Information about Submitting Cost Reports

Nursing Care Institution Uniform Account Report

Rates and Charges Cost Comparison Report

Information about Submitting Cost Reports

Dear Nursing Care Institution Licensee:

Under the authority of Arizona Revised Statues §§ 36-125.04 and 36-436, the Department revised the rules in Arizona Administrative Code, Title 9, Chapter 11, to specify requirements for nursing care institution financial reporting.  The revised rules were approved by the Governor’s Regulatory Review Council and filed with the Secretary of State of October 2, 2007.  The rules specifying requirements for nursing care institution financial reporting are available on the Secretary of State’s web site at:
http://www.azsos.gov/public_services/Title_09/9-11.rtf .  If you wish a courtesy hard copy of the Title 9, Chapter 11, rules please contact us.

These rules are effective December 1, 2007.

There are two types of nursing care institution financial reports required by the Department:

• Nursing Care Institution Uniform Accounting Report (UAR), and
• Nursing Care Institution Rates and Charges.

Both reports are to be submitted to the Department as e-mail attachments to the Cost Reporting staff listed below.

1. The Nursing Care Institution Uniform Accounting Report (UAR): The UAR is due 150 days after the nursing care institution’s fiscal year end.

List of Nursing Care Institution UAR Due Dates [XLS]

The Nursing Care Institution UAR (see forms and instructions below) will be posted on a schedule based on the facility’s fiscal year end date.  Reports will be posted in March, June, and December.  If a facility’s report is not received by the time of posting, there will be a blank space where the facility’s report should be posted.

A complete Nursing Care Institution UAR consists of:

• A Uniform Accounting Report Form [XLS], filled out with nursing care institution–specific data;
  • Uniform Accounting Report Instructions [DOC]
    
    
• A copy of the Nursing Care Institution’s Medicare Cost Report - An e-mail copy of the report in PDF format is required;
  
  
• A Statement of Cash Flows; and
  
  
• Attestation of Completeness and Accuracy Form [DOC], completed by the nursing care institution’s administrator.
  • Print and mail a hard copy of the Attestation of Completeness and Accuracy to:

  Martha LaVoy, Financial Reporting Manager
  150 N. 18th Ave., Suite 550
  Phoenix, AZ  85007-3248

2. Nursing Care Institution Rates and Charges - All nursing care institutions are required to keep their existing schedule of rates and charges on file with the Department.

A complete Nursing Care Institution Rates and Charges submission consists of:

• A Rates and Charges Form [XLS]; and
• Attestation of Completeness and Accuracy Form [DOC].
  • Print and mail a hard copy of the Attestation of Completeness and Accuracy to:

  Martha LaVoy, Financial Reporting Manager
  150 N. 18th Ave., Suite 550
  Phoenix, AZ  85007-3248

Contacts

Nursing Care Institution Uniform Account Report

2007 UAR [XLS 151KB] Available in June

Rates and Charges Report

Current Nursing Home Rates and Charges [XLS]

2007 Rates and Charges Comparison Report [XLS]