Form preview

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

Get Form
This document is a financial report required by the State of Illinois for long-term care facilities, detailing revenue, expenses, and operational statistics for the fiscal year 2007.
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 below:
1
Log in. Click Start Free Trial and create a profile if necessary.
2
Upload a document. Select Add New on your Dashboard and transfer a file into the system in one of the following ways: by uploading it from your device or importing from the cloud, web, or internal mail. Then, click Start editing.
3
Edit financial and statistical report. Add and change text, add new objects, move pages, add watermarks and page numbers, and more. Then click Done when you're done editing and go to the Documents tab to merge or split the file. If you want to lock or unlock the file, click the lock or unlock button.
4
Save your file. Choose it from the list of records. Then, shift the pointer to the right toolbar and select one of the several exporting methods: save it in multiple formats, download it as a PDF, email it, or save it to the cloud.
Dealing with documents is simple using pdfFiller.

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 necessary financial documents, including income statements and balance sheets.
02
Download the Financial and Statistical Report form from the designated regulatory agency's website.
03
Fill out the basic facility information, including name, address, and contact details.
04
Report total revenue by providing details on different income sources, such as Medicare, Medicaid, and private payments.
05
Document total expenses by categorizing them into payroll, medical supplies, administrative costs, etc.
06
Calculate occupancy rates and include statistics on resident demographics.
07
Ensure compliance with any specific state or federal requirements listed in the guidance notes.
08
Review the completed report for accuracy and completeness.
09
Submit the report electronically or via mail by the specified deadline.
10
Keep a copy of the submitted report and any correspondence for your records.

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

01
Long-term care facilities, including nursing homes and assisted living facilities, need to complete this report.
02
State and federal regulatory agencies require these reports to monitor financial health and compliance.
03
Healthcare policymakers and researchers may use this data for analysis and improvement of care standards.
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
4.6
Satisfied
42 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 document that gathers financial and operational data from long-term care institutions to ensure compliance with regulations, assess financial health, and facilitate effective management.
Long-term care facilities that receive Medicaid and/or Medicare funding are typically required to file the Financial and Statistical Report to provide transparency and accountability in their financial operations.
To fill out the Financial and Statistical Report, facilities must gather accurate financial data, carefully follow the reporting guidelines and instructions provided by the relevant authorities, and ensure that all sections of the report are completed with up-to-date information.
The purpose of the Financial and Statistical Report is to collect necessary data for evaluating the financial viability of long-term care facilities, ensuring compliance with federal and state regulations, and guiding policy decisions related to healthcare financing.
The report typically requires information such as revenue and expenses, patient demographics, staffing levels, occupancy rates, and utilization of services, as well as other relevant operational metrics.
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.