User Guide for the Cost Data Collection Instrument

Facilities Costs  CMS has broken this section down into three basic parts: 

 Facility Information   Lease/Mortgage Costs   Insurance, Maintenance, Utilities & Taxes 

Facility Information 

If a shared  service, % of  square  footage  attributable  to ground  ambulance  services 

If facility was  donated (no  cost, except  maintenance,  utilities,  insurance &  taxes) 

If your agency  or another  owns but has  a mortgage 

If your agency  or another  owns outright 

If your agency  or another  rents 

Square  Footage 

Facility  ID/Function 

Facility 1  Facility 2  Facility 3  Etc. 

 You should include anything used for call center/dispatch, vehicle storage, and admin/EMT staff     You should not include facilities used by contracted entities that your agency does not occupy itself, e.g.  a call center to which you pay a monthly fee for call services   If you had one building in which all functions occurred, list only that that one building   In those cases where non‐ambulance operations also occur, CMS states you can use your “best  estimate.”  For agencies that are fire department‐based:  o Do not include garage, storage and staff areas used for fire response  o Do include a share of office and common spaces related to both ambulance and other activities  that is in proportion to your share of total responses that are ground ambulance responses, e.g.  if half your calls are EMS, list half the square footage as the share

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