ASSISTED LIVING FACILITIES ANNUAL REPORT
DEFINITIONS AND INSTRUCTIONS
PLEASE 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

I. MANAGEMENT/OWNERSHIP

II. FACILITY

  A. Resident Occupancy Days

  D. Utilization

IV. RESIDENT INFORMATION

  B. 2019 Admissions by Race / Ethnicity

  DISCHARGES

  G. Formal Services Used (Within Last 90 Days)

* 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.