2020-2021 Cost Report AUPs

Click on links to forms below to view or download. All reports are due Sept. 30, 2021. 

For Microsoft Access 2016 or Higher

Please read instructions for any of the applications below prior to downloading.

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 on how to submit the Adult Care Report. All adult care home with seven beds or more must also submit Agreed Upon Procedures (AUPs).

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.  

Mental Health Group 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 "Preview Report" button and follow the prompts.
  • Instructions for Cost Report
  • Agreed Upon Procedures are not required for facilities with six beds or less.

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

Schedule F Position Titles with Definitions

Agreed Upon Procedures for Seven Beds or More

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