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