Form preview

Get the free FINANCIAL AND STATISTICAL REPORT (COST REPORT) FOR LONG-TERM CARE FACILITIES - hfs i...

Get Form
This document serves as a financial and statistical report focused on long-term care facilities in the state of Illinois, detailing costs, services provided, and compliance with state regulations.
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign financial and statistical report

Edit
Edit your financial and statistical report form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your financial and statistical report form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing financial and statistical report online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
In order to make advantage of the professional PDF editor, follow these steps:
1
Log in. Click Start Free Trial and create a profile if necessary.
2
Upload a file. Select Add New on your Dashboard and upload a file from your device or import it from the cloud, online, or internal mail. Then click Edit.
3
Edit financial and statistical report. Rearrange and rotate pages, insert new and alter existing texts, add new objects, and take advantage of other helpful tools. Click Done to apply changes and return to your Dashboard. Go to the Documents tab to access merging, splitting, locking, or unlocking functions.
4
Get your file. When you find your file in the docs list, click on its name and choose how you want to save it. To get the PDF, you can save it, send an email with it, or move it to the cloud.
It's easier to work with documents with pdfFiller than you could have ever thought. You can sign up for an account to see for yourself.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out financial and statistical report

Illustration

How to fill out FINANCIAL AND STATISTICAL REPORT (COST REPORT) FOR LONG-TERM CARE FACILITIES

01
Obtain the FINANCIAL AND STATISTICAL REPORT (COST REPORT) form from your state or regulatory agency.
02
Review the instructions provided with the form to understand the specific requirements.
03
Gather all necessary financial data including revenue, expenditures, payroll, and occupancy rates for the reporting period.
04
Start filling out the financial section, ensuring all numbers are accurate and match your accounting records.
05
Complete the statistical section by providing relevant metrics such as patient days, facility capacity, and staff-to-resident ratios.
06
Double-check your entries for consistency and accuracy before signing the document.
07
Submit the completed report to the appropriate agency by the specified deadline.

Who needs FINANCIAL AND STATISTICAL REPORT (COST REPORT) FOR LONG-TERM CARE FACILITIES?

01
Long-term care facility administrators and operators who are required to provide financial transparency.
02
State and federal regulatory agencies that oversee financial practices in long-term care.
03
Stakeholders such as investors, auditors, and funding organizations who need insight into the facility's financial performance.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.0
Satisfied
56 Votes

People Also Ask about

Nursing home costs by state StateShared room per dayPrivate room per day California $322 $400 Colorado $282 $320 Connecticut $453 $499 District of Columbia $345 $34547 more rows • Sep 26, 2023
The Centers for Medicare and Medicaid Services (CMS), a component of the U.S. Department of Health and Human Services (HHS), administers Medicare, Medicaid, the Children's Health Insurance Program (CHIP), the Clinical Laboratory Improvement Amendments (CLIA), and parts of the Affordable Care Act (ACA) ("Obamacare").
How to Create a Cost Report? Creating a cost report requires gathering data from multiple sources such as invoices, contracts, and timesheets. This data should then be organized into categories such as labor costs, materials, and overhead expenses.
Nursing homes and assisted living facilities Nursing homes represent the most expensive long-term care option, with private rooms costing an estimated 10,646 U.S. dollars per month in 2024. Semi-private rooms are slightly more affordable at 9,277 U.S. dollars monthly.
Cost reports are generally prepared by Cost Consultants and sometimes Quantity Surveyors to keep the client informed about the Project Cost. A cost report includes the costs incurred by the time of reporting and all the future costs (Forecast Cost) that is likely to be incurred during the rest of the project.
Each year, Medicare Part A providers must submit an acceptable Medicare Cost Report (MCR) package to their Medicare Administrative Contractor (MAC) for the purposes of determining their Medicare reimbursable cost. The MCR package consists of a variety of cost report materials.
How to Create a Cost Report? Creating a cost report requires gathering data from multiple sources such as invoices, contracts, and timesheets. This data should then be organized into categories such as labor costs, materials, and overhead expenses.
A Medicare Cost Report (MCR) is a financial account submitted from Medicare-certified entities, such as skilled nursing facilities, hospitals or hospices, to a Medicare Administrative Contractor (MAC). Each entity updates its report at the end of its fiscal year, and MCRs publish quarterly.

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

The Financial and Statistical Report (Cost Report) for Long-Term Care Facilities is a detailed document that long-term care facilities are required to submit, outlining their financial performance and operational statistics for a specific reporting period. This report includes various cost data, revenue information, and statistical details regarding patient care which are necessary for regulatory compliance and reimbursement purposes.
Long-term care facilities that participate in Medicare and/or Medicaid programs are required to file the Financial and Statistical Report (Cost Report). This typically includes nursing homes, skilled nursing facilities, and other care facilities that provide long-term care services.
To fill out the Financial and Statistical Report (Cost Report), facilities must gather all relevant financial data, including income statements, balance sheets, and organizational statistics. They should follow the reporting guidelines provided by Medicare or Medicaid, ensuring that all required sections are completed accurately. It is advisable to utilize available software tools designed for cost reporting to facilitate this process.
The purpose of the Financial and Statistical Report (Cost Report) is to provide federal and state governments with essential data regarding the financial operations of long-term care facilities. This information is used to determine appropriate reimbursement rates for services provided, assess the financial health of facilities, and ensure compliance with funding regulations.
The information that must be reported includes total revenue, expenditures, the number of patient days, staffing levels, resident populations, and varying costs associated with patient care and facility operations. Additionally, other statistical data reflecting the facility’s operational efficiency and service provision must also be included.
Fill out your financial and statistical report online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.