Cost Reporting and Review
Hospice
Dear Hospice Licensee:
Under the authority of Arizona Revised Statutes §§ 36-125.04 and 36-436, the Department revised the rules in Arizona Administrative Code, Title 9, Chapter 11, to specify requirements for hospice agency financial reporting. The revised rules were approved by the Governor’s Regulatory Review Council and filed with the Secretary of State on October 2, 2007. The rules specifying requirements for hospice agency financial reports are available on the Arizona Secretary of State’s web site. If you wish a courtesy hard copy of the Title 9, Chapter 11, rules please contact us.
All reports are to be submitted to the Department's Financial Reports Manager as e-mail attachments.
List of Hospice UAR Due Dates
(updated 07/19/2011)
There is one typeof hospice financial report required by the Department.
The Hospice Uniform Accounting Report (UAR)
The Hospice UAR is due 150 days after the hospice’s fiscal year end.
The Hospice UAR (see form 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 hospice UAR consists of:
- A Hospice Uniform Accounting Report Form, filled out with hospice-specific data;
- A copy of the Hospice’s Medicare and Medicaid Cost Report – An e-mail copy of the report in PDF format is required.
- A Statement of Cash Flows.
- Attestation of Completeness and Accuracy Form
, (updated 07/08/2011) completed by the hospice’s administrator.
Hospice Uniform Account Report
- 2011 Hospice Uniform Account Report (updated 07/05/2012)
- 2010 Hospice Uniform Account Report (updated 08/26/2011)
- 2009 Hospice Uniform Account Report (updated 03/18/2011)
- 2008 Hospice Uniform Account Report
- 2007 Hospice Uniform Account Report