2014-2015 Cost Report - AUPs
Click on links to forms below to view or download. All reports were due Dec. 31, 2015.
Please print instructions for any of the applications below prior to downloading.
For Microsoft Access 2013 or Higher
Please read instructions before beginning download.
Download "Adult Care Cost Report application for Access"
If you do not have a copy of Microsoft Access, please download a free RunTime version from Microsoft before continuing.
If you have trouble exporting your data file from the free RunTime version, please contact Susan Kesler at 919-855-3680
Submit a Report
Please read instructions before submitting your cost report. All adult care home with seven beds or more must be audited this year.
Exemptions
If your facility:
- Did not receive any State/County Special Assistance Funds or
- Does not bill Medicaid PCS
You should submit an Exemption Form. Do not complete a Cost Report.
Adult Care Homes with Six 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
- Agreed Upon Procedures not requires for six or less beds
Adult Care Homes with Seven 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 "Preview Report" button and follow the prompts.
- Instructions for Cost Report
Agreed Upon Procedures for Seven Beds or More
- Accountants Certification Form
- Adult Care Facilities
- ACF Attachments I, II and III
- Special Care Units
- SCU Attachments I, II and III
- Mental Health Facilities
- Attachments I, II and III
- Nursing Facilities
You can contact the following people if you have any questions or problems:
Susan Kesler, 919-855-3680, susan.kesler@dhhs.nc.gov
Fax: 919-715-3095
For Aup questions, email AUP.questions@dhhs.nc.gov