Health Facilities and Services Review Board
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ANNUAL FACILITY QUESTIONNAIRES
SCHEDULE FOR CALENDAR YEAR 2012 DATA COLLECTION


AMBULATORY SURGICAL CENTER QUESTIONNAIRE
Distributed: January 28, 2013
Date Due: February 28, 2013
SURVEY WORKSHEET AND DEFINITIONS
PATIENT ORIGIN WORKSHEET


ANNUAL END-STAGE RENAL DIALYSIS (ESRD) FACILITY SURVEY
Distributed: February 15, 2013
Date Due: March 18, 2013
SURVEY WORKSHEET AND DEFINITIONS


ANNUAL HOSPITAL BED REPORT
Distributed: February 28, 2013
Date Due: March 31, 2013
BED REPORT INSTRUCTIONS AND DEFINITIONS
Link to ABR report is included in the email distributed February 28, 2013


ANNUAL HOSPITAL QUESTIONNAIRE
Distributed: February 28, 2013
Date Due: March 31, 2013
SURVEY WORKSHEET AND DEFINITIONS
Link to On-Line AHQ is included in the email distributed February 28, 2013


LONG-TERM CARE FACILITY QUESTIONNAIRE
Distributed: March 15, 2013
Date Due: April 19, 2013
Worksheets, including Online Screens and Definitions, by Facility Type
Worksheet for Nursing Care (Skilled and Intermediate) Facilities
Worksheet for Hospital-Based LTC Facilities
Worksheet for Facilities Providing Skilled Under 22 Care
Worksheet for Facilities Providing ICF DD Care


Illinois Health Facilities and Services Review Board
2nd Floor
525 West Jefferson Street
Springfield, Illinois 62761
Phone 217-782-3516
Fax 217-785-4111
TTY 800-547-0466
Questions or Comments