Energy Industry Brochure

DSH S-10 Worksheet

Cost Report Worksheet S-10 – Uncompensated Care

On April 14, 2017, the Centers for Medicare & Medicaid Services (CMS) released its federal fiscal year (FY) 2018 proposed Medicare inpatient prospective payment system (IPPS) rule. Similar to the FY 2017 proposed IPPS rule, the 2018 rule proposes to begin incorporating uncompensated care cost information from Worksheet S-10 (S-10) of the Medicare cost report beginning in FY 2018. If finalized, this proposal will cause significant redistributions of the uncompensated care portion of Medicare disproportionate share hospital (DSH) payments between providers.

Regardless of stakeholders’ concerns, CMS is clearly intent on beginning to incorporate the S-10 into uncompensated care payment distribution. CMS expects cost reports beginning in FY 2017 will be the first cost reports the S-10 data will be subject to review.

How can I assess my organization’s potential financial impact?

Until the final rule is announced, it is difficult to accurately assess an organization’s impact. However, we have developed a tool to help providers estimate their potential impact and begin planning. To request the tool, please complete the information below, and we’ll email it directly to you.

How could this impact my organization?

While S-10 implementation has been postponed, it’s clear it will eventually drive future payments. It’s likely that beginning in FY2021 many organizations could see a significant change in Medicare DSH payments.

Further, if errors are identified during an S-10 audit, extrapolations reducing Medicare DSH payments likely would occur.

What actions can I be taking now?

  • Verify that detailed patient listings are available to support S-10 filed amounts
  • Establish that filed amounts are compliant with Medicare cost report instructions
  • Check that policies, procedures and reporting are compliant and consistent
  • Evaluate the impact of current cost report instructions and potential changes to cost report instructions on uncompensated care reporting


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