount of Medicare inpatient reimbursement for the cost reporting period is from Worksheet E, Part A, line 16 for PPS hospitals or from Worksheet E-3, Part I, line 17 or Worksheet E-3, Part II, Line 30 for non-PPS hospitals.

Total IP Costs

Total IP Costs corresponding to Total IP Reimbursement are calculated in the cost report and summarized on Worksheet D-1, Part II, line 49.

NPR Date

At the close of its fiscal year, a provider must submit a cost report to the MAC showing the costs it incurred during the fiscal year and the proportion of those costs to be allocated to Medicare. The MAC reviews the cost report, determines the total amount of Medicare reimbursement due the provider and issues the provider a Notice of Program Reimbursement (NPR). The NPR date is obtained from the most recent cost report data (HCRIS). There is no NPR date for cost reports as submitted or as amended by the provider (see Status above).

NPR Settlement Amount

The NPR Settlement Amount is the Balance due provider/(Program). It is the difference between the Total IP Reimbursement (above) and the total interim payments for the cost reporting period less any tentative settlements previously made by the MAC. The Balance due provider/(Program) is from Worksheet E, Part A, line 29 for PPS hospitals or from Worksheet E-3, Part I, line 20 or Worksheet E-3, Part II, Line 33 for non-PPS hospitals.

NPR Settlement Percentage

This NPR settlement percentage is the NPR settlement amount as a percentage of total inpatient reimbursement.  (It is calculated from the data elements previously defined.)