Hospital Reports:

S - Identification, Utilization, Statistical Data

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Worksheet Section	Description	Reference
Wkst. S, Parts II	Analysis of Renal Dialysis Department Costs	3650
Wkst. S-2	Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis	3650
Wkst. S-3, Parts II-III	Analysis of Renal Dialysis Department Costs	3650
Wkst. S-4	Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis	3650
Wkst. S-5	Reasonable Cost Determination for Therapy Service Furnished after April 10, 1998 by	3650
Wkst. S-6	Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis	3650

A - Reclassification And Adjustment Of Trial Balance Of Expenses

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Worksheet Section	Description	Reference
Wkst. S, Parts II	Analysis of Renal Dialysis Department Costs	3650
Wkst. S-2	Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis	3650
Wkst. S-3, Parts II-III	Analysis of Renal Dialysis Department Costs	3650
Wkst. S-4	Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis	3650
Wkst. S-5	Reasonable Cost Determination for Therapy Service Furnished after April 10, 1998 by	3650
Wkst. S-6	Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis	3650

B - Cost and Cost Allocation

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Worksheet Section	Description	Reference
Wkst. S, Parts II	Analysis of Renal Dialysis Department Costs	3650
Wkst. S-2	Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis	3650
Wkst. S-3, Parts II-III	Analysis of Renal Dialysis Department Costs	3650
Wkst. S-4	Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis	3650
Wkst. S-5	Reasonable Cost Determination for Therapy Service Furnished after April 10, 1998 by	3650
Wkst. S-6	Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis	3650

C - Computation of Ratio of Costs to Charges

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Worksheet Section	Description	Reference
Wkst. S, Parts II	Analysis of Renal Dialysis Department Costs	3650
Wkst. S-2	Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis	3650
Wkst. S-3, Parts II-III	Analysis of Renal Dialysis Department Costs	3650
Wkst. S-4	Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis	3650
Wkst. S-5	Reasonable Cost Determination for Therapy Service Furnished after April 10, 1998 by	3650
Wkst. S-6	Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis	3650

D - Apportionment of Inpatient Cost (Routine,Ancillary, Capital), Computation of Operating Cost

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Worksheet Section	Description	Reference
Wkst. S, Parts II	Analysis of Renal Dialysis Department Costs	3650
Wkst. S-2	Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis	3650
Wkst. S-3, Parts II-III	Analysis of Renal Dialysis Department Costs	3650
Wkst. S-4	Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis	3650
Wkst. S-5	Reasonable Cost Determination for Therapy Service Furnished after April 10, 1998 by	3650
Wkst. S-6	Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis	3650

E - Calculation of Reimbursement Settlement

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Worksheet Section	Description	Reference
Wkst. S, Parts II	Analysis of Renal Dialysis Department Costs	3650
Wkst. S-2	Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis	3650
Wkst. S-3, Parts II-III	Analysis of Renal Dialysis Department Costs	3650
Wkst. S-4	Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis	3650
Wkst. S-5	Reasonable Cost Determination for Therapy Service Furnished after April 10, 1998 by	3650
Wkst. S-6	Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis	3650