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Instructions for DSHS Form 04-442 Nursing Home Credit Balance Report - Washington
This document contains official instructions for DSHS Form 04-442 , Nursing Home Credit Balance Report - a form released and collected by the Washington State Department of Social and Health Services. An up-to-date fillable DSHS Form 04-442 is available for download through this link.
FAQ
Q: What is form DSHS 04-442?
A: Form DSHS 04-442 is the Nursing HomeCredit Balance Report used in Washington.
Q: Who needs to fill out form DSHS 04-442?
A: Nursing homes in Washington are required to fill out form DSHS 04-442.
Q: What is the purpose of form DSHS 04-442?
A: Form DSHS 04-442 is used to report credit balances held by nursing homes for residents who are no longer residing in the facility.
Q: When is form DSHS 04-442 due?
A: Form DSHS 04-442 is due on a quarterly basis, with specific due dates outlined by the Washington State Department of Social and Health Services (DSHS).
Q: Are there any penalties for not submitting form DSHS 04-442?
A: Failure to submit form DSHS 04-442 or submitting incomplete or inaccurate information may result in penalties imposed by the Washington State Department of Social and Health Services (DSHS).
Instruction Details:
- This 2-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 Washington State Department of Social and Health Services.
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