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- Click ‘Get Form’ to open the il form annual plan report in the editor.
- Begin by entering the hospital or hospital system name and mailing address, including city, state, and zip code. If the physical address differs from the mailing address, provide that information as well.
- Fill in the reporting period by specifying the start and end dates. Ensure you include the taxpayer number for accurate identification.
- If applicable, list all Illinois hospitals included in a consolidated financial report along with their addresses and FEIN numbers.
- Attach your organizational mission statement that outlines your commitment to community health care needs and its adoption date.
- Provide your most recent Community Benefits Plan, detailing goals for charity care and identifying served populations.
- Report charity care costs accurately based on your Medicare cost report, ensuring to attach your current charity care policy with its adoption date.
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