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FOR OF USELL1
2002STATE OF ILLINOIS
DEPARTMENT OF PUBLIC AID
FINANCIAL AND STATISTICAL REPORT FOR
LONGER CARE FACILITIES
(FISCAL YEAR 2002)I.DPH Facility ID Number:
Facility Name:0025239II.CERTIFICATION
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What is rolling hills manor?
Rolling Hills Manor is a residential care facility for the elderly.
Who is required to file rolling hills manor?
The owner or operator of Rolling Hills Manor is required to file.
How to fill out rolling hills manor?
To fill out Rolling Hills Manor, the owner or operator must provide information about the facility and its residents.
What is the purpose of rolling hills manor?
The purpose of Rolling Hills Manor is to provide care and support for elderly residents.
What information must be reported on rolling hills manor?
Information such as resident demographics, facility amenities, and quality of care provided must be reported on Rolling Hills Manor.
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