Providers

Client Data Collection and Reporting

Monthly Reporting – Other Services

Hospitalization/Institutional Lapse Form

Monthly Hospital/Institutional Lapse – Developmental Disability
Monthly Hospital/Institutional Lapse – Long Term Support

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) [no-code versions: AODA | MH services | other]. Reports are due on the tenth (10th) of the following month, and must be submitted using the same procedure as the Client Service Reports.

01/08/2015