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CFSS Cost Reporting Tool Instruction Manual

CFSS Cost Reporting Tool Instruction Manual

Provider information and attestations

Page posted: 6/27/25

This section of the cost report collects information to identify the provider organization, including:

  • · Provider identification number(s).
  • · Contact information for the organization’s chief executive officer (CEO), chief financial officer (CFO) and/or cost report preparers.

    • DHS may use this contact information to request clarifying details and supporting documentation about the provider organization’s completed cost report.

    Category

    Instructions

    Provider business information

    Provide all the following information:

  • · Business name.
  • · All National Provider Identification Numbers (NPIs) or Unique Minnesota Provider Identifiers (UMPIs) associated with the reporting entity.
  • · All annual unique recipients within the reporting year (i.e., the number of people who received PCA/agency-model CFSS services within the reporting year).
  • · Years in operation, rounded to the nearest year.
  • · Business structure (i.e., for profit, non-profit, government).

    • Note: The Federal Employer Identification Number (FEIN) automatically populates. If the FEIN is incorrect, email dhs.costreport@state.mn.us. DHS will give a placeholder FEIN to a reporting entity when the reporting entity only has an NPI or UMPI. DHS placeholder FEINs have Z at the front, followed by numbers (e.g., Example Organization has an FEIN of Z00000001).

    Quick tip: Unless the organization filed paperwork to become a non-profit or government entity, the organization is a for-profit organization.

    Contact information for cost report preparers

    Use this optional section to add contact information for additional cost report preparers (i.e., members from your organization or third party vendors that will help complete the cost report). The system automatically includes the authorized agent’s contact information.

    To add additional cost report preparers, provide all the following information:

  • · Name of the employee.
  • · Working job title.
  • · Work site address.
  • · Phone number.
  • · Email address.

    • After the authorized agent saves the additional cost report preparers’ contact information, the system sends them a welcome email with login information.

    If you receive an error, email dhs.costreport@state.mn.us to add the additional cost report preparers to your report.

    For more information, refer to authorized agents and provider users.

    Cost-reporting period

    Provide the start date and end date of the fiscal year for which the organization is providing revenue and cost information.

    The cost-reporting period must be a 12-month period that ended no more than 18 months before submission of the cost report, as required by Minn. Stat. §256B.85. For most organizations, the cost-reporting period will be the previous calendar year (e.g., Jan. 1, 2024, to Dec. 31, 2024).

    Example: If the organization is reporting in 2024, the organization’s cost report will most likely be for calendar year 2023.

    Next step

    Next, review revenues.

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