Providers

Client Data Collection and Reporting

Monthly Reporting - Other Services

Hospitalization/Institutional Lapse Form

Monthly Hospital/Institutional Lapse - Developmental Disability Microsoft Excel workbook format
Monthly Hospital/Institutional Lapse - Long Term Support Microsoft Excel workbook format

The Hospital / Institutional Lapse Report is used to collect units of service and case management hours for clients currently residing in a hospital or institution.

This is a monthly form that is required along with the Monthly Client Service Report (610 Report). Reports are due on the tenth (10th) of the following month, and must be submitted using the same procedure as the Client Service Reports.

06/21/2010