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In order to afford timely due process to the individual so accused yet protect the vulnerable frail and/or elderly residents of licensed facilities the Department of Health NJDOH requests that you provide all of the information required by the Facility Reporting Incident Data and Analysis Yield FRIDAY form within 15 business days of the incident date. New Jersey Department of Health Office of Program Compliance Reporting P O Box 358 Trenton NJ 08625-0358 FACILITY REPORTING INCIDENT DATA AND ANALYSIS YIELD FRIDAY GUIDELINES Revised 9/2008 TO All Assisted Living and/or Long Term Care Facility Administrators An accused certified nurse aide CNA personal care assistant PCA or medication aide CMA is entitled to a hearing regarding the above-referenced allegation of abuse neglect or misappropriation of resident property. This Department requires that the entire form be completed together with all information and supporting documentation requested therein* Sections 1 through 14 shall be comple....

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How to fill out the NJ LCS-8 online

The New Jersey Facility Reporting Incident Data and Analysis Yield (FRIDAY) Form, known as NJ LCS-8, is a crucial document for reporting allegations of misconduct involving certified nurse aides and medication aides. This guide provides clear, step-by-step instructions to help users accurately complete the form online.

Follow the steps to complete the NJ LCS-8 form effectively.

  1. Click ‘Get Form’ button to access the NJ LCS-8 form and open it in your online editor.
  2. Begin filling in the required information about the accused aide, starting with their name, address, and phone numbers, as specified in Section 1.
  3. Detail the type of allegation in Section 2, selecting all applicable options like physical abuse or neglect. Be sure to provide any specific details as necessary.
  4. In Section 5, collect and input information regarding the resident victim, including their age, date of the incident, and whether they were alert and oriented at the time.
  5. Section 6 requires you to specify whether the accused was employed by the facility or an agency. Fill out only the relevant information based on the employment status.
  6. Complete Section 9 by verifying the aide’s certification status and including any required attachments, like a certification verification sheet.
  7. Provide details about any disciplinary actions taken against the accused in Section 10. Include whether the police were notified and attach relevant documentation.
  8. In Section 11, document any due process hearings related to the incident, specifying if a hearing was offered and including dates and decisions if applicable.
  9. Finalize the form by completing Section 14, confirming the accuracy of the provided information, and ensuring all necessary supporting documents are included.
  10. Once all sections are filled out, save your changes, and download or print the completed form for submission. Ensure you keep a copy for your records.

Complete the NJ LCS-8 form online today to ensure accurate and timely reporting.

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