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Get Nursing Home Administrator Report Section 475102 D
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How to fill out the NURSING HOME ADMINISTRATOR REPORT Section 475102 D online
This guide provides clear and supportive instructions for filling out the NURSING HOME ADMINISTRATOR REPORT Section 475102 D online. Follow these detailed steps to ensure your form is completed accurately and efficiently.
Follow the steps to complete the NURSING HOME ADMINISTRATOR REPORT online.
- Select the ‘Get Form’ button to access the report and open it for editing.
- Begin by providing your personal information at the top of the form including your name, job assignment code, and contact information.
- Indicate whether your contact information has changed by checking the appropriate box.
- In the employment section, list each place of employment from the past 12 months. Enter the dates of employment, including the month and year for both the start and end dates.
- For each employment entry, provide the workplace name, county, state, and phone number.
- If any of your places of employment do not qualify as a nursing home, check the corresponding box.
- Record the average number of hours worked per day for each day of the week.
- After completing all sections that apply, sign and date the form where indicated.
- Finally, save your changes, then download, print, or share the form as needed to submit it.
Complete the NURSING HOME ADMINISTRATOR REPORT online today!
The Nursing Home Care Compare web site features a quality rating system that gives each nursing home a rating of between 1 and 5 stars. Nursing homes with 5 stars are considered to have much above average quality and nursing homes with 1 star are considered to have quality much below average.
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