Back to Basics: Medicare SNF Cost Report Submission

Thoughtware Article Published: Mar 01, 2018
Skilled Nursing Facility accounting resources, including: guides, checklists and tools to help you implement best practices.

Skilled nursing facilities (SNF) that provide services to beneficiaries participating in the Medicare program are required to file an annual Medicare cost report. The cost report is a collection of information for the reporting period, including facility characteristics, statistics and financial data. The Centers for Medicare & Medicaid Services (CMS) maintains the cost report data in the Healthcare Provider Cost Reporting Information System (HCRIS).

Filing & Submission Requirements

  • The annual cost report covers a 12-month period of operations based on the provider’s fiscal year. Certain circumstances will allow for a short-period cost report or submission of less than a full cost report. A short-period cost report can be filed if a provider is submitting for its initial cost reporting period, ending participation in the Medicare program or changing its cost reporting period.
  • It’s due on or before the last day of the fifth month following the close of the cost reporting period. For cost reports that end on a day other than the last day of the month, the report is due 150 days after the last day of the cost reporting period.
  • To be considered filed timely, the cost report must be postmarked by the due date. If the cost report is due on a weekend or federal holiday, the cost report is considered timely filed if postmarked by the following working day. Any delay in submission is subject to withholding of Medicare reimbursement to the provider.
  • The cost report must be submitted to the provider’s Medicare Administrative Contractor (MAC) in an electronic cost report (ECR) format using a CMS-approved vendor system.
  • Per the CMS Provider Reimbursement Manual:
    • A computer-generated Worksheet S (certification statement) must be included with the cost report submission. This will “electronically print the date and time the electronic file was encrypted and replicate the encryption coding in the ECR file parallel and to the left of the provider signature block. The signature block of the officer or administrator must contain an original signature. A facsimile or stamped copy of the signature is unacceptable.”

Low or No Utilization

Conditions that allow a provider to file less than a full cost report can include a provider that didn’t furnish any covered services to Medicare beneficiaries during the entire cost reporting period (no utilization) or if there was low utilization and a correspondingly low reimbursement of such services in a reporting period. If a provider has no or low utilization, it should check with its MAC for requirements on which worksheets are to be submitted. A low- or no-Medicare-utilization cost report does not include an ECR.

Compiling Cost Report Information

A facility should use its accounting software and records to generate the information to be provided on the cost report. Many accounting software packages can quickly generate reports for the various statistical and financial data needed that can be easily summarized for your cost report preparer. Download the Medicare Cost Report Preparation Checklist for a more detailed list of information to provide to your cost report preparer.


The SNF cost reporting requirements for Medicaid vary by state. If you have questions regarding your Medicare cost report, need assistance with preparing your cost report or for information regarding Medicaid state requirements, contact Angie or your trusted BKD advisor.

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