Get Pa Resident Assessment Form 2011-2025
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How to fill out the PA Resident Assessment Form online
The PA Resident Assessment Form is a crucial document used to assess the needs of residents in assisted living facilities in Pennsylvania. This guide provides a clear and detailed walkthrough for users on how to effectively complete this form online.
Follow the steps to fill out the form accurately and efficiently.
- Press the ‘Get Form’ button to obtain the PA Resident Assessment Form and open it in your document editor.
- Begin by selecting the type of assessment you are completing, such as 'Initial Admission,' 'Annual,' or 'Significant Change'. Enter the 'Date of Assessment' and 'Date of Admission' as applicable.
- In the 'Resident Information' section, fill in the personal details of the resident, including their name, date of birth, marital status, and room/apartment number. Indicate if the resident can safely operate key-locking devices and if they are a veteran.
- For health problems, check all conditions that currently apply to the resident. This includes conditions such as diabetes, heart trouble, or any cognitive impairments.
- Move to the 'Excludable Conditions' section. Check whether the resident has any conditions that would prevent them from being admitted. Note that a written request for exceptions can be submitted if necessary.
- List all current medications in the medications section, including both prescription and non-prescription medications, along with their dosages and frequencies.
- Indicate the level of assistance that the resident requires for medication administration and various personal care tasks, including mobility and toileting needs.
- Provide information regarding emergency evacuation needs and the resident's ability to communicate or understand instructions.
- Complete sections on resident preferences, including leisure activities, religious affiliation, and personal vehicle availability.
- Document formal and informal supports by listing the physicians, family, and friends who assist the resident.
- Ensure the certification section is signed by the appropriate personnel, confirming that the needs of the resident can be met by the services provided.
- Finally, save your completed form. You can choose to download, print, or share it directly from your document editor.
Start filling out the PA Resident Assessment Form online today to ensure a smooth admission process.
To obtain a PA Real ID, you must visit a PennDOT Driver Center and provide specific documents, such as proof of identification and residency. Completing the PA Resident Assessment Form may be part of the process for individuals using this ID for specific services. Check the Pennsylvania Department of Transportation's website for detailed requirements and locations.
Fill PA Resident Assessment Form
Complete the assessment portion first, and then use the results to create a support plan. Attach additional pages as necessary. A resident shall have a written initial assessment that is documented on the Department's assessment form within 15 days of admission. Download Resident Assessment-Support Plan (RASP) PART I – Human Services (Pennsylvania) form. INSTRUCTIONS TO LICENSED HEALTH CARE PROVIDERS: After completion of all items in Sections 1 and 2 (pages 1 – 4), return this form to the facility at the address. (a) A resident shall have a written initial assessment that is documented on the Department's assessment form within 15 days of admission. A written assessment plan is required. The licensee is responsible for assuring that a written assessment plan is completed. 2. Pennsylvania Preadmission Screening Resident Review (PASRR). Use one from our state templates or customize your own to evaluate each resident's abilities and requirements.
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