Information for Data Submitters: Nursing Facility Cost Report Submissions

Overview

CHIA collects Nursing Facility Cost Reports on an annual basis. The reports are used by CHIA and other public entities to support public policy and transparency initiatives and for health care payment policy development. Nursing facilities must submit these cost reports in accordance with 957 CMR 7.00 and the filing requirements set out in the cost report forms and instructions.

Filing Requirements

Nursing facilities must annually file a nursing facility cost report (SNF-CR). Any facility that does not own their facility's real property and pays rent to an affiliated or non-affiliated realty trust or other business entity must file or cause to be filed a realty company cost report (REA-CR).  Any nursing facility that reports management company or central office expenses must file or cause to be filed a separate management company cost report (MGT-CR). Furthermore, CHIA’s statute, as amended by Chapter 343 of the Acts of 2024, authorizes the agency to collect cost reports and financial information from management companies.

The CY 2024 SNF-CR and REA-CR were issued on February 27, 2025, and the CY 2024 MGT-CR was issued on March 27, 2025.

Note:  Failure to file the required reports in a timely manner may result in penalties for the provider. See Section 7.07 of 957 CMR 7.00: Nursing Facilities Cost Reporting Requirements at https://www.chiamass.gov/assets/docs/g/chia-regs/957-7.pdf 

Additionally, in accordance with 101 CMR 206.08(7), EOHHS may reduce the provider’s rates for current services by 5 percent on the day following the submission due date and an additional 5% for each month of noncompliance thereafter:  101 CMR 206.00: Standard Payments to Nursing Facilities | Mass.gov  

Each entity must file a Non-Confidential Data Security Agreement. Cost report submitters must also complete a CHIA User Agreement for Nursing Facilities if they have not already done so. See CHIA Submissions and INET Questions and Answers for more complete information on registration. Completed CHIA Submissions forms should be submitted to data@chiamass.gov. 

IMPORTANT: Clear your cache

As part of continuous improvement of the Nursing Facility Cost Reports, changes and upgrades have been implemented. In order for the system to function properly, all users should clear their web browser cache.  

Clearing your web browser cache will ensure that you are viewing the most recent version of SNF/MGT/REA Cost Reports. If you do not clear your cache, your browser may display older versions of the reports and generate error messages.

Instructions on how to clear your cache can be found at https://www.mass.gov/guides/clear-your-browser-cache.

Changes to the Cost Reports and Cost Report Filing Tips

In an effort to improve cost report data quality and promote a more efficient user experience, several updates have been made to the SNF/MGT/REA Cost Reports. Listed below are some of the most significant changes and other cost report filing tips for users when filing the reports:

• Save and Validate: CHIA has instituted a new loading screen for the SNF cost report when selecting “save and validate” for each schedule.
  
  
  • Please wait until the “save and validate” process is completed before moving to another schedule or exiting the application.
    
    
  • As a reminder, to “lock for review” on the Submission and Attestation schedule (Schedule 13 in the SNF-CR; Schedule 8 in the REA-CR and MGT-CR), users must “save and validate” each schedule sequentially starting with Schedule 1 of each cost report.
    
    

• Realty Company and Management Company Information: Schedule 1 of the SNF-CR will now automatically populate with the name(s) of your facility’s realty and/or management companies.
  
  
  • You must confirm whether this pre-populated data is accurate. If it is not correct for the CY 2024 period, contact CHIA at Costreports.LTCF@chiamass.gov. Please notify us as soon as possible of any needed corrections or updates.

• Reported Expenses, Non-allowable Expenses, and Add-backs: This year’s SNF-CR, Schedule 3 has split the reporting of non-allowable expenses and add-backs from one column into two.
  
  
  • As an improvement to the SNF-CR, reported expenses and certain other fields throughout the report that used to be restricted to positive entries only will now accept positive or negative values.
    
    
  • Add-backs should be entered as positive values, as applicable.
    
    
  • Non-allowable expenses must be entered as negative values.
    
    
  • The “total allowable expenses” column is the sum of reported expenses, add-backs, and non-allowable expenses.

• Nursing and Residential Care Facility Income: There is a new table in Schedule 2 of the MGT-CR to report additional detail on the management company’s Nursing and Residential Care Facility Income.
  
  
  • The new table requires management company income (e.g., management fees collected) to be reported broken down by facility for nursing and residential care facilities that are in Massachusetts.
    
    
  • The table includes a separate line to report income from non-Massachusetts facilities in aggregate.

• Uploads: Previously, users needed to upload files related to other disclosures. This year’s SNF-CR has incorporated data that was previously uploaded into fixed tables throughout the report and no longer requires these uploads. Note that uploads are still required in the REA-CR and MGT-CR.
  
  
  • Financial statements are still required as part of the SNF/MGT/REA Cost Reports. Note that “Financial Statements Unavailable” is no longer an option. Instead of uploading these files, they must be sent to data@chiamass.gov.
    
    
  • As in prior years, one of the required uploads in the MGT-CR is an organizational chart of the business structure. Pay close attention to the section of the MGT-CR instructions document regarding the organizational structure upload, as these instructions have changed for CY 2024 reporting. The organizational chart must depict the management company’s parent organization, if any, and it must show all entities (clinical or non-clinical) that are owned (wholly or partially) or controlled by the management company or the parent organization..

• As in prior years, pay close attention to two key areas of the cost report when preparing the SNF-CR:
  
  
  • Review the payer category for patient days recorded on the SNF-CR under Schedule 9, Table 2 (Patient Statistics – Days). This table, along with the rest of the cost report, is used to aid rate analysis for CHIA and EOHHS, and accuracy in reporting is crucial to the rate building process.
    
    
  • Ensure that you are following the instructions for reporting add-backs from the REA-CR and MGT-CR, where applicable.
    
    

Submitting SNF-CR XML Files

SNF-CR filers that want to submit cost report data via XML files must build new XML schemas for the updated SNF-CR. See “Process to Submit XML Test Files for the SNF-CR" for additional information on building and submitting XML test files.

Nursing Facility Cost Reports and Instructions for Reporting Year 2024

Nursing Facility Cost Report

• SNF-CR (Formerly the HCF-1)
  - The SNF-CR is filed via CHIA Submissions at https://chiasubmissions.chia.state.ma.us
• SNF-CR Technical Instructions and User Guide (PDF) | Word
• SNF-CR Pediatric and Special Contract Supplemental Form (Excel worksheet)
• SNF-CR Pediatric and Special Contract Instructions (PDF) | Word

Realty Company Cost Report Resources

• REA-CR: Technical Instructions and User Guide for the Realty Company Cost Report (PDF) | Word

Management Company Cost Report Resources

• MGT-CR: Technical Instructions and User Guide for the Management Company/Central Office Cost Report (PDF) | Word

Long-Term Care Facility Information Form

Complete and submit this form to costreports.LTCF@chiamass.gov if there were any changes in your facility’s owners, management, or realty company relationships, or if there are new or additional users accessing CHIA’s data submission systems (CHIA-INET/CHIA Submissions).

• Long-Term Care Facility Information Form (Excel worksheet)

User and Data Security Agreement Forms 

• Nursing Facility User Agreement (PDF) | Word
• Non-Confidential Data Security Agreement (PDF) | Word

Questions

For assistance with the nursing facility cost report, please email CHIA's Pricing Cost Report Help Desk at costreports.LTCF@chiamass.gov. Include the following information in the subject line of your email:

• Name of the facility and report you are asking about
• Reporting year

Subject Line example: Question on CY 2024 SNF-CR – ABC Nursing Facility