ASSISTED LIVING FACILITIES ANNUAL REPORT
DEFINITIONS AND INSTRUCTIONSPLEASE READ THESE INSTRUCTIONS BEFORE COMPLETING THE ANNUAL REPORT.
THIS REPORT MUST BE SUBMITTED ELECTRONICALLY. PAPER FORMS WILL NOT BE ACCEPTED!
All information given in this Annual Report should be for services rendered to clients in Arkansas. Please do not include data on clients residing in a state other than Arkansas
- Facility Name and Address: List only the name and location of the Facility in Arkansas for which this data is reported. Do not list the home office/corporate headquarters if that is not the Facility submitting this data.
- Vendor Number & License Number: It is now required to submit these numbers to help identify which data matches official facilities.
- County: Please name the county the report is for. Each county served must have a separate report.
A. Resident Occupancy Days
- Number of unavailable Resident Occupancy Days: Number of RODs for which beds were not available for immediate occupancy, for example, beds that were in rooms that were converted to office, storage, or other than resident use or rooms licensed for 2 beds but used for 1 resident bed in 2021.
- Total number of residents in 2021: This total includes the number of residents in your facility on January 1, 2021 plus the number of new admissions in 2021.
- Total number of resident days for your facility in 2021: A resident day is one resident in a bed for one day. If you had one resident for a year that would be 365 resident days; for a resident that did not stay for the entire year, count the number of days that the resident was in your facility. For example, a resident who stayed for 54 days would equal 54 resident days.
- Total number of Discharge days for your facility in 2021: The term "Discharge Days" is one method of calculating
an average length of stay for long term care facilities. Discharge days are the sum of the number of resident days for each resident who was discharged in 2021. For example, if 5 persons were discharged after 30 days in your facility and 6 residents were discharged after 15 days in your facility, the total number of discharge days would be (5 x 30) +(6 x 15) which equals 150 + 90 = 240 total discharge days.
- Average length of stay (in days) for discharged residents in your facility: Average length of stay [LOS] is calculated by total discharge days / number of total discharges. Using the above example, total discharge days = 240 and total discharges = 5+6 or 11; therefore, average LOS = 240/11 = 21.8 days.
- Average length of stay for the total facility for 2021: Average length of stay for one year period is calculated by adding the number of resident days and dividing it by the total number of residents in 2021.
- Annual Percentage of Turnover: Annual turnover percentage is calculated by the number of discharges divided by the number of residents in 2021. For example of the number of discharges = 10 and the number of residents who lived in your facility in 2021 is 120, then your turnover is 8%.
IV. RESIDENT INFORMATION
B. 2021 Admissions by Race / Ethnicity
- TOTAL (should be equal total # of admissions for 2021, both males and females): This means that the sum here
should be equal to the total of by age and gender admitted in 2021 from Section A.
- Total: (this total should equal the resident discharge total of 120, from page 3 question D.4): This flags your sum as "red" if it doesn't equal the value for resident discharge total, which was captured on page 3 (the 4th question in section D: "Total number of residents who were discharged (including death) from your
facility in 2021"). You can expect it to be red as you enter data for this section, but by the time you are done entering "Other (Specify)" you
values should match and the font color should be black.
G. Formal Services Used (Within Last 90 Days)
- Did individual residents contract with a home health company in the last year?: If you have "No" selected then you can not enter a following value for "If yes, how many?"…the application will zero out your entry. Only a "Yes" selection allows a value to be entered.
* Please check your totals for all items in all sections.
* Please check your database entries after entering to make sure that the system took the information. Start by clicking the Display Data link at the bottom of the page. There you can see the progress made on each of the eight steps of the survey:
A 'Y' indicates a page with non-zero values entered.
A '0' indicates a page where the numeric fields are blank or just zero in value.
A 'N' indicates a page that was skipped.
To return to the actual survey, click the linked County name and it will take you to the first page. You can navigate to specific pages by clicking the number of the page on the progress bar at the top of each page.