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This version of the form is not currently in use and is provided for reference only. Download this version of
Form LTC-26
for the current year.
Form LTC-26 Pre-admission Screening and Resident Review (Pasrr) Level I Screen - New Jersey
What Is Form LTC-26?
This is a legal form that was released by the New Jersey Department of Human Services - a government authority operating within New Jersey. Check the official instructions before completing and submitting the form.
FAQ
Q: What is the Form LTC-26?
A: The Form LTC-26 is a Pre-admission Screening and Resident Review (PASRR) Level I Screen.
Q: What is the purpose of Form LTC-26?
A: The purpose of Form LTC-26 is to determine if an individual being considered for nursing facility admission has a potential mental illness, intellectual disability, or related condition.
Q: What does a Level I Screen entail?
A: A Level I Screen involves an evaluation of an individual's medical history and potential mental health or intellectual disability concerns.
Q: Who is responsible for completing Form LTC-26?
A: The nursing facility or its designee is responsible for completing Form LTC-26.
Q: Is Form LTC-26 specific to New Jersey?
A: Yes, Form LTC-26 is specific to the state of New Jersey.
Form Details:
- Released on February 1, 2019;
- The latest edition provided by the New Jersey Department of Human Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form LTC-26 by clicking the link below or browse more documents and templates provided by the New Jersey Department of Human Services.
Download Form LTC-26 Pre-admission Screening and Resident Review (Pasrr) Level I Screen - New Jersey
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