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Volume Decrease Adjustment (VDA)

VDA applies to:

  • Applies to Sole Community Hospitals and Medicare Dependent Hospitals
  • Request must be submitted within 180 days of NPR date

Criteria

  • Total discharges for the cost reporting period must have decreased more than 5% from prior cost reporting period
  • The decrease must result from an unusual situation or occurrence beyond the control of the hospital

Supporting Documentation

  • Outline of the causes that resulted in the decrease in discharges.  Please include a description of the cause, date of its onset, and how it affected the number of discharges
  • Description of the actions taken by the hospital to reduce semifixed costs
  • Comparison of FTEs and salaries in current year and prior year, identifying core staff and services.
  • Volume Decrease Adjustment calculation
  • Working Trial Balance (in Excel format) identifying variable costs.  Calculate percentage of variable costs to total costs.  Types of variable costs include:
  • Medical Supplies
  • Pharmaceuticals
  • Cost of Goods Sold
  • Food
  • Dietary Formula
  • Linen and Bedding
  • Other Non-Medical Supplies
  • Patient Surveys
  • Hazardous Material Disposal
  • Collection Agency Fees
  • Freight
  • Advertising
  • Community Relations
  • Charitable Contributions

Please send request and documentation to j15.reimbursement@cgsadmin.com

Reviewed: 12.02.22

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