Intermediate Care Facility - Individuals with Intellectual Disabilities (ICF-IID) Cost Report

Download the “Guidance for Cost Report Preparation” document below for specific Medical Assistance requirements that must be followed when preparing the cost reporting forms.

Cost reports must be filed by the due date listed below. Medical Assistance does not plan to grant extensions except in the case of natural disasters; e.g., fires and floods. Medical Assistance does not normally permit amended cost reports except under certain circumstances.

ICF-IID Facility FYE 6/30/2019

Guidance for Cost Report Preparation for ICF-IID Group Home FYE 6/30/2019

FY2019 ICF-IID Provider Health Care Assessment Tax Schedules

Chart of Accounts

Chart of Accounts for FYE 2019 ICF/IID Facilities

Cost Limitations for ICF-IID Cost Reports for fiscal year ended June 30, 2018

Medical Director: $250 per bed annually

Management Fees: $7.13 per patient day

Capital/Lease Costs: $6,546 annually per bed

Director's Fees: $2,400 annually or $200 per meeting

Owner or Administrator Salary:

  • $57,570 (1-50 beds)
  • $69,912 (51-99 beds)
  • $74,024 (100-149 beds)
  • $79,660 (150-199 beds)
  • $90,469 (200-249 beds)

Cost Limitations for ICF-IID Cost Reports for fiscal year ended June 30, 2017

Medical Director: $250 per bed annually

Management Fees: $7.13 per patient day

Capital/Lease Costs: $6,546 annually per bed

Director's Fees: $2,400 annually or $200 per meeting

Owner or Administrator Salary:

  • $57,570 (1-50 beds)
  • $69,912 (51-99 beds)
  • $74,024 (100-149 beds)
  • $79,660 (150-199 beds)
  • $90,469 (200-249 beds)

Contact

NC Medicaid Finance Section
Phone: 919-527-7160
Fax: 919-716-0600
Email: medicaid.LTCCostReport@dhhs.nc.gov