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FOR BHF USELL1
2019STATE OF ILLINOIS
DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
FINANCIAL AND STATISTICAL REPORT (COST REPORT)
FOR LONGER CARE FACILITIES
(FISCAL YEAR 2019)
I.DPH License ID Number:
Facility
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How to fill out cost report data
How to fill out cost report data
01
Gather all relevant financial documents including invoices, receipts, and payroll records.
02
Organize the data by categories such as payroll expenses, supplies, rent, and other operating expenses.
03
Enter the data accurately into the designated fields in the cost report form.
04
Double check all figures for accuracy and completeness before submitting the cost report.
Who needs cost report data?
01
Healthcare providers who receive reimbursement from government or insurance companies
02
Hospitals, nursing homes, home health agencies, and other healthcare facilities
03
Financial auditors and regulatory agencies
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What is cost report data?
Cost report data is financial information submitted to show the costs incurred by an organization in delivering services or products.
Who is required to file cost report data?
Healthcare providers such as hospitals, nursing homes, and home health agencies are required to file cost report data.
How to fill out cost report data?
Cost report data is typically filled out using specific forms provided by regulatory agencies, and requires detailed financial information to be entered accurately.
What is the purpose of cost report data?
The purpose of cost report data is to allow regulatory agencies to determine reimbursement rates, monitor financial performance, and ensure compliance with regulations.
What information must be reported on cost report data?
Information such as revenue, expenses, patient volumes, staffing levels, and other financial data must be reported on cost report data.
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