Get Reporting Requirements And Instructions - Office Of Statewide ... - Oshpd Ca

This guide provides step-by-step instructions for completing the Reporting Requirements and Instructions from the Office of Statewide Health Planning and Development (OSHPD) for California long-term care facilities. The process outlined is designed to assist users regardless of their familiarity with legal requirements.

Follow the steps to complete the form effectively.

1. Press the ‘Get Form’ button to acquire the form and open it in your chosen editor.
2. Begin by entering the facility's legal name and State facility number in the designated fields.
3. Fill in the Medi-Cal provider number and any alternate business name if applicable.
4. Provide the facility's contact information, including the business telephone number, street address, city, and zip code.
5. If applicable, indicate the mailing address if it differs from the facility’s street address.
6. Complete the sections related to the administrator and contact person, ensuring to include their respective contact details.
7. Document any name or license number changes since the last reporting period.
8. Specify the reporting period's start and end dates.
9. After completing all necessary sections, ensure to sign the certification of the report to verify its accuracy.
10. Once all fields are filled out, save your changes, and download a copy for your records or send it as required.

Submit your completed form online as required by the Office of Statewide Health Planning and Development.