Get Nj Ltc-26 2022-2025

The NJ LTC-26 form is essential for pre-admission screening of individuals seeking admission to nursing facilities in New Jersey. Completing this form accurately is vital to ensure compliance with federal regulations and to facilitate appropriate assessments.

Follow the steps to complete the NJ LTC-26 form online.

1. Press the 'Get Form' button to access the NJ LTC-26 form in your preferred editor.
2. Begin with Section I, where you will fill in the applicant's personal information such as their name, social security number, current address, and date of birth. Ensure all fields are completed accurately.
3. Proceed to Section II, which screens for mental illness. Answer each question regarding mental health history and functioning. Be thorough in specifying any diagnoses based on the DSM-5 or ICD criteria.
4. Continue to Section III, focusing on intellectual disabilities and related conditions. Again, provide clear and detailed responses, specifying any relevant diagnoses or conditions the individual may have.
5. In Section IV, you will summarize the outcomes from the previous sections regarding the screening for mental illness and intellectual disabilities. Check the appropriate outcomes as indicated.
6. Complete the necessary sections if applicable for a PASRR Level II Evaluation request or a Categorical Determination. Ensure to follow the specific instructions provided for these sections.
7. Fill out the contact information in Section IX, ensuring all necessary parties are included to facilitate communication regarding this evaluation.
8. Review the entire form for accuracy and completeness. Save your changes to ensure all entered information is not lost.
9. Once completed, download and print the form or share it as needed. Ensure that it is submitted to the relevant agencies as required.

Take the initiative and fill out the NJ LTC-26 form online today to ensure a smooth admission process.