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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 LTC-26 form?
A: The LTC-26 form is the Pre-admission Screening and Resident Review (PASRR) Level I Screen form in New Jersey.
Q: What is the purpose of the LTC-26 form?
A: The purpose of the LTC-26 form is to conduct a preliminary screening and review of individuals seeking admission to or residing in long-term care facilities in New Jersey.
Q: Who is required to complete the LTC-26 form?
A: Long-term care facilities and their designated PASRR screeners are responsible for completing the LTC-26 form.
Q: What information is collected in the LTC-26 form?
A: The LTC-26 form collects information related to the individual's medical, psychiatric, and behavioral health status to determine if specialized services may be necessary.
Q: What happens after the LTC-26 form is completed?
A: After the LTC-26 form is completed, it is reviewed by the designated PASRR screening agent who determines if a Level II evaluation is necessary.
Q: What is a Level II evaluation in the PASRR process?
A: A Level II evaluation is a more in-depth assessment conducted by a specialized team to determine the individual's need for specialized services and the most appropriate level of care.
Q: What are the consequences of not completing the LTC-26 form?
A: Failure to complete the LTC-26 form correctly and timely may result in a delay or denial of admission to a long-term care facility.
Q: Is the LTC-26 form specific to New Jersey?
A: Yes, the LTC-26 form is specific to New Jersey's PASRR program.
Form Details:
- Released on February 1, 2022;
- 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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