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2014 - 2015 Cost Reports

(click on links to forms below to view or download)


How to send the Adult Care Cost Report to the Office of the Controller

Please print instructions before submitting your cost report.

All Adult Care Homes with 7 beds or more must be audited this year.

Exemptions

If your facility:

  • Did NOT receive any State/County Special Assistance Funds
  • Does NOT bill Medicaid PCS

You should submit an Exemption Form.   DO NOT complete a Cost Report.   Exemptions are due December 31, 2015.

Adult Care Homes with 6 beds or less

  • To obtain BLANK FORMS, download the appropriate "Adult Care Cost Report program ". See link above.

  • After downloading/installing application, click on "Print Report" button and follow the prompts.

  • Instructions for Cost Report - instr62015.pdf

  • Agreed Upon Procedures: NOT REQUIRED for 6 or less beds

Adult Care Homes with 7 or more beds

  • To obtain BLANK FORMS, download the "Adult Care Cost Report program " that you need. See the links above. After downloading application, click on "Print Report" button and follow the prompts.

  • Instructions for Cost Report - instr72015.pdf

Contact the people below if you have questions/problems:


City/Area Name Phone E-mail
Raleigh Susan Kesler Sibbett 919-855-3680 Susan.Sibbett@dhhs.nc.gov
Raleigh Paul Cole 919-855-3685 Paul.J.Cole@dhhs.nc.gov
Raleigh FAX 919-715-3095  
Raleigh AUP questions   AUP.Questions@dhhs.nc.gov

 

 

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