Published December 6, 2023

Medicare Cost Report Primers: New and Improved Medicare Home Office

This Insight is part of PYA’s Medicare Cost Report Primers, a PYA thought leadership series that offers guidance through challenges related to the Medicare cost report process.

With cost report periods beginning on October 1, 2022, a new Home Office/Chain Organization cost report (CMS-287-22) is required to be filed for Medicare-certified Home Offices (HO) or Chain Organizations (CO). For this new requirement, a Medicare-certified HO or CO has been issued a unique Centers for Medicare & Medicaid Services (CMS) certification number (CCN). See the second installment in the Medicare Cost Report Primers series for more information on HO and CO.

A notable improvement in the revised HO/CO cost report process is the ability to electronically sign the report and submit it through CMS’s Medicare Cost Report Electronic Filing portal (MCReF). Previously, the signature page of the HO/CO cost report required a manual signature, and the report was then mailed to the Medicare Administrative Contractor (MAC), along with supporting documentation on a CD or flash drive. 

In addition to the new electronic filing and uploading features, many of the schedules in the HO/CO cost report have been renamed and updated for consistency with other provider cost reports. The chart below summarizes several key changes between the old and new forms within the CMS-287-05 and CMS-287-22 reports.

Key Areas of Change on New CMS-287-22 Forms

(Old) Form
(New) Form
Schedule A,
Part I & II
Schedule S,
Parts I & II
Part I includes a Cost Statement Status. Part II added the electronic signature statement.
Schedule B Schedule A Schedule A is designated for trial balance expenses grouped to specific cost centers.  Many cost centers are the same as the old form but re-numbered. 
Schedule B-1 Schedule A-6 Schedule A-6 is designated for any cost report reclassification of expenses.
Schedule C Schedule A-8 Schedule A-8 is designated for any cost report adjustment to expenses.
Schedule D Schedule A-8-1 Schedule A-8-1 is designated for adjustments required as a result of transactions with a related organization/home office/chain organization.
Schedule E, E-1 Schedule B, B-1 Schedule B and B-1 are designated for allocation of DIRECT capital and non-capital expenses based on specific allocation statistics. 
Schedule F,
Parts I & II
Schedule C, C-1 Schedule C and C-1 are designated for allocation of FUNCTIONAL CAPITAL expenses based on specific allocation statistics. 
Schedule F-1,
Parts I & II
Schedule D, D-1 Schedule D and D-1 are designated for allocation of FUNCTIONAL NON-CAPITAL expenses based on specific allocation statistics. 
Schedule G,
Part I
Schedule E Schedule E is designated for the allocation of POOLED costs for the double allocation method. 
Schedule G,
Part II
Schedule E-1 Schedule E-1 is designated for the allocation of POOLED expenses. 
Schedule J Schedule G Schedule G is for the balance sheet.
Schedule I Schedule G-1 Schedule G-1 is for the statement of revenue and expenses.

If your organization needs assistance with the new HO/CO cost report (CMS-287-22) or other reimbursement matters, contact PYA’s reimbursement professionals via email or by calling (800) 270-9629.


CMS Website with Home Office Manual and Forms

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