Minnesota Minnesota

ICF/DD Manual

ICF/DD Manual

Occupancy report

Page posted: 01/01/06

Page reviewed: 6/24/11

Page updated: 01/16/14

Legal authority

Minn. Stat. §256B.5013, subd. 5

Definition

Occupancy report: Identification of bed use by recipients in an ICF/DD.

Documentation

The ICF/DD occupancy report is required for the submission of occupancy data on a monthly basis for private pay residents only. Refer to the form for instructions to complete it.

Submission

Print and complete the occupancy report (PDF) for each month a private pay resident is present at the ICF. Email the form to dhs.icf.occupancy@state.mn.us.

Billing

Reference the occupancy report to process ICF/DD claims for payment. DHS uses the occupancy report to verify hospital leave day and therapeutic leave day payments.

A “reserved bed” for leave days is not a vacant bed when determining occupancy rates and eligibility payments. Paid claims must match the occupancy data submitted.

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