Intermediate Care Facility - Individuals with Intellectual Disabilities (ICF-IID) Cost Report

Download the “Guidance for Cost Report Preparation” document below for specific Medical Assistance requirements that must be followed when preparing the cost reporting forms. More information is available about installing the cost reporting software or system requirements.

Cost reports must be filed by the due date listed below. Medical Assistance does not plan to grant extensions except in the case of natural disasters; e.g., fires and floods. See Cost Report Extension. Medical Assistance does not normally permit amended cost reports except under certain circumstances.

ICF-IID Facility FYE 6/30/2017

ICFIID17 (ICFMR) User Manual

Guidance for Cost Report Preparation for ICF-IID (ICF/MR) Group Home FYE 6/30/2017

FY2017 ICF-IID Provider Health Care Assessment Tax Schedules

Chart of Accounts

Cost Limitations for ICF-IID (ICF/MR) Cost Reports for fiscal year ended June 30, 2017

Medical Director: $250 per bed annually

Management Fees: $7.13 per patient day

Capital/Lease Costs: $6,546 annually per bed

Director's Fees: $2,400 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)

Cost Limitations for ICF-IID (ICF/MR) Cost Reports for fiscal year ended June 30, 2017

Medical Director: $250 per bed annually

Management Fees: $7.13 per patient day

Capital/Lease Costs: $6,546 annually per bed

Director's Fees: $2,400 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)

Contact

Medical Assistance Finance Section
Michael D'Alessio
Phone: 919-814-0030
Fax: 919-814-0031
Email: Mike.DAlessio@dhhs.nc.gov