Quick answer
Reconcile New York’s monthly nursing-home cash assessment to receipts actually collected, with documented exclusions and refunds, rather than accrual revenue. Confirm the total rate for the reporting period from current authority: the public table reviewed here lists 6.8% only through March 2025, despite publishing 2026 deadlines.
A nursing home's October revenue report can differ from its October cash-assessment base for legitimate reasons. A prior-year settlement may arrive now, resident money may pass through a bank account, and a refund may reduce cash receipts. A reliable report explains those differences instead of forcing the assessment to equal accrual revenue.
This guide produces a bank-to-assessment bridge for a New York residential health care facility. It addresses the monthly receipt report, not the separate minimum-spending tests or the amount the state may reimburse for assessment expense.
Set the reporting period and rate evidence separately
Public Health Law 2807-d establishes a cash-receipt basis and specific exclusions, including Medicare receipts under the residential-facility provision and specified grants and contributions under subdivision 3(d). Subdivision 2(b)(vi) extends a six-percent statutory assessment through March 31, 2029.
That statutory provision does not by itself establish the entire combined HFCAP rate. The DOH rates and deadlines page still labels its 6.8% residential-facility table through March 31, 2025. Its 2026 calendar identifies November 16, 2026 at 11:59 p.m. Eastern for October reporting and payment. Retain current total-rate authority with the filing; this guide does not extrapolate 6.8% to 2026.
Use two approval fields: one for the cash base and one for the applicable rate and period. A preparer can finish the receipt reconciliation while a reviewer obtains current rate confirmation. Neither field should be silently copied from last year's workbook.
Build an original October receipt bridge
Assume a fictional facility records the following gross bank deposits. The categories and amounts illustrate review logic; actual exclusions depend on the receipt's substance and applicable instructions.
| Deposit category | Amount | Initial assessment treatment |
|---|---|---|
| Current-period non-Medicare patient receipts | $800,000 | Include, subject to validated receipt classification |
| Collection for prior-year non-Medicare services | $100,000 | Include in current cash period; retain original service period |
| Verified Medicare receipts | $200,000 | Exclude under the applicable statutory provision |
| Resident trust funds deposited into custodial account | $50,000 | Separate resident-owned funds from facility operating receipts |
| Loan proceeds | $20,000 | Separate financing from patient-care or operating receipts |
| Documented qualifying charitable contribution | $15,000 | Apply supported statutory exclusion |
| Unresolved payment described only as “grant” | $15,000 | Resolve the underlying agreement; label alone is insufficient |
| Total deposits | $1,200,000 | Tie to bank and receipt records |
A separate $10,000 documented refund of previously assessable patient receipts cleared during October. Assume it qualifies for the period's refund treatment and has not already reduced the deposit totals. The bank's net cash movement for these items is therefore $1,190,000.
After the supported exclusions and refund, the unresolved-base calculation is:
$1,200,000 − $200,000 − $50,000 − $20,000 − $15,000 − $10,000 = $905,000.
That $905,000 includes the disputed $15,000 receipt. If the evidence establishes a qualifying excluded grant, the base becomes $890,000. If it establishes payment for services, the base stays $905,000. The reviewer needs a decision on the agreement, not a new bank reconciliation.
Close the classification question before releasing the report
For the disputed item, obtain the payment notice and agreement, identify the services or purpose, and record why the chosen treatment applies. A convenient general-ledger account name is not sufficient. Assign an owner and a resolution date before the filing deadline.
Assume the agreement confirms an operating payment for services. The final example base is $905,000. Store the $15,000 decision with the record so a later reviewer can reproduce it. If new evidence later changes the conclusion, preserve the filed version and use the applicable correction process; do not rewrite history.
The assessment calculation is $905,000 multiplied by the independently confirmed total rate. For sensitivity only, each one percentage point equals $9,050 on this base. This is not a proposed filing rate or amount. The supported cash bridge remains useful even while the total-rate evidence is being resolved.
Keep assessment liability apart from reimbursement
A state or payer payment intended to reimburse assessment expense is a different transaction from the assessment owed. Review its specific statutory treatment and remittance detail. Do not subtract an expected reimbursement receivable from the amount payable merely to arrive at a preferred net cash number.
Maintain a liability roll-forward with opening balance, current validated assessment, payments, authorized corrections and closing balance. Reconcile any assessment reimbursement in a separate schedule by service or reconciliation period. This avoids mistaking an old reimbursement collection for a reduction in the current month's filing obligation.
For a month with no reportable activity, retain the underlying reconciliation and the zero-report receipt. The official page expressly requires reports even when no activity exists. A blank worksheet is not evidence of a submitted zero report.
Preserve the filed result and evaluate the workflow
The completed packet contains the bank tie, category decisions, refund evidence, confirmed total-rate authority, filed report, submission timestamp and cleared payment. Preserve the exact version used, including any unresolved item that was later corrected.
A platform evaluation should ask the vendor to reproduce the $905,000 result without losing the prior-year collection or treating trust funds as revenue. It should show who approved the disputed receipt and prevent an obsolete rate from being treated as current merely because the deadline calendar is new.
Ease's skilled nursing product is planned. Confirm any future assessment, treasury or state-reporting capabilities during evaluation. The buyer's practical test is whether the proposed system can preserve an auditable receipt bridge and a separately verified rate decision.
Questions & answers
Should prior-year services collected this month be omitted?
A cash-basis assessment follows the receipt period rather than the service revenue year. Classify the receipt under the applicable assessment rules and retain both dates.
Is a report required when there are no assessable receipts?
The state’s reporting page says reports remain required even when there is no activity. Preserve the submitted zero report and confirmation.
Does the public 6.8% table establish the 2026 total rate?
No. The table reviewed ends March 31, 2025. Current Public Health Law 2807-d extends a six-percent statutory component through March 2029, but that alone does not verify the complete HFCAP rate. Obtain current total-rate authority before filing.
Primary sources
Use the cited source and its applicable version when making a facility-specific decision. These guides explain operational evaluation methods; they are not individualized clinical, coding, or legal advice.