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Cost Report Template
Cost and Financial Report Template (FY 2020-2021)
FY 2020-21 CR Training Videos and Powerpoints
Beginner/Intermediate
Advanced
Hospital
Frequently Asked Questions
Handouts
1 – General Guidelines
2 – Submission Criteria
3 – Cost Report Required Forms
4 – Cost Report Letter of Certification
4A – Source of Units of Service Information
5 – Cost Report Staff Contacts
6 – DHCS Cost Report Instruction Manual (Revised 8/4/21)
7 – Allowable/Unallowable Cost References
8 – False Claim
9 – Reporting Eligible Direct Cost Instructions
9A – Schedule of Eligible Direct Costs (Revised 8/24/21)
10 – Cost Report Sample
10A – Third Party Revenue Breakdown
10B – EPSDT Units of Service (Revised 10/26/21)
11 – Adult OTT & Child OTT Costs and Units Form (Revised 8/23/21)
12 – -LE Assigned Analyst List
13 – UOS Time Base for Rate Calculation
14 – FY 2020-21 FFP, 2011 Realignment Fund, SGF, and Local Match Allocation Percentage
15 – Proposed DHCS Audit and Settlement Timeframe for SDMC Cost Report
16 – Post CR Shift Request Form FY 2020-21
Board Letter – Approval to Waive Specialty Mental Health Services Countywide Maximum Allowances in the Determination of Reimbursable Costs for Legal Entity Cost Reports and Settlements due to Covid-19