Hospital Cost Report

Hospitals - NCDHB E-5

• Acute Supplemental E-5 Instructions and Schedule FYE 2018
• CAH E-5 Instructions and Schedule FYE 2018
• Supplemental E-5 Instructions and Schedule FYE 2017
• CAH E-5 Instructions and Schedule FYE 2017
• Supplemental E-5 Instructions and Schedule FYE 2016
• CAH E-5 Instructions and Schedule FYE 2016
• Treatment of Hospital Provider Assessment (Provider Tax) in Medicaid Cost Reports

DSH / MRI / GAP Information

• Notice to Non-public Hospitals that are eligible to receive Medicaid Enhanced Payments - 05/01/18
• Hospital Schedule B for DSH - Due with Cost Report
• Rate Adjustment Eligibility Worksheet - 9/19/18 - Due Oct. 19, 2018
• Hospital Schedules A and C for DSH - 9/19/18 - Due Oct. 19, 2018
• Hospital Cost Report Information Sheet
• Hospital Change Form

Archive

Contacts

NCDHB E-5
NC Medicaid Finance Section
Phone: 919-814-0030
Fax: 919-814-0031

DSH Schedule A, B and C
NC Medicaid Finance Section
Phone: 919-527-7179
Fax: 919-716-0600