1. (a) A facility that enters into a termination agreement or an agreement of sale, or is withdrawing or being terminated as a provider, or is otherwise undergoing a change of ownership is required to file an acceptable final cost report and outstanding annual cost reports with the Department within 45 days of the effective date of the termination, transfer, withdrawal or change of ownership and is required to provide financial records to the Department for auditing. An acceptable cost report is one that meets the requirements of § 1181.66(a)(1)(i)—(iv) (relating to setting ceilings on allowable net operating costs).
2. (b) Except for an intermediate care facility for the mentally retarded, a facility may request an extension to file its final cost reports as required by subsection (a) of up to 30 days from the date the cost reports are due if the facility’s request is received by the Department prior to the expiration of the 30th day of the 45-day period specified in subsection (a), specifies the reasons for the extension request and the amount of time requested and is for reasons beyond the control of the provider. No further extensions will be granted. The denial of a request shall be an adverse action appealable under § 1101.84(c) (relating to provider right of appeal). Failure to timely appeal a denial shall preclude any attack on the denial in another proceeding.

Source

The provisions of this § 1181.73 codified July 24, 1981, effective July 25, 1981, 11 Pa.B. 2610; amended May 3, 1985, effective retroactively as of July 1, 1984, 15 Pa.B. 1629; amended March 10, 1989, effective immediately and applies retroactively to January 1, 1989, 19 Pa.B. 1005. Immediately preceding text appears at serial page (125801).

Notes of Decisions

A corporation which merged with a Medicare health provider and the provider’s parent company could challenge interim reimbursement rates effective after the merger, since the provider did file ‘‘final cost reports’’ for the beginning of the facilities fiscal year. Manor Health Care Corporation v. Department of Public Welfare, 551 A.2d 628 (Pa. Cmwlth. 1988).

This section requiring a facility to submit a final cost report to DPW makes no provision for permitting or prohibiting a grant of an extension to file the report, and therefore the Department’s decision not to grant an extension based on no authority was arbitrary and capricious. Department of Public Welfare v. Overlook Medical Clinic, Inc., 544 A.2d 935 (Pa. Cmwlth. 1988).

The Department’s determination that this section precluded total life care facility from receiving reimbursement for depreciation and interest on capital indebtedness was incorrect, and in conflict with other Department regulations. Twining Village v. Department of Public Welfare, 523 A.2d 1199 (Pa. Cmwlth. 1987).

This section must be interpreted in context with other regulations which demonstrate a consistent policy of differentiating between operating costs, and depreciation and interest. Twining Village v. Department of Public Welfare, 523 A.2d 1199 (Pa. Cmwlth. 1987).

The Department of Public Welfare may terminate a facility’s provider agreement under § 1181.91 where the facility’s cost report is not filed on time, and may make a final cost settlement based on the facility’s last final, audited per diem rate under § 1181.73 where the final cost report is filed late, but, the regulations do not authorize the Department to imposea zero allowable cost as a sanction for the late filing. Mansion Nursing and Convalescent Home, Inc. v. Department of Public Welfare, 506 A.2d 1343 (Pa. Cmwlth. 1986).

The word ‘‘not’’ in subsection (b) means ‘‘not within 30 days’’ when read with subsection (a) and is interpreted as ‘‘not timely’’ rather than ‘‘never.’’ Michael Manor, Inc. v. Department of Public Welfare, 490 A.2d 957 (Pa. Cmwlth. 1985).

Cross References

This section cited in 55 Pa. Code § 1181.45 (relating to ongoing responsibilities of providers); and 55 Pa. Code § 1181.91 (relating to failure to file a cost report).