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May 02
Intermediate Care Facility cost report attachment 9 FRV

Intermediate Care Facility (ICF) cost report attachment 9 FRV

May 2, 2017

Dear ICF stakeholder:

In order to have the most complete dataset available, DODD has made some updates to the ICF cost report Attachment 9 FAQs and are requesting collection of data regarding any secondary facilities used for ICF activities.  The FAQs now clarify that for calendar year 2016 cost reports, Attachment 9 should be completed for the primary structure only.  Any secondary structures (Ex: detached garage, activity building, covered patio, home office building) used for ICF activities require the completion of the Secondary Building Schedule Excel worksheet.  Because these secondary buildings may be used to serve multiple ICFs, waiver individuals, and/or other community members, an allocation percentage column must also be completed.  Details for how to allocate are found in the Instructions tab of the Secondary Building Schedule.  Any changes to the cost report to account for the revised FAQs as well as completion of the Secondary Building Schedule must be submitted no later than May 31.  Revised cost reports should be submitted through the MITS Portal.  Secondary Building Schedules should be emailed to and should include the provider number in the name of the file attached. 

Thank you in advance for your responsiveness as we work to develop a new modernized system of reimbursement.  Should you have any questions please contact me by email at: or by phone at: (614) 387-0576.


ICF Secondary Building Schedule



Josh Anderson
Manager of Operations

Division of Medicaid Development and Administration

Ohio Department of Developmental Disabilities


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