Form preview

Get the free FINANCIAL AND STATISTICAL REPORT (COST REPORT) FOR LONG-TERM CARE FACILITIES - www2 ...

Get Form
This document serves as a financial and statistical report for long-term care facilities in Illinois, detailing costs, income, liabilities, and ownership information for the fiscal year 2011.
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 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
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. 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 your file from the documents list and pick your export method. You may save it as a PDF, email it, or upload it to the cloud.
It's easier to work with documents with pdfFiller than you can have believed. Sign up for a free account to view.

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, expense reports, and previous financial data.
02
Review the guidelines provided by the funding authorities to understand specific reporting requirements.
03
Start with Section A: Report your total revenue, including patient revenue, grants, and other income sources.
04
Move to Section B: Detail all operating expenses, categorizing costs into direct and indirect expenses.
05
Complete Section C: Calculate and report capital expenditures, including any significant investments made during the reporting period.
06
Fill out Section D: Provide statistical data, including the number of residents, occupancy rates, and other relevant metrics.
07
Double-check all entries for accuracy, ensuring that totals match the financial documents.
08
Submit the completed report by the deadline set by the funding authority.

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

01
Long-term care facilities seeking funding or reimbursement from government or insurance programs.
02
Administrators and managers of long-term care facilities who need to assess financial performance.
03
Regulatory bodies requiring financial transparency and accountability from healthcare providers.
04
Auditors and financial analysts looking to evaluate 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
4.3
Satisfied
38 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 document that captures detailed financial and operational statistics related to the facility's operations, costs, and revenues. It is used primarily to report cost data to state and federal agencies and to assist in the reimbursement process for Medicare and Medicaid.
Long-term care facilities, including skilled nursing facilities and nursing homes that participate in Medicare or Medicaid programs, are required to file the Financial and Statistical Report. This includes both for-profit and not-for-profit facilities.
To fill out the Financial and Statistical Report, facilities must gather relevant financial data, including operating costs, revenues, and statistical data about patient care. They then complete the report using standardized forms provided by the state or federal government, ensuring that all sections are accurately filled out and supported by documentation.
The purpose of the Financial and Statistical Report is to provide regulators with a comprehensive view of the financial health and operational aspects of long-term care facilities. It aids in setting reimbursement rates, evaluating performance, and ensuring compliance with federal and state regulations.
The report must include various types of information, such as total revenues, operating expenses, number of patient days, cost of services provided, administrative costs, and financial statistics such as profit margins and occupancy rates.
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.