Loading
Get 470-0030 Financial And Statistical Report - Iowa Department Of ... - Dhs State Ia
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the 470-0030 Financial And Statistical Report - Iowa Department Of Human Services online
This guide provides clear and detailed instructions on filling out the 470-0030 Financial And Statistical Report for the Iowa Department of Human Services. It is structured to assist users of all experience levels in completing this important financial document accurately and efficiently.
Follow the steps to successfully complete the report online.
- Click the ‘Get Form’ button to access the report. This action will open the document for you to begin filling out the necessary information.
- Complete the header section of the form, which includes fields such as the Federal ID Number, Facility Name, Physical Address, and the reporting period details. Ensure that all mandatory fields are filled correctly.
- In the section labeled ‘Type of Control’, check the appropriate box that corresponds to the ownership type of your facility, such as Government or Non-Profit Organization.
- Fill out the 'Vendor Number' and other related fields, including the dates indicating when the facility was acquired and when it entered the program.
- Provide detailed information in the ‘Statistical Data’ section, including the number of authorized beds, patient days, and occupancy rates for the reporting period.
- Complete the revenue section by detailing all sources of revenue on Schedule A, and follow with necessary adjustments in Schedule B if applicable.
- Proceed to fill in added schedules as required, including Schedules C (Expenses) and D (Depreciation), ensuring that all information aligns with your financial records.
- Review all entries for accuracy and completeness, using the Edit and Print tabs available in the workbook for compatibility with your computer's printing settings.
- Once all sections are filled out, save your progress. You can then download, print, or share the completed report by using the functionalities provided within the workbook.
Complete your 470-0030 Financial And Statistical Report online today for timely submission!
Questions on Medicaid and Applying for Health Care Coverage: If you're looking for information about health care coverage options and how to apply for Medicaid, call the Department of Human Services Contact Center toll-free at 1-855-889-7985, Monday-Friday, 7:00 a.m.- 6:00 p.m.
Industry-leading security and compliance
US Legal Forms protects your data by complying with industry-specific security standards.
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.