Worksheet E-4

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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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DIRECT GRADUATE MEDICAL EDUCATION (GME) & ESRD OUTPATIENT DIRECT MEDICAL EDUCATION COSTS Provider CCN: 420004
PERIOD:
FROM 07/01/2021
TO 06/30/2022
WORKSHEET E-4
Medicare -Title XVIII - Hospital
COMPUTATION OF TOTAL DIRECT GME AMOUNT
1 Unweighted resident FTE count for allopathic and osteopathic programs for cost reporting periods ending on or before December 31, 1996 ### 1
1.01 FTE cap adjustment under §131 of the CAA 2021 (see instructions) ) 1.01
2 Unweighted FTE resident cap add-on for new programs per 42 CFR 413.79(e)(see instructions) 2
2.26 Rural track program FTE cap limitation adjustment after the cap-building window closed under §127 of the CAA 2021 (see instructions) 2.26
3 Amount of reduction to Direct GME cap under §422 of MMA 3
3.01 Direct GME cap reduction amount under ACA §5503 in accordance with 42 CFR §413.79 (m). (see instructions for cost reporting periods straddling 7/1/2011) 3.01
3.02 Adjustment (increase or decrease) to the hospital’s rural track FTE limitation(s) for rural track programs with a rural track Medicare GME affiliation agreement in accordance with 413.75(b) and 87 FR 49075 (August 10, 2022) (see instructions) 3.02
4 Adjustment (plus or minus) to the FTE cap for allopathic and osteopathic programs due to a Medicare GME affiliation agreement (42 CFR §413.75(b) and § 413.79 (f)) 4
4.01 ACA § 5503 increase to the Direct GME FTE Cap (see instructions for cost reporting periods straddling 7/1/2011) 4.01
4.02 ACA §5506 number of additional direct GME FTE cap slots (see instructions for cost reporting periods straddling 7/1/2011) ### 4.02
4.21 The amount of increase if the hospital was awarded FTE cap slots under §126 of the CAA 2021 (see instructions) 4.21
5 FTE adjusted cap (line 1 plus and 1.01, plus line 2, plus lines 2.26 through 2.49, minus lines 3 and 3.01, plus or minus line 3.02, plus or minus line 4, plus lines 4.01 through 4.27 ### 5
6 Unweighted resident FTE count for allopathic and osteopathic programs for the current year from your records (see instructions) ### 6
7 Enter the lesser of line 5 or line 6 ### 7
  Primary Care Other Total  
1 2 3
8 Weighted FTE count for physicians in an allopathic and osteopathic program for the current year ### ### ### 8
9 If line 6 is less than 5 enter the amount from line 8, otherwise multiply line 8 times the result of line 5 divided by the amount on line 6. For cost reporting periods beginning on or after October 1, 2022, or if Worksheet S-2, Part I, line 68, is "Y", see instructions. ### ### ### 9
10 Weighted dental and podiatric resident FTE count for the current year   ###   10
10.01 Unweighted dental and podiatric resident FTE count for the current year   ###   10.01
11 Total weighted FTE count ### ###   11
12 Total weighted resident FTE count for the prior cost reporting year (see instructions) ### ###   12
13 Total weighted resident FTE count for the penultimate cost reporting year (see instr.) ### ###   13
14 Rolling average FTE count (sum of lines 11 through 13 divided by 3) ### ###   14
15 Adjustment for residents in initial years of new programs   15
15.01 Unweighted adjustment for residents in initial years of new programs   15.01
16 Adjustment for residents displaced by program or hospital closure   16
16.01 Unweighted adjustment for residents displaced by program or hospital closure   16.01
17 Adjusted rolling average FTE count ### ###   17
18 Per resident amount ### ###   18
18.01 Per resident amount under §131 of the CAA 2021   18.01
19 Approved amount for resident costs ### ### ### 19
  1  
20 Additional unweighted allopathic and osteopathic direct GME FTE resident cap slots received under 42 §413.79(c )(4) ### 20
21 Direct GME FTE unweighted resident count over cap (see instructions) ### 21
22 Allowable additional direct GME FTE resident count (see instructions) ### 22
23 Enter the locality adjustment national average per resident amount (see instructions) ### 23
24 Multiply line 22 time line 23 ### 24
25 Total direct GME amount (sum of lines 19 and 24) ### 25
COMPUTATION OF PROGRAM PATIENT LOAD Inpatient Part A Managed Care Prior to 1/1 Managed Care On or After 1/1 Total  
1 2 2.01 3  
26 Inpatient days (see instructions) ### ### ###   26
27 Total inpatient days (see instructions) ### ### ###   27
28 Ratio of inpatient days to total inpatient days ### ### ###   28
29 Program direct GME amount ### ### ### ### 29
29.01 Percent reduction for MA DGME   ### ###   29.01
30 Reduction for direct GME payments for Medicare Advantage   ### ### ### 30
31 Net Program direct GME amount       ### 31
DIRECT MEDICAL EDUCATION COSTS FOR ESRD COMPOSITE RATE - TITLE XVIII ONLY (NURSING PROGRAM AND PARAMEDICAL EDUCATION COSTS)
  1  
32 Renal dialysis direct medical education costs (from Wkst. B, Pt. I, sum of col. 20 and 23, lines 74 and 94) 32
33 Renal dialysis and home dialysis total charges (Wkst. C, Pt. I, col. 8, sum of lines 74 and 94) ### 33
34 Ratio of direct medical education costs to total charges (line 32 ÷ line 33) 34
35 Medicare outpatient ESRD charges (see instructions) 35
36 Medicare outpatient ESRD direct medical education costs (line 34 x line 35) 36
APPORTIONMENT OF MEDICARE REASONABLE COST OF GME
Part A Reasonable Cost
37 Reasonable cost (see instructions) ### 37
38 Organ acquisition costs (Wkst. D-4, Pt. III, col. 1, line 69) ### 38
39 Cost of physicians' services in a teaching hospital (see instructions) 39
40 Primary payer payments (see instructions) ### 40
41 Total Part A reasonable cost (sum of lines 37 through 39 minus line 40) ### 41
Part B Reasonable Cost
42 Reasonable cost (see instructions) ### 42
43 Primary payer payments (see instructions) ### 43
44 Total Part B reasonable cost (line 42 minus line 43) ### 44
45 Total reasonable cost (sum of lines 41 and 44) ### 45
46 Ratio of Part A reasonable cost to total reasonable cost (line 41 ÷ line 45) ### 46
47 Ratio of Part B reasonable cost to total reasonable cost (line 44 ÷ line 45) ### 47
ALLOCATION OF MEDICARE DIRECT GME COSTS BETWEEN PART A AND PART B
48 Total program GME payment (line 31) ### 48
49 Part A Medicare GME payment (line 46 x 48)(Title XVIII only) (see instructions) ### 49
50 Part B Medicare GME payment (line 47 x 48) (title XVIII only) (see instructions) ### 50
FORM CMS-2552-10  (07-2023)  (INSTRUCTIONS FOR THIS WORKSHEET ARE PUBLISHED IN CMS PUB 15-II, § 4034)
07-23     Rev. 21