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Expenses Per Patient Day
Average Staffing Cost per Hour
Average Hours Per Patient Day
Recap of Total Expenses, Rate Calculation
Recap of Patient Day Expense, Rate Calculation
Other Reports
Cumulative Rate Listing
Semi-Annual Statistical Report - NF - Section 1
Semi-Annual Statistical Report - NF - Section 2
Semi-Annual Statistical Report - NF - Section 3
Special Care Unit Add-On
Alzheimer Days
Report Card Score
Medicare Cost Report Statewide Averages Report
Cumulative Rate Listing - State Nursing Facility
Forms
Nursing Facility Cost Report
Nursing Facility Cost Report - Instructions
Nursing Facility Cost Report - Home Office
Nursing Facility Cost Report - Home Office - Instructions
Nursing Facility Quality Assessment Data Collection Form
Nursing Facility Quality Assessment Data Collection Form - Instructions
Nursing Facility Medicare/Medicaid Reconciliation Form
Nursing Facility Medicare/Medicaid Reconciliation Form - Instructions
Change in Ownership - Checklist of Management's Representations
Certification for Non-Medicare Certified Facilities
Nursing Facility Cost Report - State
Nursing Facility Cost Report - State - Instructions
Data Collection Form - New Facilities only
Instructions for Data Collection Form - New Facilities only
Cost Report Internal Control Questionaire - PDF Version
Cost Report Internal Control Questionaire - Electronic Version
Cost Report Internal Control Questionaire Instructions
Tables
CMS Nursing Home Without Capital Market Basket
Mortgage Index Table
R.S. Means Index
Weighted Median
Summary of Medicare Statewide Averages
Indiana Laws & Administrative Rules
TITLE 405 OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES
CRF/DD ICF/MR
LTCIS Reports
CRF/DD Provider Index (All Providers)
CRF/DD Provider Index by Provider
CRF/DD Statistical Data/Total Revenues, Expenses and Hours
CRF/DD Recap of Patient Expense and Rate Calculation
CRF/DD Total Historical Cost of Property
CRF/DD Percentage of Total Expense
CRF/DD Statistical Data/Per Hour and Per Patient Day Calculations
CRF/DD Recap of Expenses Per Patient Day and Rate Calculation
CRF/DD Historical Cost of Property Per Facility
Non-State ICF/MR Provider Index by Provider Number
Non-State ICF/MR Statistical Data/Total Revenues, Expenses and Hours
Non-State ICF/MR Recap of Expenses and Rate Calculation
Non-State ICF/MR Total Historical Cost of Property
Non-State ICF/MR Percentage of Total Expense
Non-State ICF/MR Statistical Data/Per Hour and Per Patient Day Calculations
Non-State ICF/MR Recap of Expenses Per Patient Day and Rate Calculation
Non-State ICF/MR Historical Cost of Property Per Facility
Other Reports
CRF/DD Cumulative Rate Listing
Non-State ICF/MR Cumulative Rate Listing
State ICF/MR Cumulative Rate Listing
Semi-Annual Statistical Report-ICF/MR - Section1
Semi-Annual Statistical Report-ICF/MR - Section2
Forms
Non-State ICF/MR & CRF/DD Cost Report - Facility
Non-State ICF/MR & CRF/DD Cost Report - Facility (Instructions)
Non-State ICF/MR & CRF/DD Cost Report - Home Office
Non-State ICF/MR & CRF/DD Cost Report - Home Office (Instructions)
State ICF/MR Cost Report
State ICF/MR Cost Report (Instructions)
Change in Ownership - Checklist of Management's Representations
Cost Report Internal Control Questionaire - PDF Version
Cost Report Internal Control Questionaire - Electronic Version
Cost Report Internal Control Questionaire Instructions
Tables
50th Percentiles
CPI-U
CMS Nursing Home Without Capital Market Basket Index
Gross National Product - Implicit Price Deflator (GNP-IPD)
Market Area Limitation
Maximum Property Basis
Mortgage Index Table
Owner/Related Party/Management - CRF/DD and Non-State ICF/MR
Owner/Related Party/Management - State ICF/MR
U.S. Treasury Bond Ten (10) Year Amortization
Weighted Median
Indiana Laws & Administrative Rules
TITLE 405 OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES
Home Health Agency
Forms
Cost Report Forms
Instructions
Tables
Inflation Index (Home Health Agency Market Basket)
State Psychiatric Hospital
Forms
State Psychiatric Hospital Cost Report
State Psychiatric Hospital Cost Report (Instructions)
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