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  3. Reporting to the State
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  5. Nursing Facilities
  6. Nursing Facility Reporting

Nursing Facility Reporting

Nursing Facility Cost Reports 2012

HCF-1 Nursing Facility Cost Report (PDF) pdf format of    2012 HCF-1.pdf  file size 1MB | Word docx format of    2012 HCF-1.docx
Instructions for HCF-1 (PDF) pdf format of    2012 HCF-1 Instructions.pdf  | Word doc format of    2012 HCF-1 Instructions.doc

HCF-1 Pediatric and Special Contract Supplemental Form (Excel) xls format of    2012 PSCSF WORKSHEET.xls
HCF-1 Instructions pdf format of    2012 PSCSF Instructions.pdf  | Word doc format of    2012 PSCSF Instructions.doc

HCF-2 Nursing Facility Realty Company or Individual Real Property Owner Report (PDF) pdf format of    2012 HCF-2-NH.pdf  | Word docx format of    2012 HCF-2-NH.docx
HCF-3 Management Company Report (PDF) pdf format of    2012 HCF-3.pdf  | Word docx format of    2012 HCF-3.docx
Instructions for HCF-2-NH and HCF-3 (PDF) pdf format of    2012 HCF-2-NH  HCF-3 Instructions.pdf  | Word doc format of    2012 HCF-2-NH  HCF-3 Instructions.doc

 

Nursing Facility Cost Report Related Forms

Nursing Facility Form to Add DHCFP-INET Users (PDF) pdf format of    form-to-add-INET-nf-users-2013.pdf  | Word docx format of    form-to-add-inet-nf-users-2013.doc
Non-Confidential Data User Agreement (PDF) pdf format of    CHIAnhf_INETuseragreement-2013.pdf
Business Partner Security Agreement Form - Non Confidential Agreement (PDF) pdf format of    nonconfidential_nf-agreement-2013.pdf
Demographic Form (PDF) pdf format of    nf-demographic.pdf  doc format of nf-demographic.doc
Ownership Information Form (PDF) pdf format of    nf-owner-info-form.pdf  doc format of nf-owner-info-form.doc
Ownership Information Form Instructions (PDF) pdf format of    nf-owner-instruct.pdf  doc format of nf-owner-instruct.doc
W-9 Form pdf format of    fw9.pdf
Regulation: 114.2 CMR 6.00: Standard Payments to Nursing Facilities

 

Nursing Facility User Fee Reports

Quarterly User Fee Filing Instructions (PDF) pdf format of    nursing_facility_quarterly_user_fee_instructions.p  doc format of nursing_facility_quarterly_user_fee_instructions.d
DHCFP-INET
Quarterly User Fee Assessment Form (Effective July 1, 2010 (PDF) pdf format of    nursing_facility_quarterly_user_assessment_form.pd  doc format of nursing_facility_quarterly_user_assessment_form.do

Hospice Days pdf format of    0318.pdf  doc format of 0318.doc
Frequently Asked Questions (FAQs)
Regulation 114.5 CMR 12.00: Nursing Facility User Fee

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