Residential Treatment Center Facilities: Report Documents
Licensed Residential Child Care Facilities:
- These reports may be downloaded for your convenience. Please submit a printed and signed copy of the completed report to the Department of Human Services' Provider Audit Unit by the appropriate deadline.
- Reports should be completed as indicated in NDAC 75-03-20. The information provided will be used to establish rates beginning January 1, 2005.
- Reports are due within three months of your fiscal year end.
- For further details contact Provider Audit at (701) 328-7560.
- Residential Treatment Center Cover Letter (38kb pdf)
- Residential Treatment Center Cost Report and Instructions (321kb Excel doc)
- Residential Treatment Center Cost Report and Instructions - Printable (237kb Excel doc)
- Residential Treatment Center CPA Authorization - Printable/Fillable (11kb RTF)
Note: The link above requires that you have Microsoft Excel on your computer. If you do not, you may download a free Excel viewer from the Microsoft web site.

