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How to fill out the Ltc 26 online
Filling out the Ltc 26 form online is a crucial step for anyone seeking admission to a nursing facility in New Jersey. This guide provides clear instructions to help users navigate each section of the form effectively.
Follow the steps to complete your Ltc 26 form smoothly.
- Click ‘Get Form’ button to access the online version of the Ltc 26. This will allow you to open the document in the editor for completion.
- Begin with Section I: Demographics and OCCO PAS Status. Fill in the applicant's name, social security number, and address. Indicate the current location setting, and provide any relevant OCCO PAS status details.
- Proceed to Section II: Mental Illness Screen. Answer the questions regarding any diagnoses of mental illness, checking 'Yes' or 'No' as applicable. Be prepared to note any specified diagnoses.
- Continue to Section III: Mental Illness Primary Dementia Exclusion, only if the outcome of Section II indicates a positive screen. Provide information related to dementia diagnoses if applicable.
- Move on to Section IV: Intellectual Disability/Developmental Disability/Related Conditions Screen. Respond to the questions about current diagnoses or history of intellectual disabilities and related conditions.
- Fill out Section V: PASRR Level I Screening Outcome and Referral. Determine and mark the outcomes of the previous sections accurately.
- Complete Section VI if applicable, for a Categorical Determination regarding positive screens. Mark the relevant condition if any are applicable.
- If positive screens apply, consult Section VII regarding the 30-Day Exempted Hospital Discharge and provide necessary details.
- Finalize by completing Section VIII, which includes the certification of the screening professional, and provide all contact information required in Section IX.
- After completing all sections, ensure that you save your work. You can then download, print, or share the Ltc 26 form as needed.
Get started with your Ltc 26 form online today to ensure a smooth admission process.
A Level 2 Evaluation is a person-centered evaluation that is completed for anyone identified by the Level 1 Screening as having, or suspected of having, a PASRR condition, i.e., serious mental illness (SMI), intellectual disability (ID), developmental disability (DD), or related condition (RC).
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