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Census-For the entire report period. Patient Days by Level of Care and Primary Source of Payment Public Aid Recipient Private Pay Total SNF SNF/PED ICF ICF/DD SC DD 16 OR LESS C. FOR OHF USE LL1 STATE OF ILLINOIS DEPARTMENT OF PUBLIC AID FINANCIAL AND STATISTICAL REPORT FOR LONG-TERM CARE FACILITIES FISCAL YEAR 2000 I. Declaration of preparer other than provider is based on all information of which preparer has any knowledge. E.g. day care meals on wheels outpatient therapy Beds at End of Bed...
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4237 s is a tax form used to report information related to certain financial transactions.
Individuals or entities involved in the specified financial transactions are required to file Form 4237 s.
Form 4237 s must be filled out accurately and completely with all the required information related to the financial transactions.
The purpose of Form 4237 s is to report specific financial information to the appropriate tax authorities.
Information such as the amount of the financial transaction, the parties involved, and other relevant details must be reported on Form 4237 s.
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