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Lars Bchs Fscd Form
Welfare
Welfare of Other Patients or Nursing Home Employees
Nonpayment for the Patient’s Stay (see Section 21773(d))
Explanation of Reason Above:
LARA-BCHS-LTC-502 (REV 03/11/2016)
Authority: P.A. 368 of 1978 as amended
Page 1 of 2
The Michigan Department of Licensing & Regulatory Affairs will not discriminate
against any individual or group because of race, sex, religion, age, national origin,
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