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picture1_Cost Sheet Format In Excel 32532 | Ucr Template 20220101


 234x       Filetype XLS       File size 0.92 MB       Source: myersandstauffer.com


File: Cost Sheet Format In Excel 32532 | Ucr Template 20220101
data schedule line column description 0 facility description 1 number medicaid provider number 0 facility description 2 name name of facility 0 facility description 3 street street address 0 facility ...

icon picture XLS Filetype Excel XLS | Posted on 09 Aug 2022 | 3 years ago
Partial file snippet.
            Data        Schedule              Line   Column Description
                      0 Facility Description   1    Number Medicaid Provider Number
                      0 Facility Description   2     Name Name of Facility
                      0 Facility Description   3     Street Street Address
                      0 Facility Description   3      City   City
                      0 Facility Description   3       Zip   Zip Code
                      0 Facility Description   3     County County
                      0 Facility Description   3     Phone Phone
                      0 Facility Description   4      FEIN Federal Employer Identification No.
                      0 Facility Description   5     Contact Person to contact for questions
                      0 Facility Description   6     Phone Phone
             12/30/1899 Facility Description   7     Begin Fiscal Year Begin
             12/30/1899 Facility Description   8      End    Fiscal Year End
                      0 Facility Description   9      Yes    Change in Ownership During Year-Yes
                      0 Facility Description   9       No    Change in Ownership During Year-No
                      0 Facility Description   10    Seller  If yes, this Cost Report, For-Seller
                      0 Facility Description   10    Buyer If yes, this Cost Report, For-Buyer
                      0 Facility Description   11     Indiv  Type of Ownership-Individual
                      0 Facility Description   11    Partner Type of Ownership-Partnership
                      0 Facility Description   11     Corp   Type of Ownership-Corporation
                      0 Facility Description   11    Church Type of Ownership-Church
                      0 Facility Description   11     Other Type of Ownership-Other (specify)
                      0 Facility Description   11    Specify Type of Ownership-Other (specify)-description
                      0 Facility Description   11     State  Type of Ownership-State
                      0 Facility Description   11    County Type of Ownership-County
                      0 Facility Description   11     City   Type of Ownership-City
                      0 Facility Description   13     Yes    Constructed with Tax Exempt Financing?-Yes
                      0 Facility Description   13      No    Constructed with Tax Exempt Financing?-No
                      0 Index                  3      Yes    Occupancy and Rate Data-Yes
                      0 Index                  4      Yes    Certification of Provider-Yes
                      0 Index                  4      Yes    Statement of Operations-Yes
                      0 Index                  5      Yes    Supporting Schedules-Revenues-Yes
                      0 Index                  6      Yes    Supporting Schedules-Allowances-Yes
                      0 Index                  7      Yes    Supporting Schedules-Nursing Care-Yes
                      0 Index                  8      Yes    Supporting Schedules-Other Patient Care-Yes
                      0 Index                  9      Yes    Supporting Schedules-Routine-Yes
                      0 Index                  10     Yes    Supporting Schedules-Administrative-Yes
                      0 Index                  11     Yes    Supporting Schedules-Capital/Property-Yes
                      0 Index                  12     Yes    Supporting Schedules-Non-operating Revenues-Yes
                      0 Index                  13     Yes    Adjustments to Expenses-Yes
                      0 Index                  16     Yes    Detailed Analysis-Owner and Administrator-Yes
                      0 Index                  17     Yes    Detailed Analysis-Employee Benefits-Yes
                      0 Index                  18     Yes    Detailed Analysis-Central Office Overhead-Yes
                      0 Index                  19     Yes    Detailed Analysis-Allocation of Indirect Expenses-Yes
                      0 Index                  21     Yes    Detailed Analysis-Services From Related Parties-Yes
                      0 Index                  22     Yes    Analysis of Capital-Yes
                      0 Index                  23     Yes    Analysis of Fund Balances-Yes
                      0 Index                  24     Yes    Balance Sheet-Proprietary Facilities-Yes
                      0 Index                  26     Yes    Balance Sheet-Voluntary Facilities-Yes
                      0 Index                  29     Yes    Detailed Analysis-Fixed Assets-Yes
                   0 Index               30    Yes   Detailed Analysis-Depreciation-Yes
                   0 Index               31    Yes   Detailed Analysis-Interest and Loans-Yes
                   0 Index               32    Yes   Detailed Analysis-Leases-Yes
                   0 Index               33    Yes   Patient Trust Funds-Yes
                   0 Index               34    Yes   Questionnaire & Checklist-Yes
                   0 Index               3      No   Occupancy and Rate Data-No
                   0 Index               4      No   Certification of Provider-No
                   0 Index               4      No   Statement of Operations-No
                   0 Index               5      No   Supporting Schedules-Revenues-No
                   0 Index               6      No   Supporting Schedules-Allowances-No
                   0 Index               7      No   Supporting Schedules-Nursing Care-No
                   0 Index               8      No   Supporting Schedules-Other Patient Care-No
                   0 Index               9      No   Supporting Schedules-Routine-No
                   0 Index               10     No   Supporting Schedules-Administrative-No
                   0 Index               11     No   Supporting Schedules-Capital/Property-No
                   0 Index               12     No   Supporting Schedules-Non-operating Revenues-No
                   0 Index               13     No   Adjustments to Expenses-No
                   0 Index               16     No   Detailed Analysis-Owner and Administrator-No
                   0 Index               17     No   Detailed Analysis-Employee Benefits-No
                   0 Index               18     No   Detailed Analysis-Central Office Overhead-No
                   0 Index               19     No   Detailed Analysis-Allocation of Indirect Expenses-No
                   0 Index               21     No   Detailed Analysis-Services From Related Parties-No
                   0 Index               22     No   Analysis of Capital-No
                   0 Index               23     No   Analysis of Fund Balances-No
                   0 Index               24     No   Balance Sheet-Proprietary Facilities-No
                   0 Index               26     No   Balance Sheet-Voluntary Facilities-No
                   0 Index               29     No   Detailed Analysis-Fixed Assets-No
                   0 Index               30     No   Detailed Analysis-Depreciation-No
                   0 Index               31     No   Detailed Analysis-Interest and Loans-No
                   0 Index               32     No   Detailed Analysis-Leases-No
                   0 Index               33     No   Patient Trust Funds-No
                   0 Index               34     No   Questionnaire & Checklist-No
                   0 Occupancy           1    Month Inpatient Days by Class of License Month
                   0 Occupancy           2    Month Inpatient Days by Class of License Month
                   0 Occupancy           3    Month Inpatient Days by Class of License Month
                   0 Occupancy           4    Month Inpatient Days by Class of License Month
                   0 Occupancy           5    Month Inpatient Days by Class of License Month
                   0 Occupancy           6    Month Inpatient Days by Class of License Month
                   0 Occupancy           7    Month Inpatient Days by Class of License Month
                   0 Occupancy           8    Month Inpatient Days by Class of License Month
                   0 Occupancy           9    Month Inpatient Days by Class of License Month
                   0 Occupancy           10   Month Inpatient Days by Class of License Month
                   0 Occupancy           11   Month Inpatient Days by Class of License Month
                   0 Occupancy           12   Month Inpatient Days by Class of License Month
                   0 Occupancy          12a   Month Inpatient Days by Class of License Month
                   0 Occupancy          12b   Month Inpatient Days by Class of License Month
           Other (SpeciOccupancy         23   Month Daily Minimum Semi-Private Rate-Other (Specify) Description
                   0 Occupancy           24   Month Daily Minimum Semi-Private Rate-Other (Specify) Description
                   0 Occupancy           1      1    Inpatient Days-Comprehensive-Private
                   0 Occupancy           2      1    Inpatient Days-Comprehensive-Private
                   0 Occupancy           3      1    Inpatient Days-Comprehensive-Private
                   0 Occupancy           4      1    Inpatient Days-Comprehensive-Private
                   0 Occupancy           5      1    Inpatient Days-Comprehensive-Private
                   0 Occupancy           6      1    Inpatient Days-Comprehensive-Private
                   0 Occupancy           7      1    Inpatient Days-Comprehensive-Private
                   0 Occupancy           8      1    Inpatient Days-Comprehensive-Private
                   0 Occupancy           9      1    Inpatient Days-Comprehensive-Private
                   0 Occupancy           10     1    Inpatient Days-Comprehensive-Private
                   0 Occupancy           11     1    Inpatient Days-Comprehensive-Private
                   0 Occupancy           12     1    Inpatient Days-Comprehensive-Private
                   0 Occupancy          12a     1    Inpatient Days-Comprehensive-Private
                   0 Occupancy          12b     1    Inpatient Days-Comprehensive-Private
                   0 Occupancy           1      2    Inpatient Days-Comprehensive-Maryland MA
                   0 Occupancy           2      2    Inpatient Days-Comprehensive-Maryland MA
                   0 Occupancy           3      2    Inpatient Days-Comprehensive-Maryland MA
                   0 Occupancy           4      2    Inpatient Days-Comprehensive-Maryland MA
                   0 Occupancy           5      2    Inpatient Days-Comprehensive-Maryland MA
                   0 Occupancy           6      2    Inpatient Days-Comprehensive-Maryland MA
                   0 Occupancy           7      2    Inpatient Days-Comprehensive-Maryland MA
                   0 Occupancy           8      2    Inpatient Days-Comprehensive-Maryland MA
                   0 Occupancy           9      2    Inpatient Days-Comprehensive-Maryland MA
                   0 Occupancy           10     2    Inpatient Days-Comprehensive-Maryland MA
                   0 Occupancy           11     2    Inpatient Days-Comprehensive-Maryland MA
                   0 Occupancy           12     2    Inpatient Days-Comprehensive-Maryland MA
                   0 Occupancy          12a     2    Inpatient Days-Comprehensive-Maryland MA
                   0 Occupancy          12b     2    Inpatient Days-Comprehensive-Maryland MA
                   0 Occupancy           1      5    Inpatient Days-Comprehensive-Other Govt.
                   0 Occupancy           2      5    Inpatient Days-Comprehensive-Other Govt.
                   0 Occupancy           3      5    Inpatient Days-Comprehensive-Other Govt.
                   0 Occupancy           4      5    Inpatient Days-Comprehensive-Other Govt.
                   0 Occupancy           5      5    Inpatient Days-Comprehensive-Other Govt.
                   0 Occupancy           6      5    Inpatient Days-Comprehensive-Other Govt.
                   0 Occupancy           7      5    Inpatient Days-Comprehensive-Other Govt.
                   0 Occupancy           8      5    Inpatient Days-Comprehensive-Other Govt.
                   0 Occupancy           9      5    Inpatient Days-Comprehensive-Other Govt.
                   0 Occupancy           10     5    Inpatient Days-Comprehensive-Other Govt.
                   0 Occupancy           11     5    Inpatient Days-Comprehensive-Other Govt.
                   0 Occupancy           12     5    Inpatient Days-Comprehensive-Other Govt.
                   0 Occupancy          12a     5    Inpatient Days-Comprehensive-Other Govt.
                   0 Occupancy          12b     5    Inpatient Days-Comprehensive-Other Govt.
                   0 Occupancy           15     5    Licensed beds at beginning of period-Comprehensive
                   0 Occupancy           16     5    Licensed beds at end of period-Comprehensive
                   0 Occupancy           17     5    Dates of change in number of certified beds-Comprehensive
                   0 Occupancy           18     5    Bed Days available during the period-Comprehensive
                   0 Occupancy           20     5    Daily Minimum Semi-Private Rate-Comprehensive
                   0 Occupancy           21     5    Daily Minimum Semi-Private Rate-Comprehensive
                   0 Occupancy           22     5    Daily Minimum Semi-Private Rate-Comprehensive
                   0 Occupancy           23     5    Daily Minimum Semi-Private Rate-Comprehensive
                   0 Occupancy           24     5    Daily Minimum Semi-Private Rate-Comprehensive
                   0 Occupancy           1      6    Inpatient Days-Non-Comprehensive-Domiciliary
                   0 Occupancy           2      6    Inpatient Days-Non-Comprehensive-Domiciliary
                   0 Occupancy           3      6    Inpatient Days-Non-Comprehensive-Domiciliary
                   0 Occupancy           4      6    Inpatient Days-Non-Comprehensive-Domiciliary
                   0 Occupancy           5      6    Inpatient Days-Non-Comprehensive-Domiciliary
                   0 Occupancy           6      6    Inpatient Days-Non-Comprehensive-Domiciliary
                   0 Occupancy           7      6    Inpatient Days-Non-Comprehensive-Domiciliary
                   0 Occupancy           8      6    Inpatient Days-Non-Comprehensive-Domiciliary
                   0 Occupancy           9      6    Inpatient Days-Non-Comprehensive-Domiciliary
                   0 Occupancy           10     6    Inpatient Days-Non-Comprehensive-Domiciliary
                   0 Occupancy           11     6    Inpatient Days-Non-Comprehensive-Domiciliary
                   0 Occupancy           12     6    Inpatient Days-Non-Comprehensive-Domiciliary
                   0 Occupancy          12a     6    Inpatient Days-Non-Comprehensive-Domiciliary
                   0 Occupancy          12b     6    Inpatient Days-Non-Comprehensive-Domiciliary
                   0 Occupancy           15     6    Licensed beds at beginning of period-Non-Comprehensive-Domiciliary
                   0 Occupancy           16     6    Licensed beds at end of period-Non-Comprehensive-Domiciliary
                   0 Occupancy           17     6    Dates of change in number of certified beds-Non-Comprehensive-Domiciliary
                   0 Occupancy           18     6    Bed Days available during the period-Non-Comprehensive-Domiciliary
                   0 Occupancy           20     6    Daily Minimum Semi-Private Rate-Non-Comprehensive-Domiciliary
                   0 Occupancy           21     6    Daily Minimum Semi-Private Rate-Non-Comprehensive-Domiciliary
                   0 Occupancy           22     6    Daily Minimum Semi-Private Rate-Non-Comprehensive-Domiciliary
                   0 Occupancy           23     6    Daily Minimum Semi-Private Rate-Non-Comprehensive-Domiciliary
                   0 Occupancy           24     6    Daily Minimum Semi-Private Rate-Non-Comprehensive-Domiciliary
                   0 Occupancy         Specify  7    Inpatient Days-Non-Comprehensive-Specify Description
                   0 Occupancy           1      7    Inpatient Days-Non-Comprehensive-Specify
                   0 Occupancy           2      7    Inpatient Days-Non-Comprehensive-Specify
                   0 Occupancy           3      7    Inpatient Days-Non-Comprehensive-Specify
                   0 Occupancy           4      7    Inpatient Days-Non-Comprehensive-Specify
                   0 Occupancy           5      7    Inpatient Days-Non-Comprehensive-Specify
                   0 Occupancy           6      7    Inpatient Days-Non-Comprehensive-Specify
                   0 Occupancy           7      7    Inpatient Days-Non-Comprehensive-Specify
                   0 Occupancy           8      7    Inpatient Days-Non-Comprehensive-Specify
                   0 Occupancy           9      7    Inpatient Days-Non-Comprehensive-Specify
                   0 Occupancy           10     7    Inpatient Days-Non-Comprehensive-Specify
                   0 Occupancy           11     7    Inpatient Days-Non-Comprehensive-Specify
                   0 Occupancy           12     7    Inpatient Days-Non-Comprehensive-Specify
                   0 Occupancy          12a     7    Inpatient Days-Non-Comprehensive-Specify
                   0 Occupancy          12b     7    Inpatient Days-Non-Comprehensive-Specify
                   0 Occupancy           15     7    Licensed beds at beginning of period-Non-Comprehensive-Specify
                   0 Occupancy           16     7    Licensed beds at end of period-Non-Comprehensive-Specify
                   0 Occupancy           17     7    Dates of change in number of certified beds-Non-Comprehensive-Specify
                   0 Occupancy           18     7    Bed Days available during the period-Non-Comprehensive-Specify
                   0 Occupancy           20     7    Daily Minimum Semi-Private Rate-Non-Comprehensive-Specify
                   0 Occupancy           21     7    Daily Minimum Semi-Private Rate-Non-Comprehensive-Specify
                   0 Occupancy           22     7    Daily Minimum Semi-Private Rate-Non-Comprehensive-Specify
                   0 Occupancy           23     7    Daily Minimum Semi-Private Rate-Non-Comprehensive-Specify
                   0 Occupancy           24     7    Daily Minimum Semi-Private Rate-Non-Comprehensive-Specify
                   0 A                   16     2    Provision for Income Taxes
           ComprehensiB                  4    Specify Comprehensive Care-Other Government (specify) Description
                   0 B                   5    Specify Comprehensive Care Description
                   0 B                   6    Specify Comprehensive Care Description
The words contained in this file might help you see if this file matches what you are looking for:

...Data schedule line column description facility number medicaid provider name of street address city zip code county phone fein federal employer identification no contact person to for questions begin fiscal year end yes change in ownership during yearyes yearno seller if this cost report forseller buyer forbuyer indiv type ownershipindividual partner ownershippartnership corp ownershipcorporation church ownershipchurch other ownershipother specify state ownershipstate ownershipcounty ownershipcity constructed with tax exempt financing index occupancy and rate datayes certification provideryes statement operationsyes supporting schedulesrevenuesyes schedulesallowancesyes schedulesnursing careyes schedulesother patient schedulesroutineyes schedulesadministrativeyes schedulescapitalpropertyyes schedulesnonoperating revenuesyes adjustments expensesyes detailed analysisowner administratoryes analysisemployee benefitsyes analysiscentral office overheadyes analysisallocation indirect analysis...

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