User Guide for the Cost Data Collection Instrument

Paid

Applies to All 

If Applicable

Hours Worked Annually (unrelated to ground  ambulance or  fire/police duties) 

Total Hours Annually   (for those with  fire/police duties) 

Number of  Staff  

Total Annual  Compensation 

Total Annual  Hours 

Provider 

EMT‐B  EMT‐I  EMT‐P  Nurse, Dr., resp. therapist, other  EMR  Ambulance driver (non‐EMR or EMT)  Admin (clerical, HR, Billing, IT, etc.)  Management (executives, officers) 

EMT/ 

Response 

Dispatch/call center  Vehicle maintenance  Facilities maintenance  Other 

Administration /Facilities 

MD 

Medical Director 

Volunteer 

Applies to All 

If Applicable

Hours Worked Annually (unrelated to ground  ambulance or  fire/police duties) 

Total Hours Annually   (for those with  fire/police duties) 

Number of  Staff  

Total Annual  Compensation 

Total Annual  Hours 

Provider 

EMT‐B  EMT‐I  EMT‐P  Nurse, Dr., resp. therapist, other   EMR  Ambulance driver (non‐EMR or EMT)  Admin (clerical, HR, Billing, IT, etc.)  Management (executives, officers) 

EMT/ 

Response 

Dispatch/call center  Vehicle maintenance  Facilities maintenance  Other 

Administration /Facilities 

MD  Medical Director  *For agencies that have a parent organization, you will need to track and allocate to your NPI the portion of  administrative labor costs incurred at the level of the parent organization, based on your organizational  approach for allocating costs to specific NPIs. 

What happens if you answer no for paid and  volunteer? 

If you answer no to both paid and volunteer for any category, you will be asked why.  The system will provide  you with three default responses:   This labor category is part of our ground ambulance operation but is paid for or provided at no cost by  another entity.  o If selected, you will be asked to report associated annual hours and associated costs.   One or more staff perform these functions but we assigned them to another category per the  instructions    We do not have staff in this category and/or we contract with another organization for this role

© 2020 Cornerstone Adminisystems, Inc.                                                                          

       Page | 14 

23 Old Depot Road, New Cumberland, PA 17070