Financial data request (due 8/5)

The Senate Appropriations Committee, in conjunction with the Department of Health, has initiated a financial resiliency study of healthcare facilities to better understand the financial resiliency of Assisted Living Facilities and Personal Care Homes, and the lasting impact of COVID. To assist in this effort, we kindly request that you complete this survey to provide basic financial data for FY19 and FY20. A list of metrics requested in the following pages can be found below. We expect that this request will take no more than a few minutes.

Note that these data are for internal use only. Facility-level responses will be kept CONFIDENTIAL; any analyses and reporting will be done in aggregate.
Please submit by end-of-day Thursday, 8/5
For any questions, please reach out to 

This survey has four pages. Below are the metrics requested in the following pages.

Metrics requested (FY19 and FY20) at the FACILITY LEVEL

Income statement:

Net patient revenue
Operating expenses
Net income
Payroll expense
Personnel benefits expense
Depreciation expense
Interest expense

Balance sheet:
Cash on hand
Temporary investments
Current assets
Total assets
Current liabilities
Total liabilities


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