Form preview

Get the free Financial and Statistical Report for Long-Term Care Facilities - hfs illinois

Get Form
This document serves as a financial and statistical report for a long-term care facility in Illinois, detailing operational data, financial statements, and compliance with state regulations for the
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.

How to edit 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
To use the professional PDF editor, follow these steps below:
1
Set up an account. If you are a new user, click Start Free Trial and establish a profile.
2
Simply add a document. Select Add New from your Dashboard and import a file into the system by uploading it from your device or importing it via the cloud, online, or internal mail. Then click Begin editing.
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. Select the name of your file in the docs list and choose your preferred exporting method. You can download it as a PDF, save it in another format, send it by email, or transfer it to the cloud.
It's easier to work with documents with pdfFiller than you could have believed. You may try it out for yourself by signing up for an account.

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 for Long-Term Care Facilities

01
Gather all relevant financial data for the reporting period.
02
Ensure all income sources are documented accurately, including patient revenue and any other funding.
03
Collect data on all expenses incurred during the reporting period, including payroll, supplies, and maintenance costs.
04
Fill out the direct care staffing section with accurate counts of staff hours worked and their roles.
05
Complete the occupancy section, indicating the number of beds available and the occupancy rate.
06
Report any additional statistical data required, such as patient demographics or health outcomes.
07
Review all sections for accuracy and completeness before submission.
08
Submit the report by the designated deadline to the appropriate regulatory agency.

Who needs Financial and Statistical Report for Long-Term Care Facilities?

01
Regulatory agencies overseeing long-term care facilities.
02
Facility administrators for internal assessment and planning.
03
State and federal government for funding and compliance purposes.
04
Researchers analyzing healthcare trends in long-term care.
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
58 Votes

People Also Ask about

ing to their national study of long-term care providers: 38.6% of nursing home residents are older than 85. 26.7% of residents are between 75 and 84.
So, 35% will use their coverage and 65% will not. As you might assume, the decline is because during those first 90 days, some people will recover and some will die.
In the U.S., long-term care costs individuals and their families thousands of dollars annually, with nursing home care often costing more than $100,000 a year (Exhibit 1). Given that many who use these services will need it for at least one year, costs can quickly become burdensome.
ing to Genworth's estimates, the median cost of a private room in a nursing home is $339 per day or $10,326 per month in 2025. Semiprivate rooms are more affordable, with a median cost of $302 per day or $9,197 monthly.
Homemaker Services Costs By State StateHome Care Median Hourly RateHome Care Daily Rate / 8 hours California $38.19 $240 Colorado $37.13 $233 Connecticut $32.89 $207 Delaware $25.46 $16048 more rows
Consider the national median costs for long-term care services²: $255 a day(or $7,756 per month) for a semi-private room in a nursing home. $290 a day (or $8,821 per month) for a private room in a nursing home. $141 a day (or $4,300 per month) in an assisted living facility.
Long-term care Long-term supports and services can be provided at home, in the community, in assisted living, or in nursing homes. Individuals may need long-term supports and services at any age. Medicare and most health insurance plans don't pay for long-term care.
How much is long-term care insurance? ing to the 2024 American Association for Long-Term Care Insurance (AALTCI) annual Price Index survey, the average annual premium for a $165,000-benefit policy with no inflation protection is $950 for a single male (age 55) and $1,500 for a single female (age 55).

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 for Long-Term Care Facilities is a detailed document that provides financial and operational data for long-term care facilities, including nursing homes and assisted living. It captures various metrics related to costs, revenue, occupancy rates, and patient care to help assess financial health and operational efficiency.
Long-term care facilities that receive Medicaid or Medicare funding are generally required to file the Financial and Statistical Report. This includes nursing homes and other similar institutions that provide long-term care services.
To fill out the Financial and Statistical Report, facilities need to gather financial data such as revenue from services, operating costs, and patient statistics. The form usually has specific sections that must be completed, detailing various aspects of financial and operational performance. Facilities often consult regulatory guidelines to ensure all required information is accurately reported.
The purpose of the Financial and Statistical Report is to provide oversight and accountability for long-term care facilities. It helps regulators, stakeholders, and the facilities themselves to assess financial performance, ensure compliance with funding regulations, and improve the quality of care provided.
The report typically requires information such as total revenue, total expenses, patient admissions and discharges, occupancy rates, types of services offered, staffing levels, and other operational statistics. Specific requirements may vary by jurisdiction or funding program.
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.