Instructions for Reading the Section 5506 Final Awards Spreadsheet - Round 19:
This spreadsheet contains the results of the FTE resident cap slot redistribution under the nineteenth round of section 5506 of the ACA, Preservation of Resident Cap Positions from Closed Hospitalsdue to the closure of Astria Regional Medical Center (ARMC) in Yakima, WA on January 15, 2020.
There are three tabs in this spreadsheet.  The second tab of this spreadsheet, labeled 'Astria Awards', lists the hospital that was awarded FTE resident cap slots from the closure of ARMC.  The third tab of this spreadsheet, labeled 'Remaining Applicants', lists the hospitals that were not awarded FTE resident cap slots under round 19.
On the 'Astria Awards' tab of this spreadsheet, you will find the following information:
* Column A contains the CMS Certification Number (CCN). 
* Column B contains the total IME slots awarded to the hospital. There are both section 422 of the MMA and non-section 422 slots associated with the IME awards.
* Column C contains the portion of the IME slots awarded to the hospital that are not section 422 slots - they are associated with the non-section 422 portion of ARMC's IME resident cap.
* Column D contains the portion of the IME slots awarded to the hospital that are associated with the increase that ARMC received under section 422 of the MMA, and are to be paid using the appropriate IME multiplier of 0.66 (see 42 CFR 412.105(d)(4) and 85 FR December 29, 2020, p. 86260).
* Column E contains the IME slots effective July 1, 2019.
* Columns F and G contain the IME slots effective July 1, 2020.
* Column H contains the IME slots effective the later of July 1, 2020 or as needed.
* Column I contains the IME slots effective the later of July 1, 2021 or as needed.
* Column J contains the IME slots effective as needed.
* Column K contains the total DGME slots awarded to the hospital.  There are both section 422 of the MMA and non-section 422 slots associated with the DGME awards.
* Column L contains the portion of the DGME slots awarded to the hospital that are not section 422 slots - they are associated with the non-section 422 portion of ARMC's DGME resident cap.
* Column M contains the portion of the DGME slots awarded to the hospital that are associated with the increase that ARMC received under section 422 of the MMA, and are to be paid using the appropriate locality-adjusted national average Per Resident Amount (see 42 CFR 413.77(g) and 85 FR December 29, 2020, p. 86260).
* Column N contains the DGME slots effective July 1, 2019.
* Column O contains the DGME slots effective July 1, 2020.
* Columns P and Q contain the DGME slots effective the later of July 1, 2020 or as needed.
* Column R contains the DGME slots effective the later of July 1, 2021 or as needed.
* Column S contains the DGME slots effective as needed.
* Column T contains the hospital's Medicare Administrative Contractor (MAC).
Please read across the entire row to find all of the effective dates for the hospitals total section 5506 IME and DGME slots awarded, respectively. Please note that a hospital may be receiving FTE resident cap slots with staggered effective dates for various reasons. Section 5506 requires no duplication of FTE slots. That is, because some hospitals receive temporary FTE resident cap slots under the regulations at 42 CFR 413.79(h) associated with displaced residents, no permanent FTE resident cap slots may be assigned under section 5506 until those temporary FTE resident cap slots have expired. Please refer to the August 31, 2012 Federal Register (77 FR 53437-53445) and the August 22, 2014 Federal Register (79 FR 50129-50134) for more information on effective dates under section 5506.  Please also note whether the award amount in a particular column is or is not associated with section 422 of the MMA cap slots.  The IME and DGME section 422 award slots are to be separately reported on your Medicare cost report and paid using the appropriate IME multiplier and DGME locality-adjusted national average Per Resident Amount.  

