Cash Flow Forecast - California Department Of Public Health
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1
2State of California - Health and Human Services Agency
California Department of Aging
CASH FLOW FORECAST
(Licensee Name)
________________________________________
(Center Name)
FROM ____________________ TO _______________________
July
August
September
October
November
December
January
February
March
April
May
June
BEGINNING CASH
$
$
$
$
$
$
$
$
$
$
$
$
BALANCE
REVENUE FROM
OPERATIONS
Medi-Cal
Participants
Donations
Other Funding Sources
TOTAL REVENUES
$
$
$
$
$
$
$
$
$
$
$
$
EXPENDITURES
Administration
$
$
$
$
$
$
$
$
$
$
$
$
Medical & Nursing
Physical Therapy
Occupational Therapy
Speech Therapy
Psychosocial Services
Nutrition
Supportive Services
Transportation
Other
TOTAL EXPENDITURES
$
$
$
$
$
$
$
$
$
$
$
$
LESS: NONCASH ITEMS
Depreciation
$
$
$
$
$
$
$
$
$
$
$
$
Amortization
Other
($
)
($
)
($
)
($
)
($
)
($
)
($
)
($
)
($
)
($
)
($
)
($
)
Cash from Operations
$
$
$
$
$
$
$
$
$
$
$
$
ADD: OTHER REVENUES
Income from Investments
$
$
$
$
$
$
$
$
$
$
$
$
Other
LESS: OTHER
EXPENDITURES
Purchase of Fixed Assets
Other
ENDING CASH BALANCE
$
$
$
$
$
$
$
$
$
$
$
$
IMS 35 (10/02)
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