Get Tn Tenncare Tnpec-3780-20 2021-2026

Navigating the process of discharging or transferring a member from a nursing facility can be straightforward with the right guidance. This comprehensive guide provides clear, step-by-step instructions on how to fill out the Nursing Facility Discharge/Transfer/Hospice Form - Tn online, ensuring a smooth transition for all involved.

Follow the steps to successfully complete the form online.

1. Begin by selecting the ‘Get Form’ button to access the Nursing Facility Discharge/Transfer/Hospice Form and open it in your preferred editing tool.
2. Fill out the member information section. Include the member's last name, first name, date of birth, MCO ID, and social security number.
3. Provide details for the representative, designee, or power of attorney if applicable, including their name and phone number.
4. Indicate the hospice effective date by entering the appropriate date.
5. In the discharging/transferring/hospice nursing facility section, enter your facility's provider number.
6. Fill out the receiving nursing facility information if applicable, including the address and contact phone number.
7. Record the NF admission date for the member.
8. Specify the date of discharge and select the appropriate option for the location to which the member is discharging (another nursing facility, home with or without CHOICES HCBS, or N/A if the member is deceased).
9. If relevant, include any approved PAE control numbers and effective dates for enhanced respiratory care services.
10. Complete any additional comments if necessary and confirm that the details are correct.
11. Finally, save your changes. You can then download, print, or share the completed form as needed.

Complete your documents online for a smoother process today!