SB 650 (Chapter 493, Statutes of 2021), the Corporate Transparency in Elder Care Act of 2021, was signed into law on October 4, 2021, as Health and Safety Code Section 128734.1. This statute authorizes the Department of Health Care Access and Information (HCAI) to collect from each facility licensed as a Skilled Nursing Facility (SNF) (1) an Annual Consolidated Financial Report (ACFR) of the organization that operates, conducts, owns, manages, or maintains the SNF, (2) individual financial statements of operating entities, licenseholders, and related parties that transacted with the SNF, and (3) detailed visual representations of the organizational structure that includes related parties and/or unrelated parties. HCAI will review the ACFRs and related documents to ensure compliance with the reporting requirements. The submitted information will be made available to the public on our website.

SNFs that are government-owned or district-operated are exempt from these requirements.

Submission of SNF Annual Consolidated Financial Reports

ACFRs are due annually four (4) months after the SNF’s fiscal year-end.

Documents must be in text-based, machine-readable Portable Document Format (.pdf).

Documents must be submitted through HCAI’s System for Integrated Electronic Reporting and Auditing (SIERA).

Submission must include a Certification Form signed by a duly authorized official of the health facility or of the health facility’s home office. A recommended blank form is available for download here and in SIERA on the Submit Reports page.

Document types are as follows:

  • ACFR: includes consolidated financial statements, combined financial statements, consolidated Statement of Patient Census, consolidated Statement of Patient Revenue, and audit report (if audited by a CPA).
  • Individual Financial Statements: for each operating entity, licenseholder, and related party in which the organization has an ownership or control interest of 5% or more and that provides any service, facility, or supply to the SNF; unless the related party financial information is already included in the consolidated report.
  • Organizational Structure – Related Parties: visual representation that includes all related parties in which the organization has an ownership or control interest of 5% or more and that provide any service, facility, or supply to the SNF.
  • Organizational Structure – Unrelated Parties: visual representation that includes unrelated parties that provide services, facilities, or supplies to the SNF or to facilities that are operated, conducted, owned, managed, or maintained by the organization (including, but not limited to, management companies and property companies) and that are paid more than $200,000 by the SNF.

SNF Annual Consolidated Financial Report Guide

SIERA SNF ACFR QuickStart Guide Series

Request an Extension

HCAI may grant a 90-day extension for submitting annual consolidated financial reports.

An extension request may be submitted online by clicking the Request Extension tab found in the top banner of the SNF ACFR pages in SIERA. Please view the QuickStart Guide – Starting a New Report for more information.

Late Submission

HCAI may impose a fine of $100 per day, not to exceed $36,500 annually, on a SNF for failure to submit the report.

Find SNF Annual Consolidated Financial Reports

Search for by facility name (or HCAI ID, city, or county) to view completed SNF ACFRs.

Additional Resources

Contact Us

For all inquiries related to the SNF Financial and Ownership Transparency program, please contact us via email at financial@hcai.ca.gov or via phone at (916) 326-3240. This inbox is supported Monday – Friday 8:00 a.m. to 5:00 p.m. PST, excluding State of California observed holidays.

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