Long Term Care Templates

This document provides information about the status of nursing facility care in the state of Colorado. It includes details about the quality and availability of care for residents in nursing homes.

This type of document is used for applying for state licensure for long-term care facilities in Alaska. It is an application form that must be completed and submitted to the appropriate licensing agency.

This form is used for applying for supplemental long term care benefits in Washington, D.C.

This form is used for determining the private daily room rate at long-term care or chronic facilities in Maryland.

This Form is used for assessing the multidisciplinary team and person-centered care planning process in California.

This type of document is an Irrevocable Letter of Credit used for Long-Term Care in the state of Wisconsin.

This Form is used for the Preadmission Screen and Resident Review (Pasrr) Level I Screen in Wisconsin. It is a screening tool used to assess the need for specialized services for individuals seeking admission to a long-term care facility.

This Form is used for participants of the Money Follows the Person (MFP) program in Wisconsin to report their information.

This Form is used for conducting a functional screening for Assisted Living Facilities in Wyoming. It provides instructions on how to properly assess the functional abilities of residents in these facilities.

File this form if you are the physician of the applicant for admission to a Community Care Facility and have a thorough knowledge of the patient's medical issues. The goal of this document is to check if the patient can continue their residential treatment at the facility.

This document is used for reporting serious injury incidents and communicable diseases in long-term care facilities in Illinois.

This form is used for the Masshealth Long-Term-Care Eligibility Review in Massachusetts. It is used to determine if individuals are eligible for long-term care services.

This Form is used for coordinating long-term care and hospice services in Missouri.

This form is used for applying for the Community First Choice (CFC) program in Alaska.

This document provides an executive summary of the state of caregiving in the United States in 2020. It highlights important statistics and trends in the caregiving sector.

This form is used for conducting a care assessment in Washington state. It helps evaluate the needs and eligibility for long-term care services.

This form is used for notifying the state of Illinois about the use of ventilators in nursing facilities.

This document is an application for Long Term Care Mainecare in the state of Maine. It is used to apply for financial assistance for long-term care services for individuals who meet certain eligibility criteria.

This form is used for applying to become a provider for the Iowa Medicaid Universal Home-And Community-Based (HCBS) Waiver program. It is necessary to complete this application in order to be considered for eligibility to provide services under the waiver program.

This Form is used for requesting an assessment related to spousal impoverishment in the state of New York.

This form is used for filing a complaint regarding the Long Term Care Ombudsman Program in North Dakota.