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FOR BHF USELL1
2013
STATE OF ILLINOIS
DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
FINANCIAL AND STATISTICAL REPORT (COST REPORT)
FOR LONGER CARE FACILITIES
(FISCAL YEAR 2013)I.DPH License ID Number:
Facility
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How to fill out lexington hlth cr ctr-lombard
01
Step 1: Obtain the necessary paperwork from the admissions office of Lexington Health Care Center-Lombard.
02
Step 2: Fill out the personal information section, including your full name, address, phone number, and date of birth.
03
Step 3: Provide your health insurance information, if applicable.
04
Step 4: Specify the reason for your visit and the services you require at Lexington Health Care Center-Lombard.
05
Step 5: If you have any medical conditions or allergies, make sure to mention them in the appropriate section.
06
Step 6: Review the completed form for accuracy and completeness.
07
Step 7: Sign and date the form.
08
Step 8: Submit the filled out form to the admissions office or the designated drop-off location.
Who needs lexington hlth cr ctr-lombard?
01
Individuals who require medical care and services provided by Lexington Health Care Center-Lombard.
02
Patients with chronic illnesses or disabilities in need of specialized care.
03
Individuals in need of rehabilitation services or physical therapy.
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Elderly individuals who require long-term care or assistance with daily activities.
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People in need of short-term rehabilitation after surgery or hospitalization.
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What is lexington hlth cr ctr-lombard?
Lexington Health Care Center-Lombard is a healthcare facility providing nursing and rehabilitation services in Lombard, Illinois.
Who is required to file lexington hlth cr ctr-lombard?
The facility administrators or designated personnel are required to file Lexington Health Care Center-Lombard reports.
How to fill out lexington hlth cr ctr-lombard?
Lexington Health Care Center-Lombard reports can be filled out online through the designated portal provided by the facility.
What is the purpose of lexington hlth cr ctr-lombard?
The purpose of Lexington Health Care Center-Lombard reports is to track and report patient care and services provided by the facility.
What information must be reported on lexington hlth cr ctr-lombard?
Information such as patient admissions, discharge summaries, medication administration records, therapy sessions, and any incidents must be reported on Lexington Health Care Center-Lombard reports.
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