Get the free Fax # 309-792-5980

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 None Beds at End...

How to fill out fax 309-792-5980

How to fill out fax 309-792-5980

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