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Finance Management - Audit Section
Phone (919) 647-8060
The Audit Section has a staff of 31 individuals and has the responsibility of settling cost reports from nursing facilities, intermediate care/mental retardation facilities, hospital-based nursing facilities, federally qualified health centers, rural health clinics, and State-owned hospitals. Desk audits are performed by DMA auditors while field audits are performed by both DMA and contract auditors. In addition, audits are performed on area mental health programs, health departments, psychiatric residential treatment facilities, and therapeutic foster care facilities. Financial and statistical data are summarized from cost reports to assist DMA in administering the reimbursement of these providers and in rate setting.
Frequently Asked Questions
- General Questions
- FQHC/RHC Providers
- Hospital-Based NF Providers
- ICF/MR Providers
- Nursing Facility Providers
General Questions
I need to obtain the cost reporting software package. How can I do this?
The cost reporting software, user manual, and Guidance for Cost Report Preparation document package can be downloaded from the DMA web site if you have a PC with Internet access using the following URL address: http://www.ncdhhs.gov/dma/dmamain.html
I have questions regarding the software and its operation. Whom do I contact?
You should refer to the software User Manual available at the DMA download website for your particular version of software. If that document does not answer your question and you need assistance regarding the software and its operation, please contact the Division of Information Resource Management helpdesk at (919) 855-3200.
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 DMA memo for further explanation by clicking the following link: Cost Report Extension.
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. You must contact the Audit Manager, Michael D'Alessio at (919) 647-8060 or via e-mail at Mike.DAlessio@ncmail.net to obtain guidance and approval before submission.
What is the correct address to use when mailing or shipping cost report documents or other information to the Audit Section?
Use the address appropriate to your shipping method:
US Mail:
Audit Section
Division of Medical Assistance
2501 Mail Service Center
Raleigh, NC 27699-2501
Express Mail/Shipping:
Audit Section
Division of Medical Assistance
One Bank of America Plaza
421 Fayetteville St.
Raleigh, NC 27601
How do I know what changes have been made to the Medicaid Cost Report forms or software for the new fiscal year?
DMA Audit Section publishes a special directive called the Guidance for Cost Report Preparation each fiscal year for ICF/MR and Nursing facility providers that announce any relevant changes or new requirements for the Medicaid Cost Report. You may review the document by clicking the software download request link shown here or download a copy from the DMA website given above.
Is the North Carolina Medicaid State Plan available on DMA's web site?
Yes, you will find a link to the document on the DMA website or you may use the following URL address: http://www.ncdhhs.gov/dma/sp.htm
Is the CMS Pub 15 Provider Reimbursement Manual available on a web site?
Yes, you may review the document on-line or download a copy from the
following URL address:
http://cms.hhs.gov/manuals/PBM/list.asp
I have questions concerning Owners and Owner Related Compensation Documentation requirements. Where can I find information on this subject?
You will find the DMA policy guidelines using the following link: Owner/Relative Comp Guide.
If I do not have Internet access but I do have e-mail capability, can the cost report software package be e-mailed to me?
If you have e-mail capability, you may send your request with your Name, Address, City, State, Zip and the type (ICF/MR, Nursing, etc.) facility cost report package needed to DMA.Audit.software@ncmail.net
Ask your local library if they have computer access to the internet available for members and you may be able to download the software that way.
Whom should I contact regarding fraudulent information reported on a Medicaid cost report?
Matters concerning suspected fraudulent information on a Medicaid cost report can be reported to: DMA Audit Section -- (919) 647-8060 or Medicaid Investigations Unit -- (919) 881-2320
ICF/MR Providers
When is the Medicaid cost report for ICF/MRs due to be filed?
ICF/MR cost reports with a fiscal year ending June 30, 2008 must be filed by October 1, 2008.
I have questions regarding the cost reporting forms for an ICF/MR facility. Whom do I contact?
If you need assistance with the cost reporting forms for an ICF/MR facility, please contact Michael D'Alessio at (919) 647-8060 or via e-mail at Mike.DAlessio@ncmail.net
Is the Chart of Accounts available on-line for the FYE 2008 ICF/MR cost reports?
Yes, you may use the Chart of Accounts for FYE 2008 ICF/MR Facilities hyperlink to review the document on-line or to download a copy.
Is the Chart of Accounts available on-line for the FYE 2007 ICF/MR cost reports with the new added Health Care Assessment and Piedmont Initiative criteria?
Yes, you may use the Chart of Accounts for FYE 2005, 2006 & 2007 ICF/MR Facilities hyperlink to review the document on-line or to download a copy.
Is the Chart of Accounts available on-line for FYE 2004 and prior period ICF/MR cost reports?
Yes, you may use the Chart of Accounts for FYE 2004 ICF/MR Facilities hyperlink to review the document on-line or to download a copy.
Has DMA changed its policy on the reporting of General and Professional Liability Insurance costs on the ICF/MR facility cost report?
Yes, prior to FY2003, General & Professional Liability Insurance costs were reported on the cost report in the Administrative & General cost center. Effective FY2003, General & Professional Liability Insurance costs can be allocated to all cost centers reporting salary expenses. The cost is to be reported on the employee benefits line. See DMA memo for further explanation by clicking the following link ICF/MR Liability Insurance Memo.
What are the established cost limitations for the ICF/MR cost reports for fiscal year ended June 30, 2008?
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)
What are the established cost limitations for the ICF/MR cost reports for fiscal year ended June 30, 2007?
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)
Nursing Facility Providers
When is the Medicaid cost report for Nursing facilities due to be filed?
Nursing facility cost reports with a fiscal year ending September 30, 2008 must be filed by December 31, 2008.
I have questions regarding the cost reporting forms for a Nursing facility. Whom do I contact?
If you need assistance with the cost reporting forms for a Nursing facility,
please contact Michael D'Alessio at (919) 647-8060 or via e-mail at Mike.DAlessio@ncmail.net
What are the established cost limitations for the Nursing facility cost reports for fiscal year ended September 30, 2008?
The cost limitations for FY 2008 are as follows:
(1) Director's Fees: $2,400 annually or $200 per meeting
(2) 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)
What are the established cost limitations for the Nursing facility cost reports for fiscal year ended September 30, 2007?
The cost limitations for FY 2007 are as follows:
(1) Director's Fees: $2,400 annually or $200 per meeting
(2) 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)
What exactly is a Geropsychiatric care unit?
Geropsychiatric care is a separate setting for nursing facility level of care individuals with long-term psychiatric and behavioral health needs and who exhibit challenging and difficult behaviors that are beyond the management capacity of traditional skilled nursing home facilities in community-based facilities.
Has the Chart of Accounts changed to appoint specific line items for Geropsychiatric service expenses for freestanding Nursing facilities?
Yes, the Chart of Accounts for FYE 2009 Free Standing Nursing Facilities has been changed to allow eligible providers to utilize Line items 477 through 486 to record either Geropsychiatric costs or HEAD Injury expenses but not both.
Will the cost report be changed to allow Geropsychiatric costs to be reimbursed for FYE 9/30/2009?
Yes, the cost report will be changed to allow eligible providers to
document Geropsychiatric costs using the existing HEAD Injury data entry
schedules. At this time, a user may input either HEAD Injury costs or
Geropsychiatric costs but not both.
Is the Chart of Accounts available on-line for the prospective FYE 2008 Nursing facility cost reports?
Yes, you may use the Chart of Accounts
for FYE 2005, 2006, 2007 & FYE 2008 Free Standing Nursing Facilities hyperlink
to review the document on-line or to download a copy.
Is the Chart of Accounts available on-line for the prospective FYE 2004 Nursing facility cost reports?
Yes, you may use the Chart of Accounts
for FYE 2004 Free Standing Nursing Facilities hyperlink to review
the document on-line or to download a copy.
Is the Chart of Accounts available on-line for FYE 2003 and prior period Nursing facility cost reports?
Yes, you may use the Chart of Accounts for FYE 2003 Free Standing Nursing Facilities hyperlink to review the document on-line or to download a copy.
Has DMA changed its policy on the reporting of General and Professional Liability Insurance costs on the Nursing facility cost report?
Yes, prior to FY2001, General & Professional Liability Insurance
costs were reported on the cost report in the Administrative & General
cost center. Effective FY2001, General & Professional Liability Insurance
costs can be allocated to all cost centers reporting salary expenses.
The cost is to be reported on the employee benefits line. See DMA memo
for further explanation by clicking the following link Liability
Insurance Memo.
I have questions concerning Quality Assurance Staffing requirements.
Where can I find information on this subject? You will find the DMA
policy guidelines using the following link NF
QA Staffing Guide.
Hospital-based NF Providers
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.
I have questions regarding a Hospital-based nursing facility cost report. Whom do I contact?
If you need assistance with cost reports for Hospital-based nursing facilities, please contact Michael D'Alessio or Bob Young at (919) 647-8060 or via e-mail at Mike.DAlessio@ncmail.net or Bob.Young@ncmail.net
If you have questions about using the new Supplemental Schedules A or
B-1 recently added to the software, please refer to the new supplemental
form instructions using the following link: Supp
Sch A & B-1 Instructions.
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). Use the mailing address shown
at the top
of the page for general correspondence or you may e-mail to Mike.DAlessio@ncmail.net or send a fax using FAX number (919)715-4711.
Is the Chart of Accounts available on-line for the prospective 2008 Hospital-based nursing facility cost reports?
Yes, you may use the Chart of Accounts
for FYE 2005, 2006, 2007 & FYE 2008 Hospital-based Nursing Facilities hyperlink
to review the document on-line or to download a copy.
Is the Chart of Accounts available on-line for the prospective FYE 2004 Hospital-based nursing facility cost reports?
Yes, you may use the Chart of Accounts for
FYE 2004 Hospital-based Nursing Facilities hyperlink to review
the document on-line or to download a copy.
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:
(1) Director's Fees: $2,400 annually or $200 per meeting
(2) 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.
If the DON performs some administrative duties, should that portion of salary be allocated to the Administrative and General Cost Center?
No, the Director of Nursing expenses are reported to the Nursing Cost Center.
FQHC/RHC Providers
I need to obtain the annual Medicaid cost reporting forms for a Federally Qualified Health Center (FQHC) and/or a Rural Health Clinic (RHC). How can I do this?
The cost reporting forms and instruction package may be downloaded from the DMA web site if you have a PC with Internet access using the following URL address: http://www.ncdhhs.gov/dma/icfmr/fqhccost.htm
If you do not have Internet Access capability but you do have e-mail capability, you may send your request with your Name, Address, City, State, Zip and the type facility (FQHC or RHC) cost report package needed to Ronald.Fulton@ncmail.net .
Ask your local library if they have computer access to the Internet available for members and you may be able to download the software that way.
If you do not have e-mail contact Ronald Fulton DMA Audit Section at (919) 647-8064 and request a package.
Has the 2008 cost report forms and instructions changed from the prior year?
No. There are only updates to the dates on the forms from 2007 to 2008. The National Provider Identifier (NPI) number was added to the 2007 cost report per CMS requirements and the legacy Medicaid provider numbers are still required in addition to the NPI number(s) to facilitate proper claims processing by the Intermediary. If you do not have an NPI number at this time, be aware CMS is requiring all providers to be in compliance by May 23, 2008. Visit the CMS website for more information at NPI Overview .
How do I find out my PPS rate for line 2 of the PPS Reconciliation schedule?
You should have received a letter from DMA regarding your PPS rate. If you do not have a letter, contact DMA Rate Setting Sherrill Johnson at (919) 855-4209.
Last updated September 18, 2008