Adult Care Facilities
2013-2014 Cost reports
(click on high-lighted forms below to view or
- All reports are due December 31, 2014
Please print instructions for any of the applications below prior to downloading. Instructions are in Microsoft Word.
NOTE: If your application does not have a printer icon, hold down control
+ P to print.
- Download this version if you already have Microsoft Access 2003 on your
PC. If you have Microsoft Access 2007 proceed to Step #2. If you do not
have Access at all or have Access 2000 or 2002 proceed to step #2.
Please print instructions before beginning download
Click to download "Adult Care Cost Report application for Access 2003" (Updated 10/01/2014)
- If you are using a version of Microsoft Access newer than 2003 to complete the cost reports.
Please print instructions before beginning download.
Click to download "Adult Care Cost Report application for Access 2007" (Updated 10/01/2014)
“NEW” Instructions for sending the Adult Care Cost Report to the Office of the Controller
This year we have new instructions on how to electronically file your cost report and what documentation needs to be sent to the Office of the Controller.
Instructions for how to complete and submit the Cost Report - print instructions.
All Adult Care Homes with 21 beds or more must be audited this year.
If your facility did NOT receive any State/County Special Assistance Funds and you DO NOT bill Medicaid PCS, you should submit an Exemption Form. DO NOT fill out a Cost Report.
Exemption Form - exem2014.pdf
Adult Care Homes with 7 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 "Print Report" button and follow the prompts.
Instructions for Cost Report - instr72014.doc
Agreed Upon Procedures: for 21 beds or more (Revised 10/31/2014)
Contact people below if you have questions/problems:
November 23, 2014