Ariz. Admin. Code § R9-11-203 - Hospital Uniform Accounting Report

A. A hospital administrator or designee shall submit a uniform accounting report to the Department, in a format specified by the Department, no later than 150 calendar days after the ending date of the hospital's fiscal year.

B. A hospital administrator or designee shall submit a copy of the hospital's Medicare cost report, if applicable, as part of the uniform accounting report required in subsection (A).

C. The uniform accounting report required in subsection (A) shall include the following information:

1. The name, physical address, mailing address, county, and telephone number of the hospital;

2. The name, telephone number, and e-mail address of the:

a. Hospital administrator,

b. Hospital chief financial officer, and

c. Individual who prepared the uniform accounting report;

3. The identification number assigned to the hospital:

a. By the Department;

b. By AHCCCS, if applicable;

c. By Medicare, if applicable; and

d. As the hospital's national provider identifier;

4. The hospital's classification;

5. Whether the entity that is the owner of the hospital is:

a. Not for profit;

b. For profit; or

c. A federal, state, or local government agency;

6. Whether or not the hospital is Medicare-certified;

7. The beginning and ending dates of the hospital's reporting period;

8. If the hospital began operations during the hospital's reporting period, the date on which the hospital began operations;

9. The date the uniform accounting report was submitted to the Department;

10. The licensed capacity, for each type of bed, at the end of the reporting period;

11. The licensed capacity at the end of the reporting period;

12. The number of available beds, for each type of bed, at the end of the reporting period;

13. The number of available beds at the end of the reporting period;

14. The number of admissions, for each type of bed, during the reporting period;

15. The total number of admissions during the reporting period;

16. The total number of patient days:

a. During the reporting period, and

b. For each type of bed during the reporting period;

17. The average occupancy rate for the reporting period;

18. The number of surgeries during the reporting period that required a patient to receive inpatient services in the hospital;

19. The number of surgeries during the reporting period that did not require a patient to receive inpatient services in the hospital;

20. The number of births during the reporting period;

21. The number of nursery patient admissions during the reporting period;

22. The number of patient days for nursery patients during the reporting period;

23. The number of episodes of care during the reporting period provided by the:

a. Emergency department,

b. Urgent care unit, and

c. Trauma center;

24. The total number of episodes of care during the reporting period provided by the emergency department, urgent care unit, or trauma center;

25. The number of episodes of care in the emergency department, urgent care unit, or trauma center during the reporting period for which the patient was subsequently admitted to the hospital;

26. The total number of FTEs at the end of the reporting period;

27. The turnover rate for the reporting period;

28. The vacancy rate for the reporting period;

29. The number of FTEs, for each type of employee, during the reporting period;

30. The vacancy rate, for each type of employee, for the reporting period;

31. The number of medical record coder FTEs during the reporting period;

32. The vacancy rate for medical record coders for the reporting period;

33. The number of medical record transcriptionist FTEs during the reporting period;

34. The vacancy rate for medical record transcriptionists for the reporting period;

35. For individuals who worked for the hospital as contracted workers during the reporting period, the number of hours worked by registered nurses;

36. The amount of revenue generated, for each type of revenue, by the hospital during the reporting period;

37. The amount of allowances given, for each type of allowance, by the hospital during the reporting period;

38. The total amount of revenue generated and allowances given by the hospital during the reporting period;

39. The operating expenses incurred, for each type of operating expense, by the hospital during the reporting period;

40. The total operating expenses incurred by the hospital during the reporting period;

41. The difference between the amount identified in subsection (C)(38) and the amount identified in subsection (C)(40);

42. The income and expenses, other than revenue and operating expenses, for each type of income received and expense incurred by the hospital during the reporting period;

43. The amount of assets, for each type of asset, of the hospital at the end of the reporting period;

44. The total amount of assets of the hospital at the end of the reporting period;

45. The amount of liabilities, for each type of liability, of the hospital at the end of the reporting period;

46. The total amount of liabilities of the hospital at the end of the reporting period;

47. The amount of net assets, for each type of net asset, of the hospital at the end of the reporting period;

48. The total amount of net assets of the hospital at the end of the reporting period;

49. The difference between the amount identified in subsection (C)(48) and the amount identified in subsection (C)(46); and

50. The statement of cash flows required in A.R.S. § 36-125.04(C)(3), unless the statement of cash flows has been submitted as part of the annual financial statement required in R9-11-202.

D. A hospital administrator or designee shall:

1. On a form provided by the Department:

a. Attest that, to the best of the knowledge and belief of the hospital administrator or designee, the information submitted according to subsections (B) and (C) is accurate and complete; or

b. If the hospital administrator or designee has personal knowledge that the information submitted according to subsections (B) and (C) is not accurate or not complete:

i. Identify the information that is not accurate or not complete;

ii. Describe the circumstances that make the information not accurate or not complete;

iii. State what actions the hospital is taking to correct the inaccurate information or make the information complete; and

iv. Attest that, to the best of the knowledge and belief of the hospital administrator or designee, the information submitted according to subsections (B) and (C), except the information identified in subsection (D)(1)(b)(i), is accurate and complete; and

2. Submit the form specified in subsection (D)(1) as part of the uniform accounting report required in subsection (A).

E. A hospital administrator who receives a request from the Department for revision of a uniform accounting report not prepared according to subsections (B), (C), and (D) shall ensure that the revised uniform accounting report is submitted to the Department:

1. Within 21 calendar days after the date on the Department's letter requesting an initial revision, and

2. Within seven calendar days after the date on the Department's letter requesting a second revision.

F. If a hospital administrator or designee does not submit a uniform accounting report according to this Section, the Department may assess civil penalties as specified in A.R.S. § 36-126.

Notes

Ariz. Admin. Code § R9-11-203

Section recodified from R9-11-202 at 10 A.A.R. 3835, effective August 24, 2004 (Supp. 04-3). Section expired under A.R.S. § 41-1056(E) at 12 A.A.R. 1784, effective January 31, 2006 (Supp. 06-2). New Section made by final rulemaking at 13 A.A.R. 3648, effective December 1, 2007 (Supp. 07-4). Amended by final rulemaking at 28 A.A.R. 1481, effective 11/7/2022.