Introduction & Instructions

TO:  North Carolina Skilled Nursing Facilities

The North Carolina Health Care Facilities Association (NCHCFA) is working collaboratively with the North Carolina Division of Medical Assistance (NC DMA) to gather data related to Fair Rental Value (FRV) in order to modernize the current Fair Rental Value system.

To develop an alternative methodology for Fair Rental Value, we must collect data on square footage from each facility. Completion of this survey is extremely important because the data you provide may be used in future Medicaid rate setting for your facility.

On-line Data Submission: Deadline - Friday, June 15, 2018

The On-line Option allows data to be entered for one facility at a time. Do not begin the on-line survey until you are ready to complete the form in one sitting. See below.

Steps:
-- Download and print the PDF version of this on-line survey and use it as a worksheet.
-- Review the FAQs at the end of the PDF survey.
-- With a completed worksheet in hand, you will be able to complete the on-line form in one sitting.
-- After pressing "DONE" at the end of the survey, you cannot go back and edit your response.

Note: Do not begin the online survey until you have read through the PDF copy and are ready to complete the survey in one sitting.  When entering the information on beds, square footage and patient days, use whole numbers only - no symbols and enter 0 (zero) in any field for which you have no data.

Also: Once you have completed the worksheet, using the print version of this data form, continue by clicking the "next" button below. Note – this online option allows data to be entered for one facility at a time. If you have more than one facility to enter data for, begin a new online entry with each facility. Alternatively, you may choose Option 2 and complete the Excel File option and report data for multiple facilities or a single facility on one spreadsheet (exit this survey and go back to the instructions in the e-mail).  The Excel version of this survey can be found by clicking here.

Questions about completing the FRVS survey online? Errors to correct?

Please contact Sam Clark Samc@nchcfa.org, or by phone, (919) 782-3827.

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