Long Term Care Assessment Tool

Long Term Care Assessment Tool - (Forms/Publications)
Document Information
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Title Long Term Care Assessment Tool (512 KB DOC)

You must mail or fax form. No emailed forms are accepted. This assessment tool is provided by L&I assessment to determine the medically appropriate level of care that will meet the Injured Worker’s needs, abilities and safety in a residential facility. This assessment is not intended as a substitute for DSHS annual assessment & treatment plan, which is the sole financial responsibility of the facility.

Form number F245-377-000
Online only. See document above to download.
Keywords long term, long term care, LTC
Languages English
Valid dates 06-2009
Contact information Healthcare Treatment Guidelines/Information

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