Get Nh Beas 3540 2012-2025

The NH BEAS 3540 form is essential for prospective residents seeking admission to assisted living facilities and similar housing. This guide will walk you through the process of completing this summary document online, ensuring clarity and compliance with state regulations.

Follow the steps to effectively complete the NH BEAS 3540 form.

1. Press the ‘Get Form’ button to retrieve the NH BEAS 3540 form and open it for editing.
2. Begin by filling out the facility information section. Enter the name of the facility and ensure any necessary logos are added.
3. Next, specify the base rate for the services provided, indicating whether payments are monthly or weekly, and if any deposits or advance payments are required.
4. Check all services included in the base rate. This section requires you to mark each meal option, housekeeping details, and personal assistance services offered at the facility.
5. Complete the personal living unit amenities section by marking amenities that are available. Indicate whether amenities are located in common areas.
6. Fill out the staff coverage section. Indicate the on-site and on-call hours for various staff members, including maintenance, nursing, and personal care attendants.
7. Document recreation and leisure activities available at the facility, including any free activities and their schedules.
8. List any additional services included in the base rate and those available for an extra charge. If needed, you may attach a separate sheet.
9. Check the regulatory oversight section to confirm if the facility holds a licensed/certified status.
10. Add any comments from the facility regarding the services or admissions process.
11. Finally, ensure that both the prospective resident and the facility staff sign and date the form.
12. Save your changes prominently. You can then download, print, or share the completed form as necessary.

Begin the process of completing the NH BEAS 3540 form online today.