Mental Health Residential Treatment Cost Report

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2008 Mental Health Residential Treatment Cost Report

• New!!! Clarification of Cost Reporting Requirements
• Cost report due date extended for calendar year providers
• Cost Report (Excel)
  The cost report includes:
  • Schedule A - Overall/General Information
  • Schedule A-1 - Facility Specific Information
  • Schedule B - Revenues
  • Schedule C - Expenses
  • Schedule C-1 - Medicaid HRI-R Expenses
  • Schedule C-2 - Position/FTEs
  • Schedule D - Related Party Transactions
• Instruction Manual
• Appendices
  • A - Provider Letter
  • B - Exemption Form
    • Adobe
    • Word
  • C - Training Registration Form - Registration deadline October 26, 2007
  • D - Provider Qualifications
  • E - Questions and Answers
  • F - Review Sheet
• Cost Report Survey
  • Adobe
  • Word

Contact Information:

Elizabeth John
Rate Setting/Financial Management
DHHS-Division of Medical Assistance
Phone: 919-855-4218
Fax: 919-715-2209
E-Mail: Elizabeth.John@ncmail.net

Last updated May 8, 2008