Industry Insights

Medicaid Cost Reporting Changes for Missouri Nursing Facilities

February 2018
Author:  Jenny Jensen

Jenny Jensen

Managing Consultant


Health Care

910 E. St. Louis Street, Suite 200
P.O. Box 1190
Springfield, MO 65801-1190 (65806)


The Missouri Medicaid nursing facility cost reporting forms and submission process have been revised by the Missouri Department of Social Services MO HealthNet Division. These changes are required beginning with cost reporting periods ending on or after the month of December 2017, i.e., fiscal year-end December 31, 2017, providers. There are minor changes to the forms and information required, with the most significant change being the move from paper filing to a new electronic filing requirement. Please note the following summary of the most significant changes.


  • Cost reports are now required to be submitted electronically. They may be emailed to
  • MO HealthNet Division recently indicated it also will accept submission of the new Excel-based cost report file on CD.

Additional information required:

Schedule D – vehicle schedule:

  • Purpose of the vehicle (administrative, maintenance, resident transportation – medical, resident transportation – activities/outings, other) and the percentage used for each purpose

Schedule K – by payroll department:

  • Number of employees at beginning of the year
  • Number of employees hired during the year
  • Number of employees who left employment during the year
  • Number of employees at the end of the year

Other notable changes to the forms:

  • Most cost report information has stayed the same, but some items have been moved to different locations on the forms.
  • Cost Report Checklist is now a separate Word document.
  • Additional lines have been added to Schedule A, Revenues, and Schedule B, Expenditures, to eliminate certain detail lines on supplemental Schedules A-1 and B-1. For Schedule A, these additions include Unrestricted and Restricted Gifts revenues. For Schedule B, these additions include:
    • Contracted RN, LPN and Aides expenses
    • Other ancillary and central supply clerk salaries
    • Owners’ compensation and directors’ fees
    • Nonemergency transportation and emergency medical transportation expenses
  • Schedule H, Statement of Owners/Directors Compensation, now asks if each applicable individual listed is the administrator and/or part of the home office and breaks out directors’ fees from other compensation.
  • Additional Worksheets 1 have been added to allow for easier reporting of more than one noncertified activity.
  • Additional Worksheets 2 have been added to allow for easier reporting of more than one related-party lease.
  • Vehicle supplemental information has moved from a separate schedule to Schedule D.

If you have questions regarding the new cost reporting requirements, contact Jenny or your trusted BKD advisor.

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