File HBHC_MEDICAL_FOSTER_HOME(633.2) Data List
| NAME |
OPENED DATE |
ZIP CODE |
LICENSE REQUIRED |
LICENSE EXPIRATION DATE |
NURSE INSPECTION |
SOCIAL WORK INSPECTION |
DIETITIAN INSPECTION |
FIRE/SAFETY INSPECTION |
PHONE NUMBER |
HOME OPERATION TRAINING DATE |
FIRE/SAFETY TRAINING DATE |
PRIMARY CAREGIVER NAME |
MEDICATION MANAGEMENT TRN DATE |
PERSONAL CARE TRAINING DATE |
INFECTION CONTROL TRAIN DATE |
END OF LIFE ISSUES TRAIN DATE |
OTHER TRAINING DATE |
COUNTY CODE |
CAREGIVER DATE OF BIRTH |
FORM 7 TRANSMIT STATUS |
FORM 7 FILED IN HBHC(634) |
FORM 7 BATCH INITIAL MM MSG # |
MAXIMUM PATIENTS |
FORM 7 MAIL MESSAGE DATE |
FORM 7 TRANSMIT FLAG EDIT DATE |
FORM 7 TRANSMIT FLAG EDIT DUZ |
FORM 7 RE-TRANS BATCH MM MSG # |
FORM 7 RE-TRANSMIT DATE |
PARENT SITE |
BEDBOUND PATIENT MAXIMUM |
CLOSURE DATE |
VOLUNTARY CLOSURE |
ADDRESS |
CITY |
STATE CODE |