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, covering fiscal year 2011. It includes data on licensing, ownership, services provided, expenses,
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
Log in to your account. Start Free Trial and sign up a profile if you don't have one.
2
Prepare a file. Use the Add New button. Then upload your file to the system from your device, importing it from internal mail, the cloud, or by 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 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.
With pdfFiller, it's always easy to deal with documents.

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 necessary financial documents, including income statements, balance sheets, and expense reports.
02
Identify the reporting period for the cost report (monthly, quarterly, or annually).
03
Fill out the basic information section, including facility name, address, and reporting period.
04
Document all sources of revenue, such as patient fees, government reimbursements, and any other income.
05
List all operational expenses categorized by type, such as salaries, utilities, supplies, and maintenance.
06
Calculate the total income and total expenses to determine net profit or loss.
07
Include statistical data, such as the number of residents, staff-to-resident ratios, and occupancy rates.
08
Review the report for accuracy and completeness, ensuring all required sections are filled out.
09
Submit the completed report to the appropriate regulatory body by the deadline.

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

01
Long-term care facilities seeking reimbursement from government programs.
02
State and federal regulatory agencies for compliance auditing.
03
Facility administrators and financial managers for internal financial analysis.
04
Investors or stakeholders interested in the financial health of the facility.
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
4.4
Satisfied
42 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 comprehensive document that details the financial performance and statistical data of a facility. It includes information on revenue, expenses, occupancy rates, staffing levels, and other relevant metrics that help assess the facility's operational efficiency and compliance with regulatory requirements.
All long-term care facilities that receive reimbursement from Medicare and Medicaid programs are required to file the FINANCIAL AND STATISTICAL REPORT (COST REPORT). This typically includes nursing homes and skilled nursing facilities.
To fill out the FINANCIAL AND STATISTICAL REPORT (COST REPORT), facilities must gather financial records, statistical data, and supporting documentation. They should follow the prescribed guidelines and instructions provided by the Centers for Medicare & Medicaid Services (CMS), ensuring accuracy and completeness in reporting various revenues and expenditures.
The purpose of the FINANCIAL AND STATISTICAL REPORT (COST REPORT) is to provide a standardized means of collecting and reporting financial and operational data. This information is used by regulatory bodies to ensure compliance, assess reimbursement rates, and evaluate the economic viability of facilities.
The information that must be reported on the FINANCIAL AND STATISTICAL REPORT (COST REPORT) includes total facility revenues, operating expenses, patient days, staffing figures, cost centers, and any other relevant data that reflects the facility's financial condition and performance metrics.
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.