Providers under contract with the North Dakota's Health and Human Services should use the attached Microsoft Excel files to complete their cost reports or budget reports. Cover letters containing directions and related information for the various cost reports may appear next to the cost report documents.
Note: The links require that you have Microsoft Excel on your computer. If you do not, you may download a free Excel viewer from the Microsoft website.
Basic Care Facilities
This cost report will be used to establish rates beginning July 1, 2023. See the cost report letter for details.
- Basic Care Facility Cover Letter (93kb PDF)
- Basic Care CPA Authorization - Printable/Fillable (Word document)
- Basic Care Cost Report - Template (Excel)
- Basic Care Cost Report Schedule C-2/Allocation for Cost Center Component with Identified Direct Costs (Excel)
Nursing Home Facilities
This cost report will be used to establish rates beginning Jan. 1, 2023. See the cost report letter for details.
- Nursing Facility Cover Letter (107kb PDF)
- NH-CPA Authorization - Printable/Fillable (Word document)
- Nursing Facility Cost Report - Template (Excel) (Updated 6/9/2022)
- Nursing Facility Cost Report Schedule T/Bad Debt Costs (Excel - updated 5/31/2022)
- Nursing Facility Cost Report Schedule C/Allocation for Cost Center Component with Identified Direct Costs (Excel)
Psychiatric Residential Treatment Facilities
This cost report will be used to establish rates beginning Jan. 1, 2023. See the cost report letter for details.
- Psychiatric Residential Treatment Facilities (PRTF) Cover Letter
- PRTF-CPA Authorization - Printable/Fillable
- PRTF Cost Report - Template (Excel)