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DEPARTMENT OF HEALTH SERVICES Division of Long Term Reinstate OF WISCONSINF01812 (9/2015)WISCONSIN MEDICAID PROGRAM 2015 NURSING HOME COST REPORT Completion of this form is required by Section 1.171
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Bloomfield Healthcare & Rehabilitation is a healthcare facility that provides medical care and rehabilitation services to patients.
The management or owner of Bloomfield Healthcare & Rehabilitation is required to file the necessary reports.
The form can be filled out online or submitted via mail, following the instructions provided by the regulatory agency.
The purpose of Bloomfield Healthcare & Rehabilitation is to provide quality healthcare and rehabilitation services to those in need.
Information such as patient demographics, medical treatments, outcomes, and financial data must be reported on the form.
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