Medicare Ground Ambulance Data Collection System (GADCS) Section 9 (Vehicle Costs) Import Template											
"Please carefully read the instructions on this tab before entering data on the ""Ground Ambulance Vehicles"" and ""Other Vehicles"" tab. Failure to do so may result in errors when you import your responses in Section 9."											
											
OVERVIEW:  											
Ground ambulance organizations can respond to a set of Section 9 questions on vehicle costs by entering information for each vehicle individually via the web-based GADCS or by completing and importing this template. Use of the template is optional. Ground ambulance organizations with fewer than 10 total vehicles may find it easier to enter information vehicle-by-vehicle than to complete and import this template.											
"This template important information only for Section 9.1, Questions 1, 2, and 5, and Section 9.1, Questions 1, 2, and 5. You must respond to other Section 9 questions directly in the web-based GADCS instrument."											
											
INSTRUCTIONS: 											
"1.) Identify in-scope vehicles and costs: Section 9 asks about the vehicle costs for your ground ambulance organization. For the ""Ground Ambulance Vehicles Tab"" consider only vehicles that constitute ground ambulances in your jurisdiction, under your state or local regulations. For the purposes of this data collection instrument, ground ambulances include both land and water ambulances. Include all ground ambulances regardless of whether the ambulance transported patients or whether you billed for transports made by this ambulance. For the ""Other Vehicles"" tab, include vehicles that were used to respond to ground ambulance calls or support ground ambulance operations that are not groundambulances. These vehicles might include SUVs, trucks, QRVs, fly-cars, lead cars, or sprint vehicles, supervisory vehicles, or other types of vehicles. Do not include any vehicles on both tabs and do not include air ambulances in either tab."			

"Note: In general, do not include vehicles that were used by contracted entities rather than your own organization (e.g., SUVs used by vehicle maintenance contractors). The only exception is if you answer ""yes"" to the second response option in Section 2, Question 18: if you do, enter the primary ground ambulances (exclude non-ambulance vehicles) used by the organization with which you contract to provide emergency medical services, select ""Owned"" instead of ""Leased/Rented,"" and select ""Yes"" in the ""Donated"" column (described in more detail below)."
								
"2.) Read instrument instructions: It is important to check that your responses within each row are consistent with GADCS instructions. Otherwise, the GADCS will display error messages when you try to import the template. Please follow these rules:"											
"a.) For each vehicle listed in the ""Ground Ambulance Vehicles"" and ""Other Vehicles"" tabs, enter ""yes"" in only one of these two columns: (1) ""Owned""; (2) ""Leased/Rented"""											
"b). For each vehicle listed in the ""Ground Ambulance Vehicles"" and ""Other Vehicles"" tabs, enter ""yes"" in only one of these three columns: (1) ""Annual depreciation""; (2) ""Purchase Cost""; (3) ""Lease/rent cost"" or ""Annual lease expense"""											
"c.) Carefully read the template column list (below) to determine which questions are required for which vehicles. For example, ""Lease Cost"" is only required if you entered ""yes"" in the ""Leased/Rented"" column for the vehicle."											
"3.) Enter information in the ""Ground Ambulance Vehicles"" and the ""Other Vehicles"" tabs: Do not modify the layout of these tabs including Row 1. Enter information only in Columns A through K. Starting in Row 2 on the ""Ground Ambulance Vehicles"" tab, enter information separately for each ambulance vehicle, one vehicle per row. Next, starting in Row 2 on the ""Other Vehicles"" tab, enter information separately for each ""other vehicle"", one vehicle per row. If your organization does not own or lease/rent any vehicles other than ground ambulances, do not enter in any information on the ""Other Vehicles"" tab. Descriptions of each column heading listed below. When a column heading is not required for the given vehicle, leave the corresponding cell blank (see example at end). "											
"4.) Upload file: When you are finished inputting the required information, save the file and upload it in Section 9 of the GADCS. If there are errors, you will see error messages highlighting which cells contain errors."											
											
TEMPLATE COLUMN LIST:											
Ground Ambulance Vehicles											
"Name or ID of Ground Ambulance: Free-text response. Please provide a name (e.g., a vehicle number, license plate, or other identifier) for each vehicle. You can choose whatever name you would like but the names must be unique. Free-text response. Required for all ground ambulances."											
"Owned: Did your organization own (including vehicles that have been purchased, gifted, or donated)this ground ambulance? Enter ""Yes"" or ""No"". Required for all ground ambulances. Enter ""yes"" if you answered ""yes"" to the second response option in Section 2, Question 18 and if this ambulance is used by the organization from which you broadly contract EMS services."											
"Leased/Rented: Did your organization lease or rent this ground ambulance? Enter ""Yes"" or ""No"". Required for all ground ambulances."											
"Transport Patients: Was this ground ambulance was used to transport patients during the data collection period? Enter ""Yes"" or ""No"". Required for all ground ambulances. "											
"Donated: Was this ground ambulance donated? Enter ""Yes"" or ""No"". Required for ground ambulances where ""Owned"" is answered ""yes"" only. Enter ""yes"" if you answered ""yes"" to the second response option in Section 2, Question 18 and if this facility is used by the organization from which you broadly contract EMS services."											
"Annual Depreciation: What was the annual depreciation expense? Enter a positive integer. Enter an answer for ground ambulances where ""Owned"" is answered ""Yes"" only and your organization depreciated the cost of the vehicle. "											
"Purchase Cost: What was the purchase cost if purchased during your organization's data collection period and you did not report an annual depreciation expense? Required for ground ambulances purchased outright during the data collection period without a reported annual depreciation expense. Enter an answer for ground ambulances where ""Owned"" is answered ""Yes"" only. Enter $0 or a positive integer. Report $0 if you did not purchase the ground ambulance during the data collection period.  "											
"Other Annual Costs of Ownership: Annual loan interest or other costs of ownership not reported previously. Enter $0 or a positive integer. Required for ground ambulances where ""Owned"" is answered ""Yes"" only."											
"Remounted: Was this ground ambulance vehicle remounted during your organization's data collection period? ""Remounted"" is defined as putting a used/refurbished ambulance ""box"" (i.e., the back part) on a new chassis (i.e., the truck part). Enter ""Yes"" or ""No"". Required for ground ambulances where ""Owned"" is answered ""Yes"" only."											
"Remount cost: What was the cost to your organization for the remount? Enter a positive integer. Required for ground ambulances where ""Remounted"" is answered ""yes"" only."											
"Lease Cost: Total lease cost of the vehicle to your organization for this vehicle. Enter a positive Integer. Required for ground ambulances where ""Leased/Rented"" is answered ""Yes"" only. "											
Other Vehicles (Non-Ambulance)											
"Type of Non-Ambulance Vehicle: Type of Non Ambulance Vehicle. Note: Other response vehicle means vehicle that responds to emergencies but is not designed to transport patients (e.g., quick response vehicles, ""fly-cars"", lead cars, or ""sprint"" vehicles). If you select ""Other vehicle,"" include both the type of vehicle and an identifier in the ""Name/Description"" column. Enter ""Fire truck"", ""Land rescue vehicle"", ""Water rescue vehicle"", ""Other response vehicle"", or ""Other vehicle"". Required for all non-ambulance vehicles. Drop-down field pasted through the first 100 data entry rows; you must select one of the five provided options."											
"Name/Description: Please provide a name (e.g., a vehicle number, license plate, or other identifier) for each vehicle. You can choose whatever name you would like but the names must be unique. Your response should include both a vehicle type and identifier if you selected ""Other vehicle"" in the ""Type of Non-Ambulance Vehicle"" column. Free-text response. Required for non-ambulance vehicles. "	
										
"Owned: Did your organization own (including vehicles that have been purchased, gifted, or donated)this non-ambulance vehicle? Enter ""Yes"" or ""No"". Required for all non-ambulance vehicles."											
"Leased/Rented: Did your organization lease/rent this non-ambulance vehicle? Enter ""Yes"" or ""No"". Required for all non-ambulance vehicles."											
"Supported Ground Ambulance Operations?: Was this vehicle used to respond to ambulance calls or support ground ambulance operations during your organization's data collection period? Enter ""Yes"" or ""No"". Required for all non-ambulance vehicles. "						

"Donated: Was this vehicle donated? Enter ""Yes"" or ""No"". Required for vehicles where ""Owned"" is answered ""yes"" only."

"Annual depreciation: What was the annual depreciation expense? Enter a positive integer.  Enter an answer for vehicles where ""Owned"" is answered ""Yes"" only and your organization depreciated the cost of the vehicle."
			
"Purchase Cost: What was the purchase cost if purchased during your organization's data collection period and you did not report an annual depreciation expense? Enter $0 or a positive integer. Enter an answer for vehicles where ""Owned"" is answered ""Yes"" only.  Report $0 if you did not purchase the vehicle during the data collection period or if you reported an annual depreciation expense."											
"Other Annual Costs of Ownership: Annual loan interest or other costs of ownership not reported previously. Enter $0 or a positive integer. Required for ground ambulances where ""Owned"" is answered ""Yes"" only. "											
"% of Ground Ambulance Related Miles: What share of the vehicle's traveled miles were related to ground ambulance services? Enter an integer (i.e., a number without decimals or fractions) 1-100. Required for all non-ambulance vehicles."											
"Annual Lease Expense: What was the annual lease expense for this vehicle? Enter a positive integer. Required for non-ambulance vehicles where ""Leased/Rented"" is answered ""Yes"" only."											
											
Example: 											
"There is an example included on the tab called ""example"". It provides an example of a fire-based organization with four ground ambulance vehicles (three owned and one rented) and four non-ambulance vehicles (three owned and one rented). The organization calculates annual depreciation expenses for ground ambulance vehicles, but not for non-ambulance vehicles. This example illustrates what type of data an organization should put in each row and when cells should be left blank. This example is for illustrative purposes only and may not be representative of a typical organization. "											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
											
