Sierra Nevada Memorial Hospital Did Not Accurately Report Certain Wage Data, Resulting in Overpayments to California Hospitals

Sierra Nevada Memorial Hospital (the Hospital), located in Grass Valley, California, generally complied with Medicare requirements for reporting wage data in its fiscal year 2014 Medicare cost report. However, errors in reporting wage data did occur. We estimated that, as a result, Medicare overpaid 173 other hospitals in California a total of $216,594 for inpatient services in the first 6 months of Federal fiscal year 2017.

We recommended that the Hospital (1) ensure that all personnel involved in Medicare cost report preparation follow the requirements in the Centers for Medicare & Medicaid Services' (CMS) Provider Reimbursement Manual and (2) strengthen its review and reconciliation procedures to ensure that the Medicare wage data it reports to CMS in the future are accurate, allowable, supportable, and in compliance with Medicare requirements.

In written comments on our draft report, the Hospital agreed with our findings. Although the Hospital did not explicitly indicate it concurred with our recommendations, it provided information on actions that it planned to take to address each finding, including implementing review and reconciliation procedures.