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FOR BHF USELL1 2019STATE OF ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES FINANCIAL AND STATISTICAL REPORT (COST REPORT) FOR LONGER CARE FACILITIES (FISCAL YEAR 2019) I.DPH License ID Number: Facility
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To fill out Caseyville Nursing & Rehabilitation form, follow the steps below:
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Obtain a copy of the form from the facility or their website.
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Read all the instructions and guidelines provided with the form.
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Fill in your personal information accurately, including your name, address, contact details, and date of birth.
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Provide your medical history, including any diseases or conditions you have or had in the past.
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Specify any medications you are currently taking.
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Mention any allergies or adverse reactions you have experienced to medications or treatments.
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If applicable, provide details of your insurance coverage or any other financial information required.
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Sign and date the form, indicating that all the information provided is true and accurate.
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Submit the completed form to Caseyville Nursing & Rehabilitation as instructed.

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Caseyville Nursing & Rehabilitation is suitable for individuals who require comprehensive nursing and rehabilitative care.
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Caseyville Nursing & Rehabilitation is designed to provide compassionate and professional care to individuals who need support and assistance in their daily lives.
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Caseyville Nursing & Rehabilitation is a healthcare facility that provides skilled nursing care and rehabilitation services to patients.
The management of Caseyville Nursing & Rehabilitation is responsible for filing the necessary reports.
The forms can be filled out electronically or manually, following the specific instructions provided by the facility.
The purpose of Caseyville Nursing & Rehabilitation is to provide high-quality care and improve the health outcomes of patients.
All relevant patient information, treatment plans, progress notes, and any other data required for proper care and record-keeping.
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