Nursing Facilities (Hospital Based) Cost Reports
Hospital-Based Nursing Facility providing Long Term (INC) and/or (SNC) Level of Care
Contact Information:
Michael D'Alessio or Bob Young
919-647-8060
Email: Mike.DAlessio@dhhs.nc.gov or Bob.Young@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.
IMPORTANT NOTICE: Transition to CMS 2540-10 and 2552-10 Cost Reporting formats for FYE 9/30/2012. See the attached memo for more details.
IMPORTANT NOTICE: All Hospital-based Nursing Facilities with 2011 cost report year ending on or before September 30, 2011 are required to complete and submit the North Carolina Medicaid Capital Data Survey 2011 to DMA with their cost report.
IMPORTANT NOTICE: All Hospital-based Nursing Facilities have been granted an extention to file their 2011 N.C. Medicaid Cost Reports. See the attached memo for exact dates extended--
Hospital-Based Nursing Facility with FYE 2011 through December 31, 2011
Hospital-Based Nursing Facility with FYE 2010 through December 31, 2010
If you want more information about the cost reporting software system requirements needed, please read the Software Installation Instructions.
Chart of Accounts for prospective Hospital-based nursing facility cost reports
Frequently Asked Questions
- 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.
- 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.
- When is the Medicaid cost report for Hospital-based Nursing facilities due to be filed?
Hospital-based Nursing facility cost reports must be filed no later than five months (150 days) after the facility FYE or concurrently with the Medicare cost report.
- If my Hospital-based nursing facility has low Medicaid utilization, will we automatically be exempted from filing a Medicaid cost report?
No, a yearly written waiver request must be sent to the DMA Audit Section (attn: Michael D'Alessio, Audit Manager). You may e-mail to Mike.DAlessio@dhhs.nc.gov or send a fax using FAX number 919-715-4711.
- What are the established cost limitations for the Hospital-based NF having a fiscal year ending on or after September 30, 2003?
The cost limitations are as follows:
Director's Fees: $2,400 annually or $200 per meeting
Owner or Administrator Salary:
$57,097 (1-50 beds)
$69,336 (51-99 beds)
$73,414 (100-149 beds)
$79,006 (150-199 beds)
$89,724 (200-249 beds)
Do not make adjustments for these limitations. The Audit Section will review and apply limitations.
- On the Hospital-based nursing facility cost report, are the compensation amounts reported on Schedule A-3 based on DMA limitation amounts?
No, compensation reported on the Hospital-based cost report, Schedule A-3, should not be based on DMA limitation amounts. Report compensation after any applicable adjustments on Schedule A-2 for non-allowable amounts.The Audit Section will review compensation and apply limitations. Do NOT make adjustments to the Hospital-based nursing facility filed cost report for the DMA limitations.
- If the hospital CEO functions as the nursing facility administrator, is a portion of the CEO’s salary allocated to the nursing facility?
No, the salary for the CEO functioning as the nursing facility administrator is reported in the Administrative and General Cost Center. Administrative and General Cost Center expenses are indirect expenses allocated on Schedule B to the appropriate cost center line.
Medicaid Providers