Form preview

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

Get Form
This document provides a comprehensive financial and statistical report for long-term care facilities in the state of Illinois, including details on costs, occupancy rates, income statements, and
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
To use our professional PDF editor, follow these steps:
1
Register the account. Begin by clicking Start Free Trial and create a profile if you are a new user.
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. Add and replace text, insert new objects, rearrange pages, add watermarks and page numbers, and more. Click Done when you are finished editing and go to the Documents tab to merge, split, lock or unlock the file.
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.
pdfFiller makes dealing with documents a breeze. Create an account to find out!

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
Gather all financial documents related to the long-term care facility including income statements, balance sheets, and expense reports.
02
Identify the reporting period for the cost report and ensure all data reflects that specific timeframe.
03
Categorize expenses such as medical supplies, payroll, utilities, and facility maintenance.
04
Input the total revenue generated from residents, including any government reimbursements or grants.
05
Calculate the occupancy rates and include any relevant statistics for the reporting period.
06
Fill out each section of the cost report form carefully, ensuring accuracy and compliance with regulations.
07
Review the completed report for any inconsistencies or errors before submission.
08
Submit the report to the required governing body or agency by the specified deadline.

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

01
Long-term care facilities seeking funding or reimbursement from government programs.
02
Administrators and financial officers of nursing homes and assisted living facilities.
03
Regulatory agencies tasked with overseeing the financial performance of healthcare facilities.
04
Researchers and policymakers analyzing the financial health of long-term care services.
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
4.2
Satisfied
40 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 financial document that provides an overview of the operational costs, patient statistics, and resource utilization of care facilities. It is used 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 includes nursing homes and skilled nursing facilities.
To fill out the FINANCIAL AND STATISTICAL REPORT (COST REPORT), facilities must gather their financial records, including income statements and balance sheets. They need to follow the specific instructions provided by the CMS (Centers for Medicare & Medicaid Services) and ensure that all data is accurate and submitted by the deadline.
The purpose of the FINANCIAL AND STATISTICAL REPORT (COST REPORT) is to provide a transparent account of the facility's operational costs and patient demographics, which helps determine Medicare and Medicaid reimbursement rates while ensuring compliance with regulatory requirements.
The report must include detailed financial information such as total operating costs, revenue, patient days, staffing information, and various statistical data related to patient care. Specific line items and metrics are outlined in the CMS guidelines.
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.