FQHC Cost Report Preparation Checklist

It covers the annual data-gathering work needed before preparing the FQHC Medicare cost report, including visit counts, revenue records, payroll support, and cost allocations. The checklist is meant to help you collect and verify source documents before the report is assembled. It does not replace the actual cost report or the accounting work behind it. Use it as the preparation layer that keeps the filing process organized.

This template is designed for annual use because the cost report itself is filed on an annual cycle. Many centers also use it as a pre-close checklist in the weeks leading up to year-end so missing records can be found early. If your finance team closes books in stages, you can add interim review points without changing the annual cadence. The key is to keep the recurrence tied to your reporting calendar.

The DRI is usually someone in finance, reimbursement, or revenue cycle who can coordinate across accounting, operations, and clinical administration. Individual checklist items may be assigned to payroll, billing, grants, or clinic managers depending on where the source data lives. The owner should be able to verify completion, resolve blockers, and escalate missing records. This is not a task for a single person to complete in isolation.

Yes, this template is built around the preparation work for the FQHC Medicare cost report, including CMS-222-17 support. It is not a generic healthcare compliance checklist and should not be used as a substitute for other facility types or other report forms. If your organization operates multiple entities, you can clone it and tailor the items to each reporting entity. That keeps the scope clear and avoids mixing data from different cost centers.

The most common issues are missing source documents, mismatched visit counts, incomplete payroll support, and unclear allocation methods for shared costs. Another frequent problem is waiting until the filing deadline to reconcile revenue or encounter data, which creates blocking work for finance and billing teams. This checklist helps surface those gaps early so they can be resolved before the report is drafted. It also reduces the risk of relying on memory instead of verified records.

Start by matching the checklist items to your chart of accounts, cost centers, and reporting entities. Then add or remove items based on how your center captures visits, grants, sliding fee revenue, and provider payroll. If you use a third-party billing system or EHR, include the exact exports or verification steps needed from those systems. Keep each item independently verifiable so the team can answer yes, no, or N/A without ambiguity.

Yes, it can be adapted to fit the systems you already use by naming the exact reports, exports, or reconciliations that need to be completed. Common integrations include accounting software, payroll systems, billing platforms, and EHR encounter reports. The checklist should still focus on the human verification step, not just the data pull. That way you know the numbers were checked, not merely exported.

An ad hoc spreadsheet often loses ownership, timing, and verification history, especially when several departments contribute data. Email threads make it hard to see which items are blocking, which are complete, and which still need review. This checklist gives you a single task list with clear owners, recurrence, and completion criteria. That makes the preparation process easier to audit and easier to repeat next year.