N.H. Code Admin. R. Rev 2702.02
Form DP-156, Nursing Facility Quality Assessment Return
Effective Jun 21, 2023#8226, INTERIM, eff 12-10-04, EXPIRES: 6-8-05; ss by #8371, eff 6-8-05; ss by #10387, eff 7-25-13; amd by #12907, eff 10-23-19; ss by #13661, eff 6-21-23Department of Revenue Administration
- (a) Form DP-156, “Nursing Facility Quality Assessment Return”, shall be completed and filed by nursing facilities with the department as provided in Rev 2904.03, including by electronic filing, pursuant to RSA 84-C:4, to report their net patient services revenue to the department.
(b) If the return was completed by a paid preparer, the preparer shall:
- (1) Sign and date Form DP-156 in ink as provided in Rev 2904.04 or by electronic signature as provided in Rev 2904.05;
- (2) Provide the preparer’s federal employer identification number; and
- (3) Provide the preparer’s complete mailing address.
- (c) The nursing facility shall be required to file the return but not remit the payment, if the resulting assessment is less than $1.00.
Source. #8226, INTERIM, eff 12-10-04, EXPIRES: 6-8-05; ss by #8371, eff 6-8-05; ss by #10387, eff 7-25-13; amd by #12907, eff 10-23-19; ss by #13661, eff 6-21-23