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SkilledMDSWorksheet PROJECTED RUG TodaysDate: ARDDate: PatientName: TherapyCoordinator: AssessmentType(circle): 5 14 30 60 90 COT EOT EOT/R SS SOT A.SpeechLanguage PathologyServices 1. Individualminutesrecordthetotalnumberofminutesthistherapywasadministeredtotheresident.

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How to fill out the Stein Ancillary Services online

This guide provides a comprehensive overview of how to accurately fill out the Stein Ancillary Services online. Follow these steps to ensure that you complete the form correctly and efficiently.

Follow the steps to accurately complete the form:

  1. Click ‘Get Form’ button to obtain the Stein Ancillary Services form and open it in the editor.
  2. Enter today's date and the assessment reference date (ARD) at the top of the form. Ensure you double-check these dates for accuracy.
  3. In the Patient Name field, provide the full name of the individual receiving therapy services.
  4. Select the Assessment Type by circling the relevant option, such as 5, 14, 30, 60, 90 days, or COT (Change of Therapy) and EOT (End of Therapy).
  5. Fill in the Therapy Coordinator's name to identify the person overseeing the therapy sessions.
  6. For Speech-Language Pathology, enter the total individual minutes, concurrent minutes with one other resident, and group minutes in their respective fields for the last 7 days.
  7. Record co-treatment minutes separately in the designated area for Speech-Language Pathology.
  8. Complete the section detailing how many days therapy was administered for at least 15 minutes daily within the last 7 days.
  9. Provide the therapy start date and therapy end date, entering dashes if therapy is ongoing.
  10. Repeat steps 6 to 9 for Occupational Therapy and Physical Therapy sections.
  11. Finally, enter the distinct calendar days of therapy received across all types of therapy for at least 15 minutes over the past 7 days.
  12. Once you have completed all sections, save your changes, download a copy of the form, print it, or share it as needed.

Complete the Stein Ancillary Services online today and ensure accurate documentation of therapy services.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232