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NC Department of Health and Human Services
NC Division of
Medical Assistance
 
 

ICF-IID Home Office Cost Reports (formerly ICF/MR)

Home Office or Related Party Organization supporting Long Term Care
Intermedial Care Facility - Individuals with Intellectual Disabilities (ICF-IID)

Contact Information:

Michael D'Alessio
919-814-0030
Email: Mike.DAlessio@dhhs.nc.gov

You will need to download the Instructions for Cost Report Preparation document as it contains specific DMA requirements that must be followed when preparing the cost reporting forms. 

The free Adobe Acrobat Reader is required to view and print PDF files.

Home Office ICF-IID (ICF/MR) FYE 6/30/2014

Home Office ICF-IID (ICF/MR) FYE 6/30/2013

 If you want more information about installing the cost reporting software or system requirements needed, please click here.

Each cost reporting package runs as a DOS base program and is capable of running using Windows screens on IBM compatible Personal Computers. Computers using IBM PC-DOS© or Microsoft MS-DOS 5.0© and higher, Windows© 3.1, 95, 98, ME, NT, XP and Win2000© machines. 

Chart of Accounts

Cost Limitations for ICF-IID (ICF/MR) Cost Reports for fiscal year ended June 30, 2014

The cost limitations are as follows: 

  • Medical Director: $250 per bed annually
  • Management Fees: $7.13 per patient day
  • Capital/Lease Costs: $6,546 annually per bed
  • Director's Fees: $2400 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/MR Cost Reports for fiscal year ended June 30, 2013

The cost limitations are as follows: 

  • Medical Director: $250 per bed annually
  • Management Fees: $7.13 per patient day
  • Capital/Lease Costs: $6,546 annually per bed
  • Director's Fees: $2400 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)

Frequently Asked Questions

  1. Will DMA grant an extension for filing a cost report beyond the due date?
    DMA does not plan to grant extensions except in the case of natural disasters, i.e. fire, floods etc.  Otherwise, cost reports must be filed by the due date. See the Cost Report Extension (21 KB) memo for further explanation.
  2. If I need to amend a cost report after it has been filed, what are the steps to do this?
    DMA does not normally permit amended cost reports except under certain circumstances.

 

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