
Get the free FINANCIAL AND STATISTICAL REPORT FOR LONG-TERM CARE FACILITIES - hfs illinois
Show details
IDPH Facility ID Number Facility Name 0040428 II. IMPORTANT NOTICE THIS AGENCY IS REQUESTING DISCLOSURE OF INFORMATION THAT IS NECESSARY TO ACCOMPLISH THE STATUTORY PURPOSE AS OUTLINED IN 210 ILCS 45/3-208. DISCLOSURE OF THIS INFORMATION IS MANDATORY. FAILURE TO PROVIDE ANY INFORMATION ON OR BEFORE THE DUE DATE WILL RESULT IN CESSATION OF PROGRAM PAYMENTS. THIS FORM HAS BEEN APPROVED BY THE FORMS MANAGEMENT CENTER. CERTIFICATION BY AUTHORIZED FAC...
We are not affiliated with any brand or entity on this form
Get, Create, Make and Sign financial and statistical report

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 your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.

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
Follow the steps down below to benefit from the PDF editor's expertise:
1
Set up an account. If you are a new user, click Start Free Trial and establish a profile.
2
Prepare a file. Use the Add New button to start a new project. Then, using your device, upload your file to the system by importing it from internal mail, the cloud, or adding its URL.
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. Select it from your records list. Then, click the right toolbar and select one of the various exporting options: save in numerous formats, download as PDF, email, or cloud.
With pdfFiller, it's always easy to work with documents. Try it!
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.
How to fill out financial and statistical report

How to fill out FINANCIAL AND STATISTICAL REPORT FOR LONG-TERM CARE FACILITIES
01
Gather necessary financial documents, including budget reports and expenditure statements.
02
Collect patient data, including demographic information and care statistics.
03
Review previous reports for consistency and reference points.
04
Fill in the financial sections by accurately reporting revenue sources and expenses.
05
Complete statistical sections with data on admissions, discharges, and average length of stay.
06
Ensure all figures are supported by the appropriate documentation to validate accuracy.
07
Review the entire report for completeness and compliance with state and federal guidelines.
08
Submit the report to the appropriate regulatory body by the deadline.
Who needs FINANCIAL AND STATISTICAL REPORT FOR LONG-TERM CARE FACILITIES?
01
Long-term care facility administrators.
02
State health department officials.
03
Regulatory agencies monitoring healthcare facilities.
04
Financial managers within healthcare organizations.
05
Researchers analyzing healthcare trends.
Fill
form
: Try Risk Free
People Also Ask about
What is the financial impact of long-term care in the United States?
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.
What is the largest source of financing LTC?
Medicaid — a government program that helps cover medical costs for people with limited income and assets — is the major source of funding for LTC in the United States.
What is the average monthly cost of long-term care?
Cost of care trends and insights Type of service and rate type2024 national median values2023 national median values Adult day health care Daily $100 $95 Assisted living community Monthly $5,900 $5,350 Nursing home semi-private room Monthly $9,277 $8,669 Nursing home private room Monthly $10,646 $9,7332 more rows
What are typical long-term care premiums?
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).
How much does long-term care cost per month?
Cost of care trends and insights Type of service and rate type2024 national median values2023 national median values Adult day health care Daily $100 $95 Assisted living community Monthly $5,900 $5,350 Nursing home semi-private room Monthly $9,277 $8,669 Nursing home private room Monthly $10,646 $9,7332 more rows
What is the average cost of long-term care in the US?
In the United States, long-term care costs between $35,000 and $108,000 a year in 2021. Out of the three different types of long-term care we compared, private rooms in nursing homes are the most costly, with an average of $108,405 a year.
Will Medicare pay for a long-term nursing home?
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.
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.
What is FINANCIAL AND STATISTICAL REPORT FOR LONG-TERM CARE FACILITIES?
The Financial and Statistical Report for Long-Term Care Facilities is a regulatory document that collects financial and operational data from long-term care providers to ensure compliance with federal and state regulations, assess the economic status of the facilities, and aid in policy-making.
Who is required to file FINANCIAL AND STATISTICAL REPORT FOR LONG-TERM CARE FACILITIES?
Long-term care facilities such as nursing homes, assisted living facilities, and other residential care providers are typically required to file this report, often mandated by state health departments or regulatory agencies.
How to fill out FINANCIAL AND STATISTICAL REPORT FOR LONG-TERM CARE FACILITIES?
To fill out the report, facilities must gather financial information including income, expenses, and occupancy rates. They should follow the specific guidelines and templates provided by the regulatory authority, ensuring all sections are complete and accurate before submission.
What is the purpose of FINANCIAL AND STATISTICAL REPORT FOR LONG-TERM CARE FACILITIES?
The purpose of the report is to monitor the financial health and operational performance of long-term care facilities, to ensure compliance with funding requirements, and to provide data for the assessment of care quality and resource allocation.
What information must be reported on FINANCIAL AND STATISTICAL REPORT FOR LONG-TERM CARE FACILITIES?
Information that must be reported typically includes revenue sources, expenses (operational and capital), total number of residents, staff-to-resident ratios, occupancy rates, and other key performance indicators relevant to the facilities’ operations.
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.

Financial And Statistical Report is not the form you're looking for?Search for another form here.
Relevant keywords
Related Forms
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.