Using UDS with the FQHC cost report

Boards of FQHCs often see UDS as a compliance filing for HRSA and the cost report as a Medicare document. Payers, grantors, and the health center's own finance team then work from three different pictures of the same year.

Treat UDS tables (visits, patients, income, staffing) as the statistical spine of the cost report and the 330 budget. When sliding-fee visits, enabling services, and contracted specialists are coded one way in the EHR and another way on Worksheet S, wrap payments and grant narratives both drift.

A one-day diagnostic is usually enough to see whether finance, quality, and grants are reconciling to the same visit. If they are not, the fix is a crosswalk, not another dashboard.

We build that crosswalk so the CFO can walk into a HRSA or board meeting with one set of facts: who was seen, what it cost, and what the PPS wrap and grants actually covered.