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FOR BHF USELL1
2016
STATE OF ILLINOIS
DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
FINANCIAL AND STATISTICAL REPORT (COST REPORT)
FOR LONGER CARE FACILITIES
(FISCAL YEAR 2016)I.DPH License ID Number:
Facility
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Date of change in refers to the date when a change was made to a particular record or document.
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The individual or entity responsible for making the change is typically required to file the date of change in.
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To fill out the date of change in, simply write down the date when the change occurred in the designated field.
What is the purpose of date of change in?
The purpose of date of change in is to keep track of when modifications were made to important records or documents.
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The date of the change and a brief description of the modification made must be reported on the date of change in.
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