Get Monthly Facility Occupancy Report Form - Division Of Health Care ... - Dhcfp State Nv

Filling out the Monthly Facility Occupancy Report Form is essential for nursing and intermediate care facilities in Nevada. This guide provides a comprehensive overview of how to accurately complete the form to ensure timely submission and compliance.

Follow the steps to complete the form accurately and efficiently.

1. Click ‘Get Form’ button to access the Monthly Facility Occupancy Report Form and open it in your document editor.
2. Begin by entering the facility name in the designated field at the top of the form. Ensure this is the official name of the facility to avoid discrepancies.
3. Provide the census details as of midnight on the first day of the month. Accurately reflect the number of occupied beds categorized by payment sources, including Medicaid, Medicare, County, Private, and VA.
4. For certified beds not available for occupancy, specify the reason for unavailability in the appropriate field.
5. Complete the certification statement as of the reporting date and sign with the name of the individual filling out the form. This attests to the accuracy of the information provided.
6. Once all fields are filled out completely, save your changes. You can then download, print, or share the form as needed. Ensure the completed form is submitted by the deadline, the 5th day of the month.

To ensure compliance, complete and submit your Monthly Facility Occupancy Report Form online today.