Form preview

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

Get Form
This document serves as a mandatory financial and statistical report for long-term care facilities, ensuring compliance with state requirements for disclosure and accuracy in reporting financial data
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
Follow the steps down below to benefit from a competent PDF editor:
1
Log in to your account. Start Free Trial and register a profile if you don't have one.
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. Rearrange and rotate pages, add and edit text, and use additional tools. To save changes and return to your Dashboard, click Done. The Documents tab allows you to merge, divide, lock, or unlock files.
4
Save your file. Select it from your list of records. Then, move your cursor to the right toolbar and choose one of the exporting options. You can save it in multiple formats, download it as a PDF, send it by email, or store it in the cloud, among other things.
pdfFiller makes working with documents easier than you could ever imagine. Try it for yourself by creating an account!

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 necessary financial documents including budgets, expenditures, and revenue reports.
02
Identify the reporting period for the cost report.
03
Categorize costs into direct and indirect costs associated with long-term care.
04
Input data into the appropriate sections of the report template carefully.
05
Ensure adherence to accounting principles and standards applicable to long-term care.
06
Review the completed report for accuracy and completeness.
07
Submit the report by the specified deadline to the relevant authorities.

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

01
Long-term care facilities such as nursing homes, assisted living facilities, and rehabilitation centers.
02
State and federal regulatory agencies that oversee healthcare funding and reimbursement.
03
Accounting or financial departments within healthcare organizations to ensure compliance and financial viability.
04
Health care providers seeking funding from Medicare, Medicaid, or other healthcare programs.
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
4.0
Satisfied
47 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, often known as the cost report, is a comprehensive document that collects financial and statistical data from long-term care facilities. It is used to assess the facilities’ operational costs, revenue, and overall financial health, helping governments and agencies allocate funds and resources.
Long-term care facilities that receive Medicaid or Medicare funding are typically required to file the FINANCIAL AND STATISTICAL REPORT. This includes nursing homes, rehabilitation centers, and other health care providers operating under similar programs.
To fill out the FINANCIAL AND STATISTICAL REPORT, facilities must gather relevant financial data, including revenue, expenses, and occupancy rates. The report usually follows a standardized format that includes detailed sections on different areas of operation, requiring accurate accounting records and possibly the assistance of a financial professional.
The purpose of the FINANCIAL AND STATISTICAL REPORT is to ensure transparency in the financial operations of long-term care facilities. It serves as a tool for government agencies and regulators to evaluate the costs associated with providing care, ensure compliance with reimbursement policies, and promote accountability in the use of public funds.
The report must include detailed financial information such as total operating expenses, revenue sources, patient days, number of residents, staffing information, and any adjustments. Additionally, specific cost categories such as direct care costs and administrative costs must be clearly outlined.
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.