Indiana State Department of Health

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42 CFR 482 (General Acute Hospitals)

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Appendix T (Swing Bed)

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State Statute (Law) IC 16-21-2

State Rules (Administrative Code) 410 IAC 15

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ISDH Reporting Guidance for year 2005

State Operations Manual

Forms

Application for License to Operate a Hospital Pursuant to IC 16-21-2: Form 44885

Application for Construction Permit for Acute Care Facilities: Form 50097

Regulatory Services Informal Dispute Resolution (IDR) Record: Form 50058

Hospital Service Report Form 49476

Hospital Fiscal Report Form 49520

Annual Non-Profit Hospital Community Benefit Statement Form 50654

Provider/Supplier Information on Medicare Intermediary Form 51055

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American Health Information Management Association

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American Osteopathic Association

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Administar

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Laboratory Services Manual 2000

Prevention and Management of Antibiotic Resistance in Indiana Health Care

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Public Health Emergencies Reference Manual

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Varicella Sentinel Surveillance Monthly Report Form

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Publications

Indiana Arthritis Strategic Action Plan

Indiana Cancer Facts & Figures

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Indiana Dentist and Dental Hygienist Surveys, 1998

Combined 2003-2004 Fireworks Injury Report

Indiana Registerd Nurse Survey, 1997

Indiana Registerd Nurse Survey, 2001

Physician Survey, 1997

Physician Survey, 2001

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Children's Special Health Care Services (CSHCS)

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Community Health Centers

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Immunization Information

Immunization Schedules

Parents & Patients

Medical Providers

Children's Special Health Care Services
(CSHCS)

Participant Eligibility Requirements

Program Summary

>>>

Overview

Extracts from the enabling legislation

>>>

Extracts: Title 410, Article 3.2

For trips to the Health Care Provider

>>>

Travel Reimbursement

Household Income Guidelines

>>>

Household Income Table

Each participant’s family must also apply for Medicaid.

Participant Manual

Where to Apply:

Indiana Family & Social Services Administration County Office Locations

First Steps Office Locations (for children age 0 to 3)
“Contact the Intake Coordinator listed.”

Riley Hospital:

Room 1950
702 Barnhill Drive
Indianapolis IN 46202
317-274-4603

Other Resources:

1-800-433-0746 ISDH Family Helpline
1-800-889-9949 Hoosier Healthwise
1-800-964-4746 The Indiana Parent Information Network
1-800-272-2937 Child Care Answers
1-800-772-1213 Social Security Income (SSI Disability)
1-800-545-7763 Vocational Rehabilitative Services
1-800-332-4433 IN*Source (Parent Information)
1-800-552-7921 Indiana Comprehensive Health Insurance Ass'n

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Children's Special Health Care Services (CSHCS)

Participant Eligibility Requirements

Participant Manual

Where to Apply:

Other Resources:

Children's Special Health Care Services
(CSHCS)