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This document is a financial and statistical report for long-term care facilities in Illinois, summarizing the facility's data for fiscal year 2005, including ownership, services provided, expenses,
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How to fill out STATE OF ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES FINANCIAL AND STATISTICAL REPORT FOR LONG-TERM CARE FACILITIES

01
Obtain the latest version of the Financial and Statistical Report form from the Illinois Department of Healthcare and Family Services website.
02
Review the instructions accompanying the form to understand the requirements and reporting period.
03
Gather all necessary financial documents, including revenue, expenses, and patient care statistics relevant to the reporting period.
04
Fill in the facility's identification information, including name, address, and license number at the top of the form.
05
Enter financial data accurately in the designated sections, ensuring to differentiate between various sources of income and types of expenses.
06
Complete the statistical sections by providing the required data on patient demographics, occupancy rates, and services offered.
07
Review all entries for accuracy and completeness, making adjustments as necessary.
08
Sign and date the report where indicated, certifying that the information is accurate to the best of your knowledge.
09
Submit the completed report by the specified deadline through the required submission method outlined in the instructions.

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

01
Long-term care facilities operating in Illinois that are required to report their financial and statistical data to comply with state regulations.
02
Administrators and financial officers of long-term care facilities who need to demonstrate compliance and secure funding or reimbursement.
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Illinois has approximately 1,200 long-term care facilities serving more than 100,000 residents, from the young to the elderly. These facilities are licensed, regulated and inspected by the Illinois Department of Public Health.

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The STATE OF ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES FINANCIAL AND STATISTICAL REPORT FOR LONG-TERM CARE FACILITIES is a document required by state authorities that collects and compiles financial and operational data from long-term care facilities in Illinois to ensure accountability and transparency in the management of healthcare services.
All licensed long-term care facilities in the state of Illinois, including nursing homes and assisted living facilities, are required to file this report.
To fill out the report, facilities must gather comprehensive financial data, including income, expenses, and occupancy rates, and complete the form according to the specified guidelines in the reporting instructions provided by the Department of Healthcare and Family Services.
The purpose of the report is to provide a standardized method for collecting financial and statistical data from long-term care facilities to assist in policy-making, budget planning, and ensuring the health and safety of residents.
The report must include various information such as the facility's income, expenditures, resident demographics, number of staff, occupancy levels, and other pertinent financial statistics to assess the facility's performance.
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