
Get the free Administrator (Type or Print Name) David Paluck - hfs illinois
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FOR BHF USELL1
2022STATE OF ILLINOIS
DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES
FINANCIAL AND STATISTICAL REPORT (COST REPORT)
FOR LONGER CARE FACILITIES
(FISCAL YEAR 2022)
I.DPH License ID Number:
Facility
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What is administrator type or print?
Administrator type or print refers to a specific format or classification of documents that must be filed by administrators managing certain entities, such as trusts or estates.
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The information that must be reported includes the name of the administrator, details of the entity being managed, the purpose of administration, and any relevant financial information.
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