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This version of the form is not currently in use and is provided for reference only. Download this version of
Instructions for Form DHCS3076
for the current year.
Instructions for Form DHCS3076 Supplemental Cost Report for Intermediate Care Facilities (Habilitative or Nursing) - California
This document contains official instructions for Form DHCS3076 , Supplemental Cost Report for Intermediate Care Facilities (Habilitative or Nursing) - a form released and collected by the California Department of Health Care Services. An up-to-date fillable Form DHCS3076 is available for download through this link.
FAQ
Q: What is Form DHCS3076?
A: Form DHCS3076 is a supplemental cost report.
Q: What are the types of facilities covered by this form?
A: The form covers Intermediate Care Facilities (Habilitative or Nursing) in California.
Q: What is the purpose of this form?
A: The form is used to report supplemental cost information for these facilities.
Q: Who needs to file this form?
A: Intermediate Care Facilities (Habilitative or Nursing) in California are required to file this form.
Q: When is the deadline to file this form?
A: The deadline to file this form is usually specified by the DHCS. Please refer to the instructions or contact the DHCS for the deadline.
Q: Are there any fees associated with filing this form?
A: The form itself does not have any fees associated with it. However, there may be other fees or costs related to the operation of the facility.
Q: Are there any penalties for not filing this form?
A: Failure to file this form or to provide accurate and complete information may result in penalties or other enforcement actions by the DHCS.
Q: Are there any additional documents required to be submitted with this form?
A: The instructions provided with the form will specify if any additional documents are required to be submitted.
Q: Who can I contact for more information or assistance?
A: For more information or assistance, you can contact the California Department of Health Care Services (DHCS) or refer to the instructions provided with the form.
Instruction Details:
- This 7-page document is available for download in PDF;
- Actual and applicable for the current year;
- Complete, printable, and free.
Download your copy of the instructions by clicking the link below or browse hundreds of other forms in our library of forms released by the California Department of Health Care Services.
Download Instructions for Form DHCS3076 Supplemental Cost Report for Intermediate Care Facilities (Habilitative or Nursing) - California
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