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Get the free ISDH Hospital Service Report State Form 49476 (R /7-02) IC 16-21-6

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ISDN Hospital Service Report State Form 49476 (R /702) IC 16216Status: Finalized I. Hospital Information Hospital FRANCISCAN HEALTH DYER Name: Provider #: 150090 City: Dyer County: Lake Year: 2019
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01
Obtain the ISDH Hospital Service Report form from the appropriate source.
02
Start by entering the relevant information in the header section of the form, such as the hospital's name, address, and contact details.
03
Fill out the patient information section, including the patient's name, date of birth, and medical record number.
04
Provide a detailed description of the services provided by the hospital in the designated section. Include information on any procedures, treatments, medications, and consultations.
05
If applicable, indicate any complications or adverse events that occurred during the period covered by the report.
06
Document any notable observations or findings related to the patient's condition or treatment.
07
Ensure that all the required fields are completed and any necessary supporting documentation is attached.
08
Review the completed report for accuracy and completeness before submitting it to the appropriate authority or designated person.
09
Keep a copy of the filled-out report for your records.
10
If you have any questions or need assistance, refer to the instructions provided with the form or contact the relevant authority.

Who needs isdh hospital service report?

01
The ISDH Hospital Service Report is typically needed by healthcare facilities and organizations responsible for oversight and monitoring of hospital services.
02
This includes government agencies, regulatory bodies, quality assurance departments, and other entities involved in healthcare administration and policy-making.
03
The report helps in assessing the quality, safety, and effectiveness of hospital services, as well as tracking trends and identifying areas for improvement.
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ISDH hospital service report is a report that hospitals in Indiana are required to file with the Indiana State Department of Health to provide information on the services they offer.
All hospitals in Indiana are required to file the ISDH hospital service report.
The ISDH hospital service report can be filled out online through the Indiana State Department of Health's website.
The purpose of the ISDH hospital service report is to gather information on the types of services and care that hospitals in Indiana provide.
Hospitals must report information on the types of medical services offered, number of patients served, and any quality improvement initiatives.
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