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FOR BHF USELL1 2022STATE OF ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES FINANCIAL AND STATISTICAL REPORT (COST REPORT) FOR LONGTERM CARE FACILITIES (FISCAL YEAR 2022) I.IDPH License ID Number: Facility Name:0044149II.220 North First St NumberCounty:CookTelephone Number:8474598700Wheeling City60090 Zip CodeFax # 8474659957Date of Initial License for Current Owners:4/1/2002Type of Ownership: VOLUNTARY,NONPROFIT X Charitable Corp.Trust IRS Exemption

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How to fill out enrolled long term care

01

Obtain the enrolled long term care application form from the relevant health department or website.

02

Fill out personal information, including your name, address, and contact details.

03

Provide details about your medical history and current health status.

04

Include information about your financial situation, such as income and assets.

05

List any current medications or treatments you are undergoing.

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Indicate the level of care or assistance needed, such as help with daily activities.

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Submit the application form to the designated agency or department.

Who needs enrolled long term care?

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Individuals who require assistance with daily living activities due to chronic illness or disability.

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Seniors who need support as they age and may not be able to live independently.

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People recovering from serious injuries or surgeries that require extended care.

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Individuals with mental health conditions that impact their ability to live independently.

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What is enrolled long term care?

Enrolled long term care refers to a type of insurance or health care plan that provides coverage for long-term services, including personal care and assistance for individuals with chronic illnesses or disabilities.

Who is required to file enrolled long term care?

Individuals who have enrolled in a long-term care insurance policy or program may be required to file paperwork to maintain eligibility for benefits or to ensure compliance with regulatory requirements.

How to fill out enrolled long term care?

To fill out enrolled long term care documentation, individuals should gather necessary personal and financial information, complete any required forms accurately, and submit them according to the instructions provided by the insurance provider or regulatory agency.

What is the purpose of enrolled long term care?

The purpose of enrolled long term care is to provide financial and resource support for individuals who need long-term assistance due to aging, disability, or chronic illness, ensuring they receive the care necessary to maintain their quality of life.

What information must be reported on enrolled long term care?

Information typically required on enrolled long term care documentation includes personal identification details, health status, type and extent of required care services, financial status, and any prior usage of benefits.

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