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FOR BHF USELL1
2021STATE OF ILLINOIS
DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
FINANCIAL AND STATISTICAL REPORT (COST REPORT)
FOR LONGER CARE FACILITIES
(FISCAL YEAR 2021)
I.DPH License ID Number:
Facility
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Individuals who are seeking medical assistance and support at home in the state of Illinois
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Medi home hfshome wwwhfsillinoisgovhome is a form used to report home and community-based services provided to individuals in Illinois.
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The purpose of medi home hfshome wwwhfsillinoisgovhome is to ensure that home and community-based services in Illinois are being provided properly and meet the necessary requirements.
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Information such as the type of services provided, the number of hours spent providing services, and the individual receiving the services must be reported on medi home hfshome wwwhfsillinoisgovhome.
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