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This document serves as a financial and statistical report required for long-term care facilities in Illinois for the fiscal year 2011. It includes data on licensure, Medicaid services, expenses,
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How to fill out STATE OF ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES FINANCIAL AND STATISTICAL REPORT (COST REPORT) FOR LONG-TERM CARE FACILITIES

01
Obtain the STATE OF ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES FINANCIAL AND STATISTICAL REPORT form.
02
Gather all necessary financial documents, including income statements, balance sheets, and expense reports.
03
Fill out the identification section with the facility's name, address, and license number.
04
Complete the revenue section, detailing all sources of income such as Medicaid, private payments, and other reimbursements.
05
Provide detailed accounts of operating expenses including salaries, medical supplies, and facility maintenance.
06
Include any non-operating income and expenses in the appropriate sections.
07
Ensure all calculations are correct, and double-check totals before submitting.
08
Sign and date the report, ensuring compliance with all state guidelines.
09
Submit the completed report to the appropriate state agency by the designated deadline.

Who needs STATE OF ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES FINANCIAL AND STATISTICAL REPORT (COST REPORT) FOR LONG-TERM CARE FACILITIES?

01
Long-term care facility administrators
02
Owners of nursing homes and assisted living centers
03
Finance departments within healthcare organizations
04
Regulatory agencies for compliance purposes
05
Healthcare providers seeking reimbursement from the state
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The cost report contains provider information such as facility characteristics, utilization data, cost and charges by cost center (in total and for Medicare), Medicare settlement data, and financial statement data. CMS maintains the cost report data in the Healthcare Provider Cost Reporting Information System (HCRIS).
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The cost report contains provider information such as facility characteristics, utilization data, cost and charges by cost center (in total and for Medicare), Medicare settlement data, and financial statement data.

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The State of Illinois Department of Healthcare and Family Services Financial and Statistical Report, commonly referred to as the Cost Report, is a required document that long-term care facilities must file. It provides detailed financial and operational data to help the state assess trends, costs, and productivity within the long-term care sector.
All long-term care facilities that participate in the Medicaid program in Illinois are required to file the Financial and Statistical Report (Cost Report). This includes nursing homes and similar care facilities that provide services to eligible Medicaid beneficiaries.
To fill out the Cost Report, facilities should gather financial records, operational data, and relevant statistical information related to care provided, revenues generated, and expenses incurred. The report typically involves entering data into a standardized form, ensuring accuracy, and submitting it by the designated deadline.
The purpose of the Cost Report is to provide transparency and accountability for the funds expended on long-term care services. It helps the state evaluate the financial health of facilities, determine reimbursement rates, and identify areas for improvement in the care delivery system.
Facilities must report various types of information, including but not limited to total expenses by category, revenues, patient days, staffing levels, and operational statistics. This information is critical for evaluating the cost-efficiency and quality of care provided.
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