Worksheet A-8

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Filing History
FORM CMS-2552-10
INSTRUCTIONS AS PUBLISHED IN CMS PUB. 15-II, , REV 1

MEDICAL UNIVERSITY OF SOUTH CAROLINA - CHARLESTON, SC
Cost report status - As Submitted
[Record Code 741780 - 2010]
This is a prior filing for this period.

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ADJUSTMENTS TO EXPENSES Provider CCN: 420004
PERIOD:
FROM 07/01/2021
TO 06/30/2022
 WORKSHEET A-8
DESCRIPTION (1) BASIS/CODE (2) AMOUNT
EXPENSE CLASSIFICATION ON
WORKSHEET A TO/FROM WHICH
THE AMOUNT IS TO BE ADJUSTED
 Wkst. A-7 Ref.  
COST CENTER LINE #
1 2 3 4 5
1 Investment income - buildings and fixtures (chapter 2) Buildings and Fixtures 1 1
2 Investment income - movable equipment (chapter 2) Movable Equipment 2 2
3 Investment income - other (chapter 2) 3
4 Trade, quantity, and time discounts (chapter 8) 4
5 Refunds and rebates of expenses (chapter 8) 5
6 Rental of provider space by suppliers (chapter 8) 6
7 Telephone services (pay stations excluded) (chapter 21) 7
8 Television and radio service (chapter 21) 8
9 Parking lot (chapter 21) 9
10 Provider-based physician adjustment Worksheet A-8-2 ###     10
11 Sale of scrap, waste, etc. (chapter 23) 11
12 Related organization transactions (chapter 10) Worksheet A-8-1 ###     12
13 Laundry and linen service 13
14 Cafeteria-employees and guests ### ### ### ### 14
15 Rental of quarters to employee and others 15
16 Sale of medical and surgical supplies to other than patients 16
17 Sale of drugs to other than patients 17
18 Sale of medical records and abstracts 18
19 Nursing and allied health education (tuition, fees, books, etc.) 19
20 Vending machines 20
21 Income from imposition of interest, finance or penalty charges (chapter 21) 21
22 Interest expense on Medicare overpayments and borrowings to repay Medicare overpayments 22
23 Adjustment for respiratory therapy costs in excess of limitation (chapter 14) Worksheet A-8-3 Respiratory Therapy 65 23
24 Adjustment for physical therapy costs in excess of limitation (chapter 14) Worksheet A-8-3 Physical Therapy 66   24
25 Utilization review - physicians' compensation (chapter 21) Utilization Review - SNF 114   25
26 Depreciation - buildings and fixtures Buildings and Fixtures 1 26
27 Depreciation - movable equipment Movable Equipment 2 27
28 Non-physician Anesthetist Nonphysician Anesthetist 19   28
29 Physicians' assistant 29
30 Adjustment for occupational therapy costs in excess of limitation (chapter 14) Worksheet A-8-3 Occupational Therapy 67 30
30.99 Hospice (non-distinct) (see instructions) Adults and Pediatrics 30   30.99
31 Adjustment for speech pathology costs in excess of limitation (chapter 14) Worksheet A-8-3 Speech Pathology 68   31
32 CAH HIT Adjustment for Depreciation and Interest 32
33 Other adjustments (specify) 33
33.01 MISC REVENUE ### ### ### ### 33.01
33.03 MISC REVENUE ### ### ### ### 33.03
33.04 MISC REVENUE ### ### ### ### 33.04
33.05 MISC REVENUE ### ### ### ### 33.05
33.06 MISC REVENUE ### ### ### 33.06
33.07 MISC REVENUE ### ### ### ### 33.07
33.08 MISC REVENUE ### ### ### 33.08
33.09 MISC REVENUE ### ### ### 33.09
33.10 MISC REVENUE ### ### ### ### 33.10
33.11 MISC REVENUE ### ### ### ### 33.11
33.12 MISC REVENUE ### ### ### ### 33.12
33.13 MISC REVENUE ### ### ### ### 33.13
33.14 MISC REVENUE ### ### ### ### 33.14
33.16 MISC REVENUE ### ### ### 33.16
33.20 MISC REVENUE ### ### ### ### 33.20
33.24 MISC REVENUE ### ### ### 33.24
33.25 MISC REVENUE ### ### ### ### 33.25
33.26 MISC REVENUE ### ### ### ### 33.26
33.27 MISC REVENUE ### ### ### ### 33.27
33.28 MISC REVENUE ### ### ### ### 33.28
33.29 MISC REVENUE ### ### ### ### 33.29
33.30 MISC REVENUE ### ### ### ### 33.30
34 OTHER OP - INTEREST INCOME ### ### ### ### ### 34
34.01 OTHER OP - INTEREST INCOME ### ### 34.01
34.02 OTHER OP - INTEREST INCOME ### ### 34.02
34.03 OTHER OP - INTEREST INCOME ### ### 34.03
34.04 OTHER OP - INTEREST INCOME ### ### ### ### ### 34.04
34.05 OTHER OP - INTEREST INCOME ### ### 34.05
34.06 OTHER OP - INTEREST INCOME ### ### 34.06
35 35
36 TRANSPLANT REMOVE IITS HEART ### ### ### ### 36
36.01 TRANSPLANT REMOVE IITS LUNG ### ### ### ### 36.01
36.02 TRANSPLANT REMOVE IITS LIVER ### ### ### ### 36.02
36.03 TRANSPLANT REMOVE IITS PANCREAS ### ### ### ### 36.03
36.04 TRANSPLANT REMOVE IITS KIDNEY ### ### ### ### 36.04
36.05 PRE TRANSPLANT MEDICARE GROSS UP - K ### ### ### ### 36.05
36.06 PRE TRANSPLANT MEDICARE GROSS UP - P ### ### ### ### 36.06
36.07 PRE TRANSPLANT MEDICARE GROSS UP - H ### ### ### ### 36.07
36.08 PRE TRANSPLANT MEDICARE GROSS UP - L ### ### ### ### 36.08
36.09 PRE TRANSPLANT MEDICARE GROSS UP - L ### ### ### ### 36.09
37 37
37.01 A-8-1 RENT/LEASE UMA BLDG ### ### ### 37.01
37.02 A-8-1 RENT/LEASE UMA BLDG ### ### ### ### 37.02
37.03 A-8-1 RENT/LEASE UMA BLDG ### ### ### ### 37.03
37.04 A-8-1 RENT/LEASE UMA BLDG ### ### ### ### 37.04
37.05 A-8-1 RENT/LEASE UMA BLDG ### ### ### ### 37.05
37.06 A-8-1 RENT/LEASE UMA BLDG ### ### ### ### 37.06
37.07 A-8-1 RENT/LEASE UMA BLDG ### ### ### ### 37.07
37.09 A-8-1 RENT/LEASE UMA BLDG ### ### ### ### 37.09
37.10 A-8-1 RENT/LEASE UMA BLDG ### ### ### ### 37.10
37.11 A-8-1 RENT/LEASE UMA BLDG ### ### ### ### 37.11
37.12 A-8-1 RENT/LEASE UMA BLDG ### ### ### ### 37.12
37.13 A-8-1 RENT/LEASE UMA BLDG ### ### ### ### 37.13
37.14 A-8-1 RENT/LEASE UMA BLDG ### ### ### ### 37.14
37.15 A-8-1 RENT/LEASE UMA BLDG ### ### ### ### 37.15
37.16 A-8-1 RENT/LEASE UMA BLDG ### ### ### ### 37.16
37.17 A-8-1 RENT/LEASE UMA BLDG ### ### ### ### 37.17
38 INTEREST EXPENSE NORTH TOWER ### ### ### ### ### 38
38.01 DEPRECIATION EXPENSE NORTH TOWER ### ### ### ### ### 38.01
38.02 INTEREST EXPENSE NEXTON/EDGEWATER ### ### ### ### 38.02
39 NURSING TRANSPLANT ADMIN ### ### ### ### 39
39.01 NURSING TRANSPLANT ADMIN ### ### ### ### 39.01
40 CRNA ### ### ### ### 40
40.01 CRNA SUPPORT ### ### ### ### 40.01
41 41
42 LOBBYING EXPENSE ### ### ### ### 42
42.01 LOBBYING EXPENSE ### ### ### ### 42.01
43 43
44 44
45 45
46 46
47 47
48 48
49 49
49.02 EXPENSE 59999 REINSTATE 406XX ### ### ### 49.02
49.07 MEDICAID STATE MATCH ### ### ### ### 49.07
49.08 PSYCH PLANT PSYCHOLOGY INTERNS ### ### ### ### 49.08
49.09 RENT/LEASE LOBBYING ### ### ### ### 49.09
50 TOTAL (sum of lines 1 thru 49) (Transfer to Worksheet A, column 6, line 200)   ###       50
(1) Description - all chapter references in this column pertain to CMS Pub. 15-1
(2) Basis for adjustment (see instructions)
A. Costs - if cost, including applicable overhead, can be determined
B. Amount Received - if cost cannot be determined
(3) Additional adjustments may be made on lines 33 thru 49 and subscripts thereof.
 
Note: See instructions for column 5 referencing to Worksheet A-7.
FORM CMS-2552-10 (03-2018) (INSTRUCTIONS FOR THIS WORKSHEET ARE PUBLISHED IN CMS PUB. 15-II, §4016)
03-18   Rev. 14