PDF
Word
Form DHCS3076 Intermediate Care Facility for the Developmentally Disabled Habilitative / Nursing (Icf-Ddh / N) Cost Report - California
What Is Form DHCS3076?
This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California. Check the official instructions before completing and submitting the form.
FAQ
Q: What is the DHCS3076 form?A: The DHCS3076 form is a cost report for Intermediate Care Facilities for the Developmentally Disabled Habilitative/Nursing (ICF-DDH/N) in California.
Q: Who is required to complete the DHCS3076 form?A: Intermediate Care Facilities for the Developmentally Disabled Habilitative/Nursing (ICF-DDH/N) in California are required to complete the DHCS3076 form.
Q: What is the purpose of the DHCS3076 form?A: The purpose of the DHCS3076 form is to report the costs and expenses incurred by Intermediate Care Facilities for the Developmentally Disabled Habilitative/Nursing (ICF-DDH/N) in California.
Q: What information is included in the DHCS3076 form?A: The DHCS3076 form includes information about the facility's revenues, expenses, patient days, staffing, and other related data.
Q: When is the DHCS3076 form due?A: The due date for submission of the DHCS3076 form is specified by the California Department of Health Care Services (DHCS). Facility operators should adhere to the specified deadline.
Q: Are there any penalties for late submission of the DHCS3076 form?A: Failure to submit the DHCS3076 form by the specified deadline may result in penalties or sanctions imposed by the California Department of Health Care Services (DHCS).
Form Details:
- Released on May 1, 2016;
- The latest edition provided by the California Department of Health Care Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form DHCS3076 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
Download Form DHCS3076 Intermediate Care Facility for the Developmentally Disabled Habilitative / Nursing (Icf-Ddh / N) Cost Report - California
1
2
3
4
5
6
7
8
